Infection Prevention and Control

Transcription

1 Infection Prevention and Control Presenter

2 Housekeeping Northern Devon Healthcare NHS Trust

3 Quiz Northern Devon Healthcare NHS Trust

4 Confidentiality To respect confidentiality within the group unless it is necessary to address a current concern about the safety of an adult at risk.

5 Learning Objectives To be aware of types of infections To understand how infections are spread To understand the importance of Standard Infection Control Precautions To be aware of individual responsibilities To be aware of local infection control contacts

6 What is Infection Prevention and Control Infection prevention and control measures aim to ensure the protection of those who may be vulnerable to acquiring an infection, both in the general community, or whilst receiving care due to health problems, in a range of settings The basic principle of infection prevention and control is hygiene (1)

7 The Cost of Infection Prevention and Control Healthcare Associated Infections Estimated cost to NHS hospitals 1billion/ year (2) Physical Cost HAI s can cause a range of symptoms from minor discomfort to serious disability and in some cases death (2)

8 Who is Responsible for Infection Prevention and Control?

9 Infections in Care Homes Infections in care homes may be serious, and in some cases life threatening They may worsen underlying medical conditions and affect the recovery of residents A number of infectious diseases can spread readily to other residents, members of staff, or visitors The most common outbreaks in care homes are due to viral, respiratory infections and gastroenteritis

10 What is an Infection? Infections occur when a micro-organism invades your body and causes a disease. The microorganism uses the host as a source of nourishment The micro-organism colonizes and reproduces It is only classed as an infection if the colonization harms the host Normal growth of bacterial flora is not an infection i.e. within the intestine, as its not harming the host

11 Malaria Scabies Hookworms Tapeworms Northern Devon Healthcare NHS Trust Parasite Pneumonia Wound Infections Cellulitis Food Poisoning Gastric Ulcers Whooping Cough Tuberculosis Diphtheria Legionnaires Leprosy Bacterial Host Fungal Viral Gastroenteritis Norovirus Influenza Common Cold Measles Chickenpox Rubella Meningitis Warts Candidiasis Athletes Foot Ring Worm Fungal Nail Infection

12 The Spread of Infection The way infection is spread can be thought of as continuous chain. This is known as the chain of infection The chain of infection has six components.

13 The Chain of Infection 1.Infectious Agent 6. Way into the body 2. Reservoir Chain of Infection 5. Person at Risk 3. Way out of the body 4. Method of Transmission

14 Lets Look at These Individually 1.Infectious Agent The infectious agent is simply the germ otherwise known as the micro-organism that can cause an infection We are surrounded by micro-organisms, most are harmless, but some can have serious consequences There are many different types of micro-organisms, such as bacteria and viruses

15 Activity In your groups, match the 5 correct labels with this component of the Chain of Infection 1.Infectious Agent

16 Examples of Infectious Agents Virus Salmonella MRSA C Diff E-Coli

17 Chain of Infection 1.Infectious Agent 2. Reservoir Chain of Infection

18 Chain of Infection 2. Reservoir The reservoir is the place where microorganisms can thrive and reproduce Examples of these include people and equipment

19 Activity In your groups, match the 5 correct labels with this component of the Chain of Infection

20 Activity In your groups, match the 8 correct labels with this component of the Chain of Infection 2. Resevoir

21 Examples of Reservoirs Infected Person Member of Staff Client Contaminated Equipment Animals Insects Water Soil

22 Chain of Infection 1.Infectious Agent 2. Reservoir Chain of Infection 3. Way out of the body

23 Chain of Infection 3. Way out of the body The way out of the body, or portal of exit, is how the micro-organism exits the reservoir Examples of this may include diarrhoea and vomiting

24 Activity In your groups, match the correct labels with this component of the Chain of Infection

25 Activity In your groups, match the 7 correct labels with this component of the Chain of Infection 3. Way Out of the Body

26 Examples of Way Out of the Body Vomiting Urine Faeces Respiratory Secretions Way out of the body Skin Cells Blood Saliva

27 Chain of Infection 1.Infectious Agent 2. Reservoir Chain of Infection 4. Method of Transmission 3. Way out of the body

28 Chain of Infection 4. Method of Transmission Transmission is how a micro-organism is moved from one site to another Examples of this include e.g. through the air, or by contact

29 Activity In your groups, match the 5 correct labels with this component of the Chain of Infection 4. Method of Transmission

30 Examples of Modes of Transmission Hands Insect Animals Contaminated Equipment Airborne

31 Chain of Infection 1.Infectious Agent 2. Reservoir Chain of Infection 5. Person at Risk 4. Method of Transmission 3. Way out of the body

32 Chain of Infection 5. Person at Risk The person at risk can be anyone, however, some people are particularly susceptible to infection Examples include older people, babies, and infants

33 Activity In your groups, match the 4 correct labels with this component of the Chain of Infection

34 Examples of Persons at Risk Reduced Immunity Invasive Device Elderly Infants Invasive Device

35 Chain of Infection 1.Infectious Agent 6. Way into the body 2. Reservoir Chain of Infection 5. Person at Risk 4. Method of Transmission 3. Way out of the body

36 Chain of Infection The way into the body or portal of entry is how the micro-organism into the body Examples of this include swallowing, or an open wound 6. Way into the body

37 Activity In your groups, match the 5 correct labels with this component of the Chain of Infection

38 Examples of Ways into the Body Ingestion Open Wounds Inhaled Injection Urinary Tract

39 Breaking the Chain of Infection To prevent an infection or stop it spreading, one or more of the links in the chain must be broken

40 How do we Break the Chain? Use of standard infection control precautions Used correctly they help prevent the spread of infection from staff to client, client to staff, and client to client

41 Standard Infection Control Precautions

42 Essentials of Hand Hygiene Always use six steps of hand washing Washing should take at least 20 seconds Use hands-free technique to turn off taps Hands should be adequately dried using disposable paper towels Dispose of paper towel in non touch bin Use hand cream to protect hands Remove all jewellery at the start of working day NEVER skip any of the above

43 Five Moments of Hand Hygiene at Point of Care 1. Before contact with resident 3. After contact with resident 4. After body fluid exposure risk 2. Before a clean or aseptic procedure 5. After contact with residents surroundings

44 Also remember bare below the elbow..

45 Bare Below the Elbow Correct- without Jewellery Incorrect

46 Bare Below the Elbow Correct-short nails/no varnish Incorrect

47 Bare Below the Elbow Correct Incorrect

48 Hygiene Facts The average kitchen chopping board has around 200% more faecal bacteria on it than a toilet seat Kitchen sponges can contain thousands of bacteria per square inch, including E.coli, and Salmonella TV remote controls and light switches are leading carriers of bacteria (3)

49 Hygiene Facts Germs from a flushing toilet can travel up to 6 feet in diameter. Air movement, including hot air dryers encourage the dispersal and transmission of this bacteria Handbags carry up to 10,000 bacteria per square inch. 30% include faecal bacteria 1 in 5 people don t wash their hands, and of those only 30% use soap (3)

50 Prevention of UTI s and CAUTI s Remember: Principles of good hygiene techniques for both yourself and your clients Keep clients well hydrated Keep catheter clean Maintain closed catheter system Keep catheter tap off the floor

51 Breaking the Chain of Infection Prevent microbes from entering the body by wearing protective clothing and equipment

52 Personal Protective Equipment SINGLE use gloves must be worn for: Invasive procedures Contact with sterile sites and non-intact skin or mucous membranes All activities that carry a risk of exposure to blood, body fluids, secretions and excretions Handling sharp and contaminated instruments NB. Where gloves are required, they should be put on immediately before the task to be performed

53 Persona Protective Equipment Gloves should NOT be worn: As a replacement for hand washing Between patient contact Whilst washing hands or using hand gel If they do not fit correctly, ensure correct size If damaged When touching items such as door handles, curtains, telephones, pens

54 NB- IT IS NEVER ACCEPTABLE TO WASH GLOVES RATHER THAN CHANGE THEM

55 Personal Protective Equipment Single use disposable plastic aprons must be worn: When there is a risk of clothing being contaminated with blood or other body fluids When a resident has a known infection During direct care and bed making When undertaking the decontamination of equipment

56 Personal Protective Equipment Single use disposable plastic aprons must be: Worn as single use only Disposed of in clinical waste Must be stored in a clean environment, and not in close proximity to toilets or sluice rooms Must not be worn outside the care home environment

57 Uniforms Uniforms should be washed after each shift, and within 24 hours of the shift starting Wash uniforms separately at a minimum temperature of 60 degrees for at least 10mins (4) Where changing facilities are not available, staff must cover their uniform and travel directly to work from home and visa versa Always wear short sleeved uniform (5)

58 Always Wear the Correct Uniform and PPE Do Not let TV programmes influence infection prevention and control!!

59 Always Challenge Inappropriate Practice

60 Safe Handling of Sharps Northern Devon Healthcare NHS Trust

61 Sharps Injury-What would you do? If you pierce or puncture your skin with a used needle, immediately: encourage the wound to bleed, ideally by holding it under running water wash the wound using running water and plenty of soap don't scrub the wound while you're washing it don't suck the wound dry the wound and cover it with a waterproof plaster or dressing You should also seek urgent medical advice as you may need treatment to reduce the risk of getting an infection: contact your employer's Occupational Health service, if you injure yourself at work otherwise call your GP, NHS 111 or go to the nearest accident and emergency (A&E) department

62 Glucose Monitoring Which Device? Single use unit Disposable Complete unit to be discarded after use Ensure hand hygiene Wear correct sized gloves

63 Safe Handling of Waste Waste should be disposed of as close to the point of use as possible Waste bins should be hands free and hard bodied Bags should be no more than ¾ full

64 Safe Handling of Waste Never touch the waste receptacle itself Seal all bags appropriately Tag waste in accordance with policy Wash hands

65 Safe Handling of Laundry When handling laundry you should always wear gloves and an apron and carry out hand hygiene Used linen and clothing must always be kept in laundry bags or baskets and not loose on the floor Separate trolleys should be used for clean, used and soiled laundry to avoid cross contamination Handling Used Trolleys It is the responsibility of the person handling linen to ensure it is segregated appropriately Items should only be washed in a dedicated laundry room using the correct processes Clean linen should be stored in a dry area above floor level It must not be stored with used linen Segregate Washed Storage

66 Cleaning and Decontamination of Equipment Decontamination can be achieved by a number of methods, which fall into three categories Cleaning Disinfection Sterilisation

67 Cleaning Cleaning Cleaning physically removes decontamination but does not necessarily destroy micro-organisms Cleaning with warm water and neutral detergent is the most common choice of decontamination within the care home setting Prerequisite to effective disinfection/sterilisation

68 Disinfection Disinfection Disinfection Reduces the number of viable microorganisms, but may not necessarily inactivate some microbial agents, such as certain viruses and bacterial spores

69 Sterilization Sterilisation Sterilisation Sterilisation Renders an object free from viable micro-organisms including viruses and spores

70 Cleaning Products Method 1 Cleaning Method 2 Disinfection Method 3 Sterilisation Examples of Detergents Examples of Disinfectants Examples of Modes of sterilisation Hand Soap Tristel Jet /Fuse Autoclave-Steam Washing up liquid Milton Dry Heat Washing Powder Anti-bacterial spray Flaming Dish washing Powder Anti-bacterial Wipes Incineration Multi-surface detergent wipes Bleach Chemical Sterilisation Sanitising Tablets Sanitising Powder/Liquid Radiation

71 Activity In your groups, identify which the type and frequency of cleaning regime required for equipment found in a care home Cleaning Disinfection Sterilisation

72 Activity In your groups, please identify which method and frequency of decontamination should be used for specific types of equipment within the care home setting

73 Infectious Disease Outbreak A number of infectious diseases may spread readily to other residents, staff, or visitors and cause outbreaks The commonest outbreaks in care homes are due to viral respiratory infections and gastroenteritis An outbreak can be defined as two or more cases of infection occurring around he same time

74 Infectious Disease Outbreak It is important to recognise potential outbreaks promptly It is essential to implement control measures as soon as possible

75 Infectious Disease Outbreak Any outbreak of infectious disease (e.g. scabies, diarrhoea and/or vomiting) in a care home setting must be reported to Public Health England via the local Health Protection Team (HPT). The HPT covers Devon, Cornwall and Somerset and can be contacted on (in and out of hours). They will provide the outbreak management and liaise with the home about any treatment required In the event of a D+V outbreak, contact with the home may also be made by the Environmental Health department of the local authority, who can also advise on management and requesting of samples. Public Health England, South West: 2 Rivergate, Temple Quay, Bristol, BS1 6EH

76 What will you do differently after today?

77 Any Questions? Northern Devon Healthcare NHS Trust

78 References 1. World Health Organisation, Health Topics; Infection Control. 2. National Audit Office, Reducing Healthcare Associated Infections in Hospital in England 3. DEB, Hand hygiene, infection prevention and food safety 4. Riley, K., Laird, K., Williams, J Washing uniforms at home: adherence to hospital policy. Nursing Standard 29, 25, NHS Professionals, Standard Infection Control Precautions 6. Department of Health,2013. Prevention and Control of infection in care homes. An information resource.

79 Contacting the Care Homes Team Becky Young: RN, Barnstaple care homes Martine Butler: RN, BLIS care homes Bridget Tait: RN, Torridge care homes Sarah Bishop: Paramedic Educator, Torridge Care Homes Mel Gravett: RN, North Devon Care Homes Meg Hill: Occupational therapist, North Devon care homes Sarah Winfield-Davies: RN, Safeguarding Nurse/Team Leader, North Devon care homes

80 Quiz Northern Devon Healthcare NHS Trust