Infection Control for Anesthesia Personnel

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Transcription:

Infection Control for Anesthesia Personnel 2017

A leading cause of death and increased morbidity for hospitalized ptns Hospitals, nursing homes, long-term care facilities, home care settings Higher rate of infections in hospitalized ptns, 5%-10 Decreased immunity, chronic disease in older population Increased use of invasive devices and procedures 2002: 1.7 million HAIs in adults and children, 33% in ICUs 99,000 related deaths, around $30 billion in medical costs

Decrease the risk of infection to patients and personnel. Monitor for occurrence of infection and implement appropriate prevention measures. Identify and correct problems relating to infection prevention practices. Maintain compliance with local, state and federal regulations and accrediting agencies relating to infection control. Integrate the IC program with the ASC s quality and safety programs and initiatives. Integrate IC into the CMS Quality Assessment and Improvement reporting requirements (mandatory for survey compliance).

Standard Precautions Contact Precautions Airborne Precautions Droplet Precautions

SPs represent measures that should be followed for ALL patients in a healthcare facility. SPs apply to blood; all body fluids, secretions, and excretions (except sweat), regardless of whether they contain visible blood; non-intact skin; and mucous membranes. SPs measures include: Hand washing/hand hygiene PPE: gloves, gown, masks and eyewear Sharps precautions Proper handling of lab specimens, blood spills, linen, bio waste

Should be followed for patients who are known to have or are highly suspected to have colonization or infection. Use if ptn is incontinent, has diarrhea, colostomy, wound drainage The goal is to reduce exogenous transmission of micro-organisms through direct or indirect contact from healthcare professionals or other patients. Gloves and gown before ptn contact, then remove prior to leaving ptn s environment. Hand washing required.

Used for patients who are highly suspected of having infection that is spread by airborne droplet nuclei. Examples include tuberculosis, measles, or varicella (chickenpox). Private room that has: Monitored negative air pressure 6 to 12 air changes per hour discharge of air outdoors or high-efficiency filtration Keep the patient in the room with the door closed Use a N95 respirator.

Targets infections that are transmitted through larger droplets Includes invasive Haemophilus influenzae type b disease, diphtheria (pharyngeal), pertussis, group A streptococcal pharyngitis, influenza, mumps, and rubella. Offer patients that are coughing, sneezing tissues and face masks. Maintain spatial separation of at least 3 feet between the infected patient and others. Special air handling and ventilation are not necessary, and the door may remain open.

Hand washing/hand hygiene is generally considered the most important single procedure for preventing Healthcareassociated infections

Turn on water to a comfortable warm temperature. Moisten hands with soap and water and make a heavy lather. Wash well under running water for a minimum of 15 seconds, using a rotary motion and friction. Rinse hands well under running water. Dry hands with a clean paper towel. Use a clean paper towel to turn off the faucet, then discard.

Hand hygiene prior to donning gloves. Gloves should be worn while providing care for the patient. Change gloves after exposure to infective material. After glove removal, perform hand hygiene immediately. Avoid direct hand contact with potentially contaminated environmental surfaces or items.

When touching excretions, secretions, blood, body fluids, mucous membranes or non-intact skin; When the employee's hands have any cuts, scrapes, wounds, chapped skin, dermatitis, etc.; When cleaning up spills or splashes of blood or body fluids; When handling potentially contaminated items; When it is likely that hands will come in contact with blood, body fluids, or other potentially infectious material; When performing phlebotomy or starting an IV.

Is the opening phrase of a dialog in the "Nunnery Scene" of William Shakespeare's play Hamlet.

Tuberculosis the lung-liquefying disease of consumption" is the world's second-biggest infectious killer, caused by Mycobacterium Tuberculosis

TB is spread through the air from one person to another. It is spread through air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.

shaking someone's hand sharing food or drink touching bed linens or toilet seats sharing toothbrushes kissing

Symptoms of TB disease include: a bad cough that lasts 3 weeks or longer pain in the chest coughing up blood or sputum weakness or fatigue weight loss no appetite Chills Fever sweating at night

Most infections do not have symptoms, known as latent tuberculosis. About 1 in 10 latent infections eventually progresses to active disease which, if left untreated, kills more than 50% of those so infected. In 2013 there was between 1.3 and 1.5 million associated deaths, most of which occurred in developing countries. The total number of tuberculosis cases has been decreasing since 2006.

Recapping of needles is acceptable only for sterile needles. In the event of a needlestick injury, the employee should: Immediately wash the wound with soap and running water; Cause the injured site to bleed; If desired, apply alcohol or hydrogen peroxide to the wound; Notify the Nursing Manager, Infection Preventionist or Employee Health Coordinator of the incident as soon as practical.

Opened multidose medication vials (MMVs) can NOT be keep in the patient treatment area (room). If an un-opened MMV is opened within the ptn treatment area, it must be treated like a single dose vial and wasted at the end of the case. Multiple syringes may be filled from the same MMV using aseptic technique, providing this is performed away from the treatment room. All syringes must be labeled, with drug name, dosage, date and time. These syringes may be placed in a zip bag within the anesthesia cart, removing only one prior to each patient case. Label the MMV with opening date, new expiration date (28 days from opening) and your initials.

Intact skin (except HPV, some parasites, but not bacteria nor fungi) Mucous membranes (respiratory, gastrointestinal, genitourinary) The membranes secretions have antimicrobial properties Immune responses (activated to resist microorganisms from invading)

Bacterial: Most common source Highest morbidity and mortality Viruses: More common in children High epidemic risk Fungal: Following prolonged antibiotic therapy Patients with compromised immune systems