Infection Control Induction Program

2013

Objectives of orientation education

• Hand hygiene • Standard & transmission based precautions• Staff health/immunisation• Waste management• Occupational exposure

Infection Control Team

• Chantal Rayner

• Jenny Lukeis

• Staff Health Nurse

.

• A MOMENT is when there is a perceived or actual risk of pathogen (germ) transmission from on surface to another via the hands.

5 Moments for Hand Hygiene

Hand hygiene Opportunities• Before starting work each day• After coughing, sneezing, touching your hair

or touching your face.• After going to the toilet ( soap & water )• Before and after glove use• Before and after working with food• After mopping, sweeping, removing garbage

or using the telephone• Before and after meal breaks ( Soap & water )

Soap & water:

• It is recommended that the AHG is used to decontaminate the hands at all times except

1. When the hands are visibly soiled2. Before meal breaks3. After using the toilet 4. When the build up of emollients are obvious

Hand Care

• Caring for the skin on the hands is important- intact skin is a natural defence against infection

• Dry or cracked skin can harbour micro-organisms.

• Cuts and abrasions are to be covered by a water resistant occlusive dressing

• Moisturiser should be used 3-4 times per shift• Moisturiser provided by the hospital only

SWH Hand Hygiene Project

• Hand Hygiene Project• Commenced in 2006- 10% (mean)• SWH current compliance rate is 68% ( October 2012 )

Target compliance rate 70%

Microbial Reservoirs

• Microbes can survive in many environments

– On or in people, as normal flora

– On or in people who have infections

– Contaminated food or fluids

– Contaminated articles

– Contaminated environment

Environmental Cleaning

• Public area• Patient care area• Patient care equipment• Office spaces

TUFFIES & TUFFIE 5’s

All purpose general cleaning A one step wipeFor everyday use For disinfection when a pt has GASTRO, VRE, MRSA or any multi-resistant bugs

TUFFIE 5

DRESS CODE POLICY• Wrist watches and bracelets are not permitted

in the clinical area• Rings – wedding ring or one plain flat band

only• Chains – one plain unadorned chain only• Earrings – small sleepers or studs only• Facial studs are not permitted• No nail polish or artificial nails permitted• No Lanyards permitted

INFECTIONSWhat is an infection?

• An infection occurs when invading microorganisms cause ill health– Viruses– Bacteria– Fungi– Protozoa– Prions Pain, tenderness, swelling, redness, pus & fever

STANDARD & TRANSMISSION BASED PRECAUTIONS

Prevent Infection Transmission

• Standard precautions– Used for ALL patient contacts

• Transmission Based Precautions– Used in addition to standard precautions when

more stringent precautions are required• Airborne transmission – Tb, chicken pox• Droplet transmission – Influenza, flu• Contact transmission- Gastro, VRE, MRSA

Use of Standard Precautions

Minimises the risk of cross-infection from:– HCW to patient.– Patient to HCW.– Patient to patient.

To be used for all patients regardless of infectious status or perceived risk.

Standard Precautions

• Cleaning hands at the 5 moments of hand hygiene

• The use of protective barriers or PPE• Appropriate handling & disposal of sharps &

other infectious waste• Use of correct aseptic technique

Transmission Based Precautions

• Use for patients known or suspected to be infected or colonised with infectious agents that cannot be contained with standard precautions alone.

Transmission Base Precautions

•Contact•Droplet•Airborne

Contact Precautions

• MRSA • VRE• Gastro• Abscess ( Draining-

hard to contain)• Conjunctivitis

Influenza

• Influenza• Lice• Norovirus• Rotavirus• Scabies• Chicken pox *contact

& & airborne precautions

virus

Contact precautions Single room if possible, with ensuite Cohort with same infection if necessary Gloves should be worn when entering the

room Gown if clothing or forearms will have direct

contact with patient or contaminated environment – remove before leaving the room

Remove gloves and gown, wash hands before leaving patient room

FOOD SERVICES STAFF

•Gel hands•Deliver / Collect tray•Gel hands

STAFF HEALTH/ IMMUNISATIONS

Staff Health

• The hospital provides an immunisation program for staff.

• Staff Health Clinic• Staff Health Nurse- to be appointed

• Each fortnight clinic will run- bookings on 55631433

• Details recorded staff database & medical record

Immunisation

• The following is a list of immunisations recommended for Health Care Workers.

• From “Immunisation Guidelines for H.C.Ws” Department of Human Services-2007

Hepatitis B

• For all staff• 3 injections (baseline, 1 month & 5 months)• Blood test one month post 3rd injection• A booster is no longer recommended

Diphtheria/Tetanus - ADT

• 10 yearly boosters is no longer recommended. • Recommend booster at 50 yrs of age

Pertussis ( Whooping Cough)• Single booster dose is recommended for all

health care workers, especially those in contact with infants

Measles/ Mumps/ Rubella

• Recommended 2 doses of MMR

• Born after 1966 should have evidence of receiving 2 doses

Poliomyelitis

• No longer administered orally

• Infanrix administered IM

Varicella Zoster Virus(Chicken Pox)

• Attempt to have documented history of all Health Care Workers

• Check Serology

• Then vaccinate

Mantoux Testing(Tuberculosis)

• BCG no longer given as it is only 50 % affective, and TB not prevalent in Aust.

• Screening (mantoux test) within 6 weeks of commencement of work ( direct patient contact workers )

Appointments for Staff Immunisation

• RING EXTENSION 31433

The Importance of Influenza

Immunization for Healthcare

Workers

Get a Flu Shot Every Year

• The flu viruses change frequently

• A new flu vaccine is made each year to protect against the new strains of flu viruses

• If the viruses change after you’ve had yourinjection, you won’t get as sick

Getting a flu shot every year protects you and

those around you

The Flu: Now You Know

• The flu is a serious contagious illness.1

• The most effective prevention is to get the yearly flu shot.1

• SWH is committed to providing flu vaccinations and making it as easy as possible for you to get vaccinated.

Influenza is Very Contagious

Influenza is Very ContagiousA sneeze transmits flu at 167km/h covering a distance of 5 metres in

1/10th of a second!

Individuals are contagious from the

day before the onset of symptoms to about 5 days after the first

symptoms

Influenza and how it affects you

None

Incubation Symptoms Recovery

24 to 72 hours 3 to 7 days up to two weeks

Fever>39°CCough, aches

ShiveringHeadaches

General weaknessPossible complication

High Contagion

(Cross Infection)

Respiratory (Cough) Etiquette

Single Use Policy

• Any items marked by manufacturer as “single use” should be discarded after use

• Multi dose vials must only be used on the same patient then discarded

• Items marked “Single Patient Use” must only be re-used on same patient then discarded

Waste Management

Waste Management

Aims:

• Reduce environmental impact• To minimise the generation of waste• Reduce disposal costs to the organisation• Ensure that OH & S obligations are not

compromised

Categorisation of Waste

• Sharps• Clinical/ Infectious• Confidential• Anatomical• Cytotoxic• Pharmaceutical• Recycling

Sustainability Victoria

• SWH Environmental Management Committee• Meet Quarterly • Covers waste, water, energy, procurement,

fleet management• Working on SWH environmental management

plan

Linen Management

Do not over fill bags (3/4 full)• No sharps into soiled linen

• Prevent seepage• Use gloves to handle moist linen

OCCUPATIONAL EXPOSURE

MANAGEMENT

Occupational Exposure

• First aid – immediate washing of area• Eye splashes – rinse thoroughly• Report incident promptly• Evaluation of exposure• Follow-up action, counselling• Blood tests if required• Ensure full documentation of incident

Infection Control Policy Manual

• Available on the SWH intranet under prompt ‘Infection Control’

Use it as a resourceFor example:• Staff Health and Vaccinations• The management of needle stick or other

occupational exposure• Management of patients with VRE, MRSA, TB• Environmental cleaning

Take Care ………….• …. of yourself and your patients

Don’t forget……… send us an e-referralChantal Rayner & Jenny Lukeis ext 31597 pager 597 #