West Liberty West Liberty Health SciencesHealth Sciences

OSHA’s Bloodborne Pathogens OSHA’s Bloodborne Pathogens StandardStandard

Prevention of Healthcare Associated Prevention of Healthcare Associated Infections and Multidrug Resistant Infections and Multidrug Resistant

Organism TransmissionOrganism Transmission

Bloodborne Pathogen Bloodborne Pathogen Standard:Standard:

Exposure Control PlanExposure Control Plan The Exposure Control Plan contains The Exposure Control Plan contains

policies/procedures for OSHA’s policies/procedures for OSHA’s Bloodborne Pathogen Standard Bloodborne Pathogen Standard

Found in each institution’s LibraryFound in each institution’s Library

Bloodborne Pathogen StandardBloodborne Pathogen Standard You are covered if it is reasonably anticipated You are covered if it is reasonably anticipated

that you could be exposed to blood or other that you could be exposed to blood or other potentially infectious body fluids as a result of potentially infectious body fluids as a result of performing your job dutiesperforming your job duties

Exposure Control Plan Exposure Control Plan (cont.)(cont.)

Details what measures will be taken Details what measures will be taken to minimize your risk of exposureto minimize your risk of exposure

Explains what procedures to follow if Explains what procedures to follow if there is an exposure incidentthere is an exposure incident

Includes a method of identifying and Includes a method of identifying and evaluating safety devices such as evaluating safety devices such as protective sharps.protective sharps.

Bloodborne Pathogens Bloodborne Pathogens

Human immunodeficiency virus Human immunodeficiency virus (HIV)(HIV) Attacks the immune systemAttacks the immune system

Hepatitis B virus (HBV)Hepatitis B virus (HBV) Infects the liverInfects the liver

Hepatitis C virus (HCV)Hepatitis C virus (HCV) Infects the liverInfects the liver

HIVHIV

A number of people infected remain A number of people infected remain healthy for yearshealthy for years

An infected person becomes An infected person becomes seriously ill when the immune seriously ill when the immune system loses its ability to fight system loses its ability to fight infectionsinfections

Some infected persons go on to Some infected persons go on to develop Aquired ImmunoDeficiency develop Aquired ImmunoDeficiency Syndrome (AIDS)Syndrome (AIDS)

HBVHBV

Most people infected by HBV Most people infected by HBV recover and clear the infectionrecover and clear the infection

About 6% of those infected become About 6% of those infected become chronically infected for lifechronically infected for life

Each year, people die from chronic Each year, people die from chronic liver disease and liver cancer linked liver disease and liver cancer linked to HBV.to HBV.

Hepatitis B VaccineHepatitis B Vaccine

HBV can be prevented by receiving HBV can be prevented by receiving the hepatitis B vaccine.the hepatitis B vaccine.

The vaccine isThe vaccine is Highly recommendedHighly recommended Given in a series of 3 shots in the armGiven in a series of 3 shots in the arm SafeSafe Very effectiveVery effective

HCVHCV

Approximately 75% of persons Approximately 75% of persons infected will have no symptomsinfected will have no symptoms

Up to 85% will be chronically Up to 85% will be chronically infectedinfected

Leading indicator for liver Leading indicator for liver transplantstransplants

No preventative vaccineNo preventative vaccine

How Bloodborne Diseases How Bloodborne Diseases SpreadSpread

Bloodborne viruses are spread Bloodborne viruses are spread through contact with blood or other through contact with blood or other potentially infectious body fluids potentially infectious body fluids which includeswhich includes Semen and vaginal secretions Semen and vaginal secretions Body fluid containing visible bloodBody fluid containing visible blood Cerebrospinal fluid (fluid around Cerebrospinal fluid (fluid around

brain/spinal cord)brain/spinal cord) Synovial fluid (fluid in joints)Synovial fluid (fluid in joints) Pleural fluid (fluid around the lung)Pleural fluid (fluid around the lung)

How Bloodborne Diseases How Bloodborne Diseases SpreadSpread

Peritoneal fluid (fluid in the abdomen)Peritoneal fluid (fluid in the abdomen) Pericardial fluid (fluid around the heart)Pericardial fluid (fluid around the heart) Amniotic fluid (fluid in the uterus of a Amniotic fluid (fluid in the uterus of a

pregnant womanpregnant woman Non-intact skin or organs Non-intact skin or organs

TransmissionTransmission To acquire a bloodborne pathogen blood To acquire a bloodborne pathogen blood

or other potentially infectious body fluids or other potentially infectious body fluids must come in contact must come in contact With mucous membranes including of theWith mucous membranes including of the

EyesEyes NoseNose MouthMouth

By contaminated sharp object punctureBy contaminated sharp object puncture Such as a needlestickSuch as a needlestick

With non-intact skinWith non-intact skin Skin abrasionSkin abrasion AcneAcne

Reducing Your RiskReducing Your Risk

Standard PrecautionsStandard Precautions Engineering ControlsEngineering Controls Work Practice ControlsWork Practice Controls HousekeepingHousekeeping Administration of the hepatitis B Administration of the hepatitis B

vaccinevaccine

Standard PrecautionsStandard Precautions

Based on the principle that the following Based on the principle that the following are potentially infectious and must be are potentially infectious and must be treated that waytreated that way Blood and body fluidsBlood and body fluids Secretions and excretionsSecretions and excretions Non-intact skinNon-intact skin Mucous membranesMucous membranes

Remember: All body fluids pose a Remember: All body fluids pose a potential risk for infectionpotential risk for infection

Standard Precautions Standard Precautions involves:involves:

Hand hygieneHand hygiene Personal Protective EquipmentPersonal Protective Equipment Respiratory Hygiene/Cough Respiratory Hygiene/Cough

EtiquetteEtiquette Safe Injection PracticesSafe Injection Practices

Hand HygieneHand Hygiene

Single most important practice to Single most important practice to reduce the transmission of infectious reduce the transmission of infectious agentsagents

Includes handwashing and use of Includes handwashing and use of alcohol based productalcohol based product

HandwashingHandwashing

HANDWASHING MUST BE DONEHANDWASHING MUST BE DONE If hands are visibly soiledIf hands are visibly soiled Before eatingBefore eating After using the restroomAfter using the restroom After caring for a patient with diarrhea After caring for a patient with diarrhea

or on contact precautions for stool or on contact precautions for stool Stool may contain Clostridium difficile Stool may contain Clostridium difficile

which forms spores that can only be which forms spores that can only be eliminated by physical removaleliminated by physical removal

Hand Hygiene GuidelinesHand Hygiene Guidelines

Must be done with soap & water or Must be done with soap & water or alcohol handrubalcohol handrub Before and after patient contact regardless of Before and after patient contact regardless of

glove useglove use After contact with the patient’s environmentAfter contact with the patient’s environment Immediately before inserting an invasive Immediately before inserting an invasive

devicedevice When moving from a contaminated body site When moving from a contaminated body site

to a cleaner body siteto a cleaner body site After removing glovesAfter removing gloves

OTHER SITUATIONS FOR OTHER SITUATIONS FOR HAND HYGIENEHAND HYGIENE

When they look or When they look or feel dirtyfeel dirty

Before preparing Before preparing food or medicationfood or medication

After eatingAfter eating

After coughing or After coughing or sneezing into your sneezing into your hand hand

After blowing or After blowing or wiping your nosewiping your nose

How To Perform How To Perform HandwashingHandwashing

Turn faucet on and Turn faucet on and adjust temperature to adjust temperature to warm, not hotwarm, not hot

Apply soap to hands Apply soap to hands to allow for sufficient to allow for sufficient coverage of entire coverage of entire surfacesurface

Scrub hands for Scrub hands for 15 15 secondsseconds

Cover entire hand Cover entire hand including fingernails including fingernails and wristand wrist

Rinse hands Rinse hands completely in completely in running water running water keeping hands lower keeping hands lower than elbowsthan elbows

Dry hands with Dry hands with paper towelpaper towel

Use a clean, dry Use a clean, dry paper towel to paper towel to turn off faucetturn off faucet

Alcohol Based HandrubAlcohol Based Handrub

Apply enough product Apply enough product to hands to cover all to hands to cover all surfaces of hands and surfaces of hands and to remain wet for to remain wet for

15 seconds15 seconds Rub hands, fingernails Rub hands, fingernails

and wrist area until and wrist area until dry dry

FingernailsFingernails

Artificial nails and gel products used Artificial nails and gel products used on nails are not permittedon nails are not permitted If you provide hands-on patient careIf you provide hands-on patient care Perform diagnostic studies that Perform diagnostic studies that

required direct patient contactrequired direct patient contact Natural nails should be kept short.Natural nails should be kept short.

Hand Hygiene for Patients Hand Hygiene for Patients and Visitorsand Visitors

Proper hand hygiene by patients and Proper hand hygiene by patients and visitors will minimize environmental visitors will minimize environmental contaminationcontamination

Instruct patient and visitors on hand Instruct patient and visitors on hand hygiene including use of alcohol hygiene including use of alcohol handrubhandrub

Provide patient with towelettes for Provide patient with towelettes for use while in beduse while in bed

Personal Protective Personal Protective Equipment (PPE)Equipment (PPE)

Wear gown and gloves whenever you Wear gown and gloves whenever you expect to touch blood and body expect to touch blood and body fluids or contaminated surfacesfluids or contaminated surfaces

Wear mask and eye protection or Wear mask and eye protection or face shield to protect from splashes face shield to protect from splashes of body fluidof body fluid

Different tasks require different Different tasks require different levels of PPElevels of PPE

WEARING PPEWEARING PPE

PUT THE GOWN ON FIRST, THEN PUT THE GOWN ON FIRST, THEN MASK, THEN GLOVESMASK, THEN GLOVES

REMOVE IN REVERSE ORDER. AVOID REMOVE IN REVERSE ORDER. AVOID TOUCHING THE OUTER SURFACES OF TOUCHING THE OUTER SURFACES OF THE PROTECTIVE GEARTHE PROTECTIVE GEAR

REMOVE GLOVES BY PINCHING FIRST REMOVE GLOVES BY PINCHING FIRST GLOVE AND PEEL BACK. SLIDE GLOVE AND PEEL BACK. SLIDE UNGLOVED FINGER UNDER CUFF OF UNGLOVED FINGER UNDER CUFF OF SECOND GLOVE AND PEEL BACKSECOND GLOVE AND PEEL BACK

WEARING PPEWEARING PPE

Remove mask by touching the stringsRemove mask by touching the strings Do not leave mask dangling around the Do not leave mask dangling around the

neck!neck! Remove gown by loosening ties, pull down Remove gown by loosening ties, pull down

from below the neckline off the arms and from below the neckline off the arms and roll inside outroll inside out

Dispose of protective wear Dispose of protective wear

immediatelyimmediately Perform hand hygienePerform hand hygiene

GlovesGloves

Perform hand hygiene before donning Perform hand hygiene before donning glovesgloves

Change gloves between tasks on the same Change gloves between tasks on the same patientpatient

Change gloves after contact with material Change gloves after contact with material that may contain a high concentration of that may contain a high concentration of organismsorganisms

Change gloves between patients and Change gloves between patients and before touching non-contaminated items before touching non-contaminated items and surfacesand surfaces

Gloves (cont.)Gloves (cont.)

Discard single use gloves after one Discard single use gloves after one useuse

If a glove tears, punctures, leaks or If a glove tears, punctures, leaks or becomes contaminated, remove it as becomes contaminated, remove it as soon as possiblesoon as possible

Wash hands to avoid transfer of Wash hands to avoid transfer of microorganisms to other patients or microorganisms to other patients or environments.environments.

Respiratory HygieneRespiratory HygieneCough EtiquetteCough Etiquette

Cover coughs and sneezesCover coughs and sneezes Perform hand hygienePerform hand hygiene If unable to perform hand hygiene If unable to perform hand hygiene

immediately, cough into arm or immediately, cough into arm or jacketjacket

Have patients who are not able to Have patients who are not able to comply wear a surgical mask when comply wear a surgical mask when out of their roomout of their room

Cover coughs and sneezesCover coughs and sneezes

Safe Injection PracticesSafe Injection Practices

Use aseptic technique to avoid Use aseptic technique to avoid contamination of sterile injection contamination of sterile injection equipmentequipment

Do not administer medications from Do not administer medications from a syringe to multiple patients, even a syringe to multiple patients, even if the needle or cannula is changedif the needle or cannula is changed

Use IV bags and other fluid infusion Use IV bags and other fluid infusion sets for one patient onlysets for one patient only

Safe Injection Practices Safe Injection Practices (cont.)(cont.)

Do not administer medications from Do not administer medications from single dose vials to multiple patients single dose vials to multiple patients or combine leftovers for later useor combine leftovers for later use

Use single dose vials whenever Use single dose vials whenever possiblepossible

Do not store multiple dose vials in Do not store multiple dose vials in immediate patient treatment areaimmediate patient treatment area

Do not use IV solutions as a common Do not use IV solutions as a common source for multiple patientssource for multiple patients

Engineering ControlsEngineering Controls

Isolate or remove hazards from the Isolate or remove hazards from the workplace and includes:workplace and includes: Sharps disposal containersSharps disposal containers Sharps with engineered sharps injury Sharps with engineered sharps injury

protectionsprotections Needleless systemsNeedleless systems Leakproof trash bagsLeakproof trash bags Resuscitation equipmentResuscitation equipment

Resuscitative EquipmentResuscitative Equipment

Use resuscitative mask or other Use resuscitative mask or other ventilation devices to avoid mouth to ventilation devices to avoid mouth to mouth resuscitationmouth resuscitation

Resuscitative masks should be in all Resuscitative masks should be in all patient rooms and care areaspatient rooms and care areas Replace as needed from storeroom Replace as needed from storeroom

stockstock Ventilation equipment is located on Ventilation equipment is located on

crash cartscrash carts

USING SHARPS SAFELYUSING SHARPS SAFELY

Never recap needlesNever recap needles Never bend or break Never bend or break

needlesneedles Use safety engineered Use safety engineered

needles, syringes and needles, syringes and scalpel bladesscalpel blades

Deposit sharps Deposit sharps immediately after use in a immediately after use in a designated sharps designated sharps containercontainer

Sharps containers should Sharps containers should not be more than 3/4ths not be more than 3/4ths full to avoid accidental full to avoid accidental needlesticksneedlesticks

Work Practice ControlsWork Practice Controls Procedures you follow to reduce exposure Procedures you follow to reduce exposure

to blood and body fluids such as…to blood and body fluids such as… Do not eat, drink, smoke, apply cosmetics Do not eat, drink, smoke, apply cosmetics

or lip balms or handle contact lenses or lip balms or handle contact lenses where blood or body fluids are presentwhere blood or body fluids are present

Do not store food or drink in places where Do not store food or drink in places where blood or body fluids are presentblood or body fluids are present

Never mouth pipette or mouth suction Never mouth pipette or mouth suction blood or body fluidsblood or body fluids

Minimize splashing or spraying of blood Minimize splashing or spraying of blood or body fluidsor body fluids

Other Safe Work Other Safe Work PracticesPractices

Transport lab specimens in closed, leak-Transport lab specimens in closed, leak-proof containers. proof containers.

Do not let contaminated equipment touch Do not let contaminated equipment touch your skin, mucous membranes, clothing, your skin, mucous membranes, clothing, other patients, visitors or items in the other patients, visitors or items in the environmentenvironment

Make sure reusable equipment is not used Make sure reusable equipment is not used on another patient until it has been on another patient until it has been properly cleanedproperly cleaned

Single-use items should be discarded Single-use items should be discarded appropriatelyappropriately

HousekeepingHousekeeping

Keep linen away from your body to avoid Keep linen away from your body to avoid contamination of clothes and armscontamination of clothes and arms

Clean frequently used surfaces oftenClean frequently used surfaces often Bedside standBedside stand

Clean blood and body spills immediatelyClean blood and body spills immediately Do not reach into trash containers or push Do not reach into trash containers or push

trash down with your hands or feet. trash down with your hands or feet.

Instead gently shake downInstead gently shake down

Housekeeping (cont.)Housekeeping (cont.)

Carry waste bags by the top, away Carry waste bags by the top, away from your bodyfrom your body

Fluorescent orange-red labels, red Fluorescent orange-red labels, red bags, red containers and warning bags, red containers and warning signs are designed to warn you that signs are designed to warn you that the contents contain blood or body the contents contain blood or body fluids. fluids.

Low Level DisinfectionLow Level Disinfection

Performed on items that come in Performed on items that come in contact with intact skin contact with intact skin BP cuffsBP cuffs MattressesMattresses

Item must be Item must be DryDry Visibly cleanVisibly clean Free of defectsFree of defects

Defective ItemsDefective Items

Defective itemsDefective items Mattress with tear or punctureMattress with tear or puncture Rough surfaces on wooden chairs armsRough surfaces on wooden chairs arms

Clean and disinfect item as neededClean and disinfect item as needed Place defective sticker on itemPlace defective sticker on item Remove from serviceRemove from service Report to managerReport to manager

Low Level Disinfection Low Level Disinfection ProcedureProcedure

Use friction toUse friction to clean clean item of all visible soil if item of all visible soil if presentpresent

Disinfect Disinfect the surface by applying the surface by applying disinfectant from a clean germicidal wipe or disinfectant from a clean germicidal wipe or spray bottle (i.e, Cavicide) and a clean towel spray bottle (i.e, Cavicide) and a clean towel

Wipe disinfectant over all surfaces using Wipe disinfectant over all surfaces using frictionfriction Friction removes 98% of microorganismsFriction removes 98% of microorganisms

and bacterial spores (Clostridium and bacterial spores (Clostridium

difficile) that the disinfectant cannot kill difficile) that the disinfectant cannot kill

Low Level Disinfection Low Level Disinfection ProcedureProcedure

Make sure surfaces are wet enough to Make sure surfaces are wet enough to assure proper exposure time required assure proper exposure time required by the manufacturer’s labelby the manufacturer’s label

Rewet if necessary to obtainRewet if necessary to obtain the required exposure timethe required exposure time

Cavicide/Caviwipes 3 minutesCavicide/Caviwipes 3 minutes Red top Sani-Cloth 5 minutesRed top Sani-Cloth 5 minutes

Neither product kills C.diff sporesNeither product kills C.diff spores Hand soap is not to be used on inanimate Hand soap is not to be used on inanimate

objects.objects.

Control Measures to Avoid Control Measures to Avoid Contamination of the Contamination of the

DisinfectantDisinfectant Empty and rinse spray bottles before Empty and rinse spray bottles before

refilling refilling Do not “top off” bottleDo not “top off” bottle Do not leave residual water in the bottleDo not leave residual water in the bottle

Avoid contamination of bottle strawAvoid contamination of bottle straw Always read the manufacturer’s label for Always read the manufacturer’s label for

exposure time and appropriate storageexposure time and appropriate storage Store in closed containerStore in closed container Avoid storing in sunlightAvoid storing in sunlight

What To Do If Exposed to What To Do If Exposed to Blood or Other Potentially Blood or Other Potentially

Infectious Body FluidsInfectious Body Fluids Act quickly, because for some Act quickly, because for some

infections, treatment should start infections, treatment should start right awayright away Post-exposure prophylaxis for HIV Post-exposure prophylaxis for HIV

should begin within hours (i.e., 4 hrs ) should begin within hours (i.e., 4 hrs ) of the exposureof the exposure

Remember that an exposure does Remember that an exposure does not always lead to infectionnot always lead to infection

What To Do If ExposedWhat To Do If Exposed

Wash the exposed area with soap and Wash the exposed area with soap and waterwater

If contaminated material gets in your If contaminated material gets in your eyes or mucous membranes, flush eyes or mucous membranes, flush them with large amounts of waterthem with large amounts of water

Report the exposure to your Report the exposure to your supervisorsupervisor

Report to EMSTARReport to EMSTAR

Healthcare-Associated Healthcare-Associated InfectionsInfections

Infections patients acquire during the Infections patients acquire during the course of receiving treatment for other course of receiving treatment for other conditionsconditions

Account for an estimated 2 million Account for an estimated 2 million infections and 90,000 deathsinfections and 90,000 deaths

$26-$33 billion in added healthcare cost$26-$33 billion in added healthcare cost 70% can be prevented by implementing 70% can be prevented by implementing

what we know for preventionwhat we know for prevention

Multidrug-Resistant Multidrug-Resistant Organism (MDRO)Organism (MDRO)

MDROs are bacteria resistant to one MDROs are bacteria resistant to one or more of the best drugs we have to or more of the best drugs we have to treat them which makes infections treat them which makes infections difficult treat.difficult treat.

Two-thirds of the bacteria that cause Two-thirds of the bacteria that cause HAIs are MDROsHAIs are MDROs

MDROs of concernMDROs of concern

Methicillin resistant Staph aureus (MRSA)Methicillin resistant Staph aureus (MRSA) Vancomycin resistant Enterococcus (VRE)Vancomycin resistant Enterococcus (VRE) Extended spectrum beta-lactamase (ESBL)Extended spectrum beta-lactamase (ESBL)

Occurs with gram negative bacteriaOccurs with gram negative bacteria E.coliE.coli Klebsiella pneumoniaKlebsiella pneumonia

Klebsiella producing carbapenemase (KPC)Klebsiella producing carbapenemase (KPC) Acinetobacter baumaniiAcinetobacter baumanii

Identification of MDROsIdentification of MDROs on culture reports on culture reports

ESBLESBL ESBL is listed beneath antibiotics on ESBL is listed beneath antibiotics on

cultureculture Positives are indicated with a (+) signPositives are indicated with a (+) sign

KPCKPC Comment will be added beneath Comment will be added beneath

Klebsiella on the culture report Klebsiella on the culture report indicating the organism is positive for indicating the organism is positive for KPCKPC

Most Common HAIsMost Common HAIs

Clostridium difficile associated Clostridium difficile associated diarrheadiarrhea

Catheter associated urinary tract Catheter associated urinary tract infectionsinfections

Central line-associated bloodstream Central line-associated bloodstream infectionsinfections

Surgical site infectionsSurgical site infections Ventilator associated pneumoniaVentilator associated pneumonia

Clostridium difficile Clostridium difficile InfectionInfection

Most common cause of infectious Most common cause of infectious diarrhea diagnosed in the hospitaldiarrhea diagnosed in the hospital

A virulent strain exists that is A virulent strain exists that is causing epidemics with significant causing epidemics with significant mortalitymortality

Forms spores that can persist in the Forms spores that can persist in the environment for monthsenvironment for months Can only be physically removed byCan only be physically removed by

Handwashing (do not use alcohol handrub)Handwashing (do not use alcohol handrub) Friction with environmental cleaningFriction with environmental cleaning

Prevention of Catheter-Prevention of Catheter-associated Urinary Tract associated Urinary Tract

InfectionsInfections Perform hand hygiene immediately before Perform hand hygiene immediately before

and after any manipulation of the catheterand after any manipulation of the catheter Strict adherence to aseptic technique Strict adherence to aseptic technique

during insertion and when obtaining urine during insertion and when obtaining urine samplesample

Use urinary catheters only when necessaryUse urinary catheters only when necessary Catheters left in place only as long as Catheters left in place only as long as

necessarynecessary Keep catheter bag below level of the Keep catheter bag below level of the

bladderbladder

Central line-Associated Central line-Associated Bloodstream Infections Bloodstream Infections

(CLABSI)(CLABSI) Maximal barrier precautions during Maximal barrier precautions during

insertion includes:insertion includes: CapCap MaskMask Sterile gownSterile gown Sterile glovesSterile gloves Full body drapeFull body drape

CLABSI PreventionCLABSI Prevention

Hand hygiene before and after Hand hygiene before and after manipulation of the central linemanipulation of the central line

Thorough cleaning of access ports Thorough cleaning of access ports prior to entryprior to entry Approx. 15 seconds or 8 rotationsApprox. 15 seconds or 8 rotations One or two swipes is not sufficientOne or two swipes is not sufficient

Surgical Site Infections Surgical Site Infections (SSI)(SSI)

Patient should have a thorough CHG Patient should have a thorough CHG bath (i.e., Hibiclens) at least the bath (i.e., Hibiclens) at least the night before and the morning of night before and the morning of surgerysurgery

Report any untreated infections to Report any untreated infections to the surgeon the surgeon UTIUTI URIURI

Ventilator Associated Ventilator Associated Pneumonia (VAP)Pneumonia (VAP)

Hand hygiene and glove useHand hygiene and glove use

before and after contact:before and after contact: With patients and respiratory equipmentWith patients and respiratory equipment After handling respiratory secretions After handling respiratory secretions

and contaminated equipmentand contaminated equipment Between contact with contaminated Between contact with contaminated

body site and respiratory devices of the body site and respiratory devices of the same patientsame patient

Head of bed elevated 30 degree angle Head of bed elevated 30 degree angle

Transmission Based Transmission Based PrecautionsPrecautions

Used in addition to Standard Used in addition to Standard Precautions for patients with Precautions for patients with infection or colonization that spread infection or colonization that spread easilyeasily

3 Types of Transmission Based 3 Types of Transmission Based PrecautionsPrecautions ContactContact DropletDroplet AirborneAirborne

Contact PrecautionsContact Precautions

Used for infection or MDRO Used for infection or MDRO colonization that is easily colonization that is easily transmitted by direct patient contact transmitted by direct patient contact or indirect contact with or indirect contact with contaminated itemscontaminated items Colonization – organism lives on a body Colonization – organism lives on a body

site but is not causing an infectionsite but is not causing an infection Surfaces can remain contaminated Surfaces can remain contaminated

with MDROs for days to monthswith MDROs for days to months

Common Contact Common Contact Precaution IndicationsPrecaution Indications

MDROsMDROs MRSAMRSA VREVRE

Clostridium difficile associated Clostridium difficile associated diarrheadiarrhea

ScabiesScabies Wound drainage not containedWound drainage not contained

within the dressingwithin the dressing

Basics of Contact Basics of Contact PrecautionsPrecautions

Private room Private room Don gown and gloves before entry Don gown and gloves before entry

into patient roominto patient room Remove gown and gloves before Remove gown and gloves before

leaving the roomleaving the room Perform hand hygiene immediatelyPerform hand hygiene immediately

Basics of Contact Basics of Contact Precautions (cont.)Precautions (cont.)

Make sure clothing and hands do not Make sure clothing and hands do not touch potentially contaminated touch potentially contaminated environmental surfaces or items upon environmental surfaces or items upon exiting the roomexiting the room

Dedicate noncritical patient-care Dedicate noncritical patient-care equipmentequipment StethoscopeStethoscope ThermometerThermometer

Clean and disinfect equipment before Clean and disinfect equipment before use with another patientuse with another patient

Multi-Use Electronic Multi-Use Electronic EquipmentEquipment

Includes VS machine and mobile Includes VS machine and mobile computerscomputers

Clean and disinfect (i.e., with germicidal Clean and disinfect (i.e., with germicidal wipes) routinelywipes) routinely At least dailyAt least daily Preferably at the beginning of each shiftPreferably at the beginning of each shift

Do not take VS machine into contact Do not take VS machine into contact precaution roomsprecaution rooms

Clean and disinfect touched surfaces of Clean and disinfect touched surfaces of mobile computer after use on contact mobile computer after use on contact precaution patientprecaution patient

Droplet PrecautionsDroplet Precautions

Droplet transmission takes place Droplet transmission takes place when large droplets from an infected when large droplets from an infected person are propelled a short person are propelled a short distance through sneezing or distance through sneezing or coughing, thereby reaching another coughing, thereby reaching another person’s eyes, nose, or mouthperson’s eyes, nose, or mouth

Patient should wear a surgical mask Patient should wear a surgical mask over nose and mouth when out of over nose and mouth when out of their roomtheir room

Droplet Precautions Droplet Precautions

Healthcare worker should wear Healthcare worker should wear surgical mask upon entering the surgical mask upon entering the patient’s roompatient’s room

Teach patient to cover coughs and Teach patient to cover coughs and sneezes into bent elbow.sneezes into bent elbow.

IndicationsIndications PertussisPertussis Seasonal influenzaSeasonal influenza

H1N1 requires use of respiratorH1N1 requires use of respirator

Airborne PrecautionsAirborne Precautions

Involves contact with small droplets Involves contact with small droplets or dust particles that suspend the or dust particles that suspend the infectious agent in the airinfectious agent in the air

IndicationsIndications TuberculosisTuberculosis MeaslesMeasles

Airborne PrecautionsAirborne Precautions

Patient wears surgical mask to leave their Patient wears surgical mask to leave their roomroom

Healthcare worker wears a fit-tested Healthcare worker wears a fit-tested respiratorrespirator Fit-testing performed by Employee Health Fit-testing performed by Employee Health

(8580)(8580) Call for appointment if need fit-testingCall for appointment if need fit-testing

Patients are placed in negative pressure Patients are placed in negative pressure rooms rooms

Door(s) to room must be kept closed tightDoor(s) to room must be kept closed tight

TuberculosisTuberculosis 0-2 cases of active TB is diagnosed between 0-2 cases of active TB is diagnosed between

Ohio, Marshall, and Belmont Counties each Ohio, Marshall, and Belmont Counties each yearyear

New employees receive a two step PPD skin New employees receive a two step PPD skin test to identify latent TB on employmenttest to identify latent TB on employment

Repeat PPD required annually on your birth Repeat PPD required annually on your birth monthmonth

Preventive therapy available for persons at Preventive therapy available for persons at high risk for active TB that have latent TB high risk for active TB that have latent TB identified by PPD testing as recommended identified by PPD testing as recommended by a physicianby a physician

Patient and Family Patient and Family EducationEducation

The Joint Commission requires the The Joint Commission requires the following patient education be following patient education be documenteddocumented C. difficile and MDROs with 48 hours of C. difficile and MDROs with 48 hours of

admission or diagnosisadmission or diagnosis Surgical site prevention prior to the Surgical site prevention prior to the

procedureprocedure Central line associated bloodstream Central line associated bloodstream

infection prevention prior to central line infection prevention prior to central line insertioninsertion

INFECTION CONTROL INFECTION CONTROL IS A TEAM EFFORT. IS A TEAM EFFORT.

HELP KEEP YOURSELF HELP KEEP YOURSELF AND OTHERS SAFE! AND OTHERS SAFE! PLAY YOUR PART IN PLAY YOUR PART IN REDUCING THE RISK REDUCING THE RISK

OF INFECTION.OF INFECTION.

QuizQuiz

1. Print the next slide: quiz1. Print the next slide: quiz2. Complete the written 2. Complete the written quizquiz3. 3. Turn it in to your clinical Turn it in to your clinical instructor/supervisorinstructor/supervisor

To take the test, go to “File,” “Print,” and change the printing to To take the test, go to “File,” “Print,” and change the printing to “Current slide only” and gray scale, then hit “Print”“Current slide only” and gray scale, then hit “Print”

Name_______________________ Dept.________________ Date Name_______________________ Dept.________________ Date ____________________________________

1. True or False Infection control benefits everyone including patients, visitors, and all healthcare workers.

2. True or False Standard precautions include hand hygiene, wearing gloves, and wearing a gown when coming in contact with body fluids.

3. True or False Transmission based precautions include contact, droplet, and airborne.

4. True or False Multidrug resistant organisms are easy to get rid of and respond well to antibiotics.

5. True or False It is OK to use alcohol based hand rub after caring for a patient with C-diff.

6. True or False Hand hygiene is the single most important step in preventing the spread of infection.

7. True or False When using a disinfectant, it is important to make sure a surface is wet enough to assure proper exposure time to kill an organism.

8. True or False Always remember to read the manufacturer’s label for exposure time and appropriate storage when cleaning and disinfecting.

9. True or False The products Cavicide and Sani-cloths used for disinfecting can kill C-diff.

10. True or False Artificial nails and gel products for nails are permitted to be worn by healthcare workers.

SCORE: _______________________________

OSHA/ INFECTION CONTROL