The Pharmacist's Role in Infection Control PDF

The Pharmacist’s Role in Infection Control PHAR 4106/4404 Institutional Pharmacy Practice Management 22nd October 2024 1  Objectives Define Describe Outline Discuss De...

The Pharmacist’s Role in Infection Control PHAR 4106/4404 Institutional Pharmacy Practice Management 22nd October 2024 1  Objectives Define Describe Outline Discuss Define Standard Describe the 10 Outline the Discuss the Infection Control elements of importance of Pharmacist’s Procedures infection control adequate role and in the infection control responsibilities institutional in the in Infection setting institutional Control setting. 2 Infection Control in the Institutional Setting https://youtu.be/Se aIY7kP2uI?si=v0bij 5QFV5NiN9OU 3  Standard Infection Control Precautions (SCIPs) SICPs are the basic infection prevention and control measures necessary to reduce the risk of transmitting infectious agents from both recognized and unrecognized sources of infection. They are to be used by all staff, in all care settings, at all times, for all patients whether infection is known to be present or not, to ensure the safety of those being cared for, staff and visitors in the care environment. 4  Secretions or Blood and Sources other body fluids excretions (excluding sweat) of Potential Non-intact Any equipment or items in the Infection skin or mucous care environment membranes that could have become contaminated. 5 Factors Affecting the Infection Risk to and from Individuals The anticipated level of Level of The task exposure to interaction blood and/or other body fluids. 6 The 10 Elements of SCIPs Patient Personal placement/assess Respiratory and Hand hygiene protective ment of infection cough hygiene equipment risk Safe management Safe management Safe management Safe management of the care of blood and body of care equipment of healthcare linen environment fluids Occupational Safe disposal of safety/managing waste (including prevention of sharps) exposure (including sharps) 7 Patient Placement/Assessment for Infection Risk Patients who may present a cross- infection risk include Assessment those: should influence With diarrhoea, vomiting, an placement unexplained rash, fever or decisions in respiratory symptoms accordance with Known to have been clinical/care previously positive with a need(s) multi-drug resistant organism (MDRO), eg MRSA, CPE Who have been an inpatient 8 in any hospital Hand Hygiene Perform hand One of the most hygiene: important ways to Before touching a reduce the patient. transmission of Before clean or infectious agents that aseptic procedures. cause healthcare After body fluid exposure risk associated infections After touching a (HCAIs). patient; and After touching a patient’s immediate 9 surroundings. Respiratory and Cough Hygiene Designed to minimize the risk of cross transmission of known or suspected respiratory illness. Staff should promote respiratory and cough hygiene helping those (eg, elderly, children) who need assistance with this. Cover the nose and mouth with a disposable tissue when sneezing, coughing, wiping and blowing the nose; if unavailable use the crook of the arm Dispose of all used tissues promptly into a waste bin Wash hands with non-antimicrobial liquid soap and warm water after coughing, sneezing, using tissues, or after contact with respiratory secretions or objects contaminated by these secretions Where there is no running water available or hand hygiene facilities are lacking, staff may use hand wipes followed by ABHR and should wash their hands at the first available opportunity Keep contaminated hands away from the eyes nose and mouth. 10  Staff should assess any likely exposure to blood and/or other body fluids, non-intact skin or mucous membranes and wear personal Personal protective equipment (PPE) that protects adequately against the risks associated with the Protectiv procedure. e Equipme Avoiding overuse or inappropriate use of PPE is a key principle that ensures this is risk-based and nt minimizes its environmental impact. Located close to the point of use. PPE for healthcare Stored to prevent Disposed of after use Changed immediately into the correct waste professionals providing contamination in a Single-use only unless after each patient stream, eg domestic Discarded if damaged care in the community clean, dry area until specified by the and/or after completing waste, offensive (non- or contaminated. and domiciliary care required (expiry dates manufacturer a procedure or task infectious) or clinical providers must be must be adhered to) waste transported in a clean receptacle 11 Safe Management of Care Equipment Care equipment is easily contaminated with blood, other body fluids, secretions, excretions and infectious agents. Before using any sterile equipment check that: The packaging is intact There are no obvious signs of packaging contamination The expiry date remains valid Any sterility indicators are consistent with the process being completed successfully. Decontamination of reusable non-invasive care equipment must be undertaken: Between each use/between patients After blood and/or body fluid contamination At regular predefined intervals as part of an equipment cleaning protocol Before inspection, servicing or repair. 12 Safe Management of the Care Environment The care environment must well maintained, visibly clean, free from non-essential in abe: good state of repair and with items and equipment to facilitate adequate ventilation for the clinical spec effective cleaning ialty. There should be routine cleaning taking place to ensure cleanliness standards. 13 Safe Management of Linen Linen in this category must not be sorted Store all but should be sealed All linen that is Infectious linen used/infectious linen in a water soluble bag deemed unfit for re- includes linen that in a designated, safe, (entirely water soluble use, eg, torn or has been used by a Infectious linen lockable area while ‘alginate’ bag or heavily contaminated, patient who is known bags/receptacles awaiting collection. impermeable bag with should be categorised or suspected to be must be tagged (eg, Collection schedules soluble seams), which at the point of use infectious and/or linen hospital ward/care must be acceptable to is then placed in an and returned to the that is contaminated area) and dated the care area and impermeable bag laundry for with blood and/or there should be no immediately on assessment and other body fluids. build-up of linen removal from the bed disposal. receptacles and secured before leaving a clinical area 14 Safe Management of Blood and Body Fluid Spillage Spillages must be Responsibilities for treated the management immediately by of blood/body fluid staff trained to spills must be undertake this clear within each safely. area/care setting. 15  Clinical waste means: Contains viable micro-organisms or their toxins which are known or reliably Safe Disposal believed to cause disease in humans or other living organisms. Contains or is contaminated with a of Waste medicine that contains a biologically active pharmaceutical agent. Is a sharp, or a body fluid or other (including biological material (including human and animal tissue) containing or contaminated with a dangerous Sharps) substance Offensive waste is waste that: Is not clinical waste, is not infectious, but may contains body fluids, secretions or excretions, is non-hazardous 16 17  a percutaneous injury eg injuries from needles, instruments, bone fragments, or bites which break the A significant skin; and/or occupational exposure of broken skin (abrasions, cuts, eczema, etc); exposure is: and/or exposure of mucous membranes including the eye from splashing of blood or other high risk body fluids. Occupational Safety: Prevention of Exposure Sharps manufacturers’ instructions for safe use and disposal handling must must be followed be assessed, needles must not be re-sheathed/recapped or kept to a disassembled after use minimum and sharps must not be passed directly hand to hand eliminated, if used sharps must be discarded at the point of use by the possible, with person generating the waste the use of always dispose of needles and syringes as 1 unit approved if a safety device is being used safety mechanisms must safety be deployed before disposal. devices. 18  Reputational risk affecting potential patients and The staff decisions Longer patient stays which can further increase Significance patients’ risk Longer patient stays resulting in fewer available of Adequate beds for other patients Infection Higher patient cost with no additional insurance reimbursements Control to Decreased insurance reimbursements or other fines and penalties Institutions Audit risk from government and accreditation/industry organizations Litigation risk 19 The Infection Control Committee Develops policies and procedures addressing: The management and provision of patient care and employee-health services. The education of staff, patients, family members, and other caregivers in the prevention and control of infections. Surveillance systems to track the occurrence and transmission of infections. Surveillance systems to track the use of antimicrobials and the development of resistance. 20  The Role of the Pharmacist in Infection Control Reducing Promoting Educating Reducing Promoting Educating the rational Health transmissi use of profession on of antimicrobi als, infections al agents patients and the public 21 Reducing the Transmission of Infections Recommendi Participating Advising Establishing Encouraging Developing ng Participating in Advising health Establishing Encouraging Developing Recommending the Infection systems on the internal appropriate guidelines for policies on the Control selection and pharmacy immunizations risk assessment, changing of IV Committee use of policies, and periodic treatment and administration appropriate procedures and screening for monitoring of sets, invasive selection and quality control transferrable patients and devices and use of programs to diseases. HCWs who have dressings. antiseptics, prevent been exposed to disinfectants and contamination of transmissible sterilants medication infectious prepared or disease. dispensed by the pharmacy. 22 Promoting Rational Use of Antimicrobial Agents. Encouraging collaboration Ensure that the number within the health system to and type of antimicrobial ensure that empiric, agents available are prophylactic and treatment appropriate for the patient uses of antimicrobial population. agents result in optimal patient outcomes. Working with microbiology Establishing and operating labs to ensure that a multidisciplinary appropriate susceptibility antimicrobial monitoring tests are reported on program to assess the patients in a timely effectiveness of the manner and assisting in antimicrobial use policy. compiling the report to be submitted to the physician. 23 Education Activities Educating and counseling inpatients, Participating in Providing clinical ambulatory care public health conferences, newsletters, patients, and home education and and other types of care patients in the awareness educational forums for following areas: programs aimed at health professionals on adherence to controlling the topics such as prescribed spread of infectious antimicrobial use and directions for diseases: resistance, antimicrobial use, a. Promoting prudent decontaminating agents storing and use of antimicrobials, (disinfectants, antiseptics, handling b. Providing and sterilants), aseptic immunization access for medications and technique and procedures, children and adults, and administration and sterilization methods. c. Promoting devices, and other appropriate infection infection control control measures procedures 24 The End 25