Standard Infection Control Precautions (2/2/2024) - Fatima College of Health Sciences - PDF

Standard Infection Control Precautions Applied Microbiology and Infection Control Practices –BSN112 Academic Year 2024- 2025 Semester 2 Week 5 2/2/2024 Standard Infection Control...

Standard Infection Control Precautions Applied Microbiology and Infection Control Practices –BSN112 Academic Year 2024- 2025 Semester 2 Week 5 2/2/2024 Standard Infection Control 1 Precautions Learning outcomes By the end of this lecture the student should be able to: Apply principles of standards of infection control precautions. Analyze methods of infection control. Demonstrate proper hand hygiene technique. Explain methods of reducing infection transmission. 2/2/2024 Standard Infection Control 2 Precautions  Topic outline Definition of standard infection control precautions. Sources of infection Elements of standards of infection control precautions Patient placement and risk assessment Hand hygiene Respiratory and cough hygiene. Safe management of care equipment Safe management of the care environment Safe management of linen Safe management of blood and body spillage Safe disposal of waste 2/2/2024 Standard Infection Control Precautions 3 Standard Infection Control precautions (SICPs) Definition Basic infection prevention and control measures that is necessary to reduce the risk of transmitting infectious agents from both recognized and unrecognized sources of infection. Reduce or prevent the transmission of infectious agents. Render and maintain objects and healthcare settings as free as possible from infectious agents. 2/2/2024 Standard Infection Control 4 Precautions Standard infection control precautions Standard infection control precautions (SICPs) 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. 2/2/2024 Standard Infection Control 5 Precautions Standard Infection Control precautions: Sources of infection Sources of (potential) infection Blood and other body fluids Secretions or excretions (excluding sweat) Non-intact skin or mucous membranes Any contaminated equipment or items. 2/2/2024 Standard Infection Control 6 Precautions Sources of infection 2/2/2024 Standard Infection Control 7 Precautions Standard Infection Control precautions Application of SICPs is determined by risk assessment and perception considering: The task Level of interaction Anticipated level of exposure to blood or other body fluids 2/2/2024 Standard Infection Control 8 Precautions Elements of SICPs There are 10 elements of SICPs: 1. Patient placement/assessment of infection risk 2. Hand hygiene 3. Respiratory and cough hygiene 4. Personal protective equipment 5. Safe management of the care environment 6. Safe management of care equipment 7. Safe management of healthcare linen 8. Safe management of blood and body fluids 9. Safe disposal of waste (including sharps) 10.Occupational safety/managing prevention of exposure (including sharps) 2/2/2024 Standard Infection Control 9 Precautions 2/2/2024 Standard Infection Control 10 Precautions 1. Patient placement & risk assessment Patients must be promptly assessed for infection risk on arrival at the care area. Should be continuously reviewed throughout their stay. Risk assessment should influence placement decisions in accordance with clinical/care need(s). Patients with cross infection risk With diarrhea, vomiting, an unexplained rash, fever or respiratory symptoms Known to have been previously positive with a multi-drug- resistant organism (MDRO), eg MRSA,‫نعزلهم‬ CPE Who have been an inpatient in any hospital are a known epidemiological link to a carrier of CPE 2/2/2024 Standard Infection Control 11 Precautions 2. Hand hygiene 2/2/2024 Standard Infection Control 12 Precautions 2. Hand hygiene One of the most important ways to reduce the transmission of infectious agents that cause healthcare associated infections (HCAIs). Clinical hand-wash basins must: othe Be used for that purpose only and not used for the r disposal of liquids Have mixer taps, no overflow or plug and be in a good state of repair Have wall mounted liquid soap and paper towel dispensers. NB: Hand hygiene facilities should include instructional 2/2/2024 Standard Infection Control 13 posters. Precautions 2. Hand hygiene Before performing hand hygiene: Expose forearms (bare below the elbow) Remove all hand and wrist jewelry Ensure fingernails are clean and short, and do not wear artificial nails or nail ‫الجروح‬products Cover all cuts or abrasions with a waterproof dressing Wash hands with non-antimicrobial liquid soap and water if: Hands are visibly soiled or dirty Caring for patients with vomiting or diarrheal illnesses Caring for a patient with a suspected or known gastrointestinal infection, eg norovirus or a spore-forming organism such as clostridioides difficile In all other circumstances, use alcohol-based handrubs (ABHRs) for routine hand hygiene during care https://www.google.com/search?q=hand+hygiene+video+for+healthcare+wor kers&rlz=1C1GCEU_e 2/2/2024 Standard Infection Control 14 nAE1029AE1029&oq=hand+hygiene+video&aqs=chrome.0.0i512j69i57j0i512l4j0i22i3 Precautions Hand hygiene Skin care Dry hands thoroughly after hand washing, using disposable paper towels Use an emollient hand cream regularly eg during breaks and when off duty Do not use or provide communal tubs of hand cream in the care setting Staff with skin problems should seek advice from occupational health or their GP and depending on their skin condition and the severity may require additional interventions or reporting 2/2/2024 Standard Infection Control 15 Precautions Hand Hygiene: Surgical hand antisepsis Surgical scrubbing/rubbing (this applies to those undertaking surgical and some invasive procedures): Perform surgical scrubbing/rubbing before donning sterile theatre garments or at other times, eg before inserting central vascular access devices Remove all hand and wrist jewelry (including wedding band) Nail brushes should not be used for surgical hand antisepsis Nail picks (single-use) can be used if nails are visibly dirty Soft, non-abrasive, sterile (single-use) sponges may be used to apply antimicrobial liquid soap to the skin if licensed for this purpose Use an antimicrobial liquid soap licensed for surgical scrubbing or an ABHR licensed for surgical rubbing (as specified on the product label) Alcohol-Based Hand Rub/ABHR can be used between surgical procedures if licensed for 2this 5&sourceid=chrome&ie=UTF-8# f/p2/2suse or 0t2a4 t between Seta=ndiavrdeIn&glove fevctilodn changes =Cocntirdol :P if 1 hands are not visibly soiled 6 3. Respiratory and cough hygiene To minimize the risk of cross transmission of known or suspected respiratory pathogens: 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 2/2/2024 Standard Infection Control 17 mouth Precautions Respiratory and cough hygiene 2/2/2024 Standard Infection Control 18 Precautions 4. Personal protective equipment (PPE) Wear personal protective equipment (PPE) that protects adequately against the risks associated with the procedure 2/2/2024 Standard Infection Control 19 Precautions Principle of PPE use All PPE must be: Located close to the point of use. PPE for healthcare professionals providing care in the community and domiciliary care providers must be transported in a clean receptacle Stored to prevent contamination in a clean, dry area until required (expiry dates must be adhered to) Single-use only unless specified by the manufacturer Changed immediately after each patient and/or after completing a procedure or task Disposed of after use into the correct waste stream, eg domestic waste, offensive (non-infectious) or clinical waste Discarded if damaged or contaminated 2/2/2024 Standard Infection Control 20 Precautions Personal protective equipment (PPE) Gloves must be: Worn when exposure to blood and/or other body fluids, non- intact skin or mucous membranes is anticipated or likely Changed immediately after each patient and/or after completing a procedure/task even on the same patient Changed if a perforation or puncture is suspected Appropriate for use, fit for purpose and well-fitting Never decontaminated with ABHR or soap between use Low risk of causing sensitization to the wearer Appropriate for the tasks being undertaken 2/2/2024 Standard Infection Control 21 Precautions Personal protective equipment (PPE) Sterile gloves must be worn: When sterility is required in an operating theatre For some aseptic techniques eg insertion of central venous catheters, insertion of peripherally inserted central catheters, insertion of pulmonary artery catheters and spinal, epidural and caudal procedures Double gloving is NOT recommended for routine clinical care. However, it may be required for some exposure prone procedures 2/2/2024 Standard Infection Control 22 Precautions Personal protective equipment (PPE) Aprons must be: Worn to protect uniform or clothes when contamination is anticipated or likely, eg when in direct care contact with a patient Changed between patients and/or after completing a procedure or task Eye or face protection (including full-face visors) must: Be worn if blood and/or body fluid contamination to the eyes or face is anticipated or likely Not be impeded by accessories such as piercings or false eyelashes Not be touched when being worn 2/2/2024 Standard Infection Control 23 Precautions Personal protective equipment (PPE) Fluid resistant surgical face masks (FRSM): Surgical face masks are required: As a means of source control, eg to protect the patient from the wearer during sterile procedures such as surgery To protect the wearer when there is a risk splashing or spraying of blood, body fluids, secretions or excretions onto the respiratory mucosa As an element of PPE for droplet precautions 2/2/2024 Standard Infection Control 24 Precautions Headw ear Headwear is not routinely required in clinical areas unless part of theatre attire or to prevent contamination of the environment such as in clean rooms. Headwear must be: Worn in theatre settings and clean rooms, eg central decontamination unit Well-fitting and completely cover the hair Changed or disposed of between clinical procedures/lists or tasks and if contaminated with blood and/or body fluids Removed before leaving the theatre or clean room Individuals with facial hair must also cover this in areas where headwear is required 2/2/2024 Standard Infection Control 25 Precautions 5. Safe management of care equipment Care equipment Easily contaminated with blood, other body fluids, secretions, excretions and infectious agents Single use- used once on a single patient then discarded Single patient use- can be reused on the same patient and may require decontamination inbetween use e.g. nebulizer masks Reusable invasive equipment- used once then decontaminated, eg surgical instruments Reusable noninvasive equipment- reused on more than one patient following decontamination between each use, eg commode, patient transfer trolley 2/2/2024 Standard Infection Control 26 Precautions 5. Safe management of care equipment 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 2/2/2024 Standard Infection Control 27 Precautions 5. Safe management of care equipment 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 2/2/2024 Standard Infection Control 28 Precautions 6. Safe management of the care environment The care environment must be: Visibly clean, free from non-essential items and equipment to facilitate effective cleaning Well maintained, in a good state of repair and with adequate ventilation 2/2/2024 Standard Infection Control 29 Precautions 6. Safe management of the care environment Routine cleaning Refers to cleaning standards (National/Institutional) Use of detergent wipes is acceptable for cleaning surfaces/frequently touched Fresh solution of general-purpose neutral detergent in warm water is recommended for routine cleaning. Environmental cleaning schedules Follow available protocols on frequency of, and method of environmental decontamination 2/2/2024 Standard Infection Control 30 Precautions Safe management of the care environment Routine cleaning 2/2/2024 Standard Infection Control 31 Precautions  7. Safe management of linen Clean linen Should be stored in a clean, designated area, preferably an enclosed cupboard If clean linen is not stored in a cupboard, then the trolley used for storage must be designated for this purpose and completely covered with an impervious covering/or door that is able to withstand decontamination 5 2/2/2024 Standard Infection Control 32 Precautions 7. Safe management of linen Do Not: Rinse, shake or sort linen on removal from beds/trolleys Place used linen on the floor or any other surfaces (eg a locker/tabletop) Re-handle used linen once bagged Overfill laundry receptacles (not more than 2/3 full); or Place inappropriate items in the laundry receptacle (ie used equipment/needles) Used linen (previously known as soiled/fouled linen): Ensure a laundry receptacle is available as close as possible to the point of use for immediate linen deposit Should be placed in an impermeable bag immediately on removal from the bed or before leaving a clinical department. 5 2/2/2024 Standard Infection Control 33 Precautions 7. Safe management of linen Infectious linen (this mainly applies to healthcare linen) Infectious linen includes linen that has been used by a patient who is known or suspected to be infectious and/or linen that is contaminated with blood and/or other body fluids, eg feces Must not be sorted but should be sealed in a water-soluble bag. Infectious linen bags/receptacles must be tagged (eg, hospital ward/care area) and dated Store all used/infectious linen in a designated, safe, lockable area while awaiting collection 2/2/2024 Standard Infection Control 34 Precautions 8. Safe management of blood & body fluid spillages Spillages of blood and other body fluids may transmit blood borne viruses. Spillages must be treated immediately by staff trained to undertake this safely. Responsibilities for the management of blood/body fluid spills must be clear within each area/care setting. 2/2/2024 Standard Infection Control 35 Precautions 9. Safe disposal of waste (including sharps) Clinical waste means waste from a healthcare activity (including veterinary healthcare) Contains viable micro-organisms or their toxins which are known or reliably believed to cause disease in humans or other living organisms. Contains or is contaminated with a medicine that contains a biologically active pharmaceutical agent Is a sharp, or a body fluid or other biological material (including human and animal tissue) containing or contaminated with a dangerous substance 2/2/2024 Standard Infection Control 36 Precautions 9. Safe disposal of waste (including sharps) Sharps containers must: Have a handle (small community boxes do not require a handle) and temporary closure mechanism, employed when box is not in use Be disposed of when the manufacturers’ fill line is reached B e labelled with point of origin and date of assembly and disposal. Where re-usable sharps containers are used, organizations must have a protocol in place to assure themselves of safe use and reprocessing Sharps handling must be assessed, kept to a minimum and eliminated, if possible, with the use of approved safety devices 2/2/2024 Standard Infection Control 37 Precautions 10. Occupational safety: prevention of exposure (including sharps injuries) There is a potential risk of transmission of a BBV (blood borne virus) There is a legal requirement to report all sharps injuries and near misses to line managers/employer. A significant occupational exposure is: A percutaneous injury (i.e. injuries from needles, instruments, bone fragments, or bites which break the skin; and/or Exposure of broken skin (abrasions, cuts, eczema, etc.); and/or Exposure of mucous membranes including the eye from splashing of blood or other high risk body fluids 2/2/2024 Standard Infection Control 38 Precautions 10. Occupational safety: prevention of exposure (including sharps injuries) Avoid unnecessary use of sharps If use of medical sharps cannot be avoided, source and use a ‘safer sharp’ device If a safer sharp device is not available, then safe procedures for working with & disposal must be in place (sticky mats, sharps bins, safety procedures & training) Follow manufacturers’ instructions for safe use and disposal Needles must not be re-sheathed/recapped or disassembled after use Sharps must not be passed directly hand to hand Sharps must be discarded at the point of use by the person who used it Always dispose of needles and syringes as 1 unit If a safety device is being2/2/2024 used safety Standard mechanisms Infection Control 6 must be 39 Precautions Thank you 2/2/2024 Standard Infection Control 40 Precautions References https://www.england.nhs.uk/national-infection- prevention-and-control- manual-nipcm-for- england/chapter-1-standard-infection-control- precautions- sicps/ file:///C:/Users/judith.rukweza/Downloads/WHO-UHL- IHS-IPC-2022.1- eng.pdf 2/2/2024 Standard Infection Control 41 Precautions