Introduction To Infection Control (Nilai University) PDF

Introduction to Infection Control  Infection Control Learning Outcomes: 1. Explain the importance of infection control. 2.List the 5 moments of hand hygiene 3. Explain the standard precautions of infection control. 4. Observe infection control measures/procedures during the care of...

Introduction to Infection Control  Infection Control Learning Outcomes: 1. Explain the importance of infection control. 2.List the 5 moments of hand hygiene 3. Explain the standard precautions of infection control. 4. Observe infection control measures/procedures during the care of client.  Infection Control Infection Control is a QUALITY STANDARD OF Patient Care Is Essential for: PATIENT WELL BEING and PATIENT AND STAFF SAFETY OBJECTIVE: To Prevent, Control and Monitor Infection in the Hospital  Infection Control A HOSPITAL INFECTION CONTROL COMMITTEE HEADED BY THE DIRECTOR OR A DOCTOR MEETS ONCE IN 3MONTHS  Infection Control INFECTION CONTROL LINK NURSES MEET ONCE EVERY MONTH TO DISCUSS: COMPLIANCE / NON-COMPLIANCE WAYS TO IMPROVE (USE THE DATA) UPDATE ON INFECTION CONTROL  RESPONSIBILITY OF I/C TEAM Safe & clean environment Availability of sterile water for invasive procedure Availability of safe food Availability of clean air supply (Specialty areas – OT, ICU, NURSERY, LABOUR ROOM)  Infection Control Ensures that: Specialty areas and isolation rooms have standard guidelines & facilities for hand washing. Available safe drinking water. Proper traffic flow of clean and soiled items. Clearly written policies and procedures.  Standard Precautions ❖WASH HANDS (liquid soap) wash after touching blood, bloody fluids, secretions and contaminated items wash immediately after gloves are removed and between patient contacts -> avoids transfer of microorganisms to other patients/oneself/another nurse or to the environment  CDC (HICPAC) Isolation Precautions Healthcare Infection Control Practices Advisory Committee 2 Tiers of Precautions: Standard precautions Transmission-Based Precautions Standard Precautions Designed for clients in the hospital Precautions apply to: blood all body fluids excretions & secretions (except sweat) non-intact skin mucous membranes  Designed to reduce risk of transmission of microorganisms from recognized & unrecognized sources Recommendations: 1. perform hand hygiene after contact with body fluids, secretions, excretions & contaminated objects whether or not gloves are worn 2. Wear clean gloves when touching blood, body fluids, secretions, excretions and contaminated items ( ex. gowns) 3. Wear a mask, eye protection, or a face shield if splashes or sprays of blood, body fluids, secretions or excretions can be expected. 4. Wear a clean, non-sterile gown if client care is likely to result in splashes or sprays of blood, body fluids, secretions, or excretions 5. Handle client care equipment that is soiled with blood, body fluid, secretions and excretions carefully to prevent transfer of microorganisms to others and to the environment 6. Handle, transport and process linen with blood…etc in a manner to prevent contamination of clothing and transfer of microorganism to others and the environment 7. Prevent injuries from used scalpels, needles, or other equipment and place in puncture- resistant containers. Transmission-Based Precautions Airborne precautions 1. Place client in a private room with negative air pressure of 6-12 air exchanges/hr. 2. If a private room is not available, place client with another client infected with the same microorganism. 3. Wear a respiratory device (N95 respirator) when entering the room of a client known or suspected with primary tuberculosis 4. Susceptible persons, unless wearing respirator should not enter the room of a client who has rubella or varicella. 5. Limit movement of client outside the room. Place surgical mask/respirator on the client during transport.  Droplet Precautions 1. Place client in a private room. 2. If private room is not available, place client with another client who is infected with the same microorganism. 3. Wear a mask if working within 3 feet of the client. 4. Limit movement of client outside the room. Place surgical mask/respirator on the client during transport.  Contact Precautions 1. Place client in a private room. 2. If private room is not available, place client with another client who is infected with the same microorganism. 3. Wear gloves as described in standard precautions. *note: if client is infected with C. difficile do not use an alcohol-based hand rub. Use soap and water. 4. Wear a gown when entering a room if there is a possibility of contact with infected surfaces or items or if the client is incontinent or has diarrhea, a colostomy or wound drainage not contained by a dressing. 5. Limit movement of client outside the room. 6. Dedicate the use of non-critical care equipment to a single client or to clients with the same infecting microorganisms. ❖WEAR GLOVES When touching blood, bloody fluids, secretions,excretions and contaminated items Put on clean gloves just before touching mucous membrane and non intact skin Change gloves between tasks and procedures Remove gloves promptly Wash hands immediately ❖ WEAR MASK AND EYE PROTECTION OR FACE SHIELD Protect mucous membranes of the eyes, nose and mouth during procedures and patient- care activities that are likely to generate splashes or sprays of blood, body fluids, secretions or excretions WEAR GOWN Protect the skin and prevent soiling of clothing during procedures that are likely to generate splashes and sprays of blood, body fluids, secretions or excretions. Remove a soiled gown as promptly as possible and wash hands to avoid transfer of microorganisms to other patients. Patient Care Equipment Handle used patient- care equipment soiled with blood, body fluids, secretions or excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing and transfer of microorganism to other patient and environment ENVIRONMENTAL CONTROL Follow hospital procedures for routine care, cleansing and disinfection of environmental surfaces, beds, bedrails, bedside equipment and other frequently touched surfaces. LINEN Handle, transport and process used in linen soiled with blood, body fluids, secretions or excretions in a manner that prevents exposures and contamination of clothing and avoids transfer of microorganism to other patients and environment OCCUPATIONAL HEALTH AND BLOODBORNE PATHOGENS Prevents injuries when using needles, scalpels and other sharp instruments or devices When handling sharp instruments after procedures When cleansing used instruments When disposing of used needles  NEVER RECAP USED NEEDLES USING BOTH HANDS Use either one-handed “scoop” technique or a mechanical device designated for holding the needle sheath. Do not remove used needles from disposable syringes by hand, bend ,break or manipulate the needles by hand. Place used disposable syringes and needles, scalpel blades and other sharp items in puncture-resistant containers. One-hand Needle Recapping  Use Resuscitation devices as an alternative to mouth-to-mouth resuscitation Patient Placement Use a private room for a patient who contaminates the environment or who does not (cannot be expected to) assist in maintaining appropriate hygiene or environmental control Resuscitation Devices  INFECTION CONTROL IS A TEAM EFFORT FOR PATIENT COMFORT AND SAFETY Handwashing  Think pair and share What is hand washing? ASEPSIS Asepsis → Is defined as the absence of disease producing micro organisms Types of Asepsis – MEDICAL – SURGICAL  MEDICAL ASEPSIS Clean technique Includes procedures used to reduce and prevent the spread of microorganisms hand hygiene Using clean gloves to prevent direct contact with blood or body fluids Cleaning the environment routines Washing hands before preparing food An area or object is considered contaminated if it contains or is suspected of containing pathogens  SURGICAL ASEPSIS Sterile technique Includes procedures used to eliminate all microorganisms, including pathogens and spores, from an object or area In surgical asepsis an area or object is considered contaminated if touched by any object that is not sterile HAND HYGIENE Control Disease Center (CDC), (2002), pg.4 published new hand washing guidelines Terminology and definitions: ✓Hand hygiene: A general term that applies to either hand washing, antiseptic hand wash, antiseptic hand rub or surgical antiseptic hand wash  HAND HYGIENE ✓Hand washing: Washing hands with plain (i.e. non antimicrobial) soap and water ✓Antiseptic hand wash: Washing hands with water and soap or other detergents containing an antiseptic agent  HAND HYGIENE ✓Antiseptic hand rub: Applying an antiseptic hand rub product to all surfaces of the hands to reduce the number of microorganisms ✓Surgical hand antisepsis: Antiseptic hand wash or antiseptic hand rub performed preoperatively by surgical personnel to eliminate transient and reduce resident hand flora. Antiseptic detergent preparation often have persistent antimicrobial activity ANTISEPTIC HAND WASHING Most basic and effective infection control measure Component of all types of isolation precautions  ANTISEPTIC HAND WASHING Hand washing – Is a vigorous ,short, rubbing together of all the surfaces of the soap lathered hands, followed by rinsing under a stream of running water – Is the rubbing together of all surfaces and of the hands using soap or chemical and water Hand washing elements - soap / chemical, water WHO’s 5 moments of hand hygiene ANTISEPTIC HAND WASHING WHY?  ANTISEPTIC HAND WASHING Why? Bacteria recovered from the hands could be divided into two categories, namely transient or resident RESIDENT FLORA consists of microorganisms residing under the superficial cells of the stratum corneum, and can also be found on the surface of the skin  ANTISEPTIC HAND WASHING Why? RESIDENT FLORA Staphylococcus epidermidis is the dominant species, and oxacillin resistance is extraordinarily high, particularly among HCWs In general, resident flora is less likely to be associated with infections, but may cause infections in sterile body cavities, in the eyes, or on non-intact skin  ANTISEPTIC HAND WASHING Why? TRANSIENT FLORA colonizes the superficial layers of the skin, is more amenable to removal by routine hand washing Transient microorganisms do not usually multiply on the skin, but they survive and sporadically multiply on skin surface ANTISEPTIC HAND WASHING Why? The transmissibility of transient flora depends on the species present, the number of microorganisms on the surface, and the skin The hands of some Health Care Workers (HCWs) may become persistently colonized by pathogenic flora such as S. aureus, Gram-negative bacilli, or yeast  TRANSMISSION OF PATHOGENS ON HANDS Transmission of health care-associated pathogens from one patient to another via HCWs’ hands requires five sequential elements:  TRANSMISSION OF PATHOGENS ON HANDS 1. Organisms are present on the patient’s skin, or have been shed onto inanimate (non living things) objects immediately surrounding the patient 2. Organisms transferred to the hands of HCWs  TRANSMISSION OF PATHOGENS 3. Organisms capable of surviving for at least several minutes on HCWs’ hands 4. Hand washing or hand antisepsis by the HCW must be inadequate or entirely omitted, or the agent used for hand hygiene inappropriate TRANSMISSION OF PATHOGENS 5. The contaminated hand or hands of the caregiver must come into direct contact with another patient or with an inanimate object that will come into direct contact with the patient  ANTISEPTIC HAND WASHING Most significant control measure for the prevention of nosocomial infection Single, most important control measure to break the chain of infection Prevents cross – contamination between patients, equipment's and health care providers  ANTISEPTIC HAND WASHING WHEN ??? After Arriving At Work Before Leaving Work Between Client Contacts After Removing Gloves When Hands Are Visibly Soiled After Contact With Body Fluids. Before And After Invasive Procedure After Handling Contaminated Equipment  ANTISEPTIC HAND WASHING WHEN ??? In accordance with Occupational Safety and Health Administration (OSHA) requirements, CDC recommends hand washing at the following times: Before patient contact Before putting on sterile gloves Before inserting catheters  ANTISEPTIC HAND WASHING WHEN ??? – After contact with a patient's intact skin (i.e. when taking pulse or blood pressure) – After contact with bodily fluids – When moving from a contaminated-body site to a non contaminated-body site – After contact with inanimate objects – After removing gloves – Before eating and after using a restroom  Hand Washing Procedure MEDICAL HAND WASHING vigorous, brief rubbing together of all surfaces of hands lathered in soap followed by rinsing under a stream of water Indications: Before contact with patients who are susceptible to infections After touching organic materials Before and after handling dressing or touching open wounds Purposes: Reduce the number of microorganism on the hands. Reduce the risk of transmission of microorganisms to clients. Reduce the risk of cross-contamination among clients. Reduce the risk of transmission of infectious organisms to oneself. Equipment: soap warm running water disposable or sanitized towels Preparations: ✓assess the nails (short); check for skin break or wounds ✓remove jewelry Applying friction Health Teaching of Medical Asepsis practices recommended at home: Washing hands before preparing food and before eating Preparing foods at temperatures high enough to ensure that they are safe to eat (fresh meat) Using care with cutting boards and utensils and washing hands before and handling raw meat Keeping foods refrigerated, especially those containing mayonnaise Health Teaching of Medical Asepsis Practices Recommended at home: Washing raw fruits and vegetables before serving them Using pasteurized milk and fruit juices Washing hands after using the bathroom Using individual personal care items (washcloths, towel and toothbrushes rather than sharing) Prevent infection in public facilities by following the guidelines: Wash hands after using any public bathroom Use paper towels or hot-air dryers in restroom Use individually wrapped drinking straws Use tongs to lift food from common service trays in cafeterias, food stores or salad bars Community medical asepsis practices: Using sterilized combs and brushes in barber and beauty shops Performing examination of food handlers for evidence of disease Encouraging food handlers to receive the hepatitis A vaccination Enforcing frequent handwashing by food handlers  Recap 1. Explain the importance of infection control. 2.List the 5 moments of hand hygiene 3. Explain the standard precautions of infection control. 4. Observe infection control measures/procedures during the care of client. Thank you!