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EN V IRONM E NT OF C A RE

1. 30. EN V IRONM E NT OF C A RE. PATHOGEN SURVIVAL. INDIRECT C O N T ACT. In v o l v e s to u c h i n g s om e th i ng with g e rms on i t , su c h as a d o o r k n o b a n d t h e n t r a n s fe r ri n g t he g e rms to y o u r s e lf or a p at i e n t. K e y boards T elephones.

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EN V IRONM E NT OF C A RE

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  1. 1

  2. 30 ENVIRONMENTOF CARE

  3. PATHOGEN SURVIVAL

  4. INDIRECT CONTACT Involves touching somethingwithgermsonit, such as a doorknoband then transferring the germsto yourself ora patient. • Keyboards • Telephones • DoorKnobs • Bedrails Equipment Keyboards Telephones 31

  5. CLEAN VS. CONTAMINATED • Linencarts remaincoveredatall times • Keepcontaminatedlinen offfloor & chairs • Items removedfrom a clean areaare considered • contaminated • Usedequipmentis alwaysconsidered • contaminated • return toCentral Supplyfor decontamination • OR • ensureitem iscleanedbeforereuse 32

  6. CLEANVS.CONTAMINATED Itemsremovedfroma cleanareaareconsideredCONTAMINATED • Including: • Linen • Supplies • Equipment • PPE • Food Patientsinisolationshouldbeprovidedwith Disposable Items DedicatedEquipment

  7. PATIENTCAREEQUIPMENT Disposable:useonceanddiscard SinglePatient:useitemfortheentirehospitalstay, discardwhenvisiblysoiled Reusable: itemsarecleanedanddisinfected betweeneachpatientorreturnedto CentralSupplyforreprocessing (dependingonitem) 34

  8. REUSABLEEQUIPMENT ITEMSWITHNOVISIBLEBLOODOR SOIL 1. Disinfectwithmanufacturerrecommended disinfectant(1 Step) 35 ITEMSWITHVISIBLEBLOODOR SOIL Cleanbyremovingvisiblesoil or blood Disinfectafter removingvisiblesoil (2 steps)

  9. DISINFECTION “ContactTime” or “WetTime” Thelengthoftime adisinfectantmustremain onasurfacetoeffectivelyeliminatepathogens. 2 minutes 5 minutes

  10. SOILED LINEN • Weargloveswhenhandling • Placeinblueleaksistantbag • 2/3full,taketosoiledutility • Don'tagitate,shake,sort,rinse • Don'tholdagainstclothes • Don'tplaceonchairs,tables, floors,hallway

  11. NO SPECIAL HANDLING REQUIRED CDCstates that detergentwith thetemperatureofthewaterand dryingcycle is sufficientto kill bacteriaandviruses.

  12. DIET TRAYS AND UTENSILS No specialhandling required Detergent,water temperature,and dishwasherdryingcycle is sufficienttokill bacteriaand viruses No need for disposable trays for isolation patients

  13. MEDICALWASTE 40

  14. UNREGULATEDWASTE • DEPOSITINAREGULARTRASH CONTAINER • Urine • Vomit • Sputum • Feces • NasalSecretions • Sweatandtears 41

  15. REGULATEDWASTE • Soakedor saturatedinbloodor bodyfluids • Itemscapableof cakingawaydriedbloodor • regulatedbodyfluids • Closeddrainagesystemsnotemptied • Tubing from bloodproducttransfusions • BioSafetyLevel4 Isolationwaste • Laboratoryspecimen,cultures • Sharpswaste(sharpscontaineronly) • Biohazardlabeledspecimenbags 42

  16. WHAT’S RIGHT? • No medication left in the IV bag • No sharps attached • PHI is covered with an “identi-hide” label tBagisproperlytied -not overfilled.

  17. WHAT’S WRONG BiohazardWaste (blood)ismixed withregulartrash 45

  18. WHAT’S WRONG Pharmaceutical andregularwaste mixedwith Biohazardwaste

  19. WHAT’S WRONG Biohazard waste (blood/body fluid) & Sharpswastein thesamecontainer, missingboththelid andtheliner 47

  20. WHAT’S WRONG 48

  21. PHARMACEUTICALWASTE • Syringes,tubexes,carpujectswithresidualpourableor scrapablemedicationIVbags/tubingwithresidualpourable medicationsuch asInsulin,Heparin,Lasix • Partiallyusedvials,tablets,capsules,powders,liquids,creams lotions,shampoos,patches,suppositories,nose/eyedrops 49

  22. SHARPSWASTE • Consideredbiohazardwaste • Donotrecap bend,break, recap,shear,unless: • there is nofeasiblealternative • requiredbyspecific medicalprocedure • usea mechanicaldeviceor aone-handed • technique • Oncecontaineris 3/4fullclose thelidand • contact EVSto replace • NEVERPUTTRASHINASHARPSCONTAINER 50

  23. REFERENCES Jane D.Siegel,MD;EmilyRhinehart,RN MPH CIC;MargueriteJackson, PhD; Linda Chiarello,RN MS;theHealthcare InfectionControlPracticesAdvisoryCommittee(2007). GuidelineforIsolationPrecautions: Preventing Transmission ofInfectiousAgentsin Healthcare Settings.http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf ChiarelloL,JacksonM,RhinehartE, SiegelJD,and theHealthcare InfectionControl PracticesAdvisoryCommittee(HICPAC)(2006).ManagementofMultidrug-Resistant OrganismsInHealthcareSettings. http://www.cdc.gov/hicpac/pdf/MDRO/MDROGuideline2006.pdf WilliamA.Rutala, Ph.D.,M.P.H.,DavidJ. Weber,M.D.,M.P.H.,and theHealthcare InfectionControl PracticesAdvisoryCommittee(HICPAC)(2008)Guidelinefor Disinfectionand Sterilizationin Healthcare Facilities,CentersforDiseaseControl and Prevention.http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf LynneSehulster, Ph.D.,RaymondY.W.Chinn, M.D.,CenterforDiseaseControland Prevention /Healthcare InfectionControlPracticesAdvisoryCommittee(HICPAC) (2003),GuidelinesforEnvironmentalInfectionControlinHealth-CareFacilities http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm 53

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