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Infection Control Principles and Practices Session 4

Infection Control Principles and Practices Session 4. Infection Control for LPHA Train the Trainer Course August 25, 2005 . Chain of infection Standard precautions Transmission-based precautions Attachments from PHEP. Topics. Objectives.

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Infection Control Principles and Practices Session 4

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  1. Infection Control Principles and PracticesSession 4 Infection Control for LPHA Train the Trainer Course August 25, 2005

  2. Chain of infection Standard precautions Transmission-based precautions Attachments from PHEP Topics

  3. Objectives • Understand the various precautions used to prevent disease transmission • Be able to practice the correct precautions for a given disease and task

  4. Agent ↓ Reservoir ↓ Portal of exit ↓ Mode of transmission ↓ Portal of entry ↓ Susceptible host Chain of Infection

  5. Standard Precautions Method of infection control that uses • work practices, • engineering controls, and • personal protective equipment (PPE) to reduce or eliminate exposure to infectious agents.

  6. Standard precautions 1) Work practices • hand hygiene • no eating, drinking in areas with risk of transmission • no re-capping of used needles 2) Engineering controls • safety devices on sharp medical devices • sharps containers • hand washing facilities

  7. Standard precautions • PPE • used as last resort when exposure has not been eliminated by work practices and engineering controls • provides protection to skin, clothing, nose, mouth, eyes • examples: gowns, gloves, goggles, masks

  8. Standard precautions • considers all person potentially infectious • applies to all individuals, regardless of presence/type of symptoms • used against exposure to blood, all body fluids, secretions, excretions (except sweat), mucous membranes, non-intact skin

  9. Standard precautions • hand hygiene • infectious waste management • sharps safety devices • PPE • respiratory hygiene/cough etiquette

  10. Standard precautions • Hand hygiene • sinks, soap, paper towels available in convenient locations • alcohol gel in convenient locations for staff

  11. Standard precautions • Wash hands: • before and after client contact • after removing gloves and other PPE • after contact with contaminated surfaces and items, specimens, even when gloves are worn • before eating or drinking • after using restroom • after coughing, sneezing, blowing nose

  12. Standard precautions CDC Hand Hygiene Guidelines • Wash with soap and warm water, using friction for at least15 seconds. Dry with a paper towel. Finally turn off the faucet with a clean paper towel. • Use of alcohol hand sanitizer is the preferred method of hand hygiene in health care settings.

  13. Standard precautions • Infectious waste management • sharps containers • puncture resistant • leak-proof, closable • labeled with biohazard symbol or red • do not overfill

  14. Standard precautions • Infectious waste management • biohazard bags • for disposal of items with blood, body fluids that are • pourable • dripable • squeezable • flakable

  15. Standard precautions • Infectious waste management • LPHA can haul waste without license if weight does not exceed 50 pounds per month • keep log of waste disposal • date • amount and description (e.g. 5 sharps containers) • destination • transported by

  16. Sharps safety devices Needlestick Safety and Prevention Act mandates use of sharps with engineered safety devices users must evaluate Standard precautions

  17. Personal protective equipment gloves gowns aprons goggles, face shields surgical/procedure masks respirators Standard precautions

  18. Standard precautions • Respiratory hygiene/cough etiquette • cover mouth and nose with tissue when coughing, sneezing • immediately toss tissue • wash hands with soap and water or use alcohol gel • have client wear mask if possible • barriers for front line staff

  19. Respiratory hygiene/cough etiquette supplies tissue alcohol gel waste baskets education posters signs Standard precautions

  20. Standard precautions • Additional work practices • restriction of eating, drinking, applying makeup in areas of contamination • exclusion of sick staff • exclusion of ill clients from LPHA when possible

  21. Transmission-basedprecautions Measures practiced in addition to standard precautions that are based on the confirmed or suspected presence of a specific communicable disease, and the mode(s) of transmission of that disease

  22. Modes of transmission • contact • droplet • airborne • common vehicle • vector-borne

  23. Modes of transmission • Contact transmission • direct: person to person by physical contact • indirect: person to intermediary object to person • hands • contaminated items, equipment, surfaces • most common mode of transmission

  24. Modes of transmission • Diseases spread by contact transmission • staph skin infections • norovirus • rotavirus • hepatitis A

  25. Modes of transmission • Droplet transmission • large particle droplets (5microns or greater) come in contact with mucous membranes (eyes, nose, mouth) • occurs during coughing, sneezing, talking, performing suctioning or bronchoscopy • droplets travel approx. 3 feet, then fall

  26. Modes of transmission • Diseases spread by droplet transmission • pertussis • influenza • mumps • Diseases spread by droplet and contact transmission • adenovirus • SARS (also airborne transmission)

  27. Modes of transmission • Airborne transmission • droplets evaporate into droplet nuclei (less than 5 microns) that can spread via air currents for up to 25 feet • requires special air handling

  28. Modes of transmission • Diseases spread by airborne transmission • TB • measles • Diseases spread by airborne and contact transmission • SARS • monkeypox • smallpox • disseminated shingles

  29. Transmission-based precautions Contact precautions • physical separation of infectious persons (exclusion from work, school, daycare, social settings, crowded areas) • use of private rooms/areas • cleaning/disinfection of environment/contaminated equipment and surfaces/patient care items • hand hygiene • use of PPE

  30. Transmission-based precautions Droplet precautions • physical separation of infectious persons (exclusion from work, school, daycare, social settings, crowded areas) • maintain distance of ≥ 3 feet • use of private rooms/areas • use of PPE

  31. Transmission-based precautions Airborne precautions • no shared air • negative pressure rooms: 6-12 air exchanges/hour, exhaust directly to outside or filtered first, or use of portable HEPA filtration units • physical separation of infectious person • use of PPE

  32. Quiz time(see notes page for answer) List the types of IC precautions used to reduce transmission of SARS and smallpox. • ___ • ___ • ___ plus________

  33. References • Siegel JD, et al. CDC HICPAC, “Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007.” • http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/Isolation2007.pdf • OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030 • http://www.osha.gov/SLTC/bloodbornepathogens/index.html • WI Public Health Emergency Plan

  34. Infection Control Principles and Practices Gwen Borlaug, CIC, MPH Infection Control Epidemiologist Bureau of Communicable Diseases 1 West Wilson Street Room 318 Madison, WI 53701 608-267-7711 gwen.borlaug@wisconsin.gov

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