Infection Control Techniques

1. Infection Control Techniques

2. Learning Outcomes • 10) Demonstrate mastery of concepts and skills related to asepsis, Universal Precautions, sanitation, disinfection, and sterilization for patient/client care settings in adherence to standards and guidelines from the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) in a lab/clinical setting. (TN Reading 3) • At the conclusion of today’s class I CAN: • Define key terms related to infection control • Compare and contrast sanitation disinfection and sterilization • Describe the significance of the CDC and OSHA related to workplace safety in healthcare

3. Introduction • Patients coming to the office for treatment may be more susceptible to infections • Immunizations and patient education are important methods of infection control You will be introduced to Occupational Safety and Health Administration (OSHA) guidelines, the Blood-Borne Pathogen Standard, reporting guidelines, and isolation procedures.

4. Employee’s Role in Infection Control • To control infectious diseases, the cycle of infection must be broken • Apply principles of infection control in workplace setting

5. Employee’s Role in Infection Control (cont.) • Follow correct sanitization, disinfection, and sterilization procedures • Help patients understand basic disease prevention • Educate patients about immunizations • Administer immunizations

6. Apply Your Knowledge What is the role of the healthcare professional in controlling infection in the medical office? ANSWER: To apply principles of infection control by following correct sanitization, disinfection, and sterilization procedures. Correct!

7. Infection Control Methods • Eliminate elements needed for disease to occur • Knowledge of • Medical asepsis • Based on cleanliness • As few microorganisms as possible • Surgical asepsis • Sterile environment • No microorganisms

8. Medical Asepsis • Keep work area clean: • Reception area: sick vs. well patients • Reception room clean, well lit, and ventilated • No sick visitors in hospital • Limit visitors during cold and flu season • Keep furniture in good repair • Strict “no food or drink” policy • Empty trash as necessary

9. Medical Asepsis (cont.) • Hand washing • Beginning of day • After breaks • Before and after each patient • Before and after handling equipment or specimens • After blowing your nose or coughing • Before and after eating

10. Medical Asepsis (cont.) • Other precautions • Avoid leaning against sinks, supplies, equipment • Avoid touching your face and mouth • Use tissues when you cough or sneeze, and always wash your hands afterward • Avoid working directly with patients when you have a cold; wear gloves and mask if you must • Stay home if you have a fever

11. Apply Your Knowledge Describe the difference between medical and surgical asepsis. ANSWER: Medical asepsis is based on cleanliness and reducing the number of microorganisms as much as possible. Surgical asepsis is maintaining a sterile environment by eliminating all microorganisms. Good Answer!

12. Sanitation • Used to promote health and prevent disease. • the process of keeping places free from dirt, infection, disease, etc., by removing waste, trash and garbage, by cleaning streets, etc.

13. Sanitization • Scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow • For cleaning items that touch only healthy, intact skin OR • First step in disinfection and sterilization for other equipment

14. Sanitization (cont.) • Collect items for sanitization • Place in water and special detergent solution • Use utility gloves • Separate sharps from other equipment • Scrub items • Follow manufacturers’ guidelines • Dry thoroughly • Examine carefully • Rubber and plastic items • Syringes and needles – use disposable whenever possible

15. Apply Your Knowledge What is sanitation, and what types of items is it adequate for cleaning? ANSWER: Sanitation is scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow. It is adequate for cleaning items that touch only healthy, intact skin. Can also include removing trash. Nice Job!

16. Disinfection • Adequate for instruments that do not penetrate skin or mucous membranes and surfaces not considered sterile OR • Second step in infection control prior to sterilization • Will not kill spores, certain viruses

17. Disinfection (cont.) • Using disinfectants • Cleaning products applied to inanimate materials to reduce or eliminate infectious organisms • Antisepticsare anti-infective cleaning agents used on human tissue • Follow manufacturers’ guidelines

18. Factors impacting effectiveness of disinfectants Number of times solution is used Wet items – surface moisture may dilute solution Traces of soap left from sanitization – alters chemical composition Evaporation Disinfection (cont.)

19. Disinfection (cont.) • Choose the correct disinfectant • Germicidal soap products • Alcohol • Acid products • Formaldehyde • Glutaraldehyde – “cold disinfection” • Bleach • Iodine and iodine compounds

20. Disinfection (cont.) • Handling disinfected supplies • Prevent contamination with other surfaces • Use sterile transfer forceps • Wear gloves • Store in clean, moisture-free environment

21. Apply Your Knowledge What is the difference between a disinfectant and an antiseptic? ANSWER: Disinfectants are cleaning products applied to inanimate materials to reduce or eliminate infectious organisms. Antiseptics are anti-infective cleaning agents used on human tissue. Excellent!

22. Surgical Asepsis • Goal is to keep the surgical environment completely free of all microorganisms • Used for even minor operations and injections • Surgical includes ANYTHING that penetrates the skin • The more extensive the procedure, the greater the risk of infection

23. Sterilization • Required for all instruments or supplies that • Penetrate the skin • Contact normally sterile areas of the body • Object is either sterile or not sterile • If unsure of sterility, consider it not sterile • Prior to sterilization • Sanitize • Disinfect

24. The Autoclave • Primary method of sterilization • Pressurized steam • Operates at lower temperatures than dry heat sterilization • Moisture causes coagulation of proteins in microorganisms at lower temperatures • Cell walls burst when cell cools, killing the microorganism

25. Prevent incomplete sterilization Correct timing Adequate temperature Properly wrapped packs Adequate steam levels Timing Preset for load types Use sterilization indicators The Autoclave (cont.)

26. The Autoclave (cont.) • Temperature • Too high – steam too little moisture • Too low – steam too much moisture • Do not overcrowd autoclave • Steam level • If incorrect, items will not be sterile at end of cycle

27. Sterile Technique • Strict adherence to set order of procedures • Sterile against sterile • Clean against clean • Unclean against unclean • Surgical scrub • Never skimp on a surgical scrub!

28. Surgical Asepsis • During surgical procedures • Do not touch sterile items without sterile gloves or transfer forceps • Aseptic technique • Throughout surgical procedures • Caring for surgical wounds

29. Surgical Asepsis (cont.) • After procedures • Sanitize, disinfect, and sterilize reusable items • Disinfect surfaces • Waste disposal • Biohazard waste containers • Leak-proof containers either color-coded red or labeled with biohazard symbol • Biohazardous materials • Biological agents that can spread disease to living things

30. Apply Your Knowledge 1. What items need to be sterilized? ANSWER: Sterilization is required for all instruments or supplies that penetrate the skin or come in contact with normally sterile areas of the body.

31. Apply Your Knowledge 2. The physician is going to remove a small growth from your patient’s back. In order to prepare for this procedure, what steps would you take to prevent the spread of infection? ANSWER: Use medical asepsis while preparing the patient, and then use surgical asepsis during the procedure. Right!

32. OSHA Guidelines • Blood-Borne Pathogen Standards • Protect health-care workers from health hazards on the job • Also protect patients and others who come to medical facilities • Dictate how to handle infectious or potentially infectious wastes • Discarded • Held for processing • Blood-borne pathogens can enter the skin through any opening, break in skin, or mucous membranes

33. OSHA Guidelines (cont.) • Blood-Borne Pathogen Standards • Measures to prevent the spread of infection • Provide a margin of safety by ensuring that medical facilities meet minimal standards for asepsis • Requirements for training, keeping records, housekeeping, and personal protective gear

34. OSHA Guidelines (cont.) • Universal Precautions • Prevent health-care workers from exposure to infections • Assume that all blood and body fluids are infected with blood-borne pathogens

35. OSHA Guidelines (cont.) • Standard Precautions • Combination of Universal Precautions and Body Substance Isolation guidelines • Used in health-care facilities to prevent transmission of disease

36. OSHA Guidelines (cont.) • Categories of tasks • Tasks that expose a worker to blood, body fluids, or tissues and require specific protective measures • Tasks that usually do not involve risk of exposure but require precautions in certain situations • Tasks that have no risk of exposure, so no special protection is required

37. Respiratory Hygiene/Cough Etiquette • Guidelines established by CDC • Education • Posting signs • Controlling source or transmission • Proper hand hygiene • Separating patients with respiratory infections from other patients

38. BBP Safety • Flush your eyes for 10 minute if blood or potentially infectious materials are splashed into your eye • Always dispose of sharps in approved container • NEVER EVER RECAP • Use ¼ cup bleach:1 gal water to effectively decontaminate most surfaces. Leave for 10 minutes

39. Personal Protective Equipment • Protective gear worn to protect against physical hazards • Employers must provide PPE at no charge to the employee • Disposable, sterile exam and utility gloves • Masks and protective eyewear or face shields • Protective clothing

40. Postprocedure Cleanup • Pick up any broken glass with tongs • Discard all potentially infectious waste materials • Decontaminate all exposed surfaces • Replace protective coverings on surfaces or equipment • Decontaminate receptacles

41. OSHA Guidelines (cont.) • Apply guidelines daily on the job • Exposure incidents • Contact with infectious substance • Rules apply to all serious infections – HIV, HBV • HBV vaccine • Transmission to patients • Nosocomial infection – an infection acquired by a patient in a health-care facility

42. Apply Your Knowledge OSHA divides medical tasks by level of risk. What are these risk categories? • ANSWER: There are three categories of risk: • Category 1: Expose a worker to blood, body fluids, or tissues and require specific protective measures • Category 2: Usually do not involve risk of exposure, but precautions are required in certain situations • Category 3: No risk of exposure, so no special protection is required

43. Apply your knowledge Mary was a patient in the hospital after suffering from a broken hip. Two days after admission she began running a fever. She was diagnosed with a Urinary Tract Infection. What type of infection is this? Nosocomial Infection

44. Reporting Guidelines • Certain diseases must be reported to state or county health department • Information is forwarded to the CDC – control of the spread of infection

45. Reporting Guidelines (cont.) • National Notifiable Disease Surveillance System (Table 33-2) • Examples • HIV/AIDS  Cholera • Rubella  Hepatitis • Legionellosis  Lyme disease • Mumps  Smallpox • Tetanus  Tuberculosis

46. Apply Your Knowledge How is the information on reportable diseases used by the CDC? ANSWER: The CDC uses the information reported to them to help control the spread of infection. Good Answer!

47. Isolation Guidelines • CDC guidelines • Types of precautions needed • Patients requiring precautions • Create an environment that protects against pathogens • Standard Precautions

48. Isolation Guidelines (cont.) • Select appropriate PPE • Gloves • Masks, face shields, respirators • Gowns

50. Apply Your Knowledge Mrs. Findley brings her child with chickenpox into the medical office. What type of personal protective equipment should you use when caring for this child? ANSWER: Chickenpox requires airborne and contact precautions, so you should use gloves and a mask and goggles or a respirator. Nice!