Infection Prevention & Control Program

1. BERGEN REGIONAL MEDICAL CENTER Infection Prevention & Control Program SAFETY For PATIENTS & STAFF Through INFECTION CONTROL To go to the next page, click the forward and reverse symbols below:

2. All 6 of theses LINKS IN THE INFECTION CHAIN must be present for an infection to start. Infectious Agent Any organism that can cause disease: Ex: bacteria, virus, fungi Susceptible HostPeople lacking resistance. Ex: young, old, immunosuppressed, immunocompromised Host Carrier of disease Ex: patients, staff, visitors CHAIN OF INFECTION Portal of Entry A way into another person. Ex: breathing, eating, breaks in skin, catheters, IV’s Portal of Exit A way out of the host Ex: blood, body fluids, sneezing, coughing Means of Transmission A way to get from one person to another. Ex: direct contact: dirty hands, wounds, bandages. Indirect contact: contaminated air or objects

3. To Control and Prevent Infections… Follow These Simple Guidelines WASH YOUR HANDS Hand hygiene is the single most effective way of preventing the spread of infections.

4. When to Wash Your Hands: When reporting to work, after contact with a source of microorganism (i.e., body fluids and substances, non-intact skin, inanimate objects that are likely to be contaminated) During medication pass Before and after patient contact Before and after glove use When leaving work After using the toilet Before and after eating When hands are visibly soiled

5. Fingernails Fingernails must be kept short, clean, and maintained in good condition and less than ¼ inch in length. All personnel providing direct patient care contact (nurses, respiratory therapists, lab and X-ray technicians, etc.) are not permitted to wear artificial fingernails or extenders.

6. Alcohol-based Hand Sanitizer Purell Dispensers are located throughout the facility! • Apply a “quarter size” squirt into palm of hand • Rub hands together covering all surfaces of hands and fingers until hands are dry

7. Standard Precautions These are to be used at all times when working with patients. Personal protective equipment (PPE) is to be used when contact with blood and body fluids is anticipated: Personal Protective Equipment (PPE): Gowns Goggles Face Shields Masks Gloves

8. Transmission-based Precautions Designed for patients documented or suspected to be infected with transmissible pathogens for which additional precautions beyond Standard Precautions are needed. There are 3 types of Transmission-based Precautions… AIRBORNE DROPLET CONTACT

12. BRMC’s OSHA EXPOSURE CONTROL PLAN

13. POST EXPOSURE PROTOCOL Remember Hotline #: 5795 (24hrs /day)

14. Bloodborne Pathogens Bloodborne pathogens are viruses, bacteria and other microorganisms that are borne (carried) in a person’s blood stream and cause disease. If a person comes in contact with blood infected with a bloodborne pathogen, he or she may become infected as well.

15. A Closer Look at Three Bloodborne Pathogens *** HBV Vaccine available free to all employees ***

16. These pathogens can be spread when infected fluids enter the body through: Needle-stick injuries Cuts, scrapes & other breaks in the skin Splashes into the mouth, nose or eyes Oral, vaginal or anal sex Using infected drug needles Tattooing Body piercing Nail salons

17. SAFE SHARPS If unfamiliar with any safety devices ask questions! BRMC complies with New Jersey Safety Needle Law. Employees need to know how to operate and utilize the safety device. Report all needlesticks or sharp injuries, whether clean or contaminated. Used sharps containers cannot be more than ¾ full.

18. What is Pulmonary Tuberculosis? (TB) A Disease caused by BACTERIAUsually affects the LUNGS Spread through the AIR Can be cured by MEDICINE

19. There Are 2 Types of TB… Active TB Disease Latent TB -The Pathogen that causes TB has entered the lungs -There are NO symptoms -The person is NOT contagious -They have a positive Tuberculin Skin Test (TST) -They may never develop Active TB -Have a Positive chest x-ray-Are experiencing symptoms -Will be contagious-Will have to take TB medication for up to one year -May or may not be hospitalized

20. How is Tuberculosis (TB) Spread? TB germs can be spread when a person with TB disease: • COUGHS • SNEEZES • SHOUTS • SINGS SENDING TB GERMS INTO THE AIR….

21. Signs & Symptoms of TB • Fever • Weight Loss • Night Sweats • Constant Tiredness • Cough • Loss of Appetite • Chest Pain

22. Annual TB Testing All employees are screened annually for TB by: • (1) Step PPD if previously known to be non-reactive • Completion of questionnaire for positive TST’s (if previously known as reactive)

23. NEGATIVE PRESSURE ROOMS: • Provides a negative pressure atmosphere for airborne isolation • Used when isolation of a patient is required to prevent the • transmission of an airborne disease • “Airborne Precautions” sign posted on the closed door • PPE: Mask N95 Respirator – must be “fit tested” prior to room entry • Availability: Operating Room, Emergency Room, Clinic, ICU, 11-4, ITCU • Engineering to be notified when precautions are instituted AIR ENTERING ROOM CONTAMINATED AIR LEAVING PATIENT ROOM VIA FAN TO THE OUTSIDE

24. Practice Good Personal Hygiene: • Bathe, shower or wash every day • Prevent dry skin by using creams and oils • Use warm, not hot water and mild soap when bathing • Don’t share personal items such as toothbrushes, • razors, towels, washcloths, combs, hairbrushes and • cosmetics

25. Home Environment Keep your home as clean as possible Keep your kitchen clean and sanitary Wash your dishes in hot soapy water Wash glasses and cutlery that go directly into the mouth first

26. GUARD AGAINST FOODBORNE ILLNESS Keep hot food above 140 degrees Keep cold food below 45 degrees Keep work area clean Prepare food with care Serve food properly

27. IMMUNIZATIONS • Ask your doctor what vaccines you need • The specific kinds will depend on your job, • age, sex and health histor. • Health Care Workers _______

28. Hepatitis B Vaccine is recommended for all: • Healthcare workers exposed to blood and body fluids • Household contacts and sex partners of HBV- positive • persons • Persons with multiple sex partners • All adolescents • Persons undergoing hemodialysis • Recipients of certain blood products • Hepatitis vaccine is given at 0, 1, and 6-month intervals

29. Flu Vaccine is recommended for people who: • Are 65 years or older • Have chronic lung disease or respiratory conditions such as • asthma, emphysema • Have medical conditions such as heart disease, diabetes or • chronic kidney disease • Have diseases or are having treatments that depress • immunity, such as cancer or HIV/AIDS • Are residing in a long-term care facility

30. Pneumococcal Vaccine is recommended for: • People who are 65 years or older • People who may have a high risk conditions, • i.e. chronic lung or heart disease, diabetes, or • compromised immunity

31. BERGEN REGIONAL MEDICAL CENTER The Bergen Regional Medical Center Pandemic Influenza Preparedness Plan is available to provide guidance in the event of a pandemic influenza situation so that the number of deaths and illnesses in the communities, served by the hospital, is minimized while protecting healthcare workers and cooperating with community leadership. Preparedness Plan

32. A GLOBAL THREAT

33. Bioterrorism refers to a deliberate attack by terrorists, releasing biological agents used to cause disease or death in people, animals, or plants.

34. Seasonal (or common) Flu is a respiratory illness that can be spread from person to person. Most people have some immunity, and a vaccine is available. Avian (bird) Flu is caused by influenza A viruses that occur naturally among birds. There are different subtypes of these viruses because of changes in certain proteins on the surface of the influenza A virus and the way the proteins combine. Pandemic Flu occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no vaccine. The disease spreads easily person-to-person, causes serious illness, and can sweep across the country and around the world in very short time.

35. The most efficient way to deliver a bioterror attack is through the use of aerosols.

36. Biological agents may include: bacteria, viruses, and toxins that can be spread through the air, through water, or in food.

37. Terrorists may use biological agents as weapons because: 1. They can be extremely difficult to detect. 2. They do not cause illness for several hours to several days. 3. They are easy to obtain. 4. They are not expensive. 5. They provide easy escape for the perpetrators.

38. Healthcare Facilities prepare for a possible bioterror attack because of the magnitude of devastation that could potentially occur. A bioterrorism attack would not be easily handled by the US Healthcare System, therefore, calling for preparedness drills and plans to be put into place.

39. Potential BioterrorBacterial Agents • ANTHRAX • TULAREMIA • BOTULISM

40. Other Potential Routes of Exposure: Person-to-person transmission (Plague, Smallpox) Consumption of contaminated food/water products (undercooked meat from infected animal, intentional contamination of water supply) Handling contaminated products

41. ANTHRAX Anthrax (Bacillus anthracis)is an acute infectious disease caused by spore forming bacterium.

43. Ricin is a poison that can be made from the waste left over from processing castor beans. It can be in the form of a powder, a mist, or a pellet, or it can be dissolved in water or weak acid.

44. Smallpox Smallpox is a serious disease that is caused by variola virus, which is spread from person to person through close contact. • Smallpox can cause: • A severe rash, which can lead to scars • High fever • Tiredness • Severe headaches and backaches • Blindness

45. Smallpox is most infectious during the first 7 to 10 days following rash onset.

46. Smallpox Vaccine: • (Vaccine does not contain smallpox virus) • Vaccine before exposure-will protect most people from • smallpox • Vaccine within 3 days after exposure- can prevent the disease • or at least make it less severe • Vaccine within a week after exposure- can still make the • disease less severe

47. In addition to Standard Precautions CONTACT Precautions must be followed for all Significant Organisms

48. MDROs(Multi-drug resistant organisms)Are organisms that have developed resistance to multiple antibiotics.

49. VRE(Vancomycin Resistant Enterococcus) (Veronica) Vancomycin-resistant enterococci (VRE) Veronica and her relatives can cause severe infections if they enter surgical wounds or the bloodstream. Enterococci are part of the normal flora in the intestines. They are durable and survive for extended periods of time on items such as bed rails, night tables, electronic thermometers, bathroom sinks, call bells, etc. She can give you a urinary tract infection, intra-abdominal infections, fever, cause lesions and/or produce wound drainage. You can get rid of VRE germs like Veronica, by WASHING YOUR HANDS PROPERLY!!!

50. (MRSAMethicillin-ResistantStaphylococcus Aureus) (Team CA-MRSA) Community-Acquired Methicillin-Resistant Staphylococcus “Mark” MRSA Mark and bacteria in his family are spread from person to person through direct contact with contaminated persons or objects. Most commonly found in patients who have open wounds from surgery or IV’s, etc. Mark MRSA plays for a TEAM MRSA. They are found outside of the hospital and they are associated with antibiotic use, sharing personal items, having active skin disease, and living in crowded areas.