Infection Control in Healthcare

1. Healthcare Epidemiology Department Healthcare Epidemiology Susan V. Donelan, M.D., Medical Director  Francina Singh, RN, BScN, MPH, CICP, Director • Department Telephone Number: 444-7430 • Department Fax Number: 444-8875 Infection Control Practitioners: • Hospital (with phone extension and beeper) Emily Locher, RN,BSN, MBA, ICP 4-8780 / 3-861-6271 Bob Garcia, BS, MT(ASCP), CICP, 4-8204 / 3-861-2379 Barbara Kranz, LPN, CICP 4-2760 / 3-861-9876 Allison Ward, RN, CMSRN, ICP 4-9122 / 3-861-2395 Infection Control is in your Hands.

2. Healthcare Epidemiology Department Phone # / Location • The HED Phone extension is 4-7430. • An ICP or Hospital Epidemiologist can be reached in an emergent or urgent situation when not in the office by calling the hospital operator. • The HED Office is located on Level 1, room 716 in the hospital (near green elevators) • Additional information can be obtained at our website: http://inside.hospital.stonybrook.edu/ sbuh/epidemiology Infection Control is in your Hands.

3. Healthcare Epidemiology Department OSHA Bloodborne Pathogen Standard The Occupational Safety and Health Administration (OSHA) issued a standard designed to protect you from the transmission of Bloodborne Pathogen . It was finalized on December 6, 1991. It details ways employees and employers can work together to reduce your risk of contracting a bloodborne pathogen on the job. All employees are covered by the standard if it is reasonably anticipated they could be exposed to bloodborne pathogen as a result of job duties. Infection Control is in your Hands.

4. Healthcare Epidemiology Department What to do if Exposed • Clean affected area immediately. • Notify your supervisor immediately. • Complete an Incident/Accident form • Immediately report to Employee Health Service, Monday – Friday, 8 a.m. – 4 p.m. (4-7767) • All other times report to the Emergency Room (4-2465) Infection Control is in your Hands.

5. Healthcare Epidemiology Department Universal Precautions Universal Precautions to be Used in the Care of All Patients 1. GLOVES • For touching any patient’s blood or body fluid • For handling any soiled items • For performing venipuncture. • Change after contact. 2. GOWNS • Worn during any procedure likely to generate droplets of blood or body fluids. Infection Control is in your Hands.

6. Healthcare Epidemiology Department Universal Precautions (continued) Universal Precautions to be Used in the Care of All Patients 3. MASKS and PROTECTIVE EYEWEAR • Worn during any procedure likely to generate droplets of blood or body fluids. 4. HANDS • Wash immediately if contaminated with blood or body fluids. • Wash immediately after gloves are removed. Infection Control is in your Hands.

7. Healthcare Epidemiology Department Facts on Nosocomial Infections • 2 million nosocomial infections / year in USA • 90,000 deaths associated with nosocomial infections • 70 % of the bacterial infections are caused by bacteria resistant to 1 drug commonly used to treat • Some bacteria are resistant to all approved drugs • Some require treatment with experimental & toxic drugs • $ 122 million - cost associated with treating antimicrobial resistance among single pathogen Infection Control is in your Hands.

8. Healthcare Epidemiology Department Healthcare-Associated Infections: Facts Hands of HCWs are the # 1 mechanism of transmitting organisms (sensitive and resistant) from one patient to another Infection Control is in your Hands

9. Infection Control is your Hands Healthcare Epidemiology Department

10. Healthcare Epidemiology Department Patient Safety Goal #7 Reduce the risk of healthcare - acquired infections (HAI) Requirements: • Comply with current CDC hand- hygiene guidelines • Manage as sentinel events all identified cases of unanticipated death or major permanent loss of function associated with a health care -acquired infections. Infection Control is in your Hands.

11. Healthcare Epidemiology Department Hand Hygiene • Hands of HCWs spread organisms • Organisms can also be carried on inanimate objects • Contamination can occur after only a brief contact Infection Control is in your Hands.

12. Healthcare Epidemiology Department Principles of Handwashing • Running water • Adequate amount of soap to create lather • Friction and thoroughness • Time spent = 15 – 20 seconds • When ? - Before and after every patient contact Infection Control is in your Hands.

13. Healthcare Epidemiology Department Hand washing Process Using Alcohol-based Hand Gel / Foam • Apply 1.5 – 3.0 ml of gel / foam to the palm of one hand and rub hands together • Cover all surfaces of hands and fingers, including areas in between fingers, around and under fingernails • Continue rubbing hands together until alcohol dries Infection Control is in your Hands.

14. Healthcare Epidemiology Department SBUMC Hand Hygiene Policy • Hand hygiene must be performed before entering and exiting a patient’s room • Soap and water or alcohol – based product both acceptable unless • Hands are visibly soiled • Patient has Clostridium difficilediarrhea Infection Control is in your Hands.

15. Healthcare Epidemiology Department System of Isolation at SBUMC Combination of: • Universal Precautions / Standard precautions • Disease Specific Precautions • Universal / Standard Precautions: To be used in the care of all patients Infection Control is in your Hands.

16. Healthcare Epidemiology Department Disease Specific Precautions Infection Control is in your Hands.

17. Healthcare Epidemiology Department Infection Control Codes Screen Definitions A = Measles, Varicella (Chicken Pox) B = MRSA / VRE C = Combination of multiply resistant organisms not coded elsewhere D = Meningitis, Mumps, Influenza, Rubella, Pertussis E = Clostridium difficile, Salmonella, Shigella, Campylobacter, E.coli, Rotavirus H = Other Blood Born Pathogens I = VISA/VRSA--Vancomycin-intermediate/-resistant Staphylococcus aureus L = Long Island State Veterans Home M = MRSA - Methicillin-resistant Staphylococcus aureus N = Resistant Gram Negative O = Other P = PRSP - Penicillin-resistant Streptococcus pneumoniae R = RSV - Respiratory Syncytial Virus T = TB - Mycobacterium tuberculosis V = VRE - Vancomycin-resistant Enterococci Z = Herpes zoster (Shingles) Infection Control is in your Hands.

18. Healthcare Epidemiology Department Quick Guide to Isolation Procedures A = Negative Pressure Room, Immune Healthcare Worker (HCW) B = Single Room, Gown/Gloves To Enter Room C = Single Room, Gown/Gloves To Enter Room, Surgical Mask Within 3 Feet D = Single Room, Surgical Mask Within 3 Feet, Immune HCW If Applicable E*= Single or Double Room, Shared Bathroom (toilet seat cover as barrier)* H = Standard Precautions I = NOTIFY HEALTHCARE EPIDEMIOLOGY (HED) IMMEDIATELY L = Surveillance C/S on Admission to R/O MRSA, Standard Room Placement Pending C/S M, N, V = Single Room, Gown/Gloves To Enter Room O = Double Room, Standard Precautions Contact HED P = Single Room, Surgical Mask Within 3 Feet R = Single Room, Gloves To Enter Room, Gown/Gloves/Face Shield For All Patient Contact T = Negative Pressure Room, Fit-Tested Respirator To Enter Room Z = Negative Pressure Room If Disseminated Zoster, Immune HCW (*See HELP [PF3] or the Infection Control Manual for further Information) Infection Control is in your Hands.

19. Healthcare Epidemiology Department Breaking the Chain of Infection Infection Control is in your Hands.

20. Healthcare Epidemiology Department Infectious Agents Wash Hands Prevent Transmission

21. Healthcare Epidemiology Department Reservoirs Wash Hands Prevent Transmission

22. Healthcare Epidemiology Department Susceptible Hosts Wash Hands Prevent Transmission

23. Healthcare Epidemiology Department Portals of Exit Wash Hands Prevent Transmission

24. Healthcare Epidemiology Department Means of Transmission Wash Hands Prevent Transmission

25. Healthcare Epidemiology Department Infection Control is in your Hands.