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2. Infection Prevention 2013 Net Learning Module for all KCI/KCC Staff • Respiratory Etiquette • Influenza • Tdap Vaccine • Hand Hygiene • TB Control Plan Mary Ellen Lesperance RN, MSN CIC Lisa Engles MT (ASCP) CIC

3. Objectives • Understand the importance of getting an annual influenza vaccine • Understand the importance of getting the Tdap vaccine • Understand Respiratory Etiquette • Understand the importance of proper Hand Hygiene • Understand the TB Control Plan

4. Why should I be concerned about influenza? • I work with cancer patients. • I care about people. • My patients, my family, my co-workers can get the flu from me if I am not vaccinated. • Working with people with illness puts me at higher risk for infection. • Preventing influenza can save lives.

5. What is Influenza? • Influenza, also known as the flu, is a contagious viral illness that targets the respiratory tract (nose, throat, airways & lungs). • Can cause serious complications, including pneumonia and death. • The most frequent cause of vaccine-preventable death in the US. Causes 24,000 deaths per year and 150,000 hospitalizations per year

6. How do I know it is the Influenza? • Influenza usually has a sudden onset, lasting about a week, and may cause some of the following symptoms: • fever • headache • aching muscles & physical discomfort • dry cough • sore throat • runny nose Nausea and vomiting are often referred to as the stomach flu, but this is not Influenza.

7. “I think I just have a cold”

8. How is the virus spread? • The virus is easily spread from one person to another through droplets formed when coughing or sneezing. • It can also be spread from hand to hand contact or by touching a surface that might be contaminated with infected droplets.

9. When is someone contagious? • Persons with the flu should be considered contagious for up to seven days after symptoms start. • In some cases, it may be possible for flu to be transmitted even the day before symptoms are noticed. Studies show that healthcare workers continue to work despite being ill, thus exposing patients to the flu.

10. Flu Prevention at Work & Home • Get your flu shot! Clean your hands frequently • Avoid touching your eyes, nose & mouth • Keep surfaces disinfected • Wipe down keyboards, telephones, doorknobs & other shared surfaces with disinfectant wipes

11. Respiratory Etiquette • Respiratory Etiquette: Cover your mouth & nose when you cough or sneeze • Cough or sneeze into a tissue • No tissue??? Cough or sneeze into your sleeve • Now clean your hands

12. What is the “Flu Shot” and “Who should get it?” • Inactivated (not live) virus is injected, usually in the upper arm. • All persons 6 months of age and older should get the flu shot unless the person has contraindications, like a severe allergy to eggs. • ALL STAFF ARE REQUIRED TO GET THE FLU SHOT ANNUALLY UNLESS THEY HAVE A DOCUMENTED CONTRAINDICATION

13. How does the vaccine work? • Within 2 weeks, your body’s defenses produce antibodies against the influenza virus. • Studies show that vaccinated healthcare workers reduce patient mortality.

14. When should I get vaccinated? • The best time to get vaccinated is October or November. • But even later in the season, the vaccine still provides protection.

15. Reminding our Visitors • Keeping our patients safe also means reminding our visitors about signs and symptoms of the flu. • Signage may be posted at the entrance of all inpatient units and in Ambulatory waiting rooms.

16. Flu Myth #1 • The flu is no worse than a bad cold FALSE • Influenza is more severe and dangerous than the common cold. The flu can lead to pneumonia and death.

17. Flu Myth #2 • The flu shot can give you the flu FALSE • The vaccine contains inactivated influenza, and cannot cause the flu. • It is possible to experience certain uncomfortable side effects such as soreness at the site of injection, mild fever, body aches or headache. • If these side effects do occur, they are mild and short-lived in comparison with the actual flu, and are NOT contagious.

18. Flu Myth #3 • Only old people & those who are sick need a flu shot FALSE • Everyone 6 months and older should get the flu shot • This includes healthy adults, children and all persons working in healthcare.

19. PatientSafety…. Every year, 5 to 10 percent of inpatients develop infections resulting in 98,000 deaths nationally. 98,000 deaths equals: • More deaths than those caused by breast cancer, colon cancer and stroke combined • Equivalent to a 747 plane crash killing all passengers/crew every other day • One death every 6 minutes What can you do to prevent this?

20. Tdap Vaccine • CDC recommends that all healthcare personnel receive the Tdap vaccine • This is a one time vaccine booster that helps prevents Pertussis (Whooping cough), in addition to tetanus and diphtheria • Pertussis is on the rise in the United States • Infants and immunocompromised patients are particularly susceptible to Pertussis • All staff are required to get the Tdap vaccine unless they have a documented contraindication

21. Patient Safety…. It's in your hands!!!! Clean hands reduce infections and save lives!!!

22. Healthcare workers should perform hand hygiene: • before and after direct contact with patients • before andafter removing gloves • before handling an invasive device for patient care • after contact with blood, body fluids or excretions, • mucous membranes, or wound dressings • after contact with contaminated items, such as medical • equipment, medical waste, soiled linen • after contact with objects in the immediate vicinity of • the patient, such as bedside trays, bedrails, phone, etc.

23. Health care workers should perform hand hygiene: • after sneezing, coughing, or disposing of tissues • before and after handling medication • before and after preparing food • before and after using the restroom

24. Healthcare workers’ hands can also become contaminated by contact with the patient care environment… not just the patient!!! In this study, each X shows where bacteria were cultured in a room that had been occupied by a patient with an infection.

25. Alcohol Hand Rubs Alcohol hand rubs have been shown to: • Be more effective in reducing bacteria on hands than soap and water • Require less time to use • Reduce hand irritation and dryness with repeated use Rub a sufficient amount of alcohol foam over entire surface of hands until completely dry

26. Soap and Water Wash Handwashing with soap and water is required when hands are visibly dirty or visibly soiled with blood or other body fluids. Wash with soap and warm water for at least 15 seconds. Rinse with warm water and turn off faucet with paper towel.

27. Hand Hygiene Score Card How often do healthcare workers REALLY clean their hands between patients? Many observation studies show that HCW use proper hand hygiene only of the time! 20% - 50% THIS ISN’T GOOD ENOUGH! WE MUST BE 100%!!

28. Use ONLY Karmanos-approved hand soaps, alcohol rubs, and lotions: Lotions from home are not approved for use in hospitals because: • They can damage the gloves you wear and cause leaks • They easily become contaminated and actually put more bacteria on your skin • They interfere with the antiseptic soaps Karmanos-approved hand lotion

29. Artificial nails hide dangerous germs and increase the risk of spreading bacteria between healthcare workers and patients! Karmanos policy regarding fingernails: • Artificial nails (including gels and wraps) are not allowed. • All nails should be nicely trimmed and should not be more than ¼ inch long • Nail polish should not be chipped • Jewels or ornaments should not be attached to the nails This fashion statement can harm patients!

30. Got 15 seconds to save a life? HAND HYGIENE ... it's the RIGHT THING TO DO!

31. Tuberculosis (TB) Control Plan What is TB? TB is a contagious disease caused by the bacteria named Mycobacterium tuberculosis. TB infects primarily the lungs. Signs and symptoms of TB include: • Fever • Weight loss • Night sweats • Fatigue, weakness • Prolonged cough (cough > 3 weeks) and/or blood-tinged sputum TB is spread when infected people cough or sneeze the bacteria into the air and others inhale the bacteria.

32. TB Control Program Protecting Staff MI/OSHA requires that all health care facilities have a TB Control Program to protect staff from exposure to TB while at work. KCC’s TB Control Program is on the Policy website in IC 124. Designated staff will get a TB skin test or TB assessment annually as part of the TB Control Program.

33. References CDC.gov/flu CDC.gov/vaccines CDC, Guidelines for Hand Hygiene in Healthcare Settings, 2002 CDC, Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Healthcare Facilities, 2005.

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