Summary of IC Training

1. Summary of IC Training Questions, please call Marietta Hill at ext. 7469

2. What is the single most important means to prevent the spread of infection? Hand Hygiene

3. When should I do hand hygiene? • Before and after patient contact • After contact with any infectious or potentially infectious material • After removing gloves or before putting on a new pair • After using the restroom • Before and after eating **Wearing gloves is not a substitute for Handwashing.

4. Hand Hygiene • Hand washing with Antimicrobial soap must be done: • When hands are visibly soiled • When caring for a patient with a diarrhea condition like Clostridium Difficile • When Eating or Drinking • When Using the restroom **Alcohol hand sanitizer is not appropriate in above situations.

5. Hand Hygiene • Alcohol hand Gel can be used: • When hand are not visibly soiled • After removal of gloves and before putting on a new pair • When you are leaving a patient room to go to another area and your hands are not visibly soiled *Any questions should be directed to the ICP (infection Control Practitioner at ext. 7469

6. Standard Precautions • Standard Precautions • Treat every person as potentially infectious • Use thorough hand-hygiene (best defense) to prevent the spread of infection in hospitals • Wear gloves & other personal protective equipment (PPE) • Never recap needles! • Report any exposures immediately to your immediate supervisor.

7. What is transmission-based Precautions? • Hospitals are a place where sick people go to get well • Unfortunately, when the people come to the hospital, they often carry infectious diseases, or sicknesses that can be passed from one person to another • The hospital wants to keep those illnesses from spreading, so we use these transmission-based precautions to do that when we are aware that a patient has a resistant, hard to treat.

8. Contact Isolation: • Used: • When infected body fluids can not be contained, such as a drainage or urine • When a patient is infected with an organism such as Methicillin Resistant Staph, Aureus (MRSA), Vancomycin Resistant Enterococi (VRE), or C. difficile that can be transmitted by direct contact, or by indirect contact with the surface of patient care items in the environment. • Contact IC office with questions at ext. 7649 or 7469.

9. Isolation • Contact Precautions • Private room, if possible, cohorting might be necessary • Gloves • Disposable gowns • Wash hands • Limit the use of non-critical patient care equipment to single patient • Clean/Disinfect common equipment used between patients

10. Droplet Isolation Droplet Precautions Used for patients with known or suspected agents transmitted by the droplet method(>5 microns) Indications: Influenza, meningitis, Meningococcal pneumonia, and resistant Streptococcus pneumonia disease.

11. Droplet Isolation • Private room • Wear a surgical mask within 3 feet of patient or when entering room • Patient transport • Patient door can be open if patient is at least 3 ft from the doorway • Gloves • Gowns • Eye shield could be used • Limit movement of patients to essential purposes • Place surgical MASK on patient if transport is necessary

12. Airborne Precautions Used for patients with suspected or diagnosed conditions that are transmitted by the airborne route such as pulmonary tuberculosis or meningococcal meningitis. These are organism that are < 5 microns in size.

13. Tuberculosis (TB) • TB kills more people world-wide than any other disease • Caused by Mycobacterium bacteria that are inhaled into the lungs • Airborne transmitted disease • Use airborne precautions with patients with active TB

14. Symptoms of TB • Cough • Weakness • Fatigue • Unexplained weight loss • Hemoptysis (coughing up blood) • Night sweats You will learn more about Tuberculosis in the TB Module

15. Airborne Isolation room • Private room that has monitored Negative Air Pressure with 6-12 air exchanges/hour • Respiratory Protection • N95 Respirator Mask with known/suspected +AFB, all staff performing patient care must wear a Respirator mask when taking care of these patients with TB. • N95 respirator wearers are required to have annual fit testing, training, and an initial medical evaluation by the Occupational Health Office. • Patient Transport • Limit to just what is essential • Put surgical mask on patient/visitor (NEVER place a respirator on a patient/family/visitor)

16. If you have a patient in Airborne Isolation • Call the Infection Control Practitioner so they can do follow up and education with patient and family • Monitor the negative pressure readings on the room to assure it is working properly • Notify engineering right away if the alarms or the readings are out of range. Always put a surgical mask on the patient in the room if you are having difficulty with the negative air exchanges. This will allow for continuation of care until the problem can be fixed.

17. Question? • Who wears a N95 respirator Mask? • Only a Trained, Fit-Tested Health care professional.. • Never place a respirator on a Patient, family member or visitor. These folks wear surgical masks.

18. If you get an bloodborne exposure • 1.-wash the area with soap & water-if it is your eye , just flush with plain water. (do not use harsh chemical like beach or betadine, it will open up the skin/mucous membranes for more exposure) • 2. Immediately notified your supervisor, so we can start the follow up process & reporting. • 3. Follow up with Occupational Health or Emergency Room. (ER is OH off tours)

19. Multi-Drug Resistant Organisms • Multi-Drug Resistant Organisms (MDROs) are growing in number. MRSA and VRE are just two of the organisms we isolate patients for. • Some others are resistant Klebsiella Pneumoniae, resistant Pseudomonas Aeruginosa and others. Check with ID or IC office for questions.

20. Biohazard waste • OSHA defines biohazard waste as something that can give off “wet blood”. • Examples are bloody body tissues, bloody dressings, dirty sharps. Urine and feces are not biohazard unless you can see blood in them. • All sharp containers must be secured either on the wall or in a caddy on the floor. No free standing sharp containers. • All sharp containers should be changed when they ¾ full. Never overfill a container.

21. Infection Control Practitioner Marietta Hill,RN,BSN,CIC ext. 7469, Pager 219-0442 Medical Center Epidemiologist Preston Church, MD ext. 7714, Pager 14342 MRSA Coordinator Monica McCrackin, RN, MSN ext. 7649, Pager 219-0435 Infection Control Resources