Infection Prevention & Control for Patient Transporters

1. Infection Prevention & Control for Patient Transporters Vydia Nankoosingh Kyla Van Dusen Infection Prevention & Control October 5, 2010

2. Outline • Chain of infection • Routine practices & additional precautions • Corporate policy change • Transporting a patient

3. Chain of Infection Routine Practices & Additional Precautions In All Health Care Settings. PIDAC Aug 2009

4. Chain of Infection VRE HOSPITALIZED PERSON GI TRACT MUCOUS MEMBRANES STOOL CONTACT

5. Break the Chain • Routine Practices: • Hand hygiene • Personal Protective Equipment • Environmental cleaning & disinfecting

6. Routine Practices • Infection prevention and control practices that are to be followed with all patients, all the time, regardless of diagnosis to prevent and control transmission of infections. • Elements of routine practices that apply to transport staff are hand hygiene , use of personal protective equipment and cleaning of multi-use equipment between patients.

7. Hand Hygiene • Single most important practice for preventing the transmission of infection • Responsibility of all individuals involved in health care • There are two methods of killing/removing microorganisms on hands: • Alcohol based hand rub • Washing with soap & water

8. When do I clean my hands? • Before and after contact with any patient, their body substances or items contaminated by them • Before putting on gloves • After taking off gloves • After using the washroom • After sneezing, coughing or blowing your nose • Any time hands are dirty

9. Routine Practices:Personal Protective Equipment Would you wear PPE?

10. Routine Practices:Personal Protective Equipment • Assess the risk of exposure and protect yourself with: • Gown • Gloves • Hand hygiene

11. Routine Practices:Personal Protective Equipment • Wear gloves to handle soiled linen and bags of linen • Remove gloves, perform hand hygiene before pushing cart throughout the hospital

12. Do you wear PPE to push the cart?

13. Do you wear PPE to push the cart? • The preferred method is to use hand hygiene • Hand hygiene kills 99.9% of germs in 15 seconds • Hand hygiene protects you while also protecting others

14. Routine Practices:Disinfecting Equipment Hospital approved disinfectant is Virox wipes Wear gloves as per label Multi-use equipment must be cleaned and disinfected between each patient Stretcher, wheelchair High touch surfaces

15. Can you tell which patient has an infection?

16. Additional Precautions • Used in addition to routine practices when a patient has a suspected or definite diagnosis of infection • Contact • Droplet/Contact • Airborne

17. Additional Precautions • A patient’s isolation status could change at any time • Microbiology results • Symptoms of concern • Contact with a positive patient

18. Additional Precautions:Disinfecting Equipment Hospital approved disinfectant is Virox wipes Wear gloves as per label Multi-use equipment must be cleaned and disinfected between each patient Stretcher, wheelchair High touch surfaces

19. The tip of the iceber g is the patients with known infections The bottom represents the patients with infections that have not been identified yet The patients in the bottom of the iceberg are a source of transmission to others Iceberg Effect

20. Corporate Policy Change Goal: Consistent and appropriate cleaning and disinfecting of all shared patient equipment • A high level of clean on a routine basis decreases the risk of transmission of infection in unidentified patients • Eliminates dirty equipment being left in halls or being used accidentally by other staff/patients/visitors

21. Corporate Policy Change • Shared equipment are cleaned and disinfected by all staff between use with patients • Transport staff will clean all high touch surfaces of the stretcher/wheelchair with virox wipes • Designated clean holding areas identified on unit • Visibly soiled transport equipment will be cleaned by housekeeping as appropriate • Porter to notify HK by using the bed tracking system • Porter to identify equipment as dirty by using signage

22. Assigned location on all units Porters to use for cleaning/disinfecting of high touch surfaces Sanitation Stations

23. Handles Side rails Intravenous pole Bumper High Touch Surfaces-Stretcher

24. Handles Seat Back rest Arm rests Intravenous pole Wheel lock handles and leg calf support High Touch Surfaces-Wheelchair

25. Clean Equipment Holding Areas • Designated areas on all units • Separate wheelchair & stretcher holding areas • Signage on wall and tape outline on the floor Clean Stretcher Holding Area

26. What do you think about this?

27. Not always this visible that a piece of equipment is dirty or has not been cleaned Mode of Transmission?

28. Clean or Dirty?

29. Clean or Dirty? • Just because it ‘looks’ clean it does not mean it is clean • Some bacteria and viruses survive for weeks or months on dry surfaces

30. Is this Okay?

31. Is this Okay? • Wear gloves for as short a time as possible • Do not walk from room to room and other areas of the hospital wearing the same pair of gloves • Hands are often contaminated in the process of glove removal • Always perform hand hygiene before & after removal of gloves • Does not replace hand hygiene

32. Is this Okay? • Gloves worn in common areas contaminate the environment • Puts patients/visitors/staff at risk • Hand hygiene kills 99.9% of germs in 15 seconds • Hand hygiene protect s you while also protecting others

33. Moving a patient on Routine Practices • Perform hand hygiene • Assist patient onto clean wheelchair or stretcher in the patient's room • If any PPE was worn to move the patient, remove it alland perform hand hygiene • PPE, including gloves should NOT be worn while transporting patients • If the patient is coughing/sneezing, the nurse will provide them with a surgical mask, the transporter does not need to wear one • Practice good hand hygiene

34. Moving a patient on Additional Precautions • Perform hand hygiene • Wear the appropriate PPE while assisting patient to a clean wheelchair or stretcher in the patient's room • Remove all PPE apparel, including gloves and perform hand hygiene after moving the patient and prior to transport • PPE, including gloves should NOT be worn while transporting patients • If the patient is coughing/sneezing, the nurse will provide them with a surgical mask, the transporter does not need to wear one (exception: airborne isolation) • Practice good hand hygiene

35. Moving a patient from ICU • Patients are moved in their hospital beds • Perform hand hygiene • Wear the appropriate PPE while in the patient’s room to prepare them for transfer • Wipe down all high touch surfaces of the hospital bed with a virox wipe before leaving the unit • Remove all PPE apparel, including gloves and perform hand hygiene prior to transport • The nurse may wear PPE during transport due to the possibility that they may need to intervene quickly (code blue situation)

38. Contact Precautions • No PPE for transporter • No PPE for patient • Porter to carry chart or put it in a plastic bag on patients lap • Hand hygiene

43. Droplet/Contact Precautions • No PPE for transporter • Patient to wear surgical mask • Porter to carry chart or put it in a plastic bag on patients lap • Hand hygiene

48. Airborne Precautions • Porter to wear N95 mask • Patient to wear surgical mask • Porter to carry chart or put it in a plastic bag on patients lap • Hand hygiene

49. Don’t be a risk! • Use PPE appropriately • Protect yourself • Protect others • Don’t forget to perform hand hygiene!