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Learn about the importance of infection control for emergency responders and how to prevent the spread of communicable diseases. This training covers topics such as bloodborne pathogens, OSHA regulations, and personal protective equipment.
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Emergency Medical Programs “Bloodborne Pathogens” OSHA 29 CFR 1910.1030 October 28, 2014
Introduction to Infection Control Instructor: Title:
Module I Introduction to Infection Control
Why is Control Important? • This training is for the protection for first responders, their families and patients • Minimizes Personal & Organizational liability • Reduces Cost • Enhances Personal Safety, Personal Satisfaction & morale
Do first responders really have a greater risk of contracting infectious diseases as a result of their job ?
What is the Risk? First Responders run a greater risk of coming in contact with blood, body fluids, tissues, airborne droplets and other infectious agents through accidental contact with spills, splashes, contact etc..
Risk • Nature of operations can often make it difficult to enforce proper precautions because of: • Stressful Conditions • Contact with High Risk Populations • Equipment Failure / Inappropriate Equipment • Lack of appropriate Personal Protective Equipment (P.P.E.)
Infection Control Programs Are Required by: • Laws: State and Federal • Regulations: Dept. of Public Health • Standards: OSHA
Why is a comprehensive infection control program important for emergency response organizations ?
Comprehensive infection control is a major organizational undertaking, requiring a well defined structure or program. • It ensures a comprehensive, integrated approach rather than reactionary, uncoordinated responses to infection control related incidents.
A sound, pro-active infection control program is not preventive, but can lessen the liability for the department and responders, and helps to provide guidelines for dealing with related incidents.
Why is a comprehensive infection control program important for emergency response organizations ?
What types of activities are included in a comprehensive Infection Control Program ?
Health Maintenance • Entry Level Health Assessment • Immunization • On-going Health Assessment • Employee Assistance Programs (E.A.P.)
Infection Control and Personal Safety Which communicable diseases can be a threat to first responders ?
Human Immunodeficiency Virus • Fear of acquiring the Human Immunodeficiency Virus ( HIV ) which can lead to Acquired Immune Deficiency Syndrome ( AIDS ) has focused increasing attention on infection control.
Which posses a great occupational threat to emergency response personnel? Acquiring HIV or Hepatitis B Virus ( HBV )?
Statistically: Hepatitis B (HBV) poses a much greater occupational health risk than HIV.
Module II Principles of Disease Transmission
Principles of Disease Transmission • Infection Control in the Workplace • Introduction to a variety of Medical Terms • You need to become familiar with these terms
How can we prevent infections? By interrupting the disease process.
Communicable Diseases can be readily passed from one person to another either directly or indirectly. Communicable diseases may be either: • Bloodborne • Airborne • Direct Contact w/Contaminated Surface
Assessing the level of risk in a specificexposure situation is sometimes difficult and confusing.
Even though some diseases pose a statistically greater risk, all patients should be treated as potentially infectious. Remember:
Module III Health Maintenance
Health Maintenance Whatis it ?
Immunizations / Vaccinations • What are they ? • Who pays for them ?
OSHArequires that Hepatitis B Vaccinations be made available to all employees with potential for occupational exposure.1910.1030(f)(1)(i)
Appropriate and ApprovedPersonal Protective Equipment (PPE) is critical in reducing exposure and should be used whenever the potential for exposure reasonable exists.
Standard Precautions Formerly known as “Universal Precautions” “Precautions taken to prevent occupational risk exposure to blood and other bodily fluids.”
Body Substance Isolation (BSI) “An infection control strategy that considers all body substances as potentially infectious.” Similar to Universal Precautions .. but goes further in isolating workers from Pathogens
Universal Precautions 29 CFR 1910.1030 (d)(3)(x)Provision. When there is occupational exposure, the employer shall provide, at no cost to the employee, appropriate personal protective equipment such as, but not limited to, gloves, gowns, laboratory coats, face shields or masks and eye protection, and mouthpieces, resuscitation bags, pocket masks, or other ventilation devices. Personal protective equipment will be considered "appropriate" only if it does not permit blood or other potentially infectious materials to pass through to or reach the employee's work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used. OSHA still defines universal Precautions
Body Substance Isolation (BSI) • Eye protection • Splash garment • Mask • Gloves BSI vs. Universal Precautions? What does your Department have? Where is it located?
Module IV Recommended Personal Protective Equipment
Recommended P.P.E. • Gloves: Nitrile (avoid potential latex allergies) • Disposable • Donning • Extra Pairs Available • First Responders should carry extra • Do Not Re-use
Glove Task Performance • Single / Multiple Victims • danger of cross contamination • Worn “Under” Firefighting / Law Enforcement Gloves • Cleaning Contaminated Areas / Equipment • DO NOT • Eat … Drink … Smoke … • Apply Cosmetics / Lip Balm • Handle Contacts While Wearing Gloves
Proper Disposal of Gloves • Disposal Procedures are determined by: Federal, State and Local regulations … • Know Them • Contaminated Articles should be enclosed in an impervious bag.
Proper Disposal of Gloves • Always wash your hands after gloves are removed … even if they are intact, in an appropriate facility • Do Not Wash Hands in Food Preparation Area • Twenty(20) Seconds w/Soap • Ten (10) Second Rinse • Waterless Antiseptic Hand Cleanser • In Response Vehicles / Med Packs • In your own pocket
Recommended P.P.E. • Masks & Protective Eye Wear: • Prior to Patient Care • Splashes of Body Fluids • Used with Level of Exposure encountered • Reminder 29CFR1910.134 Fit Testing
Recommended P.P.E. • Masks “Standard B.S.I.”: • “Standard” mask for B.S.I. is the N-95 level • These can be purchased as disposable mask or filters that will fit existing full and half face mask. • All Mask require Fit Testing • Reminder: 29CFR1910.134 Fit Testing • Responders required to wear Respiratory Protection are also required to have a medical evaluation • Reminder: 29CFR1910.134(e) • A medical questionnaire as identified is also required • Questionnaire: 29CFR1910.134 Appendix C
Patient vs. Responder • Mask should be worn by the Responder and also placed on the patient when a potential for airborne transmission of a disease exists. • Ensure the patient’s mask does not interfere with their airway
Recommended P.P.E. Gowns • CDC Guidelines • Must be realistically applied
Gowns Task Performance • Fluid Resistant gowns are available • Decision to use barrier clothing and type is normally left to the employee • However: May be guided by CDC or Public Health Department for some specific diseases which require higher scrutinization of choices
Recommended P.P.E. • Resuscitation Equipment: • Disposable Resuscitation Equipment and devices – primary choice • Reusable Equipment needs to be thoroughly cleaned and decontaminated according to the manufacturer’s recommendations
Recommended Equipment • Demand Valves with disposable face pieces • Disposable Bag-Valve Mask • Mouth to Mask
Summary • Emergency Response personnel should practice Body Substance Isolation • Proper use of Personal Protective Equipment ensures effective infection control and minimizes personal risk
Summary cont. • “If it’s WET … Assume it’s Infectious” Wear Gloves: • If there could be a splash to the face Wear Mask and Protective Eye Wear • If there could be a splash to the body Wear a Gown