Kaiser Permanente Panorama City- Specific Infection Prevention STUDENT MODULE

At the end of this presentation, the student will be able to: Objectives At the end of this presentation, the student will be able to: Discuss the importance of Hand Hygiene in the prevention of disease transmission Describe Standard Precautions & Transmission Based Precautions (Isolation) Describe the transmission and prevention of Tuberculosis Describe clean versus dirty equipment and the process for cleaning and disinfecting equipment Discuss the prevention of Blood borne Pathogens May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Infection Prevention Department Panorama City Cynthia Dorroh EdD, MSN, RN, PHN, CIC 818-815-6019 Infection Prevention Manager Natalie Lopez MPH CIC CHES 818-375-3542 Infection Preventionist May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Infection Prevention (IP) Resources IP Policy and Procedure Manual on the KP Policy Library (KPPL) webpage Contact Infection Prevention Immediate Supervisor Know Your Infection Prevention Team We’re here to be a resource to you! May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Question: How Do I Find Kaiser Permanente Panorama City Infection Prevention Policies? May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Answer: Kaiser Permanente Panorama City Infection Prevention Policies are located on KPPL Panorama City intranet homepage. May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Kaiser Permanente Policy Library May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Importance of Infection Prevention Prevention of Healthcare-Acquired Infections Patient Safety and Satisfaction Staff Safety Regulatory Agency Requirements May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Prevention of Healthcare Acquired Infections (HAIs) Strategies to prevent HAIs: Hand Hygiene compliance Patient notification, education and documentation Environmental cleaning/disinfection Healthcare workers (HCW) and Member vaccination programs May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

What is your role in Infection Prevention? Perform hand hygiene Stay healthy TB screening and current vaccinations Follow Medical Center Wide Policy and Procedures May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Large Single Point Slide May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Hand Hygiene Principles Alcohol foam or 20 seconds to germ-free May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

So, Who’s Hand Hygiene Model do we follow? May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

5 Moments of Hand Hygiene Jana, Please include title, 5 Moments for Hand Hygiene and source as World Health Organization (WHO)

Hand Hygiene Considerations Natural nails should be short. Artificial nails, nail tips, gel, and silk wraps are prohibited for all HCW who provide direct patient care or touch the patient environment. Light or clear polish without chips is acceptable at the discretion of your instructor.

Respiratory Hygiene/Cough Etiquette Safe Injection Practices Standard Precautions Hand Hygiene Respiratory Hygiene/Cough Etiquette Safe Injection Practices Hand hygiene for at least 20 seconds Soap and water or Alcohol product 5 Moments of Hand Hygiene Cover your cough including visitors if needed. Offer mask, tissues and hand sanitizer Hand Hygiene Wear Personal Protective Equipment (PPE) Activate safety device Dispose in proper sharps container Do Not recap needles – ever! Always handle sharps cautiously and safely May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Standard Precautions – continued Personal Protective Equipment PPE Infection prevention practices that are used for ALL patients Gloves: Whenever touching blood, body fluids, mucous membranes. Mask: When splashes to mouth or nose is anticipated and/or performing aseptic procedures such as Lumbar Puncture, central line insertion Goggles or Eye Shield: When splashes to eyes are anticipated. Gown: When soiling of clothing or skin is anticipated.

Sequence for Donning Personal Protective Equipment (PPE) Perform Hand Hygiene Gown Mask or Respirator Goggles or Face Shield Gloves Keep hands away from face Change gloves when torn or heavily contaminated

Sequence for Removing PPEs Gloves then Perform Hand Hygiene Goggles or Face Shield Gown Mask or Respirator Perform Hand Hygiene All PPEs are removed at doorway. Exception: Respirator is removed in anteroom after closing patient door

Standard Precautions - SIMPLIFIED FOR EVERY PATIENT CONTACT, EVERY TIME IF IT’S WET AND NOT YOURS…DO NOT TOUCH IT And DO NOT LET IT TOUCH YOU WITHOUT PPE

Respiratory Hygiene/Cough Etiquette Recommended for all individuals with symptoms of respiratory infection Cover the nose/mouth when coughing or sneezing with a tissue or mask Dispose of tissue in a receptacle Perform Hand Hygiene Encourage coughing persons to sit or stand at least 3 to 6 feet away from others in common waiting areas ANY PATIENT WITH A COUGH SHOULD BE INSTRUCTED/HANDED A MASK TO WEAR THE DURATION OF VISIT

Tuberculosis (TB) Risk factors: Recent immigrant Immunosuppressed or HIV Resident of prison, shelter, Long Term Care (LTC) facility Known exposure or previous positive skin test History of TB, did not complete therapy

Tuberculosis (TB) Latent TB VS. Active TB (pulmonary) Positive skin test Normal Chest X-Ray (CXR) No Clinical Signs or Symptoms CANNOT spread disease to others Treated with medications for prophylaxis No isolation Active TB (pulmonary) Positive skin test Abnormal Chest X-Ray (CXR) Clinical Signs and Symptoms CAN spread disease to others Must be reported to Infection Control Must be in Airborned isolation

Equipment Cleaning and Disinfection Patient Care Equipment Clean and disinfect multi-patient use equipment between patients. Discard single use items (i.e. PPE, masks). Clean and disinfect the high touch areas (door knobs, keyboards, countertops, etc) Clean and disinfect with hospital approved disinfectant wipes: allow wet surface to air dry according to manufacturer’s guidelines (see product label) This is the DWELL, “WET”, “CONTACT”, or “KILL” time that it takes for the disinfectant to effectively work. Breast Pump Need to develop system to identify if equipment has been cleaned Bio-Med developing tag which you mark if cleaned or not Contact (wet) time important

For use: Surfaces High touch areas Equipment Soiled areas May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.

Bloodborne Pathogens Exposure Plan A guideline designed to assist in protecting our health care workers against occupational transmission of viral Hepatitis B , HIV, Hepatitis C and other blood borne diseases Blood borne pathogens are organisms that are transmitted by direct contact with blood and /or body substances. Needle sticks and other sharp related injuries may expose workers to blood borne pathogen. Prevention : -Activating safety device on needle -Proper needle disposal -Contacting Environmental Services (EVS) when sharps containers are ¾ full - No 2 handed needle recap What to do if I have an exposure! Cleanse the exposure area immediately Report it to your supervisor or instructor Seek medical evaluation from ER or Urgent Care

No Food, Drinks, Gum, putting on make up in Patient Care Areas The OSHA Bloodborne Pathogen Standard prohibits food and drink in areas where contamination is likely. This regulation prohibits food and drink, chewing gum, putting on makeup in areas in which work involving exposure or potential exposure to blood or other potentially infectious material exists, or where the potential for contamination exists. This is consistent with other OSHA standards and is good industrial hygiene practice. Remember back to the Chain of Infection? Think about portals of entry – your mouth, nose, eyes. Don’t risk harming yourself!!!!!!!

Infection Prevention is in your Hands It’s everyone’s business

Contact Us! Ext 6019 & 3542 Questions? May 25, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.