Infection Control Program  The Infection Control Program is a Center wide discipline that develops effective measures to: **** prevent **** identify **** and control infections acquired in the Medical Center or brought into the Medical Center from the community.

What is the single most important means to prevent the spread of infection? Good Hand Hygiene Practices

When should I wash my hands? 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

Hand Hygiene Options Regular soap and Water Antimicrobial hand soap and water Alcohol hand gels/foams Lotions

Blood Borne Pathogens HIV Hepatitis B Hepatitis C These are the top three of most concern for healthcare workers Every direct healthcare worker should be vaccinated against Hepatitis B!

If You have possible HIV exposure… Wash exposed site with soap and water (If eye, flush with water only) In this order of preference contact: _ Your immediate supervisor –Employee Health –Emergency Department –Infection Control Physician on call Tests for HIV will most likely occur immediately and 3, 6, and 12 months after exposure.

Source of exposure You don’t know if the source of the exposure is HIV positive. Testing can ONLY be conducted with the patients consent. You may possibly receive antiviral prophylaxis, depending on the nature of the exposure.

Your patient receives a positive test result… Report and communicate with infection control. The IC office will handle the report to local and state health departments (DHEC). If any information is needed from you for the DHEC report, Infection control will contact you.

–Treat every person as potentially infectious –Use thorough hand-washing (best defense) to prevent the spread of infection –Wear gloves & other protective equipment –Never recap needles! Use Safety devices –Report any exposures immediately to your immediate supervisor Standard Precautions

Isolation Precautions Lets talk about Precautions taken in addition to standard Precautions called: Transmission-based Precautions –CONTACT –DROPLET –AIRBORNE

Contact Isolation: Used for patients that are infected with antibiotic resistant organisms 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. Used in addition to standard precautions.

Isolation Contact Precautions –Private room, if possible Cohorting might be necessary –Gloves &Gowns –Wash hands –Limit the use of non-critical patient care equipment to single patient –Clean/Disinfect common equipment used between patients

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

Isolation Droplet Precautions –Private room –Wear surgical mask within 3 feet of patient or when entering room –Patient transport Limit movement of patients to essential purposes Place surgical MASK on patient if transport is necessary Always notify all staff involved in a transfer of the precautions

Airborne Isolation Used for patients with suspected or diagnosed conditions that are transmitted by the airborne route such as pulmonary tuberculosis or meningococcal meningitis.

Symptoms of TB –Cough –Weakness –Fatigue –Unexplained weight loss –Hemoptysis –Night sweats * Mention ppd (Everyone does have a current PPD, right?)

Masks Who can wear a Respirator (N95) in our facility? Answer---Only a trained, fit-tested healthcare professional. Patients, Family, visitors, and volunteers always wear a surgical mask. Never put a respirator on someone who has not been trained or fit-tested to wear one.

Biohazard Waste Red Bag = Blood

Where Does All The Garbage Go? Sharps: Needles, lancets, surgical staples, rods, pins, intravenous catheters, protected sharps, syringes with attached needles, scalpels, scissors, guide wires, etc Sharps Container – Must be emptied when ¾ full. They become a danger when overfilled.

Isolation status does not affect Red Bag Waste Guidelines: Regular trash from an isolation room is still regular trash. Trash Can Liquid Human Waste from reusable containers like urine, feces, sputum, blood etc. Toilet (Use splash precautions) Isolation Room Waste :

Questions to check out & be familiar with: What kinds of precautions do you practice on your units or work area? How is biohazardous waste handled? Where is Personal Protective Equipment (PPE) kept? Do you have everything you need? How is equipment cleaned? (I.e., wheelchairs, laryngoscope blades, etc)?

Questions to look up & be familiar with: How do you give and receive feedback from the infection control practitioner? How do you know if items are clean or dirty? What actions have you taken to reduce risks for and/or prevent nosocomial (hospital acquired) infections?

Patient Safety Goal number seven (7) is very important for infection control: 7. “Reduce the risk of health care acquired infections” (Nosocomial Infections-Hospital Acquired Infections) Number one way…Good Hand Hygiene Practices…WASH,WASH, and WASH AGAIN!

 Infection Control Practitioner Marietta Hill,RN,BSN,CIC ext. 7469, Pager  Medical Center Epidemiologist Preston Church, MD ext. 7714, Pager Infection Control Resources