Infection Control 101

Infection Control Nosocomial vs. HAIs Standard Precautions “Protective environment” to prevent HAIs PPE (latex precautions) Biohazard Waste Transmission-based Isolation Precautions

Nosocomial vs. Healthcare Associated Infections (HAIs) Nosocomial - Infections acquired 72 hours after admission to a hospital HAIs infections associated with healthcare delivery in any setting

Standard precautions Infection control process that apply to all patients, regardless of suspected or confirmed infection status Based on the principle that all blood, body fluids, secretions, excretions excluding sweat, non-intact skin and mucous membranes may contain transmissible infectious agents

Standard precautions Hand hygiene PPE depending on the anticipated exposures 4 Additional Areas of Practice

Standard precautions Four “added” areas of practice: Respiratory Hygiene/Cough Etiquette Safe Injection Practices (re-emphasized) Use of masks for insertion of catheters or injections into the spinal or epidural spaces Use of a set of prevention measures termed Protective Environment, to prevent HAIs (e.g., measures to decrease fungi in the environment; spatial distance >3 ft)

PPE – Personal Protective Equipment Gloves clean vs. sterile Masks Gowns Booties Hairnets and surgical caps Goggles

Biohazard Waste Defined Any solid or liquid waste which may present a threat of infection to humans. It may include specimen containers, blood soaked bandages or dressings, and bloody gloves. Materials and substances found in laboratory and hospital waste which may contain disease-causing agents, such as tissue specimens, cultures, culture dishes and slides, body fluids, blood or blood products, sharps, and needles.

Red Bag Waste Disposal Absorbant materials saturated with blood or bloody fluids, such as bandages, gauzes, sponges, lap sponges; Non-absorbant disposable devices contaminated with blood or blood-contaminated body fluids, such as filled suction container liners, transfusion bags , IV tubing, drainage tubes; Blood, blood products, excretions, secretions, tissue and body parts contaminated with blood.

Sharps Container Waste Needles Scalpels Blades Glass or plastic slides Culture tubes, dishes Disposable Razors, Disposable Scissors, Broken glass ampules

Red Bag and Sharps Containers Sharps containers must be leak-proof, rigid, puncture-resistant, and not easily opened once sealed. They must be labeled BIOHAZARD with International Symbol. Must also be labeled with Facility address and phone number. (When Container 3/4 full, place DATE on container and replace). The Red “Infectious Waste” Bag must be plastic, impervious to moisture, strong enough to resist ripping, tearing or bursting. Bags must be securely tied when placed in storage. Must be labeled BIOHAZARD with International Symbol.

Point of Origin The healthcare professional generating the waste is responsible for its safe and proper disposal, and segregation at point of origin Biohazard waste mixed with chemical waste must be handled and disposed of as hazardous waste; waste contaminated by chemotherapy waste, must be handled and disposed of as chemotherapy waste. Waste contaminated with radioactive material must be handled and disposed of as radioactive waste. Biohazard Waste storage closets shall be visibly marked and inaccessible to the public.

Protect Yourself... Keep bags AWAY from your body when carrying When handling, transporting and disposing of Biohazard Red Bag or Sharps Containers Waste: Keep bags AWAY from your body when carrying Wear latex, vinyl or rubber gloves UNDER heavy duty reusable work gloves Practice good hand hygiene: Wash with soap and water and/or use Alcare regularly and before break, eating, smoking, drinking, going home. Wear a face shield or goggles when tossing bags into biohazard bin and outdoor dumpster Cover bin in transit Wear a disposable apron if chance of contamination of clothing Report any “stick” or splash to Employee Health Nurse ASAP Ask about getting a Hepatitis B Vaccine

Transmission-based ISOLATION Contact Droplet Airborne Protective

CONTACT PRECAUTIONS Gloves and gowns are required for ALL direct and indirect contact Strict Handwashing technique Handwashing + Alcohol Hand Rinse Additional PPE as indicated Visitors MUST wash hands BEFORE leaving.

DROPLET PRECAUTIONS Private room – door closed Regular masks when within 3 feet of patient With infective material will need: Gloves Gowns

DROPLET PRECAUTIONS HANDWASHING Contaminated items After touching Patient After touching Potentially contaminated items Before taking care of another patient Contaminated items Discard Bag and Label before being sent for decontamination and reprocessing .

AIRBORNE PRECAUTIONS Private room – Negative Pressure Required (AIIR = Airborne Infection Isolation Room) HEPA Masks required at ALL times Contact with infective items/material require Gowns Gloves Handwashing After touching patient After handling potentially contaminated items Before caring for another patient

AIRBORNE PRECAUTIONS Pts. wear mask when leaving the room Contaminated Items Discard Bag and Label before decontamination/reprocessing

Protective Isolation Used with immune compromised/susceptible patients Private room – full PPE Pts. wear mask when leaving the room

Let’s Practice