1. Chapter 15
Infection Control

2. Introduction
Major way of spreading pathogens is by blood and body fluids
3 pathogens of major concerns
- HBV
- HCV
- HIV

3. Bloodborne Pathogens Standard
Established in 1991 by OSHA
Must be followed by all health care workers
Civil penalties if not implemented by employer and followed by employees

4. Bloodborne Pathogens Standard
Develop written exposure control plan
Identify all employees with occupational exposure
Provide hepatitis B vaccines free of charge
Provide personal protective equipment (PPE)

5. Bloodborne Pathogens Standard
Provide adequate handwashing facilities and supplies
Ensure worksite is maintained in a clean, sanitary condition
Follow measures for immediate decontamination of surfaces when contaminated
Dispose of infectious waste correctly

6. Bloodborne Pathogens Standard
Enforce rules on limited activities (eating, drinking, etc.) in any potentially contaminated area
Provide appropriate, color-coded, and labeled containers for contaminated sharps and other infectious or biohazard wastes

7. Bloodborne Pathogens Standard
Post signs at entrance to work areas with exposure to biohazardous materials
Label biohazard items with red biohazard symbol (refer to Figure in text)
Confidential medical evaluation and follow-up for employee after exposure incident
Provide employee training
Set text in lowercase

8. Needlestick Safety Act
Passed by Congress in 2000
Centers for Disease Control and Prevention (CDC) estimated 600,000 to 800,000 needle- sticks per year
OSHA revised Bloodborne Pathogens Standard to requirements of this act

9. Needlestick Safety Act
Employer requirements
Identify and use effective and safer medical devices
Incorporate changes in annual update of exposure control plan

10. Needlestick Safety Act
Employer requirements
Solicit input from nonmanagerial employees who are responsible for direct patient care
Maintain a sharps injury log

11. Standard Precautions
Rules developed by the CDC to prevent spread of infection
Every body fluid considered potentially infectious
All patients considered potential sources of infection
Refer to Figure in text

12. Standard Precautions Use in any situation where you might contact
Blood or any fluid that contains blood
Body fluids, secretions, and excretions, etc., etc.
Mucous membranes
Nonintact skin
Tissue or cell specimens

13. 15:3 Washing Hands Major aspect of standard precautions
Most important aseptic technique
Most effective method of infection control
Hands are perfect medium for spread of pathogens

14. CDC Recommendations Regular handwashing with plain soap and water
Antiseptic handwashing with antimicrobial soap and water
Antiseptic hand rub with alcohol-based cleaner (waterless)

15. My 5 Moments for Hand Hygiene
World Health Organization (WHO) on when to wash hands
Before patient contact
Before clean or aseptic procedure
After body fluid exposure
After contact with a patient’s skin
After touching patient surroundings

16. 15:3 Washing Hands Also wash hands On arrival at facility
After contact with a patient’s intact skin
Before moving from contaminated body site to clean body site during patient care
If hands become contaminated during a procedure

17. 15:3 Washing Hands Also wash hands
Before applying and immediately after removing gloves
When gloves are torn or punctured
Before and after handling specimens
After contact with soiled or contaminated item

18. 15:3 Washing Hands Also wash hands
After picking up any item off the floor
After personal use of the bathroom
Following a cough, sneeze, or using a tissue
Before and after contact with mouth or mucous membranes

19. 15:3 Washing Hands Use soap as a cleansing agent Use warm water
Use friction
Clean all hand surfaces
Point fingertips downward
Use dry paper towels to turn faucet on and off

20. 15:3 Washing Hands Clean nails during handwashing
Waterless hand cleaning with alcohol-based gel, lotion, or foam
Use if hands are not visibly dirty or contaminated with blood or body fluids
After 6 to 10 cleanings hands must be washed with soap and water

21. Gloves must be worn….. Handwashing before and after patient contact
For possible contact with blood, bodily fluids, secretions, excretions, mucous membranes, tissue specimens, or nonintact skin
Handling and cleaning contaminated items or surfaces

22. Standard Precautions Gloves When performing invasive procedures
When performing venipuncture or blood tests
Hands must be washed immediately after removal of gloves
Gloves must not be washed or disinfected for reused

23. Standard Precautions Gowns
For procedures that cause splashing or spraying
Help prevent contamination of clothing or uniform
Contaminated gowns must be handled per policy
Hands must be washed immediately after gown removal

24. Standard Precautions Masks and eye protection
For procedures that cause splashing or spraying
Prevent exposure of mucous membranes of mouth, nose, and eyes to pathogens
Use masks once and discard; change every 30 minutes if needed

25. Standard Precautions Masks and eye protection
Protective eyewear and face shields protect front, top, bottom, and sides of eyes
If not disposable, must be cleaned and disinfected before reuse

26. Sharp Objects Needles Use extreme caution to avoid cuts and punctures
When possible, use safe needles or needleless devices
Place in sharps containers immediately after use
Leave uncapped and attached to syringe
Follow laws regarding disposal of sharp objects

27. Standard Precautions Spills or splashes
Wipe up with disposable cleaning cloths
Wear gloves when wiping up
Use disinfectant such as 10-percent bleach solution
Clean all contaminated surfaces
Absorbent powder can be used for large spills

28. Mouthpieces CPR Devices
Resuscitation devices
Use to avoid need for mouth-to-mouth resuscitation
Place in convenient location, have readily accessible
Must be disinfected between patients if device is nondisposable

29. Waste & Soiled Linen Waste and linen disposal
Wear gloves, follow agency policy
Use biohazard bags appropriately
Soak in disinfectant prior to laundered if soiled with blood, body fluids, secretions, or excretions

30. Cuts & Injuries Injuries
Immediately report cut or injury, needlestick, or splashing of blood or body fluids
Follow agency policy
Report any incidents
** Standard Precautions must be followed at all times by all health care workers**