1. Infection Control
Jan. 9-10, 2018

2. Bell Ringer How do you maintain a broad base support?
In fire safety, what does PASS stand for?
In fire safety, what does RACE stand for?
What is a standard precaution?

3. Standard
9) Demonstrate mastery of concepts and skills related to asepsis, Universal Precautions, sanitation, disinfection, and sterilization for patient/client care settings in adherence to standards and guidelines from the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) in a lab/clinical setting.

4. Class Objectives By the end of the class, I will be able to
Explain the 2 reasons we have Standard Precautions
Explain the three Transmission-based precautions
Don and Doff PPE correctly

5. Standard Precautions or Universal Precautions
The Center for Disease Control and Prevention developed a list of standard precautions that should be used for all patients, regardless of their type of illness.
Two reasons for standard precautions:
To protect health care workers
To protect patients
Standard Precautions
The Center for Disease Control and Prevention (CDC) developed a list of standard precautions that should be used for all patients, regardless of their type of sickness. The CDC created the standard precautions for two reasons. The first reason is to protect health care workers from contact with infectious materials. The second reason is to protect patients from contracting infectious diseases. Standard precautions include guidelines for patient contact and environmental cleanliness.

6. Standard Precautions
Use appropriate personal protective equipment or PPE
Perform hand hygiene
Follow respiratory hygiene/cough etiquette
Ensure appropriate patient placement (isolation precautions)
Properly clean and disinfect patient equipment devices and the environment
Follow safe injection practices and handling of needles, sharps and hazardous materials
Standard Precautions for Patient Contact
According to the CDC, every bodily fluid must be considered infectious. Therefore, health care workers must use appropriate personal protective equipment, such as gloves, masks, eyewear, and gowns, when they are likely to contact infectious materials. Infectious materials include blood and other bodily fluids, mucous membranes, non-intact skin, and tissue specimens.
Hands must be washed frequently to avoid spreading infection. Hands should always be washed before and after wearing gloves, before and after performing a procedure, after contacting blood or other bodily fluids, and between patient contacts.
Health care workers must bandage all cuts and scratches properly. Patient contact should be limited if a worker has a wound or skin condition that is likely to seep or bleed. In addition, health care workers that are sick must avoid direct contact with patients.
Whenever possible, face shields should be used instead of mouth-to-mouth contact during CPR. These devices should be stored in convenient places throughout a medical facility.

7. Disposal of Biohazardous Waste
Containers that hold blood or body fluids
Containers are required to have biohazardous labels
Biohazardous waste is any waste that may contain blood or body fluids. Recognize these labels, and dispose of material properly.

8. Precautions for Environmental Cleanliness
Place sharps in puncture-proof biohazardous waste containers
Clean up spills immediately
Discard infectious waste in biohazardous waste bag
Place contaminated linens in biohazardous laundry bags

9. Sharps and Needlestick Safety
“Sharps”—needles, scalpel blades, capillary tubes, and broken glass or slides
Dispose of in puncture-resistant containers
Never recap an uncapped needle
Replace biohazard containers when full
2/3 to the top is considered full
Protect yourself from exposure by following Standard Precautions and disposing of materials appropriately.

10. Standard Precautions
Treat all body fluids as though they are potentially infectious
Bloodborne pathogens
so always use
Personal protective equipment!
What three diseases are contracted through bodily fluids that the BBP standard discusses?
Standard precautions are guidelines to protect everyone from exposure incidents.

11. Communicable Diseases
Some communicable diseases are spread through direct contact. Others may be spread through indirect contact.
Communicable Diseases
A communicable disease is a type of infectious disease that can be transmitted from one person to another person. Some communicable diseases are spread through direct contact. Examples of direct contact are touching an open wound on an infected person or having a sexual relationship with an infected person. Communicable diseases can also be spread through indirect contact. Indirect contact includes inhaling the air after an infected person has sneezed or handling soiled bed sheets from an infected patient.

12. Transmission of Communicable Diseases
Not all communicable diseases are transmitted the same way.
There are many different types of communicable diseases, and health care workers must become familiar with the mode of transmission for each disease.
Transmission of Communicable Diseases
Not all communicable diseases are transmitted the same way. For example, AIDS, Hepatitis B, and strep throat can be spread only through direct contact. On the other hand, chicken pox, pink eye, and pneumonia can be spread through direct or indirect contact. There are many different types of communicable diseases, and health care workers must become familiar with the mode of transmission for each disease.

13. Transmission-Based Precautions
Transmission-based precautions are used only with patients who have been diagnosed with highly communicable diseases.
Three types:
Airborne
Droplet
Contact
Transmission-Based Precautions
Standard precautions are practiced with all patients, regardless of their sickness. But there is another set of precautions that are only used with patients who have been diagnosed with highly communicable diseases. These precautions are called transmission-based precautions. The three types of transmission-based precautions are airborne, droplet, and contact.

14. Introduction to Transmission-Based Precautions:

15. Contact Precautions
Contact precautions are used for patients with diseases that are spread through direct and indirect contact.
Precautions:
Isolation room
Gowns and gloves
Equipment precautions
Examples of diseases:
MRSA
VRE
Contact Precautions
Some communicable diseases can be spread through direct contact and indirect contact. Two examples are MRSA (methicillin-resistant staphylococcus aureus) and VRE (vancomycin-resistant enterococcus). These two infections are highly contagious and very dangerous. Therefore, special precautions must be applied to patients with these diseases.
Patients who require contact precautions must be placed in an isolation room. Health care workers who treat these patients must put on gowns and gloves before entering the room. After the procedure, protective equipment must be removed and discarded carefully to avoid transmitting the disease. Whenever possible, the medical equipment used on these patients should be disposable or used only with the infected patient. If equipment must be used for additional patients, it must be disinfected and sterilized first.

16. Droplet Precautions
Droplet precautions are used for patients with diseases that are spread through large airborne droplets.
Precautions:
Isolation room
Standard surgical masks
Examples of diseases:
Pneumonia
Influenza
Whooping cough
Droplet Precautions
For some types of communicable diseases, droplets that are released when a patient sneezes or coughs are large and do not stay in the air for a long period of time. Droplet precautions are required for these diseases. Diseases that require droplet precautions include pneumonia, influenza, and whooping cough.
Patients with these diseases must be placed into an isolation room, but negative air pressure is not needed. Health care workers who enter these rooms must wear standard surgical masks. However, respiratory filters are not required.

17. Airborne Precautions
Airborne precautions are used for patients with disease that are spread through tiny airborne droplets.
Precautions:
Isolation room
Respiratory protection
Negative pressure
Examples of diseases:
Tuberculosis
Chicken pox
Measles
Airborne Precautions
Some communicable diseases are spread by tiny airborne droplets. When an infected person coughs or sneezes, tiny droplets are released into the air. Because the droplets are so small, they can remain in the air for a long time and cause infection in people who inhale the droplets. Diseases that require airborne precautions include tuberculosis and chicken pox.
Patients who are diagnosed with this type of communicable disease must be treated with special care. First, they should be placed into a private room. This practice is called isolation. Second, health care workers who enter the private room must wear special respiratory protection, such as a high-efficiency particulate air filter (HEPA mask). Finally, the room must be kept at negative pressure with the door closed. Negative pressure will keep droplets from being drawn into other rooms.

18. Transmission-Based Garments
When health care workers enter isolation rooms, they must wear transmission-based garments.
Health care workers must wear appropriate garments based on the disease of the patient. Proper PPE!
Transmission-Based Garments
Patients with highly communicable diseases must be placed into isolation rooms. When health care workers enter isolation rooms, they must wear transmission-based garments.
Recall that there are three types of transmission-based precautions: airborne, droplet, and contact. These precautions require different types of protective garments. Health care workers must wear appropriate transmission-based garments based on the disease of the patient.

19. Isolation Units
Patients with communicable diseases are often placed into private rooms for isolation.
This practice helps prevent the spread of communicable diseases to health care workers and other patients.
Most procedures Requires at least two health care workers in an isolation room
Isolation Units
Patients with communicable diseases are often placed into private rooms for isolation. This practice helps prevent the spread of communicable diseases to health care workers and other patients. Health care facilities must establish specific regulations for working in isolation units. Health care workers must always use the special precautions outlined by their facility.

20. Meals in an Isolation Unit
Most facilities require that disposable food trays and eating utensils are used in isolation units. So you can dispose in patient’s room.
Leftover food and beverages should never be taken out of an isolation unit. Liquids and soft foods should be flushed down the toilet. Solid foods should be placed in biohazardous waste bags.
Meals in an Isolation Unit
Certain rules should be followed for meals in isolation units. For example, most facilities require that disposable food trays and eating utensils are used. The trays and utensils can then be discarded into biohazardous waste bags instead of risking contamination to other patients and health care workers.
Additionally, leftover food and beverages should never be taken out of an isolation unit. Liquids and soft foods should be flushed down the toilet. Solid foods should be placed in biohazardous waste bags.

21. Personal Protective Equipment
Degree of risk to exposure
Gloves, masks, eye protection, shoe covers, and gowns
Personal protective equipment (PPE) must be provided by your employer. It is up to you to wear it.

22. Gowns
Gowns should be worn when using chemical solutions and during procedures where splashing or spraying of blood and bodily fluid is likely.
Disposable gowns should be placed into biohazardous waste containers after use.
Non-disposable gowns may be placed into biohazardous linens bags.
Gowns
Gowns are personal protective equipment that must be worn during certain medical procedures. Health care workers should wear gowns when using chemical solutions for disinfection or sterilization. Gowns should also be worn during procedures where splashing or spraying of blood and bodily fluid is likely.
Health care workers must change gowns between patient visits. The same gown should never be worn for more than one patient. In addition, disposable gowns should be placed into biohazardous waste containers after use. Non-disposable gowns may be placed into biohazardous linens bags and then sent to be laundered and disinfected.

23. Masks and Eyewear
Masks and eyewear must be worn for procedures that may produce splashes or sprays of blood or bodily fluid.
Masks should be worn once and then discarded into biohazardous waste containers.
Eyewear is often reusable. However, it must be cleaned and disinfected before reuse.
Masks and Eyewear
According to standard precautions, health care workers must wear masks and eyewear for procedures that may produce splashes or sprays of blood or bodily fluid. Masks and eyewear will protect a health care worker’s eyes, mouth, and nose from exposure to pathogens.
For procedures that require other forms of personal protective equipment, masks and eyewear should be put on after gowns and before gloves. Masks should be worn once and then discarded into biohazardous waste containers. If a mask gets wet or is worn for more than 30 minutes, it must be discarded and replaced with a new mask. Eyewear is often reusable. However, it must be cleaned and disinfected before reuse.

24. Non-Sterile Gloves
Non-sterile gloves should be worn when contacting blood or other bodily fluids and when handling or cleaning contaminated items.
The same pair of gloves should never be worn in more than one procedure.
Wearing gloves should never replace washing hands.
Non-Sterile Gloves
Non-sterile gloves are essential pieces of personal protective equipment. However, wearing gloves should never replace washing hands. Hands must be washed first and then gloved. Health care workers should wear non-sterile gloves when contacting blood or other bodily fluids and when handling or cleaning contaminated items.
If other protective equipment is required for a procedure, gloves should be put on last. Gloves should always be changed between patient visits. The same pair of gloves should never be worn in more than one procedure. In addition, gloves must never be washed and reused. Washing gloves could create holes and make them ineffective.

25.
Write the five steps for Donning (putting on) and Doffing (taking off) PPE.

26. DONNING
Hand hygiene
Gown
Mask
Goggles/Eye Protector
Gloves

27. Doffing
Gloves
Goggles
Gown
Mask
Hand hygiene

28. Let’s Get Creative
Write/Draw steps for PPE on paper. Use markers, draw, anything to help you remember the steps.

29. Exit Ticket 1. Give me one thing you need more clarification on
2. Tell me something you learned today
3. What time did you go to bed last night? Please write in military time.

30. Day 2
January 10, 2018

31. Bell Ringer What are the steps for Donning and Doffing PPE
What are the main 2 reasons we have Standard Precautions?
How should you dispose containers that hold blood or body fluids?
Where would you put a needle, glass or any sharp?

32. DONNING
Hand hygiene
Gown
Mask
Goggles/Eye Protector
Gloves

33. Doffing
Gloves
Goggles
Gown
Mask
Hand hygiene

34. Disposal of Biohazardous Waste
Containers that hold blood or body fluids
Containers are required to have biohazardous labels
Biohazardous waste is any waste that may contain blood or body fluids. Recognize these labels, and dispose of material properly.

35. Standard
9) Demonstrate mastery of concepts and skills related to asepsis, Universal Precautions, sanitation, disinfection, and sterilization for patient/client care settings in adherence to standards and guidelines from the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) in a lab/clinical setting.

36. Objective for the day: By the end of class, students will:
Be able to define Asepsis, Sanitation
Disinfection, Sterilization
Know how to properly cover their cough

37. Asepsis Freedom from infection or infectious material.
Absence of viable pathogenic organisms
 The prevention of contact with microorganisms.
Asepsis refers to a condition free from pathogens. There are three levels involved.

38. Medical Asepsis
Method of performing procedures and providing patient care so that pathogenic organisms are not transmitted from ill patient to anyone else
As few microorganisms present as possible
Destruction of pathogenic organisms after they leave the body
Easiest way? Follow standard precautions
Consider specimens to be contaminated
Medical aseptic technique is a method of performing procedures and providing patient care so that pathogenic organisms are not transmitted from the ill patient to other patients or anyone else.

39. 3 Ways we Keep Asepsis
Handwashing
Sanitization
Disinfection

40. Hand Washing
Single most effective way to prevent the spread of disease
Soap and warm water, rub vigorously 15 seconds
Antiseptic hand wash, cover all surfaces of hands, and air dry
Hand washing is the single most effective thing we can do to prevent the spread of pathogens and disease. Simple hand washing can be done with soap and water or with alcohol-based hand sanitizers. Alcohol-based hand sanitizers must contain 60% to 90% alcohol for effectiveness.

41. Typical Times to Wash Hands
Beginning work
Before and after rooming patients
Before and after cleaning exam rooms
Before and after assisting the physician with procedures
Before and after cleaning equipment
Before and after using the restroom
Before and after taking a break or eating lunch
At the end of the day
Hand washing should be done many times throughout your day. These are examples of when to wash your hands.

42. Sanitization
the process whereby pathogenic organisms are reduced to safe levels on inanimate objects, thereby reducing the likelihood of cross-infection.

43. Sanitization of Equipment
Inactivating or removing microorganisms on reusable equipment and surfaces to a safe level
Chemicals, heat, and gas are used
Low-suds detergents are commonly used
Read labels, follow manufacturer’s directions, rinse all instruments, and protect yourself
The medical assistant should wear utility gloves or heavy-duty gloves when sanitizing equipment. The medical assistant should also wear other appropriate personal protective equipment (PPE) such as a gown and goggles.

44. Disinfection
Process in which most or nearly all microorganisms (whether or not pathogenic) on clothing, hard surfaces, and/or wounds are killed through the use of chemicals, heat, or ultraviolet rays.
Destruction of pathogenic microorganisms or their toxins or vectors by direct exposure  to chemical or physical agents.

45. Disinfection More thorough than sanitization
Kills bacteria and most microorganisms but not spores
Use different disinfectants for surfaces and equipment vs. skin surfaces
Read labels and follow manufacturer’s directions
Iodine, household bleach, and 70% alcohol
Disinfection typically involves the application of a substance to equipment, surfaces, or other items to kill pathogenic microorganisms. Disinfection can be done to countertops and trays, some types of furniture, and even the skin.

46. Sterilization or Surgical Asepsis
The process of destroying ALL microorganisms and their pathogenic product It can be accomplished by various methods, including heat, gas plasma, irradiation, or a bactericidal chemical compound.

47. Surgical Asepsis
Sterile technique, also called surgical asepsis, is maintaining an area that is free from all microorganisms.
Sterile technique must be practiced for all invasive procedures to protect patients from infection.
To maintain a sterile area, only sterile items may touch other sterile items.

48. Standard Precautions
Use appropriate personal protective equipment or PPE
Perform hand hygiene
Follow respiratory hygiene/cough etiquette
Ensure appropriate patient placement (isolation precautions)
Properly clean and disinfect patient equipment devices and the environment
Follow safe injection practices and handling of needles, sharps and hazardous materials
Standard Precautions for Patient Contact
According to the CDC, every bodily fluid must be considered infectious. Therefore, health care workers must use appropriate personal protective equipment, such as gloves, masks, eyewear, and gowns, when they are likely to contact infectious materials. Infectious materials include blood and other bodily fluids, mucous membranes, non-intact skin, and tissue specimens.
Hands must be washed frequently to avoid spreading infection. Hands should always be washed before and after wearing gloves, before and after performing a procedure, after contacting blood or other bodily fluids, and between patient contacts.
Health care workers must bandage all cuts and scratches properly. Patient contact should be limited if a worker has a wound or skin condition that is likely to seep or bleed. In addition, health care workers that are sick must avoid direct contact with patients.
Whenever possible, face shields should be used instead of mouth-to-mouth contact during CPR. These devices should be stored in convenient places throughout a medical facility.

49. Clean and Disinfect Equipment
CDC provides: Guidelines for environmental infection control Guidelines for disinfection and sterilization

50. Follow respiratory hygiene/cough etiquette
Post visual alerts in facility alerting patients and their family members to inform healthcare personnel of symptoms of a respiratory infection or flu like symptoms.
Offer masks to patients that are coughing.
Teach patients how to cover their cough!

51. Respiratory Hygiene Measures
Cover your mouth and nose with a tissue when coughing or sneezing;
Use in the nearest waste receptacle to dispose of the tissue after use;
Perform hand hygiene

52. Work it Out
Vocabulary: Key terms page 351
Creative PPE Assignment