1. Infection Prevention and Control
Infection Prevention and Employee Health Nurse
Stanislaus Surgical Hospital

2. Preventing the Hospital Acquired Infection

3. What is an infection? An infection is an invasion and multiplication
of microorganisms in body tissues,
as in an infectious disease.

4. Topics of Interest

5. Six EVENTS in place to cause an Infection
1. Presence of an infectious agent
Virus
Bacteria
Fungus
Protozoa
Prevention: Identification of the organism.

6. Six EVENTS in place to cause an Infection (CONT’D)
2. Reservoirs: Where organisms are found
YOU
Equipment
Surfaces
Water
Prevention:
EH screening
Environmental sanitation
Disinfection/Sterilization
3. Portal of Exit: Mode of organisms transferred
Excretions
Secretions
Skin pores
Prevention:
Proper personal protective equipment
Hand washing
Proper disposal of trash and waste.
Six EVENTS in place to cause an Infection (CONT’D)

7. Six EVENTS in place to cause an Infection (CONT’D)
Means of Transmission
Airborne fomites
Direct contact ingestion
Prevention:
Hand washing
Sterilization
Isolation
Air flow control
Food handling
Portal of Entry
GU tract
GI tract
Mucous membranes
Respiratory tract
Broken skin
Prevention:
Aseptic technique
Catheter care
Wound care
Six EVENTS in place to cause an Infection (CONT’D)

8. Six EVENTS in place to cause an Infection (CONT’D)
Susceptible Host
Immunosuppression diabetes
Surgery patients
Burn patients
Cardiopulmonary disease
Prevention:
Treatment of underlying disease
Recognition of high risk patients
Six EVENTS in place to cause an Infection (CONT’D)

9. What are the SIX Links in the Chain of Infection?

10. Answer 1. Infectious Agent 2. Reservoirs 3. Portal of Exit
4. Means of Transmission
5. Portal of Entry
6. Susceptible Host

11. Reducing the Risk of Infection

13. Standard / Universal Precautions:
Are the most frequently performed basic hygiene “Standard” in all healthcare settings
Hand washing at the beginning and completion of a task or when visibly soiled
Additional Personal Protective Equipment (PPE), (e.g. gown, mask, face shield, etc.)may be used if anticipating a splash or spray of body substances to bare skin, eyes, or clothing

14. Enhanced Contact Precautions:
Are initiated when an infection is present in an individual that can be transmitted by contact with bare skin, environmental surfaces, waste, and body substances.
Minimum REQUIRED PPE: Gown and gloves
Private room.

15. Contact Precautions
Enhance Contact Precautions
ISOLATION SIGNS

16. Airborne Precautions: Droplet Precautions:
Are initiated when an infection is present in an individual that can be transmitted by fine aerosol droplets during sneezing and coughing.
Fine aerosol droplets can stay suspended in the air for prolonged periods of time and can easily travel long distances to infect people, environmental surfaces, and waste.
Minimum REQUIRED PPE: N-95 respirator mask, & possible droplet precaution PPE as well
Private room
Are initiated when an infection is present in an individual that can be transmitted in droplet form by sneezing or coughing body substances onto people, environmental surfaces, and waste
Minimum REQUIRED PPE: Eye protection, mask, and face shield if within 3 feet of an infected person
Private room or cohort with like patient

17. Airborne Precautions
Droplet Precautions
ISOLATION SIGNS

18. Bloodborne Pathogens; Exposure Prevention

19. Bloodborne pathogens are disease causing microorganisms (pathogens) that are carried (borne) in the blood stream
Contact with blood, blood components, or body fluids known to carry these could result in you getting a bloodborne disease
Requires Standard / Universal Precautions
Know what SSH’s Policy and Procedure for Blood

20. The federal and state regulation (Bloodborne Pathogen Standard), is directed toward three viruses known to cause severe disease, although others are also considered:
Human immunodeficiency Virus (HIV)
Hepatitis B Virus (HBV)
Hepatitis C Virus (HCV)

21. How are bloodborne pathogens spread?
By infected body fluids that enter the body through:
Needlestick injuries
Cuts, scrapes, and other breaks in your skin
Splashes into the mouth, nose or eyes
Oral, vaginal or anal sex
Using contaminated drug needles

22. What do you do if you have an exposure?
Wash laceration or eyes for 10 minutes
Milk and wash punctures
Flush mucous membranes
Contact manager for further assistance

23. Bloodborne Pathogens; Exposure Prevention

24. Topic RECAP:
What are the first four actions you do if you have an exposure?

25. RECAP Answer:
Wash laceration or eyes for 10 minutes
Milk and wash punctures
Flush mucous membranes
Contact manager for further assistance

26. Tuberculosis (TB) Prevention and Testing

27. What is Tuberculosis and how does it spread?
Tuberculosis, commonly known as TB, is a contagious and an often severe airborne disease caused by a bacterial infection. TB typically affects the lungs, but it also may affect any other organ of the body. It is usually treated with a regimen of drugs taken for 6 months to 2 years, depending on the type of infection.

28. People who are at higher risk for TB:
People with HIV disease
Anyone who shares close quarters with a person with active TB
Foreign-born people from nations with high rates of TB
Alcoholics and intravenous drug users
Chronically malnourished people
Homeless people
People with diabetes or silicosis
People who live or work in nursing homes, prisons or TB treatment centers

29. What environmental factors increase risk of transmission?
Exposure to TB in a small enclosed space
Inadequate local or general ventilation
Recirculation of air containing infectious droplets

30. Latent Phase Active Phase
Person caries the germs, but cannot infect others
They:
Do not look or feel sick
May have preventative treatment recommended to reduce the chance it will become an active disease
This person carries the germs and can infect others
They:
Cough for > 3 weeks
Feel weak
Have a fever
Unexplained weight loss
Loss of appetite
Experience night sweats
Cough up blood
Painful coughing

31. California State Safety requirements :
New hire employees are required to have a two step TB Skin Test prior to starting or a Chest X-ray to rule out active infection
Annual TB Employee Health Screens: TB Skin Test Record or TB Symptoms Questionnaire
HCW must be Fit-Tested for N-95 Mask / Respirators
Patients with active TB must be in a single Airborne Infection Isolation Room with Airborne Precautions

32. Influenza

33. Influenza (flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions are at high risk for serious flu complications. The best way to prevent the flu is by getting vaccinated each year. (Herd Immunity)
- Center for Disease Control and Prevention

34. Requirements for inpatient/outpatient care:
Droplet precautions.
Respiratory and Cough Etiquette
Visitation requirements change during influenza season to minimize exposure to vulnerable patients and staff
The California Department of Public Health; Stanislaus County Public Health Officer Dr. John Walker, initiated mandatory masking order for all HCW who have chosen to not be vaccinated. This order will be for the entire influenza season (Nov. 1- Mar 31).

35. RECAP: Respiratory and Cough Etiquette
Stay home if you’re sick to prevent the spread of the flu
HAND HYGEINE!

36. Preventing Work Related Injuries

37. Work related injuries are preventable
Healthcare workers are at a higher risk for injury due to exposure to ill patients, physical tasks, and environment.
Cal-OSHA have many safety requirements for employers to enforce
SSH has developed a free to report culture on all malfunctioning equipment and environmental hazards (work order)

38. Back injuries are very common in the healthcare setting.
Things to avoid:
Twisting at the waist while lifting
Over stretching to reach an object
Lifting or carrying objects that are awkward in shape
Lifting or carrying objects that are too heavy
Bending your back to lift an object

39. Things we can do to minimize injuries:
Assess the job at hand
Redesign if possible (raise or lower shelves)
Test the weight of an object before lifting
Stand close to the load when lifting and carrying
Bend at the knees not the back
Get help
Use a dolly or push cart to transport objects

40. RECAP:
There are five safe lifting techniques an employee can do to minimize back related injuries. What are they?

41. RECAP Answer:
Stand close to the load
Bend at your knees; not your back
Let your legs do the lifting
Get help for heavy or awkward loads
Use the right tools

42. QUESTIONS?