1. Build an Isolation Cart: and they will use it
CEDEP │ Healthcare Associated Infections and Antimicrobial Resistant Infections Division

2. Goals Review the following concepts:
Categories/types of personal protective equipment (PPE)
Appropriate use for each piece of PPE
Review hand hygiene
Basic environmental cleaning
Setting up a contact isolation cart

3. Standard Precautions
Primary strategy for the prevention of healthcare associated transmission of infectious agents
Applied to ALL patients/residents in ALL healthcare settings, regardless of the suspected or confirmed presence of an infectious agent
Based on the principle that all blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes may contain infectious agents

4. Standard Precautions vs. Contact Precautions
IF you anticipate contact with something that has a high degree of infectivity, protect yourself and other patients/residents
Contact Precautions
You WILL contact something with a high degree of infectivity, protect yourself and other patients/residents
PPE for both situations is essentially the same

6. Types of PPE Used in Healthcare Settings
Gloves – protects hands
Gowns/aprons – protects skin and/or clothing
Masks and respirators – protects mouth/nose
Respirators – protect respiratory tract from airborne infectious agents
Goggles – protect eyes
Face shields – protect face, mouth, nose, and eyes

7. What Factors Influence PPE Selection?
Type of exposure anticipated
Splash/spray versus touch
Category of isolation precaution
Durability and appropriateness for the task
Fit

8. The Most Basic Concept Hand hygiene
Avoid unnecessary touching of surfaces in close proximity to the patient/resident
When hands are visibly dirty, contaminated with proteinaceous material, or visibly soiled with blood or body fluids, wash hands with soap and water
If hands are NOT visibly soiled or after removing visible material with nonantimicrobial soap and water, decontaminate hands with an alcohol based hand rub (ABHR)

9. When to Perform Hand Hygiene
Before and after direct contact with patients
Before and after contact with the patient’s environment
If hands will be moving from a contaminated body site to a clean body site during care of the same patient
After removing gloves

10. My 5 Moments of Hand Hygiene

11. So what about artificial nails?
Do not wear artificial nails/extenders if duties include direct contact with patients/residents at high risk for infection and associated adverse outcomes
Develop an organizational policy on wearing of non-natural nails by healthcare personnel who have direct contact with patients/residents

12. Dedicated Patient Care Equipment
In addition to PPE, what should be considered for the contact isolation cart?
Dedicated Patient Care Equipment
BP cuff, stethoscope, thermometer
Consider additional equipment on an individual basis
Cleaning supplies
Disinfectant wipes to be used as needed
Consider the type of isolation to provide an appropriate product
Ensure your disinfectant is appropriate for the situation, e.g., sporicidal for C. diff. or Candida auris
Hand hygiene product
May need additional ABHR on the cart
Have signage available to alert and educate staff/visitors

13. Please see nurse before entering the room

14. Egress Must be maintained in case of an emergency situation
Most healthcare facility corridors are at least 8 feet wide - Must be able to maintain at least 5 feet of clearance in case of an emergent situation
Day-to-day operations could require keeping some patient care equipment near patient rooms for safety but does NOT allow equipment to be stored in the hallway such as fax machines, files cabinets, etc.
Check with your Facilities Manager, either local or corporate, before making a decision on egress issues

15. Environmental Cleaning
Intended to remove blood, body fluids, and other contaminants from objects and surfaces
Disinfection
a process that kills many or all remaining infection-causing germs on clean objects and surfaces
Use an EPA-registered hospital disinfectant
Follow label instructions for proper dilution and proper contact or treatment time
NOT the sole responsibility of EVS

16. Environmental Cleaning (cont.)
All cleaners/disinfectants are NOT created equal!
Be sure your facility is using an EPA registered disinfectant
Tuberculocidal – a benchmark to measure germicidal potency
Tuberculosis is NOT transmitted via environmental surfaces
If a product is “tuberculocidal”, it is capable of inactivating a broad spectrum of pathogens, including less resistant organisms such as bloodborne pathogens if used as directed
When needed, ensure sporicidal disinfectants are available
EPA has other categories of efficacy claims

17. Counters at nurses’ station High-touch surfaces, common areas
Item
Nursing
Secretary
Housekeeping
When
Glucose meter X
After every use
Phones
Beginning of shift
Kiosks
Once each shift
Med cart
Beginning of shift/prn
Counters at nurses’ station
High-touch surfaces, common areas
1x each shift; increase to 2x each shift during flu season
Computers-on-wheels
Beginning of shift & after potential contamination

18. https://iaspub.epa.gov/apex/pesticides/f?p=PPLS:1

22. Thank You! Enjoy the rest of your lunchbreak!
HAI contact:
(615)
All Outbreaks are Reportable
Enjoy the rest of your lunchbreak!
Thank You!