1. Infection Control and the Bugs

2. Blanche Lenard RN, CIC Education Session Infection Control in Healthcare  Environmental Cleaning  Routes of Transmission  Prevention Strategies  Biofilms  Environmental Cleaning  Questions an IP may ask someone presenting a new cleaning product or program  Q&A

3. Hydrogen Peroxide Technology  Personal Experience

4. Routes of Transmission Contact  Direct – unwashed hands

6. Routes of Transmission  Respiratory Large Droplets – 3 to 6 feet Examples of infectious agents: Influenza viruses Childhood viral diseases

7. Routes of Transmission  Airborne Droplet Nuclei  Tb stays suspended  Air currents can disperse organism CDC and OSHA jointly direct Prevention and Control of Tuberculosis

9. Routes of Transmission  Blood or Body Fluids Occupational sharps injuries – HIV, Hepatitis B and Hepatitis C viruses Occupational sharps injuries – HIV, Hepatitis B and Hepatitis C viruses OSHA – Blood Borne Pathogen Standard prevention and Occupational exposure follow up OSHA – Blood Borne Pathogen Standard prevention and Occupational exposure follow up

11. Colonized or Infected: What is the Difference? People carry bacteria without evidence of infection (fever, increased white blood cell count) = colonization Invasion of tissue by bacteria with symptoms = infection

12. The Iceberg Effect Infected Colonized

13. Fomites, the Inanimate Environment Types of Organisms Recovered: Staph aureus/ MRSA, Enterococcus /VRE, Gram negative bacteria and Clostridium difficile spores

14. Hand Hygiene Definition – Performing handwashing, antiseptic handwashing, alcohol-based hand rub, surgical hand hygiene/antisepsis  CDC/SHEA hand antiseptic the agents of choice Recommended by CDC based on strong experimental,Recommended by CDC based on strong experimental, clinical, epidemiologic and microbiologic data clinical, epidemiologic and microbiologic data Antimicrobial superiorityAntimicrobial superiority  Greater microbicidal effect  Prolonged residual effect Ease of use and applicationEase of use and application

15. Most common mode of transmission of bacteria is via hands!  Healthcare Associated Infections – HAI  Spread of antibiotic resistant organisms So Why All the Fuss About Hand Hygiene?

16. Preventing & Reducing Transmission Hand Hygiene  Required for standard and transmission based precautions  Wash hands with soap and water or use alcohol- based hand rub  Perform… Immediately after removing PPE Immediately after removing PPE Between resident contacts Between resident contacts

17. Environmental Cleaning “If They’re Not There They Can’t Get Moved” Product Types used in healthcare:  Cleaners  Sanitizers  Disinfectant  Sterilants

18. Sanitizers Disinfectants & Sterilants  Sanitizer – Reduces organisms to safe levels, 99% of all bacteria  Disinfectant – Kill 99.999% of organisms not spores not spores  Sterilants – Kill 100% of organisms and spores

19. Bacteria & Biofilms

20. Benefits of Biofilm formation to Bacteria  Stationary growth in a hospitable environment  Resistance to antibiotics, anti-fouling agents etc. (limited toxin penetration)  Synergism between species and metabolisms  Domination of immediate environment

22. Anatomy of a Healthcare Environment  Critical Areas – Operating Room, Laboratory, Emergency & Isolation Rooms  Semi-critical Areas – Patient Rooms  Non-critical Areas Patient room general cleaning and floors Patient room general cleaning and floors Visitor bathrooms Visitor bathrooms Common areas Common areas

23. Semi & Non Critical Surfaces  Semi-Critical: Clean and Disinfect  Patient room surfaces i.e. everything from the waist up  Non-Critical: Clean, remove bio-films and residues without replacing them  Floors  Hard non-porous surfaces

26. Multi-faceted Approach  Hand Hygiene  Personal Protective Equipment  Proper Environmental Cleaning Product and Protocol  A healthcare facility must do all three and do all three right to reduce HAIs.

29. Top Questions an IP Might Ask 1. How is the product classified by the EPA? 2. What does it kill? 3. What is the contact time for the product? 4. What PPE are required for application? 5. How much staff training is required? 6. How will this product help reduce HAI? 7. Cost/Cost savings?

30. The End

31. Questions?