Infection Control

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Infection Control

• Jodie Burr
• Infection Control Coordinator
• Womens and Childrens Hospital

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Infection Control Unit

• 24 Hour Infection Control Service
• During office hours page 18041
• After hours ring 9 for Infectious Disease
  Consultant on call
• Infection Control Team
• meet weekly, concerns, enquiry's, issues can be
  discussed

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Primary Role of Infection Control

• Prevent nosocomial infections
• Reduce mortality, morbidity, and cost
• Educate and advise
• staff
• patients
• their families
• the community
• Surveillance of nosocomial infections
• Policy development, implementation and assessment

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IC Issues specific to Paediatrics

• Communicable diseases affect a higher of
  paediatric patients than adults
• non-immune - acquire - spread
• paediatric personnel are at a greater risk for
  exposure to communicable diseases - immune status
• May lack the mental / physical ability to adhere
  to IC principles
• lack of hygiene
• unable to understand / comply with IC principles

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IC Issues specific to Paediatrics

• More likely to have contact with contaminated
  environmental surfaces and objects
• Parents and siblings
• may have the same infectious agent
• involved in patient care - education about
  transmission and IC principles

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Immunization

• It is important to know your health and
  immunization history
• chicken pox
• measles
• flu vaccination
• pertussis
• For vaccinations contact ICGP or Risk Management

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IC Link Nurses

• Educate ward/unit staff
• Ensure compliance with infection control
  guidelines
• Assist with outbreaks or disease exposures
• Develop patient staff information brochures
• Promote infection control initiatives

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Standard Additional Precautions

• Standard Precautions
• all patients
• all times
• Additional Precautions
• some patients
• some times

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Standard Precautions

• Work practices necessary to fulfil basic
  infection control requirements
• For all patients regardless of diagnosis or
  presumed infectious status

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Standard Precautions

• Apply to
• Blood
• All body fluids - excretion and secretions
  (including sweat)
• Non-intact skin
• Mucus membranes
• Regardless of whether there is visible blood or
  body fluids

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Hand Hygiene

• The single most effective method in the
  prevention of disease transmission
• 80 hospital acquired infections are thought to
  be transmitted by hands
• Healthcare workers think they wash their hands
  more than what they do

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Hand Hygiene

• Soap and Water
• mechanical removal of most transient flora and
  soil
• minimal microbial kill
• no sustained activity
• 15 seconds

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Hand Hygiene

• Antimicrobial Soaps
• removes soil, removes transient and reduces
  resident flora
• may have sustained activity
• 15 seconds (antiseptic handwash)
• 60 seconds (clinical handwash)
• 2 minutes (surgical scrub)

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Hand Hygiene

• Alcohol Handrubs / Gels
• very rapid kill
• destroys transient and reduces resident flora
• no residual activity (except with antiseptic)
• will not remove or denature soiling
• 15 seconds

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Areas most frequently missed
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Personal Protective Equipment

• Eye and/or facial protection (goggles, face
  shields)
• Gloves
• Gowns
• Masks
• Assess the likely hood of contamination and
  prepare accordingly

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Equipment Reprocessing

• If it comes into contact with
• intact skin clean
• mucous membranes high level disinfection
• sterile site sterilise
• All items must be cleaned first
• Single-use items must not be reused

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Environmental Controls

• Cleaning
• detergent and water is adequate
• ensure patient care areas are cleaned regularly
• minimize clutter
• Linen and Laundry
• no need to mark infectious
• if the skip is wet then place in a plastic bag

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Waste

• General Waste (Green Bin)
• dressings, bandages, nappies, sanitary pads,
  flowers, kitchen waste, plastic, paper, empty
  containers of blood, body fluid, IV lines,
  urinary catheters
• Medical Waste (Yellow Bin)
• ALL sharps, bags or tubing of blood, human
  tissue, lab specimens and cultures, cytoxic waste
  (sealed in purple cytoxic container or bag first)

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Blood and Body Spills

• Small spills
• wipe up with paper towel
• detergent and water
• Large spills (easy to clean surface)
• wipe up with paper towel
• detergent and water
• Large spills (difficult to clean surfaces)
• wipe up with paper towel
• detergent and water
• wipe over with Milton(R)

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Assessment of Risk Factors

• Your knowledge or experience with the situation
  or procedure
• The likely hood of exposure to blood or body
  fluids at the time
• The patients ability to cooperate through out the
  procedure

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Additional Precautions

• Are applied in addition to Standard Precautions
• Apply with
• highly transmissible organisms
• epidemiologically significant organisms

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Additional Precautions

• May include
• Single room accommodation (ensuite for some)
• Special ventilation (negative, positive pressure)
• Special room cleaning
• Dedicated patient equipment
• Rostering of immune staff
• Extended sterilization (or use of disposable
  equipment)
• Cohorting may be considered

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Bed Management

• CATEGORY AVery High Risk of Cross Infection or
  Adverse OutcomeMandatory Negative pressure
  single room
• CATEGORY B High Level of Cross
  InfectionMandatory Single room or cohort same
  contagious agent
• CATEGORY C Moderate Risk of Cross
  InfectionSingle Room in Selected Circumstances
  
• CATEGORY DHigh Risk to the Newborn Rooming in
  not allowed
• CATEGORY ELow risk of Cross Infection No
  segregation required

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Respiratory Syncitial Virus

• Highly contagious and nosocomial infection common
• Causes upper and lower respiratory infection
• Usually occurs during winter
• No vaccine at present
• Can be reinfected during the same season
• Transmitted by contact or droplet
• Can survive for several hours in the environment

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Rotavirus

• Highly contagious and nosocomial infection is
  common
• Usually a winter disease but pattern changing
• Onset is sudden and lasts for 4 - 6 days
• Mainly infants and children up to 3 years
  affected
• Transmitted usually through contact
• Can survive in environment for several hours

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Gastrogard-RTM

• Hospital Acquired Rotavirus diarrhoea prevention
  program
• Eligible if
• aged between 0 days and 48 months
• regardless of whether they already have or
  develop gastroenteritis
• Ineligible if
• cows milk protein intolerant (not lactose
  intolerant)
• if on a protein restricted diet
• fasting
• breast fed

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Varicella Zoster VirusChicken Pox

• Highly contagious
• Most cases in children, over 90 of adult
  population is immune
• Transmitted by droplet and contact
• Infectious 2 days prior and 4 - 6 days after rash
• Now a notifiable disease
• Vaccination now available

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Varicella Zoster VirusChicken Pox
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BUG WATCH
Infection Control Awareness Program for
Visitors