INFECTION CONTROL

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INFECTION CONTROL

• EPIDEMIOLOGY DEPARTMENT
• Veronica Haschke, RN
• Nurse Epidemiologist
• Nancy King, RN
• Infection Control Nurse

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What is Infection Control?
Processes used to reduce the risk of patients and
healthcare workers becoming sick due to exposure
to infections and infectious diseases in a
healthcare workplace. Have to comply with AOA,
CDC, Title 22 24 (CCR), DHS, OSHA, and CMS
regulations and recommendations.
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INFECTION CONTROL PRACTICES help to prevent the
spread of infection

• Hand Hygiene
• Standard Precautions
• Personal Protective Equipment
• Isolation Precautions
• Biohazard Waste Disposal
• Management of Contaminated Linen
• Proper use of Computerized Tube System

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Healthcare-Acquired Infections (HAI)

• not present or incubating on admission
• evident more than 48 hrs after admission
• associated with a treatment or procedure done
  in a healthcare setting
• incubating on admission and related to a
  previous hospitalization

• Common Types
• Urinary Tract Infection
• Surgical Site Infection
• Pneumonia
• Wound Infection

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Healthcare-Acquired Infections (HAI)

• Occur in more than 2 million hospitalizations
  per year
• Increased related deaths by 35
• Increased average length of stay
• 7 - 9 days
• Increased average ICU stay 8 days
• Increased hospital stay 14 days
• Average HAI cost 13,973

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Top six leading causes of death in the U.S. 1.
Heart disease 2. Cancer 3. Stroke 4. Chronic lung
disease 5. Motor vehicle accidents 6. ??
HAIs
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How infections are spread
1. Existence of a germ that causes infection 2.
Germ is brought into hospital by person or on
object 3. Method of travel 4. Method to get on or
into another person 5. Susceptible person
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Standard Precautions

• Work practices that help prevent the spread of
  infections and infectious diseases.
• ALL PATIENTS SHOULD BE CONSIDERED INFECTIOUS!!!
• employees
• registry staff
• visitors
• physicians
• students
• vendors
• contractors

Anyone who enters hospital
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Hand Hygiene is the right thing to do.
If you could save someones life in 15 seconds,
would you? Decontaminate your hands before and
after every patient contact and you will !! Hand
hygiene is still the 1 way to stop the spread
of infection!
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No excuses! No exceptions!

• Surgical scrub - department specific
• Traditional 15 second wash with soap and water
• When hands VISIBLY soiled with blood or body
  fluids
• Alcohol Based Hand Rub
• After contact with intact skin/surfaces

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When to wash your hands

• After contact with patients or patient care
  equipment
• After contact with environmental surfaces
• AFTER GLOVE REMOVAL
• Before after any procedure involving patient
  care
• After using restroom

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• How to wash every time
• Wet both hands
• Obtain 2-3 pumps of soap in palm of one hand
• Rub all surfaces of lathered hands
• Scrub for a full 15 seconds
• Rinse well
• Dry thoroughly with paper towel
• Use towel to open door(s)

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Alcohol - based hand antiseptic

• Use waterless alcohol-based product after contact
  with environmental surfaces or after contact with
  patients intact skin.
• Horizontal Surfaces
• Equipment
• Light switches
• Beds/Bed Rails
• Door knobs

Can use ALL day unless hands visibly soiled.
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Why all the fuss???

• Hands Spread Infection
• Hospital Acquired Infections (HAIs)
• Preventable
• Undue Pain and Suffering to Patient
• Prolongs Hospitalization
• dollar to treat each
• Can cause HCW illness

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CDC Hand HygieneRecommendations

• Artificial fingernails, including anything that
  enhances the natural nail, are not allowed for
  employees who have direct contact with patients,
  or provide patient care services.
• Natural nails are to be kept clean and no longer
  than 1/4 long. Nail polish must be without
  chipping, cracking or peeling.

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Keep long hair pulled up/back
and away at all times when performing patient
care.
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OSHA Regulation

• There will be no eating or drinking, applying
  cosmetics or handling contact lenses in ANY
  patient care areaincluding
• nurses station
• hallways
• med room
• procedure carts
• EVS carts
• patient supply carts
• sitters chairs

For your protection
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• ISOLATION PRECAUTIONS
• Contact
• Wounds, abscesses, diarrhea, RSV
• MRSA, VRE, ESBL, C. diff

CONTACT ISOLATION

• Airborne
• Mycobacterium tuberculosis (MTB)
• Chickenpox, measles

AIRBORNE INFECTION ISOLATION

• Droplet
• pneumonia or sputum w/ drug resistant
  organisms, bacterial meningitis

DROPLET ISOLATION
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Notify Infection Control
Isolation

• When patients placed into isolation for
• Droplet - i.e., Pertussis, Rubella, Mumps,
  Bacterial meningitis (not for viral)
• Contact - i.e. Lice, Scabies
• Airborne - Tuberculosis, Chickenpox, Measles
• When patient w/ a Critical Care Indicator (CCI)
  are admitted
• Fax IC Notification Form to 00086
  
  or
• Leave message at Ext. 00072 or 02354

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• Computerized Tube System
• Used to transport medications AND biohazard lab
  specimens
• Specimens should be
• - Placed in correct container
• -Double bagged in biohazard bag, then a
  re-sealable plastic bag prior to placing into
  carrier
• - Padded with foam inside carrier to prevent
  leaking/breaking

Major infection control problems when specimen
leaks/spills!!
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Biohazard Waste
Only items filled, saturated or dripping with
blood or other medical or regulated body fluids
will be discarded in biohazard containers.
blood semen cerebral spinal fluid
synovial pleural pericardial
peritoneal amniotic vaginal secretions
those of unidentified sources
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Biohazard Waste
Non-Regulated Body Fluids urine feces
vomitus nasal secretions sputum sweat and
tears Items contaminated with these body fluids
are discarded into the regular trash.
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Biohazard Waste
All used sharps or sharp instruments are
considered contaminated and must be discarded
into sharps disposal container. These
items should be discarded in sharps
disposal containers needles burrs
syringes drills scalpels bits
lancets wires
Engage sharps safety feature after use and
before discarding !
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Sharps Waste does not include
paper alcohol swabs wrappers
gloves tubing cups plastic vials
glucose test strips batteries etc., etc.,
etc.
Batteries go into special containers in your
department.
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Biohazard Waste
Each red biohazard waste bag MUST be tied shut
with a SINGLE knot prior to discarding into the
large barrel or tote.
Do not overfill
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Contaminated Linen

• Once clean linen is removed from the cart - it
  is never replaced.
• Clean linen cart covers are to be in place at
  all times.
• Linen is NEVER discarded in trash.
• Special hampers for reject linen

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Biohazard Waste
Pharmaceutical Waste must be discarded, stored,
transported and disposed separately from all
other biohazard waste. Special containers for
partial/wasted regular and hazardous
pharmaceutical waste.
More info during Nursing Orientation
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Do not be afraid to remind a co-worker, doctor,
or visitor of the importance of proper hand
hygiene, use of personal protective equipment and
strict isolation precautions. Its up to each
one of us to be a shining example to others and
to protect all of our patients.
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Remember
Clean hands and effective IC practices save
lives!