Infection Control and Personnel Safety

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Infection Control and Personnel Safety

• Michael Bell, M.D.
• Division of Healthcare Quality Promotion
• National Center for Infectious Diseases
• Centers for Disease Control and Prevention

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Isolation vs Quarantine

• Quarantine
• Public Health Law
• Limitation of movement / seizure of property of
  individuals for the good of the community
• Isolation
• Infection Control Techniques
• Prevent exposure of personnel and other patients
  to infection risk while delivering/receiving care

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History of Infection Control Precautions

• 1877 Separate facilities
• 1910 Antisepsis and disinfection
• 1950-60 Closure of Infectious disease
  hospitals and TB sanitoria
• 1970 CDC Isolation Techniques for use in
  Hospitals
• (7 categories, over-isolation)

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History of Infection Control Precautions

• 1983 CDC Guideline for Isolation Precautions
  in Hospitals
• (Disease-specific and category-based
  precautions including blood and body-fluids)
• 1985 Universal Precautions
• 1987 Body Substance Isolation

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History of Infection Control Precautions

• 1996 Publication of CDC/HICPAC revised
  guidelines Standard Precautions

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Standard Precautions

• Constant use of gloves and handwashing (plus
  face-shields, masks or gowns if splashes are
  anticipated) for any contact with blood, moist
  body substances (except sweat), mucous membranes
  or non-intact skin.

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Standard Precautions

• Constant use of gloves and handwashing (plus
  face-shields, masks or gowns if splashes are
  anticipated) for any contact with blood, moist
  body substances (except sweat), mucous membranes
  or non-intact skin.
• Additional, Transmission-based Precautions

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Standard PrecautionsGlove use

• Worn for all activities when hand contamination
  is likely
• Removed ( hands washed) when
• single contaminating activity is completed
• glove integrity in doubt
• between patients

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Standard PrecautionsMask / Eye Protection use

• Worn to protect mucous membranes during
  procedures with risk of splashing body fluids.
• Note When mask worn to protect mouth/nose, dont
  forget to protect eyes.

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Standard PrecautionsGown use

• A clean, non-sterile gown is worn to protect skin
  and prevent soiling of clothing
• Used during procedures likely to generate
  splashes of body fluids

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Standard Precautions

• Transmission-based Precautions
• Airborne (TB, Chicken pox, Measles, Smallpox)
• Droplet (Diphtheria, Pertussis,
  Meningococcus,....)
• Contact (Enteric infections, Respiratory
  infections, Skin infections,. )

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Standard Precautions

• Transmission-based Precautions for Smallpox
• Airborne
• Droplet
• Contact

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Goals of Smallpox Isolation

• Protect unvaccinated individuals
• including healthcare/response personnel and other
  patients
• PREVENT
• Sharing closed airspace with potentially
  infectious patients
• Direct contact with potentially infectious
  patients
• Contact with of infectious materials

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Prevent sharing closed airspacewith potentially
infectious patients

• Negative pressure isolation rooms
• Separate facilities for larger groups
• Respirators for unvaccinated care-providers

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Prevent direct contact with potentially
infectious patients or materials

• Standard Precautions
• prevents direct contact during care
• prevents transmission of other infections
• Contact Precautions
• prevents dispersal of potentially infectious
  material by care-providers

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Guide C

• Community-based isolation
• Type C Confirmed
• Exposed - Vaccinated - Symptomatic
• Type X Unknown
• Exposed - Vaccinated - Febrile
• Type R Residential
• Exposed - Vaccinated - Asymptomatic

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www.cdc.gov/ncidod/hip/isolat/isolat.htm

• Complete text of the current CDC/HICPAC Isolation
  Precautions are available on-line.