Patient Empowerment Education Campaign

1
Patient Empowerment Education Campaign

• Patients will receive a hand hygiene brochure in
  their admission packet .
• As you review the admitting pack and brochure
  with each patient , stress that we know patient
  safety is a topic in the media. We want them to
  know that it is important to us too. So, we are
  encouraging them to ask their healthcare workers
  when they enter their room
• Have you washed your hands?

2
Health Care Worker Response

• When a patient asks you if you have washed
  your hands, what are some responses?
• Yes, thank you for asking. or
• No, thank you for reminding me.
• (go and wash)

3
Standard Precautions

• For ALL patients
• Does NOT mean do Nothing!!!
• If it is wet and its not Yours ., wear gloves.
• If your patient has an undiagnosed rash, wear
  gloves.
• If your patient is incontinent or has large open
  draining wounds, use contact precautions.
• Do NOT reuse gowns, even for contact with the
  same pt. !!!!!!
• Do NOT wear PPE (e.g., gown, gloves, mask
  hanging around neck) outside of patients room.
• During aerosol generating procedures
  (bronchoscopy, suctioning w/o in-line suction
  catheters, endotracheal intubation- wear face
  protection (goggles and mask or face shield).
• Wear masks when placing a catheter or injecting
  material into the spinal canal or subdural space
  (i.e. myelograms, lumbar puncture, and spinal or
  epidural anesthesia.

4
Contact Isolation Precautions

• If Indicator Screen is up, isolation is required.
  Call Infection Control Department to screen for
  deisolation.
• Patients with Necrotizing fasciitis need contact
  isolation masks worn during debridements.
• Gloves and Gown required to enter the room to
  provide patient care
• Door card to remain on door until room is
  cleaned.
• If multi-use equipment is used, disinfect between
  patients. (e.g., EKG, BP cuffs)

5
Contact Precautions Sign
6
Modified Contact Precautions

• Clostridium difficile infection diarrheal
  disease from spore-forming bacteria
• Hand washing with soap and water is
• necessary to remove spores from hands.
• Do not use hand sanitizers!

7
Modified Contact Precautions Sign
8
3M Air-Mate High Efficiency Powered Air
Purifying Respirator (PAPR)

• If patient has suspected or confirmed TB
• Obtain PAPR from equipment pool in addition to
  isolation cart.
• A Fit Test is now required if you wear a N95 TB
  mask (orange duckbill)
• Fit Check-each time mask is put on
• Use a Powered Air Purifying Respirator (PAPR) to
  enter a room with a patient who has active
  pulmonary TB if not fit tested.

9
Airborne Precautions Sign
10
Airborne Isolation

• Daily pressure checks need to be done on negative
  pressure rooms and documented. http//ozone.ohsu.e
  du/healthsystem/dept/infection/specialAirflowdocfo
  rm.pdf
• No ambulation allowed outside of room.
• No admits to room for 1 hour after discharge.
• Patients with extrapulmonary TB, who have
  infectious skin lesions or drains in place, must
  be placed on Airborne Contact isolation.

11
Airborne Precaution Transportation

• If procedure area does not have a negative
  pressure room
• Perform procedure in patients room if possible.
• Postpone procedure until airborne precautions are
  not needed if possible or
• Make patient the last case of the day if
  possible.
• Patients cannot go to IRU or PACU, but must be
  recovered in a negative pressure isolation room.

12
Droplet

• Mask-blue surgical
• Attention to hand hygiene
• No ambulation outside of room allowed.

13
Droplet Precautions Sign
14
Transportation of Isolated Patients

• Notify receiving dept. of isolation requirement
• Patients to go directly in exam/procedure room
• Patients are not to be held in patient common
  waiting areas
• Transportation staff should not need to wear
  isolation garb out of room to transport patients

15
Transportation of Isolated Patient

• Droplet and Airborne Precautions
• Mask the patient provide tissue for coughing,
  bag for tissues
• Contact Precautions
• Cover pt. with clean sheet
• Cover/contain actively draining areas if possible
• Best to use transportation vehicle other than bed
• Wipe off bed rails, head and foot board of bed
• Disinfect equipment used

16
Isolation Room Cleaning

• Keep door card on room until cleaning is
  completed
• No admits to negative pressure room for 1 hour
  post discharge of previously isolated TB patient.
  
• Keep room door closed
• Airborne isolation precautions must be followed
  if room is cleaned within 1 hour of discharge of
  patient.

17
Ambulation of Contact/Modified Contact
Precautions Patients

• Can have 3 supervised ambulations on unit with an
  MD order if
• Patient continent wounds able to be contained
• Patient follows directions, puts on a clean gown
  washes hands.
• Patient is NOT allowed to leave nursing unit or
  go in other patients rooms or common areas.