Health Occupation Student Orientation Module 3: Infection Prevention

Health Occupation Student

Orientation Module 3: Infection Prevention

STANDARD PRECAUTIONSSection 1

Infection Prevention

Chain of Infection

How to Break the Chain of Infection1. Perform hand hygiene.

2. Surface disinfection

3. Follow transmission based precautions.

4. Practice injection safety.

5. Practice safe respiratory hygiene and cough etiquette.

When to Clean Your Hands: use hand sanitizer or soap and water -

Each time you enter or exit a threshold in a patient care environment

Before and after patient contact

Before donning and after removing gloves – gloves do not replace hand hygiene

After touching your face or hair

After using the rest room – must use soap and water!


Standard Precautions - Hand Hygiene

How To Wash Your Hands

1. Wet hands with warm running water.

2. Apply soap.

3. Rub hands for 20 seconds (If necessary, use a nail brush to clean nails. However, the brush must be kept clean and sanitary.)

4. Rinse hands thoroughly

5. Dry hands with a paper towel

6. Turn off the tap with the paper towel


Standard Precautions – Hand Hygiene

How to Apply Hand Sanitizer

Infection Prevention Standard Precautions - Hand Hygiene


Standard Precautions – Surface Disinfection

When to Clean Equipment: Wipe down re-useable equipment after each

patient use Clean High touch objects daily such as

bedrails, over bed table, call light/TV remote

What to Use: Germicidal wipe such as CaviWipes. Alert: be

sure to wear gloves with use. Bleach Wipe for patients with clostridium

difficile and Norovirus. Alert: be sure to wear eye protection and gloves with use.


Standard Precautions – Surface Disinfection.

Use this Cleaning Product

Wearing this Required PPE

To Clean this Equipment

Contact Time (wet time)

Sani Cloth Gloves Oximeter WOW’sWheelchair Gurney Dynamap IVAC Bed 1

Bleach wipes Gloves

Safety glasses

Alert: Equipment for patients with C. dif or Norovirus

Alert: Alaris pumps, glucometers can only be cleaned with this product

3

Injection Safety Guidelines From CDC Never administer medications from the same syringe to

more than one patient, even if the needle is changed. After a syringe or needle has been used to enter or connect

to a patient’s IV it is contaminated and should not be used on another patient or to enter a medication vial.

Never enter a vial with a used syringe or needle. Do not use medications packaged as single-dose vials for

more than one patient. Assign medications packaged as multi-dose vials to a

single patient whenever possible. Do not use bags or bottles of intravenous solution as a

common source of supply for more than one patient. Follow proper infection control practices during the

preparation and administration of injected medications.


Standard Precautions – Injection Safety


Hospital Influenza Plan – Your Role

1. Use respiratory etiquette education (Cough and/or sneeze into your sleeve)

2. Practice Hand Hygiene.

3. Get Influenza vaccinations for seasonal flu (October to March)

Vaccinated students must wear colored plastic tag identifier.

Unvaccinated staff:

Sign a Declination form as required by state law and Cal/OSHA

During flu season (October to March), wear a surgical mask if within six feet of a patient .


Hospital Influenza Plan – Your Role

Vomiting

Diarrhea related to Gastroenteritis

Sore throat with fever

Fever of 100 or higher and cough

Draining wound and/or open wound infection for staff that provide direct patient care

Stay Home if Sick:

TRANSMISSION-BASED PRECAUTIONS

Section 2

Infection Prevention Transmission Based Precautions

Personal Protective Equipment Health care workers wear PPE in patient’s

room

Patient wears PPE when outside the room

Staff and volunteers are NOT to wear PPE (including gloves) in the hallway unless providing critical care during transport

Tie BOTH neck and waist ties on the gown

PPE is disposed in regular trash unless grossly contaminated with a patient’s body fluids

Wrong!


How to Put On PPE

Alert: Both neck and waist of gown must be tied.


How to Remove PPE

Alert: Do NOT Wear PPE outside the Patient Room


Contact Precautions: (example diseases: MRSA, VRE, Scabies, Lice)

Wear Personal Protective Equipment: gloves, gowns upon entry to patient room; remove before leaving the room: PPE NOT required in arc of the door


Droplet Precautions: (example diseases: Influenza, Bacterial Meningitis)

Wear Personal Protective Equipment: mask upon entry to patient room; remove before leaving the room

N95 or PAPR for high hazard procedures

N95 Mask PAPR


Airborne Precautions: (example diseases: TB, Novel or Unknown Disease)

Wear Personal Protective Equipment:

N95 mask- must be fit tested

PAPR* for high hazard procedures such as Bronchoscopy, suctioning, SVN etc.

* PAPR = Powered Air Purifying Respirator

N95 Mask PAPR


Other Measures

No food or drink in patient care areas (includes nurses’ station)

Food and drink items must be covered when carried through hospital hallways

Hand hygiene before entering a patient room every time

Educate patients, family, and visitors about hand hygiene (entering and exiting)

Clean up! – examples: wrappers on floor, spilled beverages in pantry

Students may NOT perform the following standardized procedures: Vaccinations

Students may NOT care for patients in Airborne Isolation


Student Restrictions

COMMUNICABLE DISEASESSection 3


Communicable Diseases

ESBL – Extended Spectrum Beta Lactamase A newly emerging MDRO

(enzymes produced by certain bacteria that provides resistance to certain antibiotics)

Clostridium Difficile Survival (Not a MDRO but “Other Organism of Concern”)

C. diff spores can live and infect up to 5 months on environmental surfaces

special requirements for hand hygiene and environmental cleaning

MRSA Survival (Methacillin Resistant Staph Aureus)

Formica surfaces = 14 days Cotton blanket material = 6-9

weeks S. aureus (MRSA) can remain

virulent and capable of causing an infection for 10 days after exposure to dry surfaces

VRE Survival (Vancomycin Resistant Enterococcus)

Bedrails = 24 hours Telephones = 60 minutes Gloved and ungloved hands > 60

minutes

Superbugs” live on surfaces…also known as Multidrug Resistant Organisms (MDROs). Note the survival rates for each.


Other Communicable Diseases About Pulmonary tuberculosis (TB)

A contagious bacterial infection that mainly involves the lungs. State of California has a high incidence

Annual testing (TB skin Test) for exposure is required

Student are not allowed to provide care of patients in Airborne Isolation Precautions.

Type of Isolation Precautions: Airborne

N95 respirator {fit tested}

Negative air pressure – contact engineering to turn on alarm, conduct daily pressure testing


Other Communicable Diseases About Meningitis:

Meningitis is among the ten most common infectious causes of death

The major causes of community-acquired bacterial meningitis in adults in developed countries are Streptococcus pneumoniae and Neisseria meningitidis

The classic symptom triad of acute bacterial meningitis consists of fever, nuchal rigidity, change in mental status

Type of Isolation Precautions: Droplet

Wear PPE until 24 hours after initiation of effective treatment

AEROSOL TRANSMISSIBLE DISEASE

Section 3

Students DO NOT Take Care of

Patients with Airborne Infection

Aerosol Transmissible Disease

What is an Aerosol Transmissible Disease? A disease transmitted by aerosols

(gaseous suspension of fine solid/liquid particles) through sneezing or coughing


Smallpox Tuberculosis (Suspect/Confirmed) Measles (Rubeola) Novel or Unknown pathogen Any other disease or pathogen for

which the State or local Health Department recommends Airborne Infection Isolation

Airborne spore release (anthrax)

Avian influenza Varicella disease

Chicken pox Shingles Herpes zoster Varicella-zoster (disseminated

disease) Monkeypox Severe Acute Respiratory

Syndrome (SARS)

What Diseases Spread via Airborne Infection Isolation (AII)?

Diphtheria Influenza (seasonal) Meningococcal disease Mumps Mycoplasma pneumonia Pertussis Plague (pneumonic)

Rubella Viral hemorrhagic fevers Any other disease or

pathogen for which the State or local Health Department recommends Droplet Precautions

What Diseases are Spread by Droplets?



Respiratory Protection

When entering an “Airborne” Isolation room wear a N95 respirator

When assisting with High Hazard Procedures on patients in “Airborne” Isolation diseases, wear a PAPR during procedure and 35 minutes after while in room

When entering a “Droplet” Isolation room wear a Surgical or Isolation Mask

When assisting with High Hazard Procedures on patients in Droplet precautions, wear a N95 respirator and eye protection or PAPR during the procedure (door to remained closed during the procedure)

Students DO NOT Take Care of Patients with Airborne Infection


What are Considered High Hazard Procedures: Any clinical, surgical & lab procedure that may

aerosolize pathogens Sputum induction Intubation & bronchoscopy Open circuit suctioning Aerosolized administration of meds Pulmonary function testing Autopsies

Health Occupation Student Orientation Module 3: Infection Prevention

Documents

single patient

patient contact

hand hygieneafter

clean equipment

gloves gloves

sleeve practice hand

patient care environment

clean nails