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Why does this matter to me?

Occupational Safety & Health Administration (OSHA) Training Infection Control Blood Borne Pathogens Tuberculosis Awareness Employee Health. Why does this matter to me?. “Clinic staff infect patients by re-using drug vials”. “New mom recovering from flesh-eating bacteria”.

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Why does this matter to me?

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  1. Occupational Safety & Health Administration (OSHA) TrainingInfection ControlBlood Borne PathogensTuberculosis AwarenessEmployee Health

  2. Why does this matter to me? “Clinic staff infect patients by re-using drug vials” “New mom recovering from flesh-eating bacteria” “N.H. Hospital Facing Legal Action Over Hepatitis C Outbreak” “Denver Dentist Could Have Infected Thousands” “Hospital Acquired Infections Costly, Preventable” “Man Eats Face off unconscious person, wanted brains”

  3. Overview • Responsibilities: • Individual • Supervisory • Chain of Infection Model • Standard & Transmission Based Precautions • Infection Control Policies & Procedures • Infection Control Program • Bloodborne Pathogens Exposure Control Plan • Tuberculosis Exposure Control Plan

  4. Individual Responsibilities In the event of contagious zombie infection, it is your responsibility to trip the person next to you and run! Review Review Section OI Adhere to standard IC practices/procedures Report all suspected Healthcare Associated Infections (HAI’s) Bottom line: We can’t do infection control without YOU. You are the Infection Control Program!

  5. Unit Manager/Supervisory Responsibilities • Ensure personnel know & comply with all infection control policies/practices • Ensure all personnel complete unit-specific: • Orientation/Initial Training • Annual/Refresher Training • Ongoing/In-service Education as required • Review section Infection Control OI annually (if one exists) • Appoint section IC Coordinator (if desired) • Complete appointment letter and route through IP

  6. Healthcare-Associated Infections Formerly Nosocomial Infections • An infection that occurs in a patient, staff member, or visitor in a hospital or other healthcare facility that was not present or incubating at the time of admission or entry to the facility. • Complete Facility/Community Acquired Infection Reportto Infection Prevention: Ask patients if they have any history of infections i.e. MRSA ,VRE, c-diff, etc.

  7. “ Chain of Infection” Model 1. Reservoir 2. Portal of Exit 5. Susceptible Host 3. Means of Transmission 4. Portal of Entry

  8. “ Chain of Infection” Model 1. Zombie is hungry 2. Virus in saliva 3. Bite wound 5. Host re-animates into zombie 4. Saliva and blood mix

  9. HAND HYGIENE can break the “chain” **Single most effective way to prevent infection** is to destroy the brain

  10. Standard Precautions • Standard precautions MUST be used on all patients, all of the time when there may be contact with blood and/or body fluids. • CDC • OSHA • AAAHC • HSI • NPSG • NOTAMS

  11. Transmission Based Precautions • Contact • Droplet • Airborne Don’t get bitten

  12. Contact Precautions Used for patients known or suspected to be infected or colonized with epidemiological important microorganisms that can be transmitted by direct or indirect contact. Some diseases requiring Contact Precautions are: • MRSA (Methicillin Resistant Staphylococcus Aureus) • RSV (Respiratory SyncytialVirus) • Norovirus • C-diff (Clostridium Difficile)

  13. Droplet Precautions Used for patients known or suspected to be infected with micro-organism transmitted by larger droplets which are generally confined to a four foot dispersal area and do not remain airborne for long. Some diseases requiring Droplet Precautions are: • Neisseria meningitis • RSV (with active cough/sneeze) • Influenza • Adenovirus • Pertussis

  14. Airborne Precautions For patients with known/suspected infections with microorganisms transmitted by airborne droplet nuclei that stay aloft for long periods of time. This type of Precautions calls for the use of N-95masks and special ventalation. The does not maintain rooms capable of housing a patient in Airborne Precautions.Arrange for transfer ASAP. • Some diseases requiring Airborne Precautions are: • Tuberculosis • Rubeola (Measles) • Varicella (Chicken Pox) • Disseminated herpes Zoster • Some bioterror agents (Anthrax, Small Pox)

  15. Personal Protective Equipment(PPE) ALWAYS USE APPROPRIATE PPE! Mask, eye protection, gown and gloves Remove and dispose of properly in hazardous waste. Scrubs are not PPE! ALWAYS USE YOUR HEAD! Think about probable exposure VS possible exposure

  16. Zombie Control Policies & Procedures

  17. Infection Control • Hand Hygiene • Sharps Disposal • Hepatitis B Vaccine • Hazardous waste • Linen • Cleaning/Instruments

  18. Hand Hygiene Hand wash: at least 20 seconds NO artificial nails in patient care areas NO nails more than 1/4 in. beyond fingertips Will not prevent zombification

  19. HAND HYGIENE Alcohol based hand rubs: Replaces hand washing if hands are not visibly soiled, If soiled, use soap and water for washing Increases Compliance & improves condition of hands Will not prevent zombification

  20. Sharps Disposal • DO NOTrecap “dirty” needles • Dispose of “potential” sharps • Dispose of at point of origin! • Empty when ¾ full • Reconsider risky work practices

  21. Human Immunodeficiency Virus(HIV) HIV: a viral disease -spread through contact with infected blood, unprotected sex with an infected partner, or from mother to child during pregnancy. HIV can also be spread to babies through the breast milk of infected mothers. HIV: acts by killing/damaging cells of the immune system, destroying the body's ability to fight infections. -may get life-threatening diseases and opportunistic infections, caused by viruses or bacteria that do not normally infect healthy people.

  22. Hepatitis Hepatitis B:is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. Hepatitis C:is a liver disease caused by the Hepatitis C virus (HCV), which is found in the blood of persons who have the disease. HCV is spread by contact with the blood of an infected person.

  23. Hepatitis B Vaccine Three doses: Initial dose 1 months later 6 months later The vaccine is safe and has a published sero-conversion efficacy of >95%. HBV vaccine is required for all active duty medical personnel who have a reasonably anticipated exposure to blood and other potentially infectious materials. Although civilians can not be made to receive the vaccine, it is generally a condition of employment. It is offered free of charge.

  24. Regulated Medical Waste Ensure all zombie parts are disposed of properly, to ensure they do not re-animate The MTF is charged by the pound No routine trash in RED/BIOHAZARD bags No sharps in RED/BIOHAZARD trash No linen in RED/BIOHAZARD trash Only biohazardous waste in RED/BIOHAZARD trash

  25. Regulated Medical Waste Any liquid or semi-liquid blood or other potentially infectious materials Contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed Items that are caked with dried blood or other potentially infectious materials (OPIM) and are capable of releasing these materials during handling Pathological and microbiological wastes containing blood or other potentially infectious materials

  26. Linen DON’T: -Separate soiled linen -Wear scrubs outside or home -Throw away linen DO: -Use gloves when handling -Separate clean & dirty linen areas

  27. Area Cleaning No shipping containers in patient supply areas Use appropriate cleaning products and concentration. Use only from approved list in

  28. Instrument Cleaning No scrubbing of instruments in any areas other than Sterile Processing and Distribution (SPD) or Dental Instrument Processing Center (DIPC) Must be transported in puncture-resistant container with Biohazard label.

  29. Blood Borne Pathogen Exposure Procedures • Wash/flush area for 5 minutes • Notify supervisor immediately • Get treatment immediately • CDC recommends just hours • Paperwork – Complete a • Forward to Safety • Include device brand & type involved • (OSHA requirement) • Notify Public Health • Required to complete paperwork.

  30. Tuberculosis Exposure Control Plan Report to PH on arrival to • TB screening is initial and event related • Respiratory Protection Program • Managed by Bioenvironmental Engineering • Base wide program • Physical Assessment for all at risk personnel (N-95 “just in time” fit testing) • TB Risk assessment done annually by Public Health • Isolation requirements not available at • PH conducts exposure/contact investigation

  31. TB Awareness • Prolonged cough 3 weeks • Chest pain, night sweats or fevers • No appetite • Weight loss • Weakness or fatigue • Coughing up blood • History of exposure or travel to high risk area

  32. Documentation Employee training must be documented on AF Form 55 “Infection Control/OSHA BBP/TB” Patient and Family Education must be completed and documented IAW unit policy.

  33. Summary: • Responsibilities • Chain of infection • Standard Precautions

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