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Infection Control. Jodie Burr Infection Control Coordinator Women’s and Children’s Hospital. Infection Control Unit. 24 Hour Infection Control Service During office hours page 18041* After hours ring 9 for Infectious Disease Consultant on call Infection Control Team
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Infection Control Jodie Burr Infection Control Coordinator Women’s and Children’s Hospital
Infection Control Unit • 24 Hour Infection Control Service • During office hours page 18041* • After hours ring 9 for Infectious Disease Consultant on call • Infection Control Team • meet weekly, concerns, enquiry's, issues can be discussed
Primary Role of Infection Control • Prevent nosocomial infections • Reduce mortality, morbidity, and cost • Educate and advise • staff • patients • their families • the community • Surveillance of nosocomial infections • Policy development, implementation and assessment
IC Issues specific to Paediatrics • Communicable diseases affect a higher % of paediatric patients than adults • non-immune - acquire - spread • paediatric personnel are at a greater risk for exposure to communicable diseases - immune status • May lack the mental / physical ability to adhere to IC principles • lack of hygiene • unable to understand / comply with IC principles
IC Issues specific to Paediatrics • More likely to have contact with contaminated environmental surfaces and objects • Parents and siblings • may have the same infectious agent • involved in patient care - education about transmission and IC principles
Immunization It is important to know your health and immunization history • chicken pox • measles • flu vaccination • pertussis • For vaccinations contact ICGP or Risk Management
IC Link Nurses • Educate ward/unit staff • Ensure compliance with infection control guidelines • Assist with outbreaks or disease exposures • Develop patient & staff information brochures • Promote infection control initiatives
Standard + Additional Precautions Standard Precautions • all patients • all times Additional Precautions • some patients • some times
Standard Precautions • Work practices necessary to fulfil basic infection control requirements • For all patients regardless of diagnosis or presumed infectious status
Standard Precautions • Apply to: • Blood • All body fluids - excretion and secretions (including sweat) • Non-intact skin • Mucus membranes • Regardless of whether there is visible blood or body fluids
Hand Hygiene • The single most effective method in the prevention of disease transmission • 80 % hospital acquired infections are thought to be transmitted by hands • Healthcare workers think they wash their hands more than what they do
Hand Hygiene • Soap and Water • mechanical removal of most transient flora and soil • minimal microbial kill • no sustained activity • 15 seconds
Hand Hygiene • Antimicrobial Soaps • removes soil, removes transient and reduces resident flora • may have sustained activity • 15 seconds (antiseptic handwash) • 60 seconds (clinical handwash) • 2 minutes (surgical scrub)
Hand Hygiene • Alcohol Handrubs / Gels • very rapid kill • destroys transient and reduces resident flora • no residual activity (except with antiseptic) • will not remove or denature soiling • 15 seconds
Personal Protective Equipment • Eye and/or facial protection (goggles, face shields) • Gloves • Gowns • Masks • Assess the likely hood of contamination and prepare accordingly
Equipment Reprocessing • If it comes into contact with: • intact skin = clean • mucous membranes = high level disinfection • sterile site = sterilise • All items must be cleaned first • Single-use items must not be reused
Environmental Controls • Cleaning • detergent and water is adequate • ensure patient care areas are cleaned regularly • minimize clutter • Linen and Laundry • no need to mark ‘infectious’ • if the skip is wet then place in a plastic bag
Waste • General Waste (Green Bin) • dressings, bandages, nappies, sanitary pads, flowers, kitchen waste, plastic, paper, empty containers of blood, body fluid, IV lines, urinary catheters • Medical Waste (Yellow Bin) • ALL sharps, bags or tubing of blood, human tissue, lab specimens and cultures, cytoxic waste (sealed in purple cytoxic container or bag first)
Blood and Body Spills • Small spills • wipe up with paper towel • detergent and water • Large spills (easy to clean surface) • wipe up with paper towel • detergent and water • Large spills (difficult to clean surfaces) • wipe up with paper towel • detergent and water • wipe over with Milton(R)
Assessment of Risk Factors • Your knowledge or experience with the situation or procedure • The likely hood of exposure to blood or body fluids at the time • The patients ability to cooperate through out the procedure
Additional Precautions • Are applied in addition to Standard Precautions • Apply with: • highly transmissible organisms • epidemiologically significant organisms
Additional Precautions • May include: • Single room accommodation (ensuite for some) • Special ventilation (negative, positive pressure) • Special room cleaning • Dedicated patient equipment • Rostering of immune staff • Extended sterilization (or use of disposable equipment) • Cohorting may be considered
Bed Management • CATEGORY AVery High Risk of Cross Infection or Adverse OutcomeMandatory Negative pressure single room • CATEGORY B High Level of Cross InfectionMandatory Single room or cohort same contagious agent • CATEGORY C Moderate Risk of Cross InfectionSingle Room in Selected Circumstances • CATEGORY DHigh Risk to the Newborn Rooming in not allowed • CATEGORY ELow risk of Cross Infection No segregation required
Respiratory Syncitial Virus • Highly contagious and nosocomial infection common • Causes upper and lower respiratory infection • Usually occurs during winter • No vaccine at present • Can be reinfected during the same season • Transmitted by contact or droplet • Can survive for several hours in the environment
Rotavirus • Highly contagious and nosocomial infection is common • Usually a winter disease but pattern changing • Onset is sudden and lasts for 4 - 6 days • Mainly infants and children up to 3 years affected • Transmitted usually through contact • Can survive in environment for several hours
Gastrogard-RTM Hospital Acquired Rotavirus diarrhoea prevention program • Eligible if: • aged between 0 days and 48 months • regardless of whether they already have or develop gastroenteritis • Ineligible if: • cow’s milk protein intolerant (not lactose intolerant) • if on a protein restricted diet • fasting • breast fed
Varicella Zoster VirusChicken Pox • Highly contagious • Most cases in children, over 90% of adult population is immune • Transmitted by droplet and contact • Infectious 2 days prior and 4 - 6 days after rash • Now a notifiable disease • Vaccination now available
BUG WATCH Infection Control Awareness Program for Visitors