BERGEN REGIONAL MEDICAL CENTER Infection Prevention & Control Program SAFETY For PATIENTS & STAFF Through INFECTION CONTROL To go to the next page, click the forward and reverse symbols below:
All 6 of theses LINKS IN THE INFECTION CHAIN must be present for an infection to start. Infectious Agent Any organism that can cause disease: Ex: bacteria, virus, fungi Susceptible HostPeople lacking resistance. Ex: young, old, immunosuppressed, immunocompromised Host Carrier of disease Ex: patients, staff, visitors CHAIN OF INFECTION Portal of Entry A way into another person. Ex: breathing, eating, breaks in skin, catheters, IV’s Portal of Exit A way out of the host Ex: blood, body fluids, sneezing, coughing Means of Transmission A way to get from one person to another. Ex: direct contact: dirty hands, wounds, bandages. Indirect contact: contaminated air or objects
To Control and Prevent Infections… Follow These Simple Guidelines WASH YOUR HANDS Hand hygiene is the single most effective way of preventing the spread of infections.
When to Wash Your Hands: When reporting to work, after contact with a source of microorganism (i.e., body fluids and substances, non-intact skin, inanimate objects that are likely to be contaminated) During medication pass Before and after patient contact Before and after glove use When leaving work After using the toilet Before and after eating When hands are visibly soiled
Fingernails Fingernails must be kept short, clean, and maintained in good condition and less than ¼ inch in length. All personnel providing direct patient care contact (nurses, respiratory therapists, lab and X-ray technicians, etc.) are not permitted to wear artificial fingernails or extenders.
Alcohol-based Hand Sanitizer Purell Dispensers are located throughout the facility! • Apply a “quarter size” squirt into palm of hand • Rub hands together covering all surfaces of hands and fingers until hands are dry
Standard Precautions These are to be used at all times when working with patients. Personal protective equipment (PPE) is to be used when contact with blood and body fluids is anticipated: Personal Protective Equipment (PPE): Gowns Goggles Face Shields Masks Gloves
Transmission-based Precautions Designed for patients documented or suspected to be infected with transmissible pathogens for which additional precautions beyond Standard Precautions are needed. There are 3 types of Transmission-based Precautions… AIRBORNE DROPLET CONTACT
BRMC’s OSHA EXPOSURE CONTROL PLAN
POST EXPOSURE PROTOCOL Remember Hotline #: 5795 (24hrs /day)
Bloodborne Pathogens Bloodborne pathogens are viruses, bacteria and other microorganisms that are borne (carried) in a person’s blood stream and cause disease. If a person comes in contact with blood infected with a bloodborne pathogen, he or she may become infected as well.
These pathogens can be spread when infected fluids enter the body through: Needle-stick injuries Cuts, scrapes & other breaks in the skin Splashes into the mouth, nose or eyes Oral, vaginal or anal sex Using infected drug needles Tattooing Body piercing Nail salons
SAFE SHARPS If unfamiliar with any safety devices ask questions! BRMC complies with New Jersey Safety Needle Law. Employees need to know how to operate and utilize the safety device. Report all needlesticks or sharp injuries, whether clean or contaminated.
What is Pulmonary Tuberculosis? (TB) A Disease caused by BACTERIAUsually affects the LUNGS Spread through the AIR Can be cured by MEDICINE
There Are 2 Types of TB… Active TB Disease Latent TB -The Pathogen that causes TB has entered the lungs -There are NO symptoms -The person is NOT contagious -They have a positive Tuberculin Skin Test (TST) -They may never develop Active TB -Have a Positive chest x-ray-Are experiencing symptoms -Will be contagious-Will have to take TB medication for up to one year -May or may not be hospitalized
How is Tuberculosis (TB) Spread? TB germs can be spread when a person with TB disease: • COUGHS • SNEEZES • SHOUTS • SINGS SENDING TB GERMS INTO THE AIR….
Active TB Disease Latent TB
Practice Good Personal Hygiene: • Bathe, shower or wash every day • Prevent dry skin by using creams and oils • Use warm, not hot water and mild soap when bathing • Don’t share personal items such as toothbrushes, • razors, towels, washcloths, combs, hairbrushes and • cosmetics
Signs & Symptoms of TB • Fever • Weight Loss • Night Sweats • Constant Tiredness • Cough • Loss of Appetite • Chest Pain
Annual TB Testing All employees are screened annually for TB by: • (1) Step PPD if previously known to be non-reactive • Completion of questionnaire for positive TST’s (if previously known as reactive)
NEGATIVE PRESSURE ROOMS: • Provides a negative pressure atmosphere for airborne isolation • Used when isolation of a patient is required to prevent the • transmission of an airborne disease • “Airborne Precautions” sign posted on the closed door • PPE: Mask N95 Respirator – must be “fit tested” prior to room entry • Availability: Operating Room, Emergency Room, Clinic, ICU, 11-4, ITCU • Engineering to be notified when precautions are instituted AIR ENTERING ROOM CONTAMINATED AIR LEAVING PATIENT ROOM VIA FAN TO THE OUTSIDE
Home Environment Keep your home as clean as possible Keep your kitchen clean and sanitary Wash your dishes in hot soapy water Wash glasses and cutlery that go directly into the mouth first
GUARD AGAINST FOODBORNE ILLNESS Keep hot food above 140 degrees Keep cold food below 45 degrees Keep work area clean Prepare food with care Serve food properly
IMMUNIZATIONS • Ask your doctor what vaccines you need • The specific kinds will depend on your job, • age, sex and health history
Flu Vaccine is recommended for people who: • Are 65 years or older • Have chronic lung disease or respiratory conditions such as • asthma, emphysema • Have medical conditions such as heart disease, diabetes or • chronic kidney disease • Have diseases or are having treatments that depress • immunity, such as cancer or HIV/AIDS • Are residing in a long-term care facility
Hepatitis B Vaccine is recommended for all: • Healthcare workers exposed to blood and body fluids • Household contacts and sex partners of HBV- positive • persons • Persons with multiple sex partners • All adolescents • Persons undergoing hemodialysis • Recipients of certain blood products • Hepatitis vaccine is given at 0, 1, and 6-month intervals
Pneumococcal Vaccine is recommended for: • People who are 65 years or older • People who may have a high risk conditions, • i.e. chronic lung or heart disease, diabetes, or • compromised immunity
BERGEN REGIONAL MEDICAL CENTER The Bergen Regional Medical Center Pandemic Influenza Preparedness Plan is available to provide guidance in the event of a pandemic influenza situation so that the number of deaths and illnesses in the communities, served by the hospital, is minimized while protecting healthcare workers and cooperating with community leadership. Preparedness Plan
Bioterrorism refers to a deliberate attack by terrorists, releasing biological agents used to cause disease or death in people, animals, or plants.
Seasonal (or common) Flu is a respiratory illness that can be spread from person to person. Most people have some immunity, and a vaccine is available. Avian (bird) Flu is caused by influenza A viruses that occur naturally among birds. There are different subtypes of these viruses because of changes in certain proteins on the surface of the influenza A virus and the way the proteins combine. Pandemic Flu occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no vaccine. The disease spreads easily person-to-person, causes serious illness, and can sweep across the country and around the world in very short time.
BIOTERRORISM A Global Threat!!!
Biological agents may include: bacteria, viruses, and toxins that can be spread through the air, through water, or in food.
The most efficient way to deliver a bioterror attack is through the use of aerosols.
Terrorists may use biological agents as weapons because: 1. They can be extremely difficult to detect. 2. They do not cause illness for several hours to several days. 3. They are easy to obtain. 4. They are not expensive. 5. They provide easy escape for the perpetrators.
Healthcare Facilities prepare for a possible bioterror attack because of the magnitude of devastation that could potentially occur. A bioterrorism attack would not be easily handled by the US Healthcare System, therefore, calling for preparedness drills and plans to be put into place.
Potential Bioterror Bacterial Agents • ANTHRAX • TULAREMIA • BOTULISM
Other Potential Routes of Exposure: Person-to-person transmission (Plague, Smallpox) Consumption of contaminated food/water products (undercooked meat from infected animal, intentional contamination of water supply) Handling contaminated products
The following are general symptoms of anthrax, usually occurring within 7 days of infection: • Fever (greater than 100 degrees Fahrenheit) often accompanied by chills and/or night sweat • Flu-like symptoms and malaise • Cough (usually non-productive) • Chest pain or discomfort • Shortness of breath • Muscle pain • Fatigue • Sore throat and/or difficulty swallowing • Swollen/enlarged lymph nodes • Headache • Nausea, vomiting, loss of appetite, diarrhea
ANTHRAX Anthrax is an acute infectious disease caused by spore forming bacterium Bacillus anthracis.
Anthrax most commonly occurs in cattle, sheep, goats, camel, antelope, and other herbivores, but it also occurs in humans when they are exposed to infected animals or tissue from infected animals.
Anthrax is Transmitted in 3 ways: Inhalation: Inhaling spores from contaminated animal products. Gastrointestinal: Spread by eating undercooked meat from infected animals. Cutaneous (skin): Humans can become infected by handling products from infected animals. * Not transmitted from person-to-person
Ricin is a poison that can be made from the waste left over from processing castor beans. It can be in the form of a powder, a mist, or a pellet, or it can be dissolved in water or weak acid.
Smallpox Smallpox is a serious disease that is caused by variola virus, which is spread from person to person through close contact. • Smallpox can cause: • A severe rash, which can lead to scars • High fever • Tiredness • Severe headaches and backaches • Blindness
How you could be exposed to Ricin? • It would take a deliberate act to make ricin and use • it to poison people. • Accidental exposure to ricin is highly unlikely. • People can breathe in ricin mist or powder and be • poisoned. • Ricin can also get into water or food and then be • swallowed. * Not transmitted from person-to-person
It is believed that terrorists or governments hostile to the United States may have the smallpox virus as well as other agents that could be used as biological weapons.