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INFECTION PREVENTION Part 1. N ational Patient Safety Goal #7. PREVENTION OF HEALTHCARE ASSOCIATED INFECTIONS. Comply with hand hygiene guidelines by either Centers for Disease Control and Prevention (CDC) OR World Health Organization (WHO)

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Infection prevention part 1



Part 1

N ational patient safety goal 7
National Patient Safety Goal#7


  • Comply with hand hygiene guidelines by either

    • Centers for Disease Control and Prevention (CDC) OR

    • World Health Organization (WHO)

  • Healthcare facilities must implement evidence based practices for the prevention of

    • Multi-drug resistant organisms (MDRO)

    • Central Line Associated Blood Stream Infections (CLABSI)

    • Surgical Site Infections (SSI)

    • Catheter Associated Urinary Tract Infections (CAUTI)

  • HAIs causing death or permanent loss of function are managed as sentinel events

Infection prevention part 1

Surgical Site Infection (SSI)

Ventilator Associated Event (VAE)


Catheter Associated

Urinary Tract Infection (CAUTI)

Central Line Associated Blood Stream Infection


H ealthcare associated i nfections hai
Healthcare Associated Infections (HAI)

  • An infection not present or incubating on admission

  • Related to a previous hospitalization (within 30 days)

  • May be associated with a procedure performed at a healthcare facility

Infection prevention part 1



Infection prevention part 1

Most Frequently




Less Frequently


H and hygiene practice
Hand Hygiene Practice

Before and after contact with a patient or contaminated surfaces:

  • Antibacterial soap and water when hands are:

  • Visibly soiled

  • Had contact with blood or body fluid

  • If C. dif. is suspected or confirmed

Alcohol gel hand rub on any other occasion

  • Use friction

  • Cover all surfaces of hands


To ensure you have washed long enough

  • Don’t forget to keep nails ¼ inch in length to decrease accumulation of bacteria

Skin care
Skin Care

An important part of hand hygiene.

Hands that are chapped and dry not only present an exposure risk, but healthcare workers are less likely to wash when skin integrity is impaired.

Maintain good skin health with a hospital grade lotion.

Hospital grade lotions are compatible with alcohol gel.

Other lotion will decrease the efficacy of alcohol based gel.

Infection prevention part 1







Multi drug resistant organisms mdro
Multi-drug Resistant Organisms (MDRO)

  • Microorganisms that are resistant to

  • one or more classes of antimicrobial

  • agents .

  • Antibiotics fight off disease when

  • patient’s immune system cannot.

  • But what happens when a patient

  • (in a weakened state) acquires an

  • infection that is resistant to

  • antibiotics?

07 03 01 ep 8 9 laboratory based alert system for mdro
07.03.01 EP# 8&9 Laboratory-Based Alert System for MDRO

Why identify patients who have a history of drug resistance?

Patients with a history of MDRO

pose a risk to the inpatient

population because they may

remain colonized with the

infectious bacteria even after


Identification of these patients

on admission allows us to

protect other patients and staff.

Infection prevention part 1

Those aren’t flammin’ hot Cheetos!

U niversal identifier for c difficile
Universal Identifier for C.difficile

Clostridium difficile (C.dif) while not technically a drug resistant organism is

considered epidemiologically important due to:

  • A propensity for transmission within healthcare facilities.

  • Patients may develop as a result of antibiotic use.

  • General association with serious disease and increased morbidity /mortality.

Place a black square magnet on the

Patient Census board (white board)

next to the name of any patient who

is suspected or confirmed to have


Purpose: identifies any transmission risk to other patients and staff

1. alerts healthcare personnel to

wash with soap and water

2. alerts EVS that a 2 step terminal

cleaning process is indicated

Use proper technique during specimen collection to avoid
Use Proper Technique During Specimen Collection to Avoid…

Wrong Diagnosis

False positive or negative result

Wrong treatment

Antibiotic prescribed when not

needed will delay or

prevent the appropriate


Poor Outcomes

Antibiotic resistance

C.difficile colitis

Drug allergies

…..AND public reporting of erroneous rates by the IP

Hai report to the stakeholders
HAI Report to the Stakeholders

07.03.01 EP#6 ▬07.04.01 EP#5 ▬07.05.01 EP#6

  • Report of identified acquired infections within the facility

  • Posted in designated areas for staff to review

  • Includes a brief analysis with suggested strategies for improvement

Analysis: 1 VRE, 5/27DX Sepsis & Sacral Abscessè 5/28 intra-operative Cultures are negative è

6/9 wound Cultures test + VRE

Risks Factors: multiple co-morbidities, multiple transfers during visit, bowel prep when patient has sacral wound

Action Plan: Opportunities for improvement are use of rectal tube if indicated, wound care consult, limit


S tandard precautions
Standard Precautions

  • Otherwise known as Universal Precautions

  • Assumes blood and body fluid of any patient is infectious

  • Type of PPE used is determined by type of clinical interaction with patient

Infection prevention part 1

Personal Protective Equipment (PPE)

  • Gloves

  • Gowns

  • Masks

  • Respirators

  • Aprons

  • Eye shields


Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, 2007. Jane D. Siegel, MD; Emily Rhinehart, RN MPH CIC; Marguerite Jackson, PhD; Linda Chiarello, RN MS; the Healthcare Infection Control Practices Advisory Committee.

Chiarello L, Jackson M, Rhinehart E, Siegel JD, and the Healthcare Infection Control Practices Advisory Committee (HICPAC) (2006). Management of Multidrug-Resistant Organisms In Healthcare Settings.

William A. Rutala, Ph.D., M.P.H., David J. Weber, M.D., M.P.H., and the Healthcare Infection Control Practices Advisory Committee (HICPAC) (2008) Guideline for Disinfection and Sterilization in Healthcare Facilities, Centers for Disease Control and Prevention.

Lynne Sehulster, Ph.D., Raymond Y.W. Chinn, M.D., Center for Disease Control and

Prevention / Healthcare Infection Control Practices Advisory Committee (HICPAC)

(2003), Guidelines for Environmental Infection Control in Health-Care Facilities