INFECTION CONTROL

INFECTION CONTROL HLTIN301C Comply with infection control policies and procedures

What are Infectious Diseases? • disorders caused by organisms • Bacteria • Viruses • Fungi • Parasites • Can be passed (transmitted) by • Person to person • bites from insects or animals • ingesting contaminated food or water • Needles (sharps) or other exposures in the environment. • Signs and symptoms vary, but often include fever and chills

Duty of Care • If you do not adhere to infection control policy and procedure you have the potential to harm patient/clients, staff and customers • Who is responsible? • Employers • Persons in control of a workplace • Self-employed persons • Employees • Manufacturers, Importers and Suppliers

Duty of Care • Take all reasonably practicable steps to protect the health, safety and welfare at work of the employer’s employees and third parties • Provide and maintain • A safe work environment • Safe systems of work

Duty of Care • Use equipment in accordance with instruction, consistent with its safe and proper use • Not create or increase risk to another person • Cooperate to extent necessary to enable one to fulfil duty

Workplace Health & Safety (WHS) Legislation • depends on State and Territory Legislation and requirements • common law duties to meet the general duty of care requirements • requirements for the maintenance and confidentiality of records of occupational injury and disease • provision of information, induction and training • regulations and approved codes of practice relating to hazards present in work area • health and safety representatives and health and safety committees • prompt resolution of health and safety issues

Standard Precautions • Aseptic technique • Procedure used to prevent the spread of infection • Goal is to make the environment free of harmful micro-organisms • Practices usually set by each healthcare setting (e.g., clinics, surgery rooms, etc.)

Standard Precautions • Minimising contamination • Protecting materials, equipment and instruments from contamination until required for use • Ensuring instruments used for invasive procedures are sterile at time of use • Cleaning all environmental surfaces

Standard Precautions • Techniques to minimise contamination • Personal hygiene practices • Personal protective equipment • Routine environmental cleaning • Transmission-based precautions • Contact precautions • Droplet precautions • Airborne precautions • Good reference: Clinical educators guide for the prevention and control of infection in healthcare (NHMRC, 2010) • Surface cleaning and management of blood and body fluid spills

Standard Precautions • Personal hygiene practices especially washing and drying hands (eg. before and after client contact) • Hand hygiene must be performed before and after every episode of patient contact. This includes: • before touching a patient; • before a procedure; • after a procedure or body substance exposure risk; • after touching a patient; and • after touching a patient’s surroundings. • Hand hygiene must also be performed after the removal of gloves.

Standard Precautions • Use of personal protective equipment • Specialised clothing or equipment worn for protection against infectious materials • Gloves (most common) that comply with current Australian/New Zealand standards • Be aware of guidelines for latex allergic clients and staff • Aprons and gownsthat comply with Australian/New Zealand standards • Face shields • Protective eyewear e.g., goggles, glasses • Masks and respirators • Footwear to protect from dropped sharps and other contaminated items

Standard Precautions • Cleaning Procedures • Damp dusting benches, equipment and shelving • Maintaining the interior of drawers and cupboards in a clean and tidy state • Cleaning floors daily using a mop and water and detergent • Storing cleaning equipment clean and dry • Managing the removal of a small blood or body fluid spill

Standard PrecautionsSharps • 70% of needlestick / sharps injuries are preventable. • The main reasons recapping needles, manipulation of needles, or incorrect disposal of needles. • Safe handling of sharps • Assemble all equipment required for the procedure to be performed. • Minimise distractions • Use equipment strictly according to protocols and only for the purpose for which it was designed. • Choose the safest equipment available. T • Practice with new equipment so it can be used safely.

Standard PrecautionsSharps • Safe disposal of sharps and other clinical waste • Any used syringe could be contaminated and should be disposed • using a yellow receptacle. • Ensure sufficient sharps’ containers or suitable yellow biohazard bins are available in all areas where syringes are likely to be used or disposed of. • Ensure that sharps containers are puncture resistant, moisture-proof, shatterproof, capable of being sealed and able to withstand heavy handling. • Containers must conform to Australian Standard (AS) 4031 Non-reusable containers for the collection of sharp medical items used in health care areas. • Appropriate reprocessing and storage of reusable instruments • Reusable sharps must be placed immediately after use in a puncture-resistant sharps container specially kept for that purpose • When more than one reusable sharp is carried in a container special care is required during placement and removal of sharps

Standard PrecautionsGeneral Waste • Discard general waster via a small bin lined with plastic, mounted on the wall or on a bench • The usual waste paper bin under the desk can be used for waste not contaminated by blood or body fluids.

Standard PrecautionsMRSA • Methicillin-resistant Staphylococcus aureus (MRSA) Infections • bacteria that is resistant to many antibiotics • In the community, most MRSA infections are skin infections. I • In medical facilities, MRSA causes life-threatening bloodstream infections, pneumonia and surgical site infections. • The Centers for Disease Control and Prevention (USA) has fantastic resources at preventing MRSA infections • http://www.cdc.gov/mrsa/

Additional Precautions • Special ventilation requirements • Dedicated equipment (eg. to each client or as appropriate to work function) • Use of a special facility

Clean Zone • Storage areas for materials, medicaments, equipment • Sterile storage areas • Administration areas

Contaminated Zone • Area used for items that have become contaminated during use • Receiving area for contaminated instruments in the instrument reprocessing centre

Waste • Clinical waste • discarded sharps; • laboratory and associated waste directly involved in specimen processing; • human tissues (but excluding hair, teeth, urine and faeces); • materials or solutions containing free flowing or expressible blood and animal tissues or carcasses used in research • Related waste • includes cytotoxic waste, pharmaceutical waste, chemical waste and radioactive waste • General waste • includes all waste materials that do not fall into the clinical or related waste categories.

Disposal of Waste Requirements • Disposal in accordance with: • Environment Protection (Waste Management) Policy • Environment Protection (Waste Management) Regulations • Australian and New Zealand standards • Organisation policies and procedures

Clean zone • Storage areas for materials, medicaments, equipment • Sterile storage areas • Administration areas

Contaminated Zone • Area used for items that have become contaminated during use • Receiving area for contaminated instruments in the instrument reprocessing centre

Waste • Clinical waste • discarded sharps; • laboratory and associated waste directly involved in specimen processing; • human tissues (but excluding hair, teeth, urine and faeces); • materials or solutions containing free flowing or expressible blood and animal tissues or carcasses used in research • Related waste • includes cytotoxic waste, pharmaceutical waste, chemical waste and radioactive waste • General waste • includes all waste materials that do not fall into the clinical or related waste categories.

Disposal of Waste Requirements • Disposal in accordance with: • Environment Protection (Waste Management) Policy • Environment Protection (Waste Management) Regulations • Australian and New Zealand standards • Organisation policies and procedures

Infection Risks • Contact with waste materials • Inhalation of aerosols • Contact with blood and other body substances • Personal contact with infectious materials, substances and/or clients • Stock including food which has passed 'use-by' dates • Animals, insects and vermin

Procedures for Risk Control • Eliminating a hazardous process • Using personal protective equipment appropriately • Changing a system of work to reduce a hazard. • Isolating the hazard • Using protective devices to decrease exposure • Using safe handling techniques • Following infection control policies and procedures • Procedures to minimise the risk of exposure to blood and body fluids

Protocols for care following exposure to blood / body fluids • Immediate care following: • A sharps injury • A splash of blood or other body fluids • Post exposure care • Record keeping and notification • Legal requirements for the notification of all work related occurrences of injury, disease or illness

Hand Hygiene Procedures(refer to Hand Hygiene Australia http://www.hha.org.au) • Routine handwash • Surgical handwash • Use of antiseptic wipes and alcohol based preparations in specific situations where waterless hand hygiene is acceptable

Routine Hand Wash • When needed • Before eating and/or smoking. • After going to the toilet. • Before significant contact with patients (eg physical examination, emptying a drainage reservoir such as a catheter bag). • Before injection or venepuncture. • Before and after routine use of gloves. • After handling any instruments or equipment soiled with blood or body substances. Reference: http://toolboxes.flexiblelearning.net.au/demosites/series7/702/content/lr_hygiene/006_routine_wash.html

Routine Hand Wash • Washing technique • Remove jewellery. • Method 1 - Essential if hands are soiled • Wet hands thoroughly and lather vigorously using neutral pH liquid handwash. • Rinse under running water. • Do not touch taps with clean hands - if elbow or foot controls are not available, use paper towel to turn taps off. • Method 2 - Permissible only if hands are not soiled • Apply sufficient alcohol rub or gel into the palm of the hand to enable rubbing for 10 - 15 seconds. • Rub this over all surfaces of both hands for 10 - 15 seconds. • Drying • Pat dry using paper towel, clean cloth towel, or a fresh portion of a roller towel. Reference: http://toolboxes.flexiblelearning.net.au/demosites/series7/702/content/lr_hygiene/006_routine_wash.html

Surgical Hand Wash • A five minute scrub which includes cleaning of the fingernails is to be undertaken as the first scrub of the day • Subsequent scrubs of three minutes duration (which omit the fingernails) are undertaken between cases • Hands are kept higher than the elbows at all times to allow water to run in one direction only – from clean to dirty (hands to elbows) • The bristles of the nail brush are used to clean the fingernails only • Arms are washed in a circular motion, from the hands to the elbows without returning to the hands • The antimicrobial soap used for the first scrub of the day should continue to be used for subsequent scrubs Reference: http://www.health.qld.gov.au/qhpolicy/docs/gdl/qh-gdl-321-1-1.pdf

Hand Care • Use suitable water-based hand creams that are registered on the Australian Register of Therapeutic Goods • Use warm water for handwashing • Dry hands thoroughly after handwashing • Wear heavy-duty utility gloves when handling irritant chemicals

INFECTION CONTROL