Infection Control Induction Program

1. Infection Control Induction Program 2013

2. Objectives of orientation education • Hand hygiene • Standard & transmission based precautions • Staff health/immunisation • Waste management • Occupational exposure

3. Infection Control Team Chantal Rayner Jenny Lukeis Staff Health Nurse

4. . • A MOMENT is when there is a perceived or actual risk of pathogen (germ) transmission from on surface to another via the hands.

5. 5 Moments for Hand Hygiene

6. Hand hygiene Opportunities • Before starting work each day • After coughing, sneezing, touching your hair or touching your face. • After going to the toilet ( soap & water ) • Before and after glove use • Before and after working with food • After mopping, sweeping, removing garbage or using the telephone • Before and after meal breaks ( Soap & water )

7. Soap & water: • It is recommended that the AHG is used to decontaminate the hands at all times except • When the hands are visibly soiled • Before meal breaks • After using the toilet • When the build up of emollients are obvious

8. Hand Care • Caring for the skin on the hands is important- intact skin is a natural defence against infection • Dry or cracked skin can harbour micro-organisms. • Cuts and abrasions are to be covered by a water resistant occlusive dressing • Moisturiser should be used 3-4 times per shift • Moisturiser provided by the hospitalonly

9. SWH Hand Hygiene Project • Hand Hygiene Project • Commenced in 2006- 10% (mean) • SWH current compliance rate is 68% ( October 2012 ) Target compliance rate 70%

10. Microbial Reservoirs • Microbes can survive in many environments • On or in people, as normal flora • On or in people who have infections • Contaminated food or fluids • Contaminated articles • Contaminated environment

11. Environmental Cleaning • Public area • Patient care area • Patient care equipment • Office spaces

12. TUFFIES & TUFFIE 5’s All purpose general cleaning A one step wipe For everyday use For disinfection when a pt has GASTRO, VRE, MRSA or any multi-resistant bugs

13. TUFFIE 5

14. DRESS CODE POLICY • Wrist watches and bracelets are not permitted in the clinical area • Rings – wedding ring or one plain flat band only • Chains – one plain unadorned chain only • Earrings – small sleepers or studs only • Facial studs are not permitted • No nail polish or artificial nails permitted • No Lanyards permitted

15. INFECTIONSWhat is an infection? • An infection occurs when invading microorganisms cause ill health • Viruses • Bacteria • Fungi • Protozoa • Prions Pain, tenderness, swelling, redness, pus & fever

16. STANDARD & TRANSMISSION BASED PRECAUTIONS

17. Prevent Infection Transmission • Standard precautions • Used for ALL patient contacts • Transmission Based Precautions • Used in addition to standard precautions when more stringent precautions are required • Airborne transmission – Tb, chicken pox • Droplet transmission – Influenza, flu • Contact transmission- Gastro, VRE, MRSA

18. Use of Standard Precautions Minimises the risk of cross-infection from: • HCW to patient. • Patient to HCW. • Patient to patient. • To be used for all patients regardless of infectious status or perceived risk.

19. Standard Precautions • Cleaning hands at the 5 moments of hand hygiene • The use of protective barriers or PPE • Appropriate handling & disposal of sharps & other infectious waste • Use of correct aseptictechnique

20. Transmission Based Precautions • Use for patients known or suspected to be infected or colonised with infectious agents that cannot be contained with standard precautions alone.

21. Transmission Base Precautions • Contact • Droplet • Airborne

22. Contact Precautions • Influenza • Influenza • Lice • Norovirus • Rotavirus • Scabies • Chicken pox *contact & & airborne precautions • virus • MRSA • VRE • Gastro • Abscess ( Draining- hard to contain) • Conjunctivitis

23. Contact precautions • Single room if possible, with ensuite • Cohort with same infection if necessary • Gloves should be worn when entering the room • Gown if clothing or forearms will have direct contact with patient or contaminated environment – remove before leaving the room • Remove gloves and gown, wash hands before leaving patient room

24. FOOD SERVICES STAFF • Gel hands • Deliver / Collect tray • Gel hands

25. STAFF HEALTH/ IMMUNISATIONS

26. Staff Health • The hospital provides an immunisation program for staff. • Staff Health Clinic • Staff Health Nurse- to be appointed • Each fortnight clinic will run- bookings on 55631433 • Details recorded staff database & medical record

27. Immunisation • The following is a list of immunisations recommended for Health Care Workers. • From “Immunisation Guidelines for H.C.Ws” Department of Human Services-2007

28. Hepatitis B • For all staff • 3 injections (baseline, 1 month & 5 months) • Blood test one month post 3rd injection • A booster is no longer recommended

29. Diphtheria/Tetanus - ADT • 10 yearly boosters is no longer recommended. • Recommend booster at 50 yrs of age Pertussis ( Whooping Cough) • Single booster dose is recommended for all health care workers, especially those in contact with infants

30. Measles/ Mumps/ Rubella • Recommended 2 doses of MMR • Born after 1966 should have evidence of receiving 2 doses

31. Poliomyelitis • No longer administered orally • Infanrix administered IM

32. Varicella Zoster Virus(Chicken Pox) • Attempt to have documented history of all Health Care Workers • Check Serology • Then vaccinate

33. Mantoux Testing(Tuberculosis) • BCG no longer given as it is only 50 % affective, and TB not prevalent in Aust. • Screening (mantoux test) within 6 weeks of commencement of work ( direct patient contact workers )

34. Appointments for Staff Immunisation • RING EXTENSION 31433

35. The Importance of Influenza Immunization for Healthcare Workers

36. Get a Flu Shot Every Year • The flu viruses change frequently • A new flu vaccine is made each year to protect against the new strains of flu viruses • If the viruses change after you’ve had yourinjection, you won’t get as sick

37. Getting a flu shot every year protects you and those around you

38. The Flu: Now You Know • The flu is a serious contagious illness.1 • The most effective prevention is to get the yearly flu shot.1 • SWH is committed to providing flu vaccinations and making it as easy as possible for you to get vaccinated.

39. Influenza is Very Contagious Influenza is Very Contagious A sneeze transmits flu at 167km/h covering a distance of 5 metres in 1/10th of a second! Individuals are contagious from the day before the onset of symptoms to about 5 days after the first symptoms

40. Fever>39°C Cough, aches Shivering Headaches General weakness Possible complication None Symptoms Recovery Incubation 24 to 72 hours 3 to 7 days up to two weeks High Contagion (Cross Infection) Influenza and how it affects you

41. Respiratory (Cough) Etiquette

42. Single Use Policy • Any items marked by manufacturer as “single use” should be discarded after use • Multi dose vials must only be used on the same patient then discarded • Items marked “Single Patient Use” must only be re-used on same patient then discarded

43. Waste Management

44. Waste Management Aims: • Reduce environmental impact • To minimise the generation of waste • Reduce disposal costs to the organisation • Ensure that OH & S obligations are not compromised

45. Categorisation of Waste • Sharps • Clinical/ Infectious • Confidential • Anatomical • Cytotoxic • Pharmaceutical • Recycling

46. Sustainability Victoria • SWH Environmental Management Committee • Meet Quarterly • Covers waste, water, energy, procurement, fleet management • Working on SWH environmental management plan

47. Linen Management • Do not over fill bags (3/4 full) • No sharps into soiled linen • Prevent seepage • Use gloves to handle moist linen

48. OCCUPATIONAL EXPOSURE MANAGEMENT

49. Occupational Exposure • First aid – immediate washing of area • Eye splashes – rinse thoroughly • Report incident promptly • Evaluation of exposure • Follow-up action, counselling • Blood tests if required • Ensure full documentation of incident

50. Infection Control Policy Manual • Available on the SWH intranet under prompt ‘Infection Control’ Use it as a resource For example: • Staff Health and Vaccinations • The management of needle stick or other occupational exposure • Management of patients with VRE, MRSA, TB • Environmental cleaning