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IDEAL+Infectious Diseases Education through Active Learning
Dr. Erika VLIEGHE, Universiteit Antwerpen, BelgiumDr. Caroline CHARLIER-WOERTHER, Université de Paris, France
Dr. Muge CEVIK, NHS Lothian, UK
Principles of infection prevention and control
IDEAL+Infectious Diseases Education through Active Learning
Learning objectives Understand the goal and basic principles of infection prevention and
control in the health care setting List the ‘standard precautions’ and explain their goal Explain and apply hand hygiene on the right moments and with the right
techniques Demonstrate how to use needles safely Describe the ‘additional precautions’ (contact, droplet, airborne) Connect the correct type of additional precaution with the most common
infectious diseases
IDEAL+Infectious Diseases Education through Active Learning
Pre-class education material
• Watch this movie: https://youtu.be/K-2XWtEjfl8• Read ‘Hand hygiene: why, how and when’• Read ‘IS needle-stick leaflet’• Watch this movie:
https://www.publichealthontario.ca/en/videos/ipac-fullppe-off
IDEAL+Infectious Diseases Education through Active Learning
What is IPC?
WHO definition:– Infection prevention and control (IPC) is a scientific
approach and practical solution designed to prevent harm caused by infection to patients and health workers.
– It is grounded in infectious diseases, epidemiology, social science and health system strengthening.
– it is relevant to health workers and patients at every single health-care encounter.
IDEAL+Infectious Diseases Education through Active Learning
Why do we need IPC in our health care settings?• Please watch now this movie: https://youtu.be/K-2XWtEjfl8
IDEAL+Infectious Diseases Education through Active Learning
O’neill 2015
IDEAL+Infectious Diseases Education through Active Learning
IDEAL+Infectious Diseases Education through Active Learning
2015
IDEAL+Infectious Diseases Education through Active Learning
WHO Global Action Plan 2015• Objective 1: Improve awareness and understanding of antimicrobial resistance through
effective communication, education and training
• Objective 2: Strengthen the knowledge and evidence base through surveillance and research
• Objective 3: Reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures
• Objective 4: Optimize the use of antimicrobial medicines in human and animal health
• Objective 5: Develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions
SURVEILLANCE
INFECTION CONTROL
ANTIBIOTIC STEWARDSHIP
IDEAL+Infectious Diseases Education through Active Learning
Holmes, Lancet 2016
IDEAL+Infectious Diseases Education through Active Learning
IDEAL+Infectious Diseases Education through Active Learning
IDEAL+Infectious Diseases Education through Active Learning
Focus on the precautions to prevent transmission • Standard precautions• Additional precautions
• Stops transmission – from patient to HCW– from HCW to patient
meant to protect health care workers, patients, visitors,…
IDEAL+Infectious Diseases Education through Active Learning
Standard precautionsThis applies ALWAYS in health care
This protects us against common and unknown pathogens
1. Hand hygiene2. PPE when risk for exposure to body fluids:
gloves, goggles, gown3. Safe disposal of sharps4. Respiratory hygiene and cough etiquette5. Aseptic techniques6. Clean materials, clean environments
IDEAL+Infectious Diseases Education through Active Learning
Standard precaution 1: hand hygiene
• Rubbing (hand alcohol gel)
IDEAL+Infectious Diseases Education through Active Learning
Rubbing hands: technique
IDEAL+Infectious Diseases Education through Active Learning
Hand hygiene: how
• Hand washing (water and soap)
IDEAL+Infectious Diseases Education through Active Learning
Washing hands: technique
IDEAL+Infectious Diseases Education through Active Learning
Hand hygiene: how?
Good hand hygiene is NOT possible with– Watches– Jewelry– nail polish– long sleeves
Bare below the elbow!!
Remove all of these when working!
IDEAL+Infectious Diseases Education through Active Learning
Hand hygiene: when?
IDEAL+Infectious Diseases Education through Active Learning
Hand hygiene: what about gloves…?
Gloves = for any contact with blood and other body fluids
IDEAL+Infectious Diseases Education through Active Learning
Standard precaution 2: for contact with blood or body fluids
IDEAL+Infectious Diseases Education through Active Learning
Standard precaution 3: prevention of needle stick injury
IDEAL+Infectious Diseases Education through Active Learning
Never never recap needles!!
Always have a sharps box nearby
IDEAL+Infectious Diseases Education through Active Learning
Standard precaution 4: cough etiquette
For patients and health care workers:
• Sneeze/cough in your elbow
• Frequent hand hygiene
• Dispose immediately of handkerchiefs
• Wear mask when working with respiratory symptoms
IDEAL+Infectious Diseases Education through Active Learning
IDEAL+Infectious Diseases Education through Active Learning
Additional precautions: for specific pathogens
Transmission relevant for the health care setting
1. Hands: contact
2. Respiratory: droplets
3. Respiratory: aerogenic
IDEAL+Infectious Diseases Education through Active Learning
How pathogens get transmitted
IDEAL+Infectious Diseases Education through Active Learning
IDEAL+Infectious Diseases Education through Active Learning
Droplets or airborne…?Droplets precautions - Particles > 5 micrometers Airborne precautions particles < 5 micrometers
Adenovirus Coronavirus
B. pertussis MeaslesParamyxovirus influenzae
C. diphteriae M. Tuberculosis
H. influenzae M. leprae
M. influenzae VZV
M. parotidis
N. menigitidis
Rubivirus
S. pyogenes
Respiratory syncitial virus
Y. pestis
IDEAL+Infectious Diseases Education through Active Learning
Additional precaution 1: contactProtect yourself + others from pathogens that transmit through hand contact with skin/mucosa:
• Gown• Gloves• Hand hygiene• (for MRSA surgical mask to prevent contact
with nose)
IDEAL+Infectious Diseases Education through Active Learning
1. Contact precautions: when and how?
IDEAL+Infectious Diseases Education through Active Learning
Ebola, the most ‘extreme’ type of contact precaution
IDEAL+Infectious Diseases Education through Active Learning
Additional precaution 2: droplet
Protect yourself and others from large droplets that can spread in the air and environment at a maximal distance of 1-2 m
Surgical mask + hand hygiene
Remove mask by the strapsApply hand hygiene after removal
IDEAL+Infectious Diseases Education through Active Learning
Do not cover only your mouth!
IDEAL+Infectious Diseases Education through Active Learning
IDEAL+Infectious Diseases Education through Active Learning
Additional precaution 3: airborne
Protect yourself and others from small droplets/aerosols that can spread in the air and environment at a distance > 2 m
Hand hygiene + FFP2 (or 3) Mask
!! Fit test for this mask!! Remove mask by the strapsApply hand hygiene after removal
IDEAL+Infectious Diseases Education through Active Learning
Probably over-cautious!
IDEAL+Infectious Diseases Education through Active Learning
Airborne precautions: how to correctly use your FFP2/3 mask
IDEAL+Infectious Diseases Education through Active Learning
Precautions for emerging pathogens
• MERS-CoV, COVID-19: contact + droplet/aerogenic
• Ebola: ‘high level’ contact + droplet/aerogenic
IDEAL+Infectious Diseases Education through Active Learning
Additional precautions: how to put PPE on?
IDEAL+Infectious Diseases Education through Active Learning
Additional precautions: how to take PPE off?
• Peel of one by one• Avoid touching surfaces or face• Keep your mask on until last part
• Mask removal: • touch the straps at the back of your head• Do NOT touch the front part
• Always finish with hand hygiene
IDEAL+Infectious Diseases Education through Active Learning
Donning and doffing PPE safely
Watch this video to learn how to safely remove the personal protective equipment for contact precautions: www.publichealthontario.ca/en/videos/ipac-fullppe-off
IDEAL+Infectious Diseases Education through Active Learning
To summarize
