REDUCING/PREVENTING HOSPITAL-ACQUIRED INFECTIONS—

IT’S EVERYONE’S JOB

Infection Control

Objectives

Describe Standard and Isolation PrecautionsDescribe transmission and control of MDROsIdentify important infection control processesIdentify risk factors for Hospital-Acquired

Infections (HAI)

Infection Control Web Page

The Infection Control Web Page can be reached by going to:

Kaleidascope Departments and Services

Patient Care / ClinicalInfection Control

Take your questions to the Experts!

Infection Control is Everyone’s Business

Family/Visitors

Administrators

CNA/PCA/CMA

Child Life

Nutritionists

Healthcare Associated Infections—Some sobering statistics:

Prevention and Control Methods—Quick, Easy and Simple

Transmission-Based Precautions:CONTACT Precautions

Transmission Based precautions:

Contact Precautions used for patients

with diagnosis of:

Precautions include Private room

Gloves Hand hygiene Gowns

ESBL

MRSA, VRE,

C. . Difficile

Transmission-Based Precautions:

DROPLET PrecautionsCommunicable diseases

are passed on by droplet dispersion. These include: Upper respiratory

infections (cold and flu) Neisseria meningitis Pertussis or whooping

cough Adenovirus

Precautions to prevent

spread of droplet-borne diseases include: Private roomHand hygieneUse of surgical mask if within 6 feet of the patient.

Airborne Isolation is a means of protecting against the spread of some diseases:

These diseases include:Varicella Virus (Chicken pox, Disseminated Shingles)Surgical MaskM. tuberculosisN-95 respirator MaskPandemic Flu

Airborne Isolation

Place in negative pressure roomWear respirator for TB, Pan fluFacilities Management (daily smoke test)Keep doors closedMask patient for transportCommunicate with other departmentsInstruct visitors: N-95 respirator useOSHA Reg’s-Fit testing Annually!

Transporting Patients

Transporting Patients on Special Precautions Droplet/Airborne: mask patient Contact: cover open areas

Minimize travel off unit Off-unit procedures: last case of the day

Hand Hygiene

Culture plate showing growth of bacteria 24 hours after a nurse placed her hand Culture plate showing growth of bacteria 24 hours after a nurse placed her hand on the plateon the plate

When to Wash Your Hands

Are alcohol-based hand rubs really effective?

More than 20 published studies have shown that alcohol-based hand rubs are more effective than either plain soap or antibacterial soaps in reducing the number of live bacteria on the hands.

Advantages of cleaning hands with alcohol-based hand rubs

When compared to traditional soap and water hand washing, alcohol hand rubs have the following advantages:

take less time to use can be made more accessible than sinks cause less skin irritation and dryness are more effective in reducing the number of

bacteria on hands Kaleida Health makes alcohol-based hand rubs

readily available to personnel has led to improved hand hygiene practices

A 24-year-old man who had quadriplegia due to a traumatic spinal cord injury was found on routine surveillance cultures to have methicillin-resistant Staphylococcus aureus (MRSA) colonization of his anterior nares. He had no history of MRSA infection or colonization. To assess the potential implications of the patient's MRSA carriage for infection control, an imprint of a health care worker's ungloved hand was obtained for culture after the worker had performed an abdominal examination of the patient. The MRSA

colonies grown from this handprint on the plate (CHROMagar Staph aureus).

After the worker's hand had been cleaned with alcohol foam, another hand imprint was obtained, and the resulting culture was negative for MRSA (Panel B). These images illustrate the critical importance of hand hygiene in caring for

patients, including those not known to carry antibiotic-resistant pathogens.

This is the image…………………………

January 15, 2009

Image of before (A) and after (B) using Alcohol based hand foam……

A. Before using hand foam

B. After using hand foam

When should you wash your hands with soap and water?

Wash your hands with plain soap and water, or with antimicrobial soap and water if: your hands are visibly soiled

(dirty) hands are visibly

contaminated with blood or body fluids

before eating after using the restroom after caring for patients with

C diff

Multi-Drug Resistant Organisms and Clostridium Difficile

VRE•MRSAMRSA

•C-DIFFC-DIFF

So What’s The Fuss All About ?

Drug resistant Pathogens are a growing threat

2 Million patients acquire a HAI90,000 patients die as result of a HAI50% -70% of S.aureus isolates are MRSA> 70% of bacteria that cause HAI’s are

resistant to at least one antibiotic used for treatment

Source: CDCSource: CDC

Financial Impact of MRSA

Annual cost to treat MRSA patients in the U.S. between $ 3.2 billion and $ 4.2 billion

Extra cost associated: a blood stream infection $ 17,422 (MSSA $

9,661) a surgical site infection $ 36,133 (MSSA $

4,989) Source: Source: Abramson,ICHE1999;20:408 Abramson,ICHE1999;20:408 Engelman et al. 2001;ICAAC Engelman et al. 2001;ICAAC Cosgrove et al Clin Inf Dis 2003;36:53-59 Cosgrove et al Clin Inf Dis 2003;36:53-59 Cosgrove et al. ICAAC 2001 Cosgrove et al. ICAAC 2001 Kaye et al. ICAAC 2002 Kaye et al. ICAAC 2002 International Society of Pharmacoeconomics Outcome Research, 5/05International Society of Pharmacoeconomics Outcome Research, 5/05 Cheng, J Hosp. Inf. 1988; 12:91-101 Cheng, J Hosp. Inf. 1988; 12:91-101 Wakefield, AJIC 1988; 16: 185-192Wakefield, AJIC 1988; 16: 185-192

The inanimate environment is a reservoir of pathogens

~ Contaminated surfaces increase cross-transmission ~Abstract: The Risk of Hand and Glove Contamination after

Contact with a VRE (+) Patient Environment. Hayden M, ICAAC, 2001, Chicago, IL.

Eating and Drinking

The previous slide displayed why it is so important not to eat or drink around the patients.

OSHA Regulation Food and drink should not be consumed in

patient care areas or areas where contamination with blood or other potentially infectious material could occur.

Environmental Surfaces

Toys and playroom surfaces should be disinfected as often as possible, but at least daily.

Is someone designated to clean toys and surfaces on each floor???

Personnel Health Guideline The following are guidelines for personnel who have various diseases

Disease Entity1.Strep Throat

2.Zostera) Localized

b) General

3.Viral Upper respiratory infection

Staff restrictions1.Restrict working until

24 hours after start of antibiotics

2. Zostera) Cover lesions; restrict from

caring for high risk patients

b) Restrict from patient contact until lesions are dry/crusted

2.Consider exclusion from care of high risk patients

Personnel Health Guideline con’t

Disease Entity4.Conjunctivitis

5.HSV-1 a) Hand

b) Oro-facial

Staff Restrictions4.Restrict from patient

care until discharge ceases

5.HSV-1a) Restrict until lesion(s)

healedb) Evaluate worker for

need to be restricted from care of certain patients

Questions

If you have any questions regarding how to prevent Hospital Acquired Infections, please contact the Infection Control Specialist at your own site.

Preventing infection is – everyone’s job!