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Infection Control Education Session 2010 review Presented by

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Title: Infection Control Education Session 2010 review Presented by


1
Aged Care Staff Infection Control Education
Session2010 review
  • Presented by Margaret Jennings
  • Infection Control Education Session

2
Recommended References to have
  • AUSTRALIAN GUIDELINES FOR THE
  • PREVENTION AND CONTROL OF
  • INFECTION IN HEALTHCARE
  • CONSULTATION DRAFT
  • 7 JANUARY 2010
  • Also the 9th ed Immunization handbook 2008
  • And the Blue Book (DHS) shown at right

3
Why are residents susceptible to infection?
  • Why do the following conditions predispose to
    infection?
  • Diabetics?
  • Elderly?
  • Wounds?
  • Non-ambulatory (not able to walk etc)?
  • Catheterized?
  • Smoker?

4
Your role in reducing transmission of infection
  • Observation e.g. immediately report resident with
    diarrhoea, blood in faeces or urine, rash or
    wound/sore etc
  • Do not come to work if you have a sore throat,
    cold, rash or diarrhoea/vomiting and report this
    to your manager
  • Think how you can best observe the 5 moments in
    hand hygiene (more later)
  • Remember it takes less bacteria/viruses to
    infect your residents than it does a healthy
    person and the infection may be fatal
  • Think about what it must be like to have an
    infection when you are not able to speak up or
    let people know how unwell you feel

5
Precautions to reduce transmission
  • 1. Standard Precautions
  • Think about spread of Blood Borne Infections e.g.
    hepatitis B. Wash hands and wear gloves if
    contact with blood and body fluids (except sweat)
    is likely
  • 2. Transmission Based Precautions
  • Droplet e.g. influenza Wear mask when close to
    person
  • Indirect Contact e.g. gastro - Use bleach after
    cleaning contaminated surfaces

6
Something to protect you
7
Droplet spread of Influenza is more likely if you
are within a metre of coughing person
8
Cleaning
  • Detergent separates soil from surfaces e.g.
    washing machine, surface wipes, dishwasher.
  • Use a Neutral pH for most work, alkaline pH for
    stains suggest microfibre cloth for windows.
  • Use fresh cloth per room, separate cloths for
    toilet/bath area (use paper towel in some areas
    during a gastro outbreak)
  • Use detergent wipes for clinical surfaces.
  • Clean surfaces with figure S technique why
  • Avoid spraying use a pour bottle
  • Do not top up hand wash or cleaning bottles
    (contamination)

9
Avoid spray bottles, use pour bottles
10
Too many unnecessary products
11
Nozzles can clog and drip
12
Sprays and reusable cloths not ideal
13
Kitchen
  • Constant cleaning and keep surfaces dry
  • Separate surfaces for raw and cooked food
  • Separate hand washing sink to food duties
  • Separate gloves for clean and dirty surfaces
  • Sanitizers are used for surface cleaning with a
    second clean and left to dry. This reduces the
    number of bacteria allow correct contact time
  • Instead of the normal sanitizer, during a gastro
    outbreak, clean the surface and then leave bleach
    (250 ppm) for 10 minutes then wash off
  • Keep temperature of food low e.g. cooked rice,
    raw egg. Refrigerate cooked food do not allow
    hot food to cool

14
Laundry
  • Water temp for health care facilities set for
    around 75 degrees Celsius
  • 20 minutes at this temperature is required to
    kill bacteria and viruses..
  • Use separate washing machines for personal items,
    bed linen and kitchen linen
  • Follow directions for regular servicing of
    machines and weekly maintenance to ensure
    temperature is hot enough
  • Check for any extra requirements during gastro
    outbreak

15
Cleaning up body fluid spills
  • ALWAYS WEAR PROTECTIVE WEAR
  • Urine absorb with paper towel, clean
  • Faeces scoop up if solid, clean
  • Vomit use kitty litter to absorb, scoop then
    clean
  • Blood drop wipe with paper towel, clean
  • USE DETERGENT TO CLEAN

16
A spill kit may be useful
17
Use of disinfectants
  • Disinfectants are not always needed and can
    generally only be used after the surface is first
    cleaned because they may not be effective when
    dirt/food etc. is present
  • A disinfectant is needed when enough virus or
    bacteria remain on a surface after cleaning where
    infection could still be transmitted
  • An example of when a disinfectant is needed after
    cleaning is during a gastro outbreak. The only
    suitable disinfectant for the norovirus which is
    the most common cause is bleach and it needs to
    be left wet for 10 mins. Carpet is steam cleaned.
    The temperature of both the dishwasher and
    washing machines needs to be regularly checked to
    make sure it is hot enough to stop infection
    spreading

18
Are we using disinfectants correctly?
19
Clinical waste sharps
  • Sharps are items that can penetrate skin and
    include needles, glucose lancets and small glass
    bottles ie even unbroken glass.
  • Treat needle syringe as a sharp unit and
    dispose of to a sharps bin
  • Clinical waste is that contaminated with any
    blood other body fluids but not usually urine
    or faeces unless gastro nor tissues unless flu.
  • Simple examples are dressings and tissues with
    blood on them.

20
Overfilled sharps bins are unsafe
21
Sharps bins on floor are unsafe.
22
Keep Clinical Waste area locked
23
Sharps injuries immediate response
  • Do not delay in acting treatment is best given
    within 2-4 hours of injury
  • Wash with soap, no need to squeeze, no
    disinfectant
  • Report to supervisor and stop work immediately.
  • Protocol should indicate who does what but it
    is important that a doctor assess the source for
    risk of being infectious. The doctor can also
    call a large hospital to speak to the on call
    Infectious Diseases doctor at any hour for
    assessment and advice
  • The injury also needs to be assessed and you may
    need to attend casualty e.g RMH, Western or
    Sunshine. Blood testing and counselling may be
    involved

24
Immunization for staff
  • Influenza staff have annual flu shot to protect
    residents too
  • Hepatitis B advised for all staff
  • Ensure your community immunizations are up to
    date
  • Why do staff resist flu immunization?

25
Our hands
  • We have two groups of bacteria that are found on
    our hands
  • Those that grow in our skin and have been with us
    since we were a few hours old. They are called
    our residents. They live in the layers of the
    skin and do spread up to the surface. Washing our
    hands with plain soap does not reduce our
    bacteria but does affect the second group see
    below. We need our own bacteria to protect us
    from other bacteria that may cause infection.
  • Those that are picked up and stay on our skin til
    we wash or use alcohol handrub on our hands. They
    are called contaminants. Washing with plain soap
    or alcohol is usually sufficient to remove these.
    Sometimes, bacteria that are resistant to
    antibiotics may not be removed with a single wash
    and we may need to use a product with
    chlorhexidene and alcohol

26
Hand Hygiene
  • Activities that can cause contamination include
  • handling contaminated equipment
  • direct contact with body secretions or excretions
  • going to the toilet and not washing hands

27
The 5 moments of hand hygiene
  • Before and after contact with a patient e.g. a
    resident with flu or gastro
  • Before and after a procedure e.g. a wound
    dressing
  • After contact with the patients environment e.g.
    a touched surface in the sick residents room
  • Aged Care staff would wash or handrub after
    removing gloves e.g taking a temperature, after
    toileting a resident and emptying a pan
  • Soap or alcohol handrub may be used although
    alcohol may not be as effective during a gastro
    outbreak caused by norovirus

28
Technique to protect hands
  • To help maintain skin condition on staff hands
    and remove contaminating bacteria and viruses
  • Use a product designed for Health Care Workers
  • Wet hands first to dilute detergent
  • Use warm water (not hot) for hand washing
  • Rinse off all product thoroughly
  • Pat hands dry thoroughly do not wipe
  • Use compatible hand cream 2 - 4 times/day

29
Have soap and hand towel near sink
30
Correct alcohol hand hygiene
  • Use alcohol if no sinks nearby
  • Do not use alcohol handrub in kitchen
  • Only use on clean looking hands
  • Alcohol is active against flu viruses but not
    always against gastro viruses
  • Allow 15 seconds minimum wet contact
  • Allow alcohol to air dry do not wipe off

31
Alcohol used if sink not handy
32
About gloves
  • Wear gloves when body fluid contact may occur
  • Dont overuse gloves i.e. dont use when feeding
    resident unless they always dribble
  • Change between cleaning rooms
  • Always wash hands after removing gloves
  • Allow alcohol handrub to dry before glove use
  • Gloves get small holes so they are not perfect

33
Hygiene when giving medication
  • Liquid
  • The resident can expect a cup that is clean and
    not contaminated with other medication (this
    could cause a reaction)
  • If the staff is giving the liquid medication to
    the resident then hand washing is needed because
    their hands may be in contact with the residents
    mouth etc
  • 2. Solid
  • The resident can expect to ingest a tablet that
    does not have contaminating bacteria/viruses from
    staff or residents. A small disposable patty pan
    or piece of paper with the tablet on it is one
    suggestion. Hands must not be used to pass
    medication. If the tablet is to be crushed then a
    clean surface is used

34
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