Professional Documents
Culture Documents
1
Infection Prevention Contact Info
2
Infection Control Program
What is it and why have one?
Surveillance
Identify healthcare associated infections and report
as required by law
Prevention and control of infections and
infection risks
Provide interventions
Assess effectiveness and modify as needed
Educate staff about infection prevention
Result
A safer hospital
3 Improved patient care
Infection Control Manual
6
Indications for Hand Hygiene
All personnel involved in direct patient care shall wash hands with
soap and water or use hand sanitizer:
At the beginning of work
Before and after patient contact, including dry skin contact
Before gloving
After removing gloves
Before performing invasive procedures
Before and after contact with wounds
After contact with patients body substances
After handling equipment, supplies, or linen contaminated with body
substances
Before handling sterile or clean supplies
After using the restroom
After touching or blowing your nose
7 Before leaving the unit
8
Which product should I use?
Hand Sanitizer
For non visibly
soiled hands
Use after removing
gloves
Use after dry skin
contact
Dispense gel or
foam and rub all
surfaces of hands
10 until dry
Isolation Precautions
Protects patients,
healthcare workers and
visitors from the spread
of communicable
diseases
Prevents spread of
infection by the
standard, airborne,
droplet and contact
routes
11
Standard Precautions
Standard Precautions is
the foundation of
Infection Prevention
Used for every patient,
every encounter
Intended for the
protection of the patients
and the health care
workers
Patients are AT RISK
for infection
Patients can be THE
SOURCE of infection
12
Standard Precautions
Three Major
Components
Hand Hygiene
Proper Use of
Personal Protective
Equipment
Surface Cleaning
and Disinfection
13
Respiratory Etiquette
In waiting areas:
Provide tissues and no
touch receptacles for
disposal
Provide hand sanitizer;
make sure that appropriate
supplies are always
available in hand washing
areas
Offer masks to coughing
patients; place immediately
in exam rooms if possible
Perform hand hygiene after
contact with respiratory
14 secretions and
Transmission-based Precautions
Transmission based
precautions are used in
addition to Standard
Precautions for patients with
documented or suspected
infection or colonization with
certain epidemiologically
significant organisms.
A sign should be posted
outside the door indicating
the type of precautions
15
Transmission-based Precautions
Contact Precautions
Draining wounds
Multi-Drug Resistant Organisms
Diarrhea of unknown origin
C. difficle (soap and water hand
hygiene required)
Rotavirus
Other organisms at the
discretion of the Infection
Control Department
Gown and gloves required
upon entrance to room AND
Other PPE as required by
Standard Precautions
16
Transmission-based Precautions
Droplet Precautions
Coughing, sneezing
RSV
Influenza
Meningococcal
meningitis
Mask required when
within arms reach of
patient AND
Other PPE as required
by Standard
Precautions
17
Transmission-based Precautions
Airborne Precautions
Chickenpox
Disseminated Varicella
(Herpes) zoster
M. tuberculosis (TB),
suspected or confirmed
Negative pressure room
required, door closed
Fit tested N-95 respirator
AND
Other PPE as required by
18 Standard Precautions
Personal Protective Equipment
(PPE)
19
Blood-borne Pathogens
20
Blood-borne Pathogens
21
Blood-borne Pathogens
Approximate risk of transmission following exposure
Hepatitis B 6 to 30% depending on the hepatitis Be antigen status
of the source individual
Hepatitis C 1.8% following needlestick or cut exposure
HIV 0.3% (percutaneous) 0.09% (mucous membrane)
Following an exposure you should
Wash the area immediately with soap and water
Report the injury to Employee Health/Needlestick Hotline (3278)
Inform your supervisor
Needlestick Hotline (3278)
Report all needlesticks, lacerations and splashes
Confidential assessment/triage, counseling, testing, treatment and
information
Prophylaxis and/or treatment available following work related
22 exposures to blood-borne pathogens
Tuberculosis
Transmission by inhalation
Must have active pulmonary disease
to transmit
Classic symptoms
Prolonged productive cough
lasting >3 weeks
Coughing up blood
Weakness
Weight loss
Night sweats
TST skin test annually (for everyone)
TST is a test for EXPOSURE
(latent TB)
90% of TST positive persons do
26
What is Quality Assurance?
27
What is Performance
Improvement?
Performance refers to the way people do their jobs and the
results of their work.
Performance Improvement uses a systematic methodology
used to find the root causes of a performance problem and
then implement an intervention that applies to that specific
performance deficit.
PI helps to ensure that selected interventions are supported
and sustained by involving a stakeholder group from the
outset and ensuring that an organizations staff participates
actively in every step of the process.
28
Avoidable Harm
Prevent harm from high-alert medications, including
anticoagulants, sedatives, narcotics and insulin.
Prevent injurious falls by implementing evidence-based practices.
Reduce surgical complications by implementing all of the changes
recommended by the Surgical Care Improvement Project (SCIP)
Prevent pressure ulcers by using science-based guidelines for
their prevention.
Reduce methicillin-resistant staphylococcus aureus (MRSA)
infection by reliably implementing scientifically proven infection
control practices.
Deliver reliable, evidence-based care for congestive heart failure
to avoid readmissions.
29
Avoidable Harm
Deploy Rapid Response Teams at the first sign of patient decline
Deliver Reliable, Evidence-Based Care for Acute Myocardial Infarction to
prevent deaths from heart attack
Prevent Central Line Infections by implementing a series of
interdependent, scientifically grounded steps called the "Central Line
Bundle"
Prevent Catheter-associated Urinary Tract Infections through compliance
with CAUTI bundle
Prevent Ventilator-Associated Pneumonia by implementing a series of
interdependent, scientifically grounded steps including the "Ventilator
Bundle"
30
Occurrence Reporting
31
Life Safety
32
Life Safety Code
34
CODE RED: Fire
35
Equipment Safety
36
Hospital Beds
Over 900 incidents involving harm or death
Avoid use of electric beds in psych unit due to cord and suicidal
precautions
Prevent fires involving electric beds
Make sure power cord is not damaged
Plug power cord directly into wall outlet
Make sure plug and outlet fit together safely and securely
Reduce risk of bed rail entrapment
- Use bed rail protector pads
- Test beds for gaps that pose a risk of entrapment
37
Infusion Pumps
Risks:
Infiltration
Time-to-alarm
Occlusion release bolus
Air emboli
Air-in-line detection
Device failure
38
Infusion Pumps (cont.)
39
Other equipment
40
Single-Use Devices
Risks:
Initial use (defects)
Use of reprocessed SUDs
- Risk for infection and device failure
41
Hazardous Waste &
Materials Management
42
Hazardous Materials
Responsibilities:
Manufacturer: Must record all hazard info in a
Safety Data Sheet (SDS) & provide to
purchaser
Employer: Must have list of all hazardous
chemicals used in facility, and a SDS for each.
Employee: Should know what hazardous
materials are used in work area, where to find
SDS, and how to read SDS
44
Safety Data Sheets at Thorek
45
Labeling of Hazardous Chemicals
46
Personal Protective Equipment (PPE)
Employer responsibilities:
Select types of PPE appropriate for all hazards
& train all workers required to use PPE
Employee responsibilities:
Follow facility procedures for PPE
47
Types of PPE
48
Information Management
49
Commitment to Information Management
50
Overview of policies
51
Overview of policies (cont.)
52
Other safeguards
54
Patient Rights
Prepared by
Janie Lane, RN, MSN
55
Why important?
56
Overview of Patient Rights
57
Information Disclosures
Patient rights must be presented so that the patient can understand it. Some
patients may need special help to overcome language barriers, hearing
deficits, or other mental/physical barriers to understanding.
58
Participation in Treatment Decisions
Patients have the right to make decisions about their care, and set
the course of treatment.
Patients have the right to know about their diagnosis, prognosis,
and treatment options.
Patients have a right to effective pain management.
Patient must give informed consent before the start of any
procedure or treatment.
Patients have the right to refuse or discontinue treatment.
Healthcare professionals play a critical role in protecting patient
rights.
59
Respect, Safety, and Non-discrimination
60
Complaints and Grievances
Prepared by
Janie Lane, RN, MSN
Learning Objectives
Training content will ensure that staff have education, training and
demonstrated knowledge based on the specific needs of the patient
population, and shall include:
1) Techniques to identify staff/patient behaviors that may trigger
circumstances that require use of a restraint/seclusion
2) Use of non-physical intervention skills
3) Choice of least restrictive intervention
4) Safe application and use of all types of restraints/seclusion
5) Recognition/response to physical or psychological distress
6) Clinical identification of specific behavioral changes that indicate
restraint/seclusion are no longer necessary
7) Monitoring the physical/psychological well-being
8) Use of first aid techniques
Training Program Overview
Training interval:
a) Initial orientation
b) Annually
Goal: To find the safest, least restrictive way to care for the patient.
4 side rails up
Posey Vest
Soft limb restraints
Case Study
Mittens:
Place hands in each mitt and secure strap ABOVE wrist bone.
Secure with quick release tie to bed frame, if needed.
Limb restraint:
Wrap the limb with the soft limb restraint and secure the
plastic clip.
Tighten the restraint so that the patient is unable to pass
his/her wrist through the restraint, being careful not to restrict
blood flow to extremity.
Physical restraints:
Safe application (cont.)
Posey Vest
Choose appropriate size
Put vest on with the V neck in front only. Crisscross strap,
making sure to thread the left strap though the slot. Secure to
bed frame with quick release tie. The tie should be done so
that it does not slide in any direction.
Ensure that you are able to slide your open hand (flat)
between device and patient.
Patient should be able to breathe comfortably.
Physical restraints:
Patient monitoring & assessment
Nutritional needs
ROM exercises
- By appropriate trained staff
- One limb at a time must be released to perform ROM
Hydration needs
Elimination needs
Personal hygiene needs
Special considerations:
Hand mitts & Siderails
Mitts not typically restraint unless. . .
Pinning or otherwise attaching those same mitts to bedding or using a
wrist restraint in conjunction with hand mitts.
Applied so tightly that the patients hand or fingers are immobilized.
Mitts are so bulky that the patients ability to use their hands is
significantly reduced.
Siderails **
Seizure precautions with all side rails padded and raised
Immobile patients
Patient on stretcher, recovering from anesthesia, sedated, experiencing
involuntary movement etc
** Considered restraint if all four side rails raised in order to immobilize or
reduce ability of patient to move his/her arms, legs, body or head freely
Physical holding for forced medications
Patient must be seen face to face within 1 hour after the initiation of
the intervention by a physician or LIP, or trained nurse to evaluate:
Recognize: Respond:
Compromised breathing Immediately release restraint
Circulation changes Complete nursing
Change in level of assessment
consciousness Intervene as necessary, ie
first aid or CPR
Increased agitation
Withdrawal