Just For The Health Of It! Elizabeth Watson RN BScN CIC Objective Understanding how the IP&C Core Competencies for Healthcare Workers protects the health and well being of the employee, as well as those around them. Core Competency Categories Basic Microbiology Chain of Infection Surveillance
Point of Care Risk Assessment Routine Practices Hand Hygiene Appropriate use of PPE Additional Precautions Blood and body fluid exposures Waste Streams Cleaning and Disinfection Immunization Critical thinking
Basic Microbiology Various Microorganisms Normal flora verses pathogenic microorganisms
Transient vs Resident Organisms Antibiotic Resistant Microorganisms MRSA, VRE, CRE Types of Microorganisms
Normal Flora vs Pathogenic Microorganisms, like certain bacteria and yeasts, living on the human skin or in the nose, mouth, throat, small and large intestine and vagina, are part of the normal human flora A persons normal flora prevents overgrowth of harmful
microorganisms However some of these microbes, when overgrow, may become pathogenic or capable of causing disease. what-whenhow.com What factors can make your normal flora become pathogenic?
the microbial virulence invasion through the bodys barriers ( broken skin) the amount of microorganisms
the bodys immune defense system AROs Antibiotic Resistant Organisms When a bacteria or organism becomes resistant to certain drugs which they use to be susceptible to.
Examples: MRSA, VRE, CRE Infections caused by AROs are often more difficult to treat, may complicate recovery and increase hospitalization stays. Staff Risks
Staff hands, uniforms, equipment like stethoscopes can become contaminated with AROs Staff can act as vectors and put other staff and clients/ patients at risk Staff could inadvertently colonize themselves if they do not
perform hand hygiene as per the four moments, use PPE appropriately and clean and disinfect equipment Staff who become colonized could have an increased risk of infections caused by an ARO themselves Chain of Infection Causative Agent
Susceptible Host Reservoir Portal of Entry Portal of Exit Mode of
Transmission Routes of Transmission Contact Direct or indirect MRSA, VRE, C. diff
Droplet Within 2 meters Mumps, meningitis, Group A Strep( 24 h) Routes of Transmission
AB/contact ( Chicken Pox ) Surveillance You cannot manage what you do not measure ARO, CDI Clusters
of infection, outbreaks Travel history and related restrictions- information is power travel.gc.ca Routine Practices
Cornerstone of best practices in infection prevention and control The basic level of care required for all patients Prevents your risk of exposure to
microorganisms Prevents transmission of microorganisms among health care workers, patients/clients/residents and visitors All clients/patients/staff and our environments
are potentially infectious PCRA -Point of Care Risk Assessment Must be completed prior to each interaction Patients/clients/coworkers conditions can change
Identifies microorganisms potentially present Determines which Additional Precautions are required
Prevents the transmission of microorganisms http://www.cdha.nshealth.ca/media-centre/video/point-care-risk-assessment Hand Hygiene What are you bringing home ? Natural fingernails are best. Minimal or no hand jewelry. Nail polish is to be freshly applied with no chips, cracks or peeling. Artificial nails, which include gels and shellacs put you at risk! PPE
Personal Protective Equipment 101 Barriers include: gowns, gloves, masks (surgical or N95), face shields. Skin is a natural barrier: hand hygiene part of the equation
Specific sequence for donning & removal of isolation garb Contamination possible, esp. during removal Masks- Procedural, Surgical, N95
Gowns- level of fluid protections Gloves- nitrile, vinyl, latex Face Shields What goes on first ? Hand Hygiene Gown Mask Eye
( procedure, surgical, N95) protection Gloves Removing Protective Equipment Untie gown in back
Remove gloves Remove eye protection ( if wearing) Remove mask using ties
Remove gown Wash hands Removal of Protective EquipmentAirborne Remove
gloves Remove Gown Wash Exit hands
Room Clean hands Remove goggles*
Remove Mask with straps* Clean hands Management of Blood and Body Fluid Exposures Prevention is everyone's responsibility.
Safely handle blood and body fluids Safely manage sharps Understands how to recognize any occupational
exposure, including first aid and follow up for sharps, blood or body fluid exposures Management of Occupational Exposure to Blood and Body Fluids First Aid Assessment Post and Bloodwork ( Source and Staff)
Exposure Prophylaxis Counseling Follow Up at 6 weeks, 3 months and 6 months Waste Stream Cleaning and Disinfection of Equipment and the Environment
Critical, Semi Critical and Non Critical Cleaning Dirty followed by disinfection or sterilization equipment and environment put staff at risk
Non Critical Cleaning and Disinfection Not all cleaning/disinfection chemicals are the same Know wet soak times High
touch contact areas within patient and workplace environment A cleaner all environment is a safer environment for
Measles killed over 2.5 million people a year until vaccine was widely administered. Polio is making a comeback in Pakistan and Philippines. New cases were reported in September 2019 after 19 years ago being declared Polio free. https://www.youtube.com/watch?v=y6ezbEW9QZ4
Influenza Vaccine Free to all over 6 months of age Safe and effective Herd
Immunity Very good match this year! Be a Critical Thinker Break the Chain by protecting yourself! Hand Hygiene
PCRA- dont wait for diagnosis Proper PPE as per Routine Practice/ Additional Precautions
Cleaning and Disinfection Immunization Stay home when you are sick
The irony is that with infection prevention and control if nurses take their own safety seriously first, they will also be protecting their patients and loved ones.
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Landon: Specialization and Quality of Care. Generalist with HIV-expertise same outcomes as ID specialists. Low volume and non-expert providers did not perform as well. Expert generalist should be part of the HIV workforce. Landon, B. E. (2005). Physician Specialization and...
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