2HH3- Infection Prevention and Control

Infection Control Professional (ICP)

An indivudal who has responsibility in their workplace for: the development, implementation, evaluation, and education related to policies, procedures, and practices that impact the prevention of healthcare-associated infections (HAIs)

When was IPAC Canada created?

1976

Chain of Infection

infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host

The Three C Rule for patients in isolation

Coherent; understand the importance

Compliant; will follow the directions

Cover it; cover the open wound, portal of exit, etc.

Breaking the chain of infection: infectious agent

Killing or removing the infectious agent at the source (antibiotics, cleaning, disinfection or sterilization)

Breaking the chain of infection: reservoir

Environmental controls, food safety

Breaking the chain of infection: Portal of exit

Manage secretions, excretions (e.g., respiratory etiquette, hand hygiene, cover wounds)

Breaking the chain of infection: mode of transmission

Cleaning hands, cleaning equipment

Breaking the chain of infection: portal of entry

Good technique, following best practice using PPE

Breaking the chain of infection: susceptible host

Minimize interventions, vaccinations, proper placement

Routine practices include:

Things are done regardless of whether the patient is know to be infectious or not:

-Risk assessment, hand hygiene, personal protective equipment, environmental controls, administrative controls

Goal of Routine Practices

Prevent transmission of microorganisms from:

-patient to patient

-patient to staff

-staff to patient

-staff to staff

Four moments of hand hygiene

1. Before patient contact

2. Before aseptic procedure

3. After exposure to body fluids

4. After patient contact

Factors influencing PPE selection

-Type of exposure anticipated (splash/spray vs. touch, category of isolation precautions)

-Durability and appropriateness for the task

-Fit

When cleaning, do you work clean to dirty or dirty to clean?

Clean to dirty

When to change gloves

-During use, if torn and when heavily soiled (even during use on the same patient)

-After use on each patient

-Never wash or reuse disposable gloves

Sequence for putting on PPE

Gown

Mask or respirator

Goggles or face shield

Gloves

Sequence for removing PPE

Gloves

Gown

Clean hands

Face shield or goggles

Mask or respirator

Clean hands

When is the exception to the removal sequence of gown and gloves?

In the OR, where gown and gloves essentially come off at once with assistance

Where to remove PPE

At doorway, before leaving patient room or in anteroom

*ensure hand hygiene facilities are available at the point needed. e.g., sink or alcohol-based hand rub

Which elastic should be removed first when doffing a respirator?

Bottom elastic over head first, then lift off top elastic

Needlestick and other sharps injuries- key Canadian public health issue affecting how many people per year and costing how much? When was this reduced?

70,000 per year and around $140 million (this was reduced when legislation for safety-engineered devices was enacted)

Healthcare worker vaccination recommendations

-Hep B

-Influenza, COVID

-MMR

-Varicella

-Tetanus/diphtheria

-Meningococcal- give 1 dose to microbiologists who are routinely exposed to isolates of N.meningitidis

Indirect contact

When a third person or an article transmits the microbes from one person to another

E.g., antibiotic-resistant organisms (AROs)