Hospitals, nursing homes, and assisted living facilities

In nursing homes and hospitals, floors must be ______.

smooth, light colored, and easy to clean

Healthcare associated infections

Infections you get from being in the hospital

Klebsiella is a bacteria ________.

associated with ventilators and breathing machines

MRSA

Resistant to antibiotics; usually from poor personal hygiene

Clostridium difficle is associated with _______.

the overuse of antibiotics

Reservoir

Place where pathogen lives, aka host

Host susceptibility

Person who may become infected; very young, old, and immunocompromised

Examples of means of entry

food, water, air, fecal-oral route, skin, blood

Chain of infection

Starts with a reservoir → exit (means of escape) → transmission (direct and indirect = contaminated objects and vectors) → entrance → susceptible host

Pseudomonas is a _______.

very adaptive and versatile microorganism that can be found nearly everywhere

The single most effective method of preventing the spread of disease is _______.

handwashing

Exposure Control Strategies

• Universal precautions = assume all blood & body fluids as infectious

• Immunization

• Personal protective equipment (PPE)

• Containment

• Decontamination

• Emergency procedures for accidental exposures

• Good personal work habits (hand-washing)

Refrigerators for biohazards or any hazardous chemicals must _______.

be labeled and not contain any food or drink

When PPE is removed, it must be _______.

stored in a properly labeled soiled linen container

If you refuse the hepatitis B vaccination, you ______.

must sign a waiver sheet declining the vaccination

EH professionals must ________.

review plans for hospitals, nursing homes, adult care homes, and other facilities they inspect

Construction around or in hospitals/nursing homes can ______.

affect air quality, sanitation standards, lead to the spread of water born diseases, and higher noise levels

Carpeting in hospitals or nursing homes must be _______.

clean, odor free, dry, and in good repair (no holes or rips)

Two most important things when reviewing the plans

water supply and wastewater

If they decide to use flood-type cleaning, the floor must be _______.

sloped to drain and have a floor drain

Floors must be __________.

smooth, light-colored, and easy to clean

Walls must be smooth and easy to clean up to the _______.

highest level reach by splash or spray

Sources of Indoor air pollution

• Formaldehyde = has a “new” smell; used as a preservative for wood, furniture, and other things; difficulty breathing and asthma-like symptoms

• Mold = must need moisture

• Carbon monoxide

• Legionella = airborne; causes pneumonia; traced back to cooling towers for large AC units

• Environmental Tobacco Smoke

Mold of most concern in Environmental Health

Stachybotrys

There are _______.

outside designated smoking areas in nursing homes

Furniture and patient contact items should be _______.

clean and in good repair

Soiled laundry must be _______.

properly labeled (must say Soiled Laundry) and stored in a separate container

Bedpans, urinals, and emesis basins shall be _______.

clean after each use or between patients

• don’t clean them in the hand-sick of patients room → cleaned in soiled utility room

Shared bathing equipment must be clean ______.

after each use or between patients

For nursing homes if they are without water for more than 4 hrs, they must ______.

notify the local health department

Nursing homes must have a _______.

backup water plan for when water is out for more than 4 hrs

Main components of Backup Water Plan

Include Logistics for relocating residents or provide an alternative source of drinking water

A disposable water pitcher must be _______.

properly labeled with the patient’s name

Ice must be _______.

properly handled and stored

• treated as a food item

The ice scoop for a manual ice machine must be ________.

stored in a reasonably secure dry space, such as a holder on the side of the ice machine

Any ice machine accessible to patients or the general public must be _______.

automatic

A cross-connection is any actual or potential link between a clean (potable) water supply and a contaminated source or wastewater system. To prevent cross-connections, use an _______.

air gap to prevent it and backflow in a commercial or residential ice machine

• prevents the contamination of ice with any bacteria or pathogens