Infection Control Basics

The following is  a description of the best practices for control of infectious. This post will try and make it as easy as possible

Question: What are Infection Control Basics in a Nutshell?

Answer: In a nutshell, the CDC recommends 2 things (1) Standard Precautions for the care of all patients, regardless of their diagnosis or presumed infection status and (2) additional precautions  should be taken (beyond Standard Precautions) in certain situations (see Transmission-Based Precautions below)

Question: What are Standard Precautions?

Answer:  Standard Precautions apply to 1) blood; 2) all body fluids, secretions, and excretions, except sweat, regardless of whether or not they contain visible blood; 3) non-intact skin; and 4) mucous membranes. Standard precautions are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection in hospitals.Standard precautions includes the use of: hand washing, appropriate personal protective equipment such as gloves, gowns, masks, whenever touching or exposure to patients’ body fluids is anticipated.

Question: What are the 3 Transmission-Based Precautions?

Answer:  the  3 additional types of precautions that apply (aka Transmission-Based Precautions)  are: (i) Airborne Precautions, (ii) Droplet Precautions, and (iii) Contact Precautions. Please note that these precautions are done above and beyond Standard precautions (ie. in addition to, not in place of)

Question: Why are they called Transmission-Based Precautions?

Answer:  because you only engage in them if you think the patient in question has a specific condition (the type that you want to avoid transmitting to someone else).

Question: What does each of the 3 Precautions require?

#1) Airborne Precautions are used for infections spread in small particles in the air such as chicken pox. This means that the bacteria or virus causing their disease is so small that it can be suspended in the air for long periods of time and may be carried for long distances on air currents. Examples of diseases that require Airborne Precautions are tuberculosis (TB), varicella (chickenpox), zoster (shingles), and measles. The following measures are required for Airborne Precautions.

· The patient must be placed in a special isolation room. Isolation rooms are private rooms with a negative air pressure in relation to the outside corridor, have 6 air exchanges per hour, and the room air is directly exhausted to the outside. A complete listing of isolation rooms is maintained by Bed Control. Hospital Epidemiology, and the Nursing supervisors.

· If the patient’s diagnosis is varicella, zoster, or measles, employees need not wear a respirator if they have had natural disease or have been adequately immunized. Occupational Health Service can assist you in determining your immune status if you are uncertain. Employees who are not immune to the disease should not enter the room unless absolutely necessary. If they must enter, they must wear an approved respirator such as the N­95. Visitors should be assisted by the nursing or medical staff in determining their immune status (i.e., natural disease, immunization). Immune visitors need not wear a mask. Non­immune visitors should be discouraged from entering. If visitation is essential, then the non­immune visitor must wear a surgical mask.

· For patients with known or suspected tuberculosis, all people should wear a respirator, such as the N­95 respirator, to enter an Airborne Isolation room (a surgical mask is not an approved respirator). Respirators must also be worn when participating in cough­inducing procedures such as bronchoscopy or sputum induction with TB patients. Visitors of TB patients will wear surgical masks.

#2) Droplet Precautions are used for infections spread in large droplets by coughing, talking, or sneezing such as influenza. Droplet transmission occurs when the person coughs or sneezes and releases large respiratory droplets into the air. Unlike airborne particles, these droplets are heavy and fall to surfaces rapidly, usually falling within 3 feet of the patient. These particles are too heavy to remain in the air and to be carried on air currents. Examples of infections that require Droplet Precautions are meningococcal meningitis, Respiratory Syncytial Virus (RSV), and pertussis. The following measures are required for Droplet Precautions.

· Place the patient in a private room. No special ventilation is required.

· Employees and visitors must wear a surgical mask to enter the room.

#3) Contact Precautions are used for infections spread by skin to skin contact or contact with other surfaces such as herpes simplex virus. In addition to Standard Precautions, use Contact Precautions for those diseases that are spread by direct or indirect contact. This means that the bacteria or virus can be acquired by either directly touching the infected site or body fluid or by touching equipment that may be contaminated with infectious material. Examples of infections that are spread by the contact route are multiply antibiotic­resistant bacteria such as methicillin­resistant S. aureus (MRSA) and vancomycin­resistant enterococcus (VRE), RSV (which also requires Droplet Precautions), and Clostridium difficileenterocolitis. The following measures are required for Contact Precautions.

· Gloves are to be worn when entering the room. A gown should be worn if you anticipate that your clothing will become contaminated with infectious materials (e.g., wound drainage or respiratory secretions). Gown and gloves should be removed before leaving the patient’s room and hands washed thoroughly.

· When possible, dedicate the use of patient­care equipment such as stethoscopes and walkers. This avoids sharing of items between patients. If use of common equipment is unavoidable, then adequately clean and disinfect the item with Vesphene 11 or alcohol before use for another patient.

Question: are there additional precautions for people who use needles?

Answer: Yes! Needlesticks and other sharps-related injuries which expose workers to bloodborne pathogens continue to be a significant hazard for hospital employees. OSHA estimates that 5.6 million workers in the healthcare industry and related occupations are at risk of occupational exposure to bloodborne pathogens. Bloodborne pathogens are pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and others.

Any worker handling sharp devices or equipment such as scalpels, sutures, hypodermic needles, blood collection devices, or phlebotomy devices is at risk. Nursing staff are most frequently injured. Exposure Prevention Information Network (EPINET) data shows that needlestick injuries occur most frequently in the operating room and in patient rooms.

Handling Needles/Sharps: (i)Do not bend, recap, or remove contaminated needles and other sharps unless such an act is required by a specific procedure or has no feasible alternative (ii) Do not shear or break contaminated sharps. (OSHA defines contaminated as the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface)

Containerization:  (i) Have needle containers available near areas where needles may be found (ii) Discard contaminated sharps immediatelyor as soon as feasible into appropriate containers.

Click here for the best website to avoid needlestick injuries

Bottom line: find out what condition your aging loved one has and find out if (i) Standard Precautions are enough or (ii) if in addition to Standard Precautions, any of the 3 Transmission Based Precautions are recommended

We hope this was helpful. If you have any questions or if you know of a senior that could benefit from our vast array of home care services, please call us at 212-614-8057 or email us at manhattan@homeinstead.com. We accept all types of long term care insurance as payment

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Christian & Claudia

Christian and Claudia

 

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