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Infection Control & PPE Guidelines

The document outlines principles of infection control and the use of personal protective equipment (PPE) to prevent the transmission of influenza in healthcare settings. It details various modes of transmission, including droplet, contact, and airborne, and emphasizes the importance of standard precautions, hand hygiene, and proper use of PPE. Additionally, it provides guidelines for patient placement, isolation precautions, and specific measures to ensure safety during patient care activities.

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14 views43 pages

Infection Control & PPE Guidelines

The document outlines principles of infection control and the use of personal protective equipment (PPE) to prevent the transmission of influenza in healthcare settings. It details various modes of transmission, including droplet, contact, and airborne, and emphasizes the importance of standard precautions, hand hygiene, and proper use of PPE. Additionally, it provides guidelines for patient placement, isolation precautions, and specific measures to ensure safety during patient care activities.

Uploaded by

nazurah alwi
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

PRINCIPLES OF

INFECTION
CONTROL &
USE of PPE
Pandemic Preparedness Training Programme
Penang State
9-10 Jan 2007

Chan Kwai Cheng


Session Overview
 Mode of Transmission in PI
 Infection control precautions
 Standard
 Contact
 Droplet
 Infection Control Measures
 General
 Specific
 Patient Placement
 Use PPE
 Demonstration
Principles of Infection
Control

Prevent or limit transmission of influenza virus


during patient care in healthcare settings
Strategies
 Screen ALL persons entering the healthcare
facilities
 Designated
 Screening area
 Route for PI patient movement
 Transportation
 Ward with isolation facilities
 Staff
 Strict infection control practices in ALL patient
contact activities
Routes of Influenza
Transmission
Droplet

Contact

Airborne
Chain of Infection

Quantity ofVirulence Route of Port Sensiti


pathogen transmission ve
host
Routes of Transmission :
Contact
Direct Contact Indirect Contact

 Host comes into contact


 Contaminated surfaces
(fomites)
with reservoir
 Contaminated instruments
 Kissing, skin-to-skin
contact, sexual intercourse
Routes of Transmission :
Droplet
 Contact of conjunctiva or mucous membrane
by large droplets from infected person
 Coughing, sneezing, talking
 Medical procedures (suctioning, bronchoscopy)
 Requires close contact
 Only travel short distances ( 3 feet)
Routes of Transmission :
Airborne
 Very small particles of evaporated droplet
(droplet nuclei)
 5 um or smaller
 Remain in air for a long time
 Travel farther than droplets
 Become aerosolized during procedures
Isolation Precautions
(Pandemic Influenza)
Standard

Contact

Droplet

Airborne
Standard Precautions
 Designed to reduce the risk of transmission of
microorganisms
 both recognized and unrecognized sources of infection
in hospitals
 Assume infectious agent could be present in the
patient’s
 Blood
 Body fluids, secretions, excretions
 Non-intact skin
 Mucous membranes
 Hand hygiene
Hand Hygiene

 Alcohol hand rub

 Wash hands with


soap and water
PPE for Standard
Precautions
1. Gloves
2. Gowns
3. Eye Protection
4. Mask

When come into contact:


 Blood & body fluids
 Secretions, excretions
 Contaminated items
 Mucous membranes
 Non-intact skin
Contact Precautions
Taken in addition to Standard Precautions
 Limit patient movement
 Private room or cohort patients
 Gloves when entering room
 Remove before leaving the room and hand hygiene
 Gowns for substantial patient contact
 Do not touch eyes, nose, mouth with hands
 Avoid contaminating environmental surfaces
Contact Precautions
 Hand hygiene immediately after removing PPE

 Use dedicated equipment if possible


 BP cuff, stethoscope, thermometers

 If not, clean and disinfect between uses

 Clean and disinfect patient room daily


 Bed rails

 Bedside tables

 Lavatory surfaces

 Blood pressure cuff, equipment surfaces


Droplet Precautions
Taken in addition to Standard Precautions

 Wear surgical mask within 1 meter of patient

 For some infections, wear face shield or goggles


within 1 meter of patient

 Place patients in single rooms or cohort (1 meter


apart)

 Limit patient movement within facility


Patient wears surgical mask when outside of room
Airborne Precautions
Taken in addition to Standard Precautions

 N95 mask (or equivalent) for personnel


 Fit check with each use

 Negative pressure isolation room


 Air exhaust to outside versus re-circulated

 Patient to wear a surgical mask if outside of the


isolation room
Aerosol-generating Procedures
(Example: Endotracheal intubation, suctioning,
chest physio etc)
 N95 particulate respirator
 If not available, wear tight fitting surgical mask
 Eye protection
 Gloves
 Gown and waterproof apron
 Hair cover (optional)
 Isolation room with negative pressure
Infection Control
Measures

General

Specific
General measures

 Proper diet
 Adequate rest
 Reduce stress
 Avoid smoking
 Respiratory hygiene / Cough etiquette
 Hand hygiene
 Avoid touching nose, eyes or mouth
 Do not share food or drinks
Respiratory Hygiene / Cough
etiquette
Aim: to contain respiratory viruses
 Cover nose/mouth when coughing or

sneezing
 Use tissues to contain respiratory secretions

 Dispose tissues in waste receptacle after use

 Perform hand hygiene


 Facilities
 Tissues
 Receptacle
 Hand hygiene materials
Specific Measures

 Patient Placement
 Proper use of PPE
 Environmental and waste handling
 Patient care equipment
 Dedicated
 Disposable / Proper sterilization and disinfection
Placement of Patient
 Ideally in negative air pressure room
 To create a negative air pressure room:
Install exhaust fan and direct air from inside to an
outside area
 Private room: open windows in isolation
areas but keep doors closed
 Cohort patients
 well defined area
 away from other patient care areas
 Separate placement for suspected /
probable / confirmed PI cases
Negative Pressure Isolation
Room
Natural Ventilation : Cohorting
Room

1 meter
Personal Protective
Equipment
Personal Protective
Equipment
 When used properly can
protect you from exposure to
infectious agents

 Know what type of PPE is


necessary for the duties you
perform and use it correctly
Personal Protective
Equipment
 Gloves
 Gowns
 Masks
 Eye protection / Face shield
 Boots
Gloves
 Use to protect user
 Could become source of
contamination

 Different kinds of gloves


 Housekeeper gloves
 Clean gloves
 Sterile glove

 Avoid “touch contamination”


 Eyes, mouth, nose, surfaces

 Change gloves between


patients
Gowns
 Used when potential for
contaminating clothing

 Fully cover torso

 Fit comfortably

 Have long sleeves

 Fit snuggly at the wrist


Masks and Respirators:
Barriers and Filtration
 Cover nose and mouth, fit
snugly

 Surgical masks
 Cotton, paper

 Particulate respirators (N95)


 Filter efficiency (95%, 0.3 um)
 Fit testing essential

 Alternative materials (barrier)


 Tissues, cloth
Eye Protection

 Goggles

 Face shields
Donning & Removal of
Personal Protective
Equipment
Demonstration
Sequence of Donning of PPE

 Hand hygiene
 Cap
 Gown
 Respirator/Mask
 Goggles / Face shield
 Gloves
Sequence of Removal of PPE

 Gloves
 Hand hygiene
 Goggles / Face shield
 Gown
 Respirator / Mask
 Cap
 Hand hygiene
Key Infection Control
Points
 Minimize exposures
 Plan before entering room (e.g., supplies, equipment)

 Avoid adjusting PPE after patient contact


 Do not touch eyes, nose or mouth!

 Avoid spreading infection


 Limit contact with surfaces and items

 Change torn gloves


 Perform hand hygiene before donning new gloves
Other Precautions

 Access / Visitation
 Limit number of health care workers, family
members and visitors
 Designate experienced staff to provide care
 Specimen handling
 Postmortem precautions
Precautions for Collecting
Specimens
 Notify laboratory in advance

 Health care worker collecting specimen should wear


full barrier PPE

 Place specimen in leak-proof bag

 Hand deliver, if possible

 Label specimen clearly as “suspected pandemic


influenza”
Precautions for
Handling Bodies

 Mortuary staff should use Full Barrier PPE


 Double gloves
 Boots
 N95/100 or PAPR
Summary
 Influenza transmission occurs mainly through
respiratory droplets
 Contact can be prevented using PPE
 Virus can be inactivated with infection control procedures
 Hand washing is key

 PPE must be donned and removed appropriately to


prevent contamination of wearers and environments

 Guidelines for using PPE and infection control


measures for pandemic influenza in humans should
be practiced until they are routine
Precautions for Suspected or Confirmed Cases
Patient

Acute influenza Surgical mask for patient,


symptom + use tissue when coughing,
Plus exposure sneezing
history Isolation room, use of PPE
Test for influenza
Apply all infection control
A/H5
precautions
Confirmed Influenza Different Re-evaluate
A/H5 diagnosis the
precaution
Maintain required infection control measures
precautions
Adults and adolescents > 12 Infants and children < 12
years: Continue for 7 days years: Continue for 10-14
after resolution of fever days after symptom onset
Thank You

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