INFECTION CONTROL AND PPE

Group WHS April 2016

LEARNING OUTCOMES

At the completion of this presentation the participant will be able

to explain and demonstrate:

• Infection prevention, control principles and standard precautions

• Hand hygiene and Personal Protective Equipment (PPE)requirements

• How to safely clean up a biological spill

• How to prevent the transmission of infection

At the end of the presentation you will be required to complete a Quiz

INFECTION CONTROL PRINCIPLES

What is the goal of infection prevention and

control?

• To create a safe health care environment

• To have well established, good work practices thatminimise the risk of transmission of infectious agents

• To prevent the transmission of infectious agents to ourpatients and ourselves

‒ We should adopt the philosophy that all body fluids fromANY person may be infectious

CHAIN OF INFECTIONInfection requires three main elements:

• a source of the infectious agent,

• a mode of transmission,

• a susceptible host

This is known as the chain of infection.

The chain of infection describes the ways in whichpathogenic microorganisms are transmitted from person toperson.

Interruption of this cycle is a strategy used to limit thespread of infection.

By using infection control measures the cycle can bebroken.Cruickshank M & Ferguson J (eds) (2008) Reducing Harm to patients from Health care Associated Infection: The Role of Surveillance. Australian Commission for Safety and Quality in Health Care. p3.

PREVENTING THE SPREAD OF INFECTION

The spread of infection can be limited through the use of standard precautions.

These include:

• Routine hand hygiene

• Wearing of gloves

• Using personal protective equipment (PPE)

• Wearing of aprons/gowns

• Safe handling of sharps

• Safe disposal of sharps

PREVENTING THE SPREAD OF INFECTION

• Cleaning of environmental surfaces

• Cleaning of shared diagnostic equipment between patients

• Reprocessing (cleaning, disinfection/ sterilization) of re-usable medical devices

• Single-use devices – used once and then disposed

• Surface barriers (as applicable)

• Spills of blood or other potentially infectious materials - management by containment, cleaning, decontamination and disposal

AIM OF STANDARD PRECAUTIONS

To minimise exposure to:

• Blood, body fluids, secretions, and excretions with the

exception of sweat.

• We must assume that all body fluids from ANY person may

be infectious.

• Precautions must be used for every patient

– Appropriate PPE must be worn when carrying out procedures

that have the potential to expose us to blood or body fluids.

HAND HYGIENE

• Hand hygiene is a general term referring to any action

of hand cleansing.

• It is the single most important strategy in preventing

health care associated infections as it breaks the

cycle of infection.

HAND HYGIENE

Hand hygiene must be performed before and after every

episode of patient contact

The five moments of hand hygiene are:

1. Before touching a patient

2. Before a procedure

3. After a patient contact

4. After touching a patient’s surroundings

5. After the removal of gloves

HAND HYGIENE

Source: Grayson et al (2009)

ASSESSING THE NEED FOR PPE

Gloves: When you may be exposed to potentially

infectious secretions or materials.

Gowns: When your uniform/cloths may get exposed

to potentially infectious secretions.

Face mask: When splashing or aerosolised material

may occur and potentially contaminate your mouth or

nose.

Face shield or eye goggles: When splashing may

occur and potentially contaminate your eyes.

SUMMARY OF PPE REQUIREMENTS

PPE - GOWNS

Aprons or gowns should be worn when:

• Close contact with the patient, materials or equipmentmay lead to contamination of skin, uniforms or otherclothing with infectious agents

• There is an increased risk of contamination with bloodor body fluids

Source: (Garner 1996; Pratt et al 2001;Clark et al 2002; Pratt et al 2007)

PPE –GOWN APPLICATION

PUTTING A GOWN ON

1. Picks up gown by shoulders allows to fall open without touching any contaminated surface.

2. Slips arms into the sleeves

3. Fastens ties at the neck.

TAKING A GOWN OFF

1. Undo ties

2. Slips arms out the sleeve

PPE – MASK APPLICATIONFace MaskIdentify the top edge of the mask by locating the thin metal strip that goes over the bridge of the nose.

1. Pick up the mask with the top ties or ear loops.2. Place metal strip over bridge of nose and tie upper ties

or slips loops over ears.3. Place lower edge of mask below chin and tie lower ties.4. Press metal strip so it conforms to the bridge of the

nose.

Face Shield1. Don face shield by placing shield over eyes, adjusting

metal strip over bridge of nose, and tucking the lower edge below the chin. Straps are secured behind the head.

PPE - GLOVES

• Gloves must be worn:

• For all invasive procedure

• When dealing with non-intact skin or mucous membranes

• When in contact with sterile sites

• For any activity that has been assessed as carrying a risk of exposure to blood, body

substances, secretions and excretions

• Handling chemicals

• Gloves must be changed between each patient and after every episode of individual

patient care

• Gloves are a single-use item

• Hand Hygiene must be preformed after the removal of gloves. Gloves are not a

substitute for hand hygiene

APPLYING PPE SEQUENCE

• Perform hand hygiene

• Apply gown if needed (All ties should be

properly secured with a simple bow)

• Apply mask if needed

• Apply Safety Goggles/ glasses if needed

• Apply gloves, bring the cuff of the glove cuff over

the gown cuffs.

REMOVING PPE SEQUENCE

Gloves → Safety glasses/safety shield → Gown → Mask

• Removing Gloves

– Grip the outside of a glove with opposite gloved hand

and pull off

– Hold removed glove in gloved hand

– Slide fingers of un-gloved hand under remaining

gloves at the wrist

– Peel glove off over first glove

– Discard gloves into suitable waste bin

REMOVING PPE SEQUENCE

• Removing Gowns

– Unfasten ties

– Pull away from neck and shoulders, touching inside of

gown only

– Turn gown inside out

– Fold or roll gown into a bundle ready for disposal

REMOVING PPE SEQUENCE

• Removing Mask

– Grab bottom then top ties or elastics and remove

– Discard into waste

SPILL DECONTAMINATION

Spills of blood or other potentially infectious materials should be promptly cleaned as follows:

• wear gloves and other PPE appropriate to the task;

• confine and contain spill, clean visible matter with disposable absorbent material (spill kit) and discard the used cleaning materials in the appropriate waste container;

• clean the spill area with a cloth or paper towels using detergent solution. Wet paper towel with detergent/bleach and lay over the spill to avoid generating aerosols

• Use of chemical disinfectants as per your local procedure should be based on assessment of risk of transmission of infectious agents from that spill.

CLEANING SMALL SPILLS

When cleaning small spills – up to 10 cm diameter:• Put on gloves

• Wipe up spill immediately with absorbent material

• Place contaminated absorbent material into biohazardwaste bin for disposal

• Clean the area with detergent solution, using disposablecloth or sponge (discard into biohazard bin)

• Wipe the area with chemical disinfectants as per your localprocedure and allow to dry

• Perform hand hygiene

When cleaning spills – greater than 10cm diameter:

• Put on gloves and goggles

• Cover area of the spill with the contents of a spill kit and allow to absorb

• Use disposable scraper and pan to scoop up absorbent material and anyunabsorbed blood or body substances

• Place all contaminated items into impervious container or plastic bag for disposal

• Discard contaminated materials into biohazard waste bin

• Mop the area with detergent solution

• Wipe the area with chemical disinfectants as per your local procedure and allowto dry

• Perform hand hygiene

• Re-order spill kit or products used.

CLEANING LARGE SPILLS

THANKYOU FOR YOUR ATTENTION

This is the end of the presentation, please

complete assessment quiz on Primary Learning

Hub.

If you are uncertain of any of the presented

material or would like further information please

contact your State WHS Manager