HTHSCI 2HH3 Lecture Notes - Lecture 6: Personal Protective Equipment, Bronchiolitis, Microorganism
26 May 2018
School
Department
Course
Professor
Infection Control
Routine Practice and Additional Precautions
McMaster University
The Chain of Infection
Source
• Patient
• Visitor
• Staff
• Environment
• Equipment
• Other sources such as food or contamination at the manufacturer.
Transmission
• Contact – skin to skin
• Indirect Contact - skin to inanimate object
• Droplet
• Airborne
• Blood and Body fluids
• Vector (mosquito)
Susceptible Hosts
• Age
• Immunosuppression
• No immunity
• Chronic underlying conditions (diabetes)
• Emergency procedures
Routine Practices
• Published in 1999 by Health Canada (now PHAC).
• Recommends practices for the routine care of all patients in various settings and incorporates
previous precautions against bloodborne pathogens.
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• Similar to Standard Precautions, published by the CDC in 1996.
• Canada Communicable Disease Report: Infection Control Guidelines, July 1999
• Provincial Infectious Diseases Advisory Committee (PIDAC) for Ontario has published Guidelines
for Routine Practices and Additional Precautions 3rd revision 2012
• Available for viewing on their website:
o http://www.oahpp.ca/resources/pidac-knowledge/index.html
• Determined by the interaction with the patient not y the patiet’s diagosis.
• Anticipate the risk of exposure to blood and other body fluids
• ALL body substances (Blood, body fluids, secretions, excretions, drainage) of ALL patients are
considered potentially infective.
• Practice determined by risk of encountering body substance NOT by diagnosis.
• To be used in conjunction with Additional Precautions, based on the method of transmission.
• Additional Precautions for
o Droplet and airborne
o Bacteria that are resistant to multiple antibiotics
o Organisms/infections of significance
Hand hygiene ...
• Good hand hygiene can terminate outbreaks in health care facilities, reduce transmission of
antimicrobial resistant organisms and reduce overall infection rates.
Hand Hygiene
• An increase in hand hygiene adherence of only 20% results in a 40% reduction in the rate of HAI
• Most healthcare providers believe they are already practicing good hand hygiene
• Hand washing with soap and running water remains most sensible strategy in non health care
settings
• Hand rubs with alcohol-based products significantly reduce the microorganisms, fast acting, and
cause less skin irritation.
Gloves
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o Should be used as an additional measure not as a substitute for hand hygiene.
o To be used when in direct contact with any body fluids or moist substances/exudate
from wounds.
• The use of gloves does not eliminate the need for hand hygiene.
• The use of hand hygiene does not eliminate the use of gloves.
• Gloves reduce hand contamination by 70% to 80%, prevent cross contamination and protect
patients and health care personnel from infections
Hand hygiene before donning gloves and after glove removal
Mask, eye protection, face shield
• To protect the mucous membranes of the eyes, nose and mouth during procedures and patient
care activities likely to generate splashes or sprays of blood, body fluids, secretions or
excretions.
• Or within 2 metres of coughing patient.
Gowns
• Where gowns when clothing likely to be soiled.
• Protect clothing during procedures and patient care activities likely to generate splashes or
sprays of blood, body fluids, secretions or excretions.
Routine Practices
Accommodation- single room not required unless patient visibly soils environment.
Patient Care Equipment- All reusable equipment to be cleaned between patients. Safe disposal of
sharps.
Environmental Control – establish routine care, cleaning of surfaces and furniture, using hospital
appoed disifetat. High touh ites ad hoizotal sufaes daily.
Exposures to Blood
Factors for Risk of Infection:
• The pathogen involved
• The type of exposure
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Document Summary
Source: patient, visitor, staff, environment, equipment, other sources such as food or contamination at the manufacturer. Indirect contact - skin to inanimate object: droplet, airborne, blood and body fluids, vector (mosquito) Immunosuppression: no immunity, chronic underlying conditions (diabetes, emergency procedures. Hand hygiene : good hand hygiene can terminate outbreaks in health care facilities, reduce transmission of antimicrobial resistant organisms and reduce overall infection rates. Hand hygiene before donning gloves and after glove removal. Gowns: where gowns when clothing likely to be soiled, protect clothing during procedures and patient care activities likely to generate splashes or sprays of blood, body fluids, secretions or excretions. Accommodation- single room not required unless patient visibly soils environment. Patient care equipment- all reusable equipment to be cleaned between patients. Environmental control establish routine care, cleaning of surfaces and furniture, using hospital app(cid:396)o(cid:448)ed disi(cid:374)fe(cid:272)ta(cid:374)t. (cid:862)high tou(cid:272)h(cid:863) ite(cid:373)s a(cid:374)d ho(cid:396)izo(cid:374)tal su(cid:396)fa(cid:272)es daily. If vaccinated and developed immunity, then virtually no risk.
