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Infection Prevention and Control

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Infection Prevention and Control Infection prevention and control DRAFT FOR FIELD TESTING 1 | Training module: infection prevention and control Risk assessm ent A risk assessm enthelps determine whatm easures should be used and when to use them Transmission of influenza increases if: œ Close contact(usually proximity < 1 metre) œ Direct contact (with infected patients then self contamination) œ Indirect contact (with surfaces/objects contaminated with virus then self contamination) œ Aerosol generating procedures (endotracheal intubation, suctioning) 2 | Training module: infection prevention and control Actions to prevent infection 1. Social distancing / separation of sick from well people 2. Respiratory etiquette 3. Hand hygiene 4. PPE according to risk Most transmission occurs when infected people come into close contact with those who are susceptible. 3 | Training module: infection prevention and control Priority for PPE 1. Control transmission at the source(the patient) 2. Protect care givers/care providers - people in close contact with patients (PPE - Personal Protective Equipment such as masks) 4 | Training module: infection prevention and control Control at the source A patient should cover mouth and nose, if possible with a mask or scarf, when in close contactwith other people During a pandemic, give a surgical or procedure maskto all patients presenting to health facilities withfever/acute respiratory symptoms (cough or shortness of breath) œ Masks do not need to be used by patients when they are alone! œ W earing a mask all day long is difficult and the mask gets wet. 5 | Training module: infection prevention and control Separation n the home, separate the sick person from those who are well In health facilities- identify a completely separate building or structure, e.g. school, for use as temporary respiratory healthcare facility with respiratory waiting room. œ Patients should be triagedbefore entering health units. œ Separate waiting areasfor patients with fever/acute respiratory symptoms (cough or shortness of breath) from those with other symptoms Vital services for other illnesses should continue! . | Training module: infection prevention and control P,rotecting care givers/providers 3espiratory etiquette / social distancing / hand hygiene œ Everyone, always Masks œ patients (source) when in close contact with others (receptors) œ health care workers and care givers when in close contact with anyone with respiratory symptoms œ other essential staff œ when in close contact with anyone with respiratory symptoms Gloves/gowns/aprons/eye protection (staff) œ performing procedures (specialised medical, cleaning, burials) where eyes, hands or clothes could get contaminated with respiratory secretions. œ Use precautions according to the risk, as shown in the following tables. 7 | Training module: infection prevention and control P,recautions for health staff High risk Intensive care Inpatient care OPD care Health unit procedures health worker health worker health worker non-health staff Respiratory etiquette Yes Yes Yes Yes Yes Social distance Yes Yes Yes Yes Yes Hand Hygiene Yes Yes Yes Yes Yes Gloves Yes Yes acc. to risk acc. to risk acc. to risk Apron According to risk acc. to risk No No acc. to risk Gown acc. to risk acc. to risk No No acc. to risk Hair cover No No No No No Surgical m ask No Yes Yes Yes acc. to risk Particulate respirator Yes No No No No Eye protection Yes Yes Yes No No Surgical m ask on patient No acc. to risk acc. to risk acc. to risk acc. to risk * According to risk: when transmission is possible because there is a source and a receptor. Exam ple, when patients (the source) are alone, there is no "receptor" so they do not need to wear a mask. W hen non-health staff are not in close contact with patients, they do not need to wear a mask. Gloves, aprons or gowns may be necessary when performing procedures (including cleaning) where hands or clothes will get contaminated with respiratory secretions. 0 | Training module: infection prevention and control P,recautions for com m unities Com m unity Distributor of Hom e care Patient Fam ily and health worker essential services giver com m unity Respiratory etiquette Yes Yes Yes Yes Yes Social distance Yes Yes Yes Yes Yes Hand Hygiene Yes Yes Yes Yes Yes Gloves No No No No No Apron No No No No No Gown No No No No No Hair cover No No No No No Surgical m ask Yes acc. to risk acc. to risk acc. to risk acc. to risk Particulate respirator No No No No No Eye protection No No No No No Surgical m ask on patient According to risk acc. to risk acc. to risk - acc. to risk * According to risk: where transmission is possible because there is close contact between a source and a receptor. Exam ple, W hen patients are alone there is no receptor so they do not need to use a mask. People should maintain distance from others or at least cover their mouth and nose during a pandemic when near anyone with respiratory symptoms to prevent infection. 2 | Training module: infection prevention and control H7and hygiene Hand hygiene is an important measure to prevent the spread of anyinfection in a health-care facility Hands should be cleaned after touching people or contaminated objects or surfaces œ W ash with soap and water, rubbing for 20 seconds before rinsing œ Rub hands with an alcohol-based preparation until hands dry 10| Training module: infection prevention and control Hand hygiene with soap and water Wet hands with apply enough rub hands palm to right palm over left water soap to cover all palm dorsum with interlaced hand surfaces fingers and vice versa palm to palm with backs of fingers to rotational rubbing of rotational rubbing, fingers opposing left backwards and interlaced palms with fingers thumb clasped in right forwards with interlocked palm and vice versa clasped fingers of right hand in left palm and vice versa rinse hands with dry thoroughly with use towel to turn …and your hands water a single use towel off faucet are safe. 11 | Training module: infection prevention and control Hand hygiene with alcoholœbased rub Apply a palmful of the Rub hands palm to Right palm over left product in a cupped palm dorsum with interlaced hand and cover all fingers and vice versa surfaces. palm to palm with backs of fingers to rotational rubbing of left fingers interlaced opposing palms with thumb clasped in right fingers interlocked palm and vice versa rotational rubbing, …once dry, your hands backwards and forwards are with clasped fingers of safe. right hand in left palm and vice versa 12 | Training module: infection prevention and control Principles for use and rem oval of PPE Outside contaminated, inside clean The front contaminated, the back clean 13 | Training module: infection prevention and control Gloves 4lovesshould be worn if contact with blood and body fluids is anticipated, but are not a substitute for hand hygiene Gloves must be disposed of after each use Handsshould be washed afterdisposal of gloves 14 | Training module: infection prevention and control Dos and Don‘ts of Glove Use Protect yourself, others, and the environment œ Limit opportunities for —touch contamination“ • Avoid touching: œ your face or adjusting PPE with contaminated gloves œ environmental surfaces except as necessary during patient care 15 | Training module: infection prevention and control Rem oving gloves • Grasp outside edge near wrist • Peel away from hand, turning glove inside-out • Hold in opposite gloved hand • Slide ungloved finger under the wrist of the remaining glove • Peel off from inside, creating a bag for both gloves • Discard 16 | Training module: infection prevention and control Masks (1) Masks, if worn and disposed of properly, are likely to be the most effective PPE intervention œ Health-care workers with direct close contact with influenza patients should wear a tightly fittingsurgical mask and eye protection. • o r a s c a rf o r a p ie c e o f c lo th o v e r th e n o s e a n d m o u th if m a s k s a re u n a v a ila b le 17 | Training module: infection prevention and control Masks (2) Any respiratoryaerosol-generating proceduresmust NOT be performed without PPE (including particulate respirators and eye protection) Masks (particulate respirators, surgical or procedure) should be thrown awaywhen leaving isolation wards, OR every 4 hours or when wet or visibly soiled After removingor changing masks,hand hygieneshould be performed 18 | Training module: infection prevention and control Masks (3) Other essential staff (without direct patient care responsibilities) œ can wear surgical or procedure masks but œ need to change masks twice a day, or when wet or visibly soiled. 19 | Training module: infection prevention and control R3emovinga surgical m ask Do NOT touch the mask itself. Lift the bottom elastic over your head first Then lift off the top elastic If no elastics, untie. Discard W ash hands afterwards. 20| Training module: infection prevention and control Preventing infection at hom e (1) The patientshould: œ Follow respiratory hygiene/cough etiquette. Use a mask or a scarf or a piece of cloth! œ Ensure proper hand hygiene œ Avoid close contact with uninfected people for at least 7 days after the beginning of flu symptoms 21 | Training module: infection prevention and control Preventing infection at hom e (2) The caregivershould: œ Take proper precautions • R e s p ira to ry e tiq u e tte a n d h a n d h y g ie n e • P ro p e r u s e a n d d is p o s a l o f m a s k s , if a v a ila b le (o r s c a rf o r c lo th ) œ Limit close contact with people who are not sick.
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