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HAND HYGEINE

Hand hygiene is a way of cleaning one's hands that substantially reduces potential pathogens (harmful microorganisms) on the hands. Hand hygiene is considered a primary measure for reducing the risk of transmitting infection among patients and health care personnel.

STEPS

1. Step 1: Wet Hands. Wet your hands and apply enough liquid soap to create a good lather
2. Step 2: Rub Palms Together
3. Step 3: Rub the Back of Hands.
4. Step 4: Interlink Your Fingers
5. Step 5: Cup Your Fingers
6. Step 6: Clean the Thumbs.
7. Step 7: Rub Palms with Your Fingers.

STANDARD PRECAUTIONS

Standard precautions are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. These measures are to be used when providing care to all individuals, whether or not they appear infectious or symptomatic.

AIRBORNE

Airborne precautions are required to protect against airborne transmission of infectious agents.

Diseases requiring airborne precautions include, but are not limited to: Measles, Severe Acute Respiratory Syndrome (SARS), Varicella (chickenpox), and Mycobacterium tuberculosis. Airborne precautions apply to patients known or suspected to be infected with microorganisms transmitted by airborne droplet nuclei.

Preventing airborne transmission requires personal respiratory protection and special ventilation and air handling.

Airborne precuation neeed standard precaution plus

Masks and Respirators

• Wear an N95 Respirator
  Prior fit-testing that must be repeated annually and fit-check / seal-check prior to each use.
  OR
  Powered Air-Purifying Respirator (PAPR)
• The respirator should be donned prior to room entry and removed after exiting room

CONTACT

In addition to Standard Precautions, use Contact Precautions in the care of patients known or suspected to have a serious illness easily transmitted by direct patient contact or by indirect contact with items in the patient’s environment.

Illnesses requiring contact precautions may include, but are not limited to: presence of stool incontinence (may include patients with norovirus, rotavirus, or Clostridium difficile), draining wounds, uncontrolled secretions, pressure ulcers, presence of generalized rash, or presence of ostomy tubes and/or bags draining body fluids.

Additional Personal Protective Equipment (PPE) for Contact Precautions

Contact precautions are in addition to Standard Precautions

PLUS

Gloves

• Wear gloves when touching the patient and the patient’s immediate environment or belongings
• Remove gloves promptly after use and discard before touching non-contaminated items or environmental surfaces, and before providing care to another patient
• Wash hands immediately after removing gloves

PLUS

Gowns

• Wear a fluid resistant, non-sterile gown if substantial contact with the patient or their environment is anticipated
• Do not wear the same gown for the care of more than one patient

How contact transmission occurs:

• Contact transmission can occur in two ways:
  • Direct Contact Transmission
  • Indirect Contact Transmission

Contact precautions are required to protect against either direct or indirect transmission.

Contact precautions are indicated for persons with gastrointestinal (diarrheal) illness, and incontinent persons including those who use incontinent products.

Direct Contact Transmission

• Involves body-surface to body-surface contact and physical transfer of microorganisms between a susceptible person (host) and an infected or colonized person.

• More often occurs between a health care worker and a patient than between patients.

Indirect Contact Transmission

• Involves contact of susceptible person (host) with a contaminated intermediate object such as needles, dressings, gloves or contaminated (unwashed) hands.

• Disease is more likely to develop following direct or indirect contact transmission when the pathogen is highly virulent or has a low infectious dose or the patient or health care worker is immunocompromised.

• Poor hand hygiene is most often cited as a cause of contact transmission.

DROPLET PRECAUTION

Droplet Precautions

Droplets can be generated from the source person during coughing, sneezing, talking and during the performance of certain procedures such as suctioning or bronchoscopy.

Droplets may contain microorganisms and generally travel no more than 3 feet from the patient. These droplets can be deposited on the host’s nasal mucosa, conjunctivae or mouth.

Diseases requiring droplet precautions include, but are not limited to: Pertussis, Influenza, Diphtheria and invasive Neisseria meningitidis

Additional Personal Protective Equipment (PPE) for Droplet Precautions

Droplet precautions are in addition to Standard Precautions

PLUS

Masks and Respirators

• Wear a facemask, such as a procedure or surgical mask, for close contact (within 3 feet of the patient) with the patient; the facemask should be donned upon entering the exam room

Additional Procedures

Room

• Place the patient in an exam room with a closed door as soon as possible (prioritize patients who have excessive cough and sputum production)
• If an exam room is not available, provide the patient a facemask and place them in a separate area as far from other patients as possible while awaiting care

Patient

• Instruct patient to wear a facemask when exiting the exam room, avoid coming into close contact with other patients, and practice respiratory hygiene and cough etiquette

CHEMICAL HAZARD

Chemical Safety Precautions

• Safety glasses are to be worn whenever working with acids, bases, or any flammable materials.
• Let the instructor know immediately about any glassware breakage or chemical spills that may occur so that proper cleanup procedures can be instituted.
• Use pipet fillers whenever pipeting any fluid.Whenever working with acids or bases, have the chemicals available at your work station, do not carry pipets with fluid across the room.
• When diluting acids, pour the acid into the water, NOT water into acid as this may cause spattering of the acid.
• When acid is mixed with another reagent, an exothermic reaction may occur which heats up the container, This is natural, so do not panic and spill contents.
• All volatile materials must be handled in a hood with the exhaust fan on.When refluxing any solutions, perform this operation under a hood, and use boiling beads in the reflux vessel to prevent any excessive "bumping" and possible glass breakage.
• Use heat-resistant gloves and/or tongs when handling hot glassware, chinaware, etc.
• Use plastic gloves when handling any hazardous materials to prevent skin contact.
• Label and date all chemical mixtures that are made up and kept for future use.
• Do not store basic solutions in glass containers with glass stoppers, use plastic or rubber stoppers.
• Dispose of all used solutions in an approved manner as directed by the instructor.
• Empty all used inoculated bacteriological media from test tubes or dishes into a designated container so that it may be sterilized before disposal.
• Before leaving, turn off all power and heat to the apparatus you have used, or place in the standby mode.
• Clean all spatulas, glassware, and dishes after use and before storage to prevent contamination.
• Return all chemicals you are using to their proper storage space.Be familiar with the use of the eye-wash, the laboratory shower (if equipped), and the first-aid kit if they are needed at any time.

BIOLOGICAL TERRORISM

Bioterrorism is the deliberate release of viruses, bacteria, toxins or other harmful agents to cause illness or death in people, animals, or plants.These agents are typically found in nature, but could be mutated or altered to increase their ability to cause disease, make them resistant to current medicines, or to increase their ability to be spread into the environment. Biological agents can be spread through the air, water, or in food. Biological agents are attractive to terrorists because they are extremely difficult to detect and do not cause illness for several hours to several days. Some bioterrorism agents, like the smallpox virus, can be spread from person to person and some, like anthrax, cannot.

Bioterrorism may be favored because biological agents are relatively easy and inexpensive to obtain, can be easily disseminated, and can cause widespread fear and panic beyond the actual physical damage. Military leaders, however, have learned that, as a military asset, bioterrorism has some important limitations; it is difficult to use a bioweapon in a way that only affects the enemy and not friendly forces. A biological weapon is useful to terrorists mainly as a method of creating mass panic and disruption to a state or a country. However, technologists such as Bill Joy have warned of the potential power which genetic engineering might place in the hands of future bio-terrorists

PERSONAL PROTECTIVE EQUIPMENT

Personal Protective Equipment (PPE) is specialized clothing or equipment worn by an employee for protection against infectious materials.

PPE prevents contact with an infectious agent or body fluid that may contain an infectious agent, by creating a barrier between the potential infectious material and the health care worker.

• Components of Personal Protective Equipment
  Additional information on specific components of PPE. Including gloves, gowns, shoe covers, head covers, masks, respirators, eye protection, face shields, and goggles.
  Gloves | Gowns | Shoe and Head Covers | Masks and Respirators | Face and Eye Protection

• Guidelines and Resources for Personal Protective Equipment (PPE) in Healthcare Settings
  Links to guidelines and resources for ppe in health care settings.

• Making Disposable PPE Kit
  Information on compiling materials for a disposable PPE kit.