2. Hand Hygiene
1.7 million hospital-acquired infections annually
99,000 deaths annually
6 billion dollars annually
Northwestern Memorial Hospital
VRE and MRSA survive 24 hours on keyboard
Contact resulted in hand transfer of MRSA 92% of he
time
Lab coats contaminated with MRSA 65% of the time
when leaning over infected patient
3. Hand Hygiene
Plain soap
Detergent removes, soil, and organic substances
Some transient bacteria
Alcohol
60-95% alcohol to denature proteins rapidly
Potent against many different organisms
Not appropriate when hands visibly contaminated
May dry skin
4. Hand Hygiene
Chlorhexidine (CHG)
Used in anti-microbial soaps
Sustained residual activity
Microbial resistance can develop
Other
Quaternary ammonia
Triclosan
Iodaphors
5. Hand Hygiene
When to perform:
Before patient contact
After contact with blood, body fluids, or contaminated
surfaces
Before invasive procedures
After removing gloves
6.
7.
8. Standard Precautions
Assume that blood and body fluids from all patients
contains infectious organisms
Treat all patients the same
Anticipate potential exposures before they happen
10. Gloves
Use:
Utilize when skin could potentially come in contact
with blood or other potentially infectious body fluids
(OPIM)
Applying pressure to bleeding sites
Suctioning
Handling contaminated objects
Dressing changes
Performing procedures
12. Gowns
Utilize when splashes, sprays, or droplets from body
fluids are anticipated
Wound irrigation
Cleaning instruments
Cleaning major blood spill
13. Mask/Eye Shield
Utilize when splashes, sprays, or droplets from body
fluids are anticipated
Suctioning
Intubation
Removing drains/devices
Eye glasses are not considered appropriate eye
protection
14. Isolation Precautions
Devised to prevent spread of certain infectious
organisms
Certain PPE required with any patient contact
Signs indicate isolation and appropriate PPE
15. Special Contact
MRSA, VRE, other MDRO
Daily cleaning
Patient specific equipment
Gown and gloves required for all contact
Patient transport
Patient wears gown, mask, and gloves (no gloves if on
stretcher)
Staff wears gown and gloves
16.
17. Contact
C-diff, Scabies, Lice
Daily cleaning
Gown and gloves required for all contact
Patient transport
Patient wears gown and gloves (no gloves if on
stretcher)
Staff wears gown and gloves
Alcohol hand rubs not effective, must wash hands
All equipment cleaned with bleach solution
18. Droplet
Bacterial meningitis, mumps, certain pneumonias, influenza
Daily cleaning
Patient specific equipment
Mask and gloves required for all contact
Patient transport
Patient wears mask and gloves (no gloves if on stretcher)
Staff wears mask and gloves
19. High Risk Precautions
Immunosuppressed
Daily cleaning
Gloves and mask required for all contact
Patient transport
Patient wears mask whenever leaving room
Hand hygiene extremely important
21. References
Centers for Disease Control and Prevention. (2002). Guideline for hand hygiene
in health-care settings: Recommendations of the healthcare infection control
practices advisory committee and the HICPAC/SHEA/APIC/IDSA hand hygiene
task force. Morbidity and Mortality Weekly Report, 51(16).
Tampa General Hospital Bloodborne Pathogen Exposure Control Plan
Tampa General Hospital Standard Precautions and Transmission-Based Isolation
Precautions, IC11
