infection control overview: tb session 1: infection control basics
TRANSCRIPT
1: Infection Control Overview - TB Slide 2
Learning Objectives
This session deals with the control of TB
By the end of the session, participants will be able to protect themselves and others from TB
1: Infection Control Overview - TB Slide 3
Steps to Prevent the Spread of TB to Staff and Patients
Detect infectious patients early
Ensure cross ventilation and wear masks during cough-inducing procedures
Leave windows open and direct air flow from staff to patients
Separate AFB smear positive patients from others
Instruct patients to turn their head and cover their mouth when coughing
1: Infection Control Overview - TB Slide 4
Early Detection and Treatment of TB Protects You!
TB is the greatest hazard nurses face
Most infections are passed from patients, visitors and staff whom no one suspects of having TB
1: Infection Control Overview - TB Slide 5
Our visitor has been coughing for three weeks and is losing weight!
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Doctor, we are sending you a person to be evaluated for TB. Please let us know
when she can come back to the ward
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Have Chronic Coughs Evaluated
A cough greater than 3 weeks should be evaluated whether in you, another staff member, a visitor, a volunteer, family member or patient
Act early!
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Discussion: Tuberculosis and Nurses
What are the tasks that puts you at most risk for contracting TB?
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Cough Producing Procedures that put Health-Care Personnel at Risk
Bronchoscopy
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Cough Producing Procedures that put Health-Care Personnel at Risk (cont’d)
Getting a sputum specimen
1: Infection Control Overview - TB Slide 11
Cough Producing Procedures that put Health-Care Personnel at Risk (cont’d)
Suctioning
1: Infection Control Overview - TB Slide 12
Cough Producing Procedures that put Health-Care Personnel at Risk (cont’d)
Nebuliser treatments
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What are the Risks Involved in these Procedures? Surgery
Placing intercostal drains
Handling mycobacterium cultures
Cleaning suction cups
Post-mortem
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Discussion: High Risk Procedures
Before proceeding for bronchoscopy, what precautions should you follow?
In what way may you be putting yourself or your patients at risk?
How could this be improved?
How is this similar or different from other high-risk procedures?
1: Infection Control Overview - TB Slide 15
TB (N95) Masks
TB masks should be used during high risk procedures:
N95 mask has a filter efficiency of 95%
Can be reused until contaminated or clogged
Must be discarded when breathing becomes difficult
1: Infection Control Overview - TB Slide 16
Do other Masks Help?
A paper or cloth mask can get wet in as little as 10 minutes, allowing bacteria to pass
If mask is not tight over the nose and mouth, unfiltered air will be sucked in around the nose and cheeks
What is more important than masks? Early detection and treatment
Good ventilation
Isolation of pulmonary TB cases
1: Infection Control Overview - TB Slide 17
Other Factors that put Staff at Risk: No cross breeze
Patients care areas without 2 open facing windows
DANGER:
Bronchoscopy suite without windows or outside airflow
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Protect Yourself with Good Ventilation
Open windows
See patients in rooms with a window on each side of the room
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Protect Yourself with Good Ventilation (cont’d)
Health worker Patient Open window
Proper Airflow Direction
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How can you Reduce the Risk of TB for these Staff?
Nurse placing PPD’s in center of the office
Clerical staff entering records behind in office near window
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Instruct Coughing Patients to Turn their Heads, and Cover their Mouths
Cover the mouth with a cloth, a sleeve or a sari to stop germs going into the air
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Protecting Yourself and Others from TB
Separate infectious TB (smear + or smears pending) patients from other patients
Staff who do not work directly with patients should not enter areas with infectious TB patients
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Which is the Most Dangerous Mix of Patients and Why? HIV - and HIV +
Smear + TB and HIV +
MDRTB smear + and HIV+
MDRTB smear + and HIV -
Greatest Risk!
Low risk
High risk
High risk
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Don’t Mix Non-Infectious TB and Infectious TB Patients
Questions for discussion:
When do we consider people non-infectious?
What precautions should we take with patients who are on ARVs?
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MDRTB Patients Should not Mix with other Patients Multiple drug resistant TB (MDRTB) is not
treatable by first line treatment
50% or more who develop MDRTB disease will die
These patients must not be in the same building as uninfected persons
Patients in a hospital can infect more people than at home
1: Infection Control Overview - TB Slide 26
Summary: Steps to Protect Yourself and Others from TB Ensure a cross breeze, open windows and the
direction of air flow from the health care worker to the patient to outside
Separate non-infected patients from patient who are, or might be infectious
Have patients turn their head and cover their mouth when they cough
Keep non-essential staff out of areas with infectious patients or cough-inducing procedures
1: Infection Control Overview - TB Slide 27
Key Points
Preventing the spread of TB includes:
Early detection and treatment
Strict isolation of smear positive patients
Good ventilation
Extra precautions during cough inducing procedures
Attention to patient placement
Teaching cough hygiene