Siobhan Prout, BSAP 1

Conference 2006

National

“Pointing Out the Future for Irish Healthcare workers”

Needlestick njuries

Infection Prevention & Control

Siobhan Prout, BSAP 2

Education & Training

Tradition & Ritual

Modern ApproachStrategic Management

Siobhan Prout, BSAP 3

The Prevention of Transmission of Blood-Borne Diseases in the Health-Care Setting

“The most effective way of preventing transmission of blood borne pathogens in the health-care setting is to make the working environment as safe as possible”

Good infection prevention & control practices

Implementation of standard precautionsProvision of effective risk management

policies

Siobhan Prout, BSAP 4

Infection prevention & control practices

Health care workers require knowledge on

Source of micro-organisms Susceptibility of the Host Transmission methods of micro-

organisms

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Source• Patients- acute disease, incubation

period, colonised but asymptomatic or chronic carriers.

• Endogenous flora• Health care personnel• Environment, • Equipment, medications.• Visitors

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HostFactors effecting :• age• underlying disease• medications e.g. antibiotics,

steroids • irradiation• skin integrity• indwelling devices

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Transmission

• Contact• Droplet• Airborne• Common vehicle transmission

• Vectorborne

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Implementation of standard precautions

• Designed to reduce the risk of transmission of blood-borne and other pathogens from recognised and unrecognised sources

• Apply to all patients receiving care, regardless of their diagnosis or presumed infection status

• Apply to;– blood– all body fluids ( except

sweat)– non-intact skin– mucous membranes

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Guidelines; Hand hygiene• Promote hand hygiene

as a key component of infection prevention & control in the hospital & community setting

• Addresses the resources issues– Facilities location &

design– Products available– Education, promotion of

hand hygiene and audit of practice

Implementation of standard precautions

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Implementation of standard precautions

Personal protective equipment • Appropriate use of gloves• Cover cuts and abrasions• Use of visor or goggles/safety

spectacles• Waterproof/repellent masks• Plastic aprons/gowns• Appropriate footwear

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Implementation of standard precautions

• Use safety devices“an increased emphasis on precautionary

measures to protect the health and safety of health-care workers….these measures should be taken with all patients in all health-care facilities at all times by all staff in both the public and private healthcare sectors”

M. Harney, Tánaiste & Minister for Health & Children

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Implementation of standard precautions

Safety devices & technology; Phlebotomy

Siobhan Prout, BSAP 13

Implementation of standard precautions

Safety devices & technology; Cannulation

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Implementation of standard precautions

Safety devices & technology; Subcutaneous infusions

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Implementation of standard precautions

• Single use items disposed after use 2• Safe use of sharps disposal units• Prevention of surface contamination by

blood and body fluids• Appropriate decontamination of spillages• Routine and terminal cleaning equipment

& environment• Patient linen storage and laundry

segregation• Patient placement and transportation

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Risk management focuses on

• Active compliance of the healthcare worker with Infection Prevention & Control measures

• Analysis of the working environment, conditions and practices that may contribute to the risk of transmission of BBV

Effective risk management policies

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Efforts to prevent inoculation injury are focused on three main areas

• Altered behavior & improved safety culture through ongoing education/training

• Utilisation of engineering controls• Disease prevention through uptake of

available vaccination and medical prophylaxis

Effective risk management policies

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Professional issues• “Health care should be delivered with

compassion and dignity in compliance with best practice in relation to safety and standards of care”

• Acceptance of responsibility and understanding of accountability for own practice

• Knowledge updated by on-going education

• Documentation • Evaluation of own practice through audit

process.

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Reason’s model on accident causation

• Active errors : those having an immediate effect

• Latent errors : conditions that lie dormant until activated by active errors.

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Unsafe acts

Reason’s model on accident causation

Local management

Safeguards

Organisational

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Reason’s Model on Accident Causation

Organisational problemsLocal Management

Unsafe Acts

Safeguards

Danger

Injury