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HUTT VALLEY DHB

INFECTION PREVENTION AND CONTROL

STUDENT HANDBOOK

Introduction:

Infection Prevention and Control for Students HVDHB IPC 2019

Welcome to Hutt Valley DHB. This booklet is designed to help you understand the importance of infection prevention and control (IPC) and your role in minimising the spread of microorganisms and reducing healthcare associated infections.

The IPC team:The IPC team consits of Clinical Nurse Specialists, Infectious Diseases Consultants and an Antimicrobial Pharmacist. The role of the IPC team is to educate and support both staff and patients, ensure the hospital environment is safe, carry out surveillance and manage outbreaks. They can be contacted for advise via the operator.

Chain of infection:Microorganisms can be involved in either colonisation or infection, depending on the susceptibility of the host.

Colonisation occurs when there is a sustained presence of the microorganism on or in the body, without an immune response or disease.

Infection occurs when there is an invasion of the microorganism into the body resulting in an immune response, with or without symptomatic disease.

Infection is the result of a complex relationship between a host and an infectious agent and people can vary in their response. Healthcare associated infections are the most common complication affecting patients in hospital, however they are often preventable and it is possible to significantly reduce the rates of healthcare associated infections through effective infection prevention and control.

Standard precautions:


Standard precautions are the practices that are applied to everyone, regardless of their infection status. This is the first-line approach to infection control and will minimise the risk of transmitting infectious agents.

These precautions include:

Hand hygiene The use of personal protective equipment (PPE) Appropriate handling of waste and linen Cleaning Appropriate reprocessing of reusable equipment Practicing respiratory hygiene and cough etiquette Aseptic non-touch technique Appropriate handing and disposal of sharps

Hand hygiene:

Effective hand hygiene is the single most important strategy in preventing healthcare associated infections. Hand hygiene is a general term applying to the use of soap/solution and water, or a waterless antimicrobial agent such as alcohol hand gel. Hutt Valley DHB participates in auditing of hand hygiene in accordance with the 5 moments outlined by the World Health Organisation. These 5 moments of hand hygiene are the key times when a healthcare worker is most likely to transmit microorganisms from one patient to another.

Wearing disposable gloves is never a substitute for hand hygiene. Gloves do not provide a complete barrier and can be difficult to remove without causing contamination to your hands. Disposable gloves are only required where there is a risk of exposure to blood or body fluids. Hand hygiene must be preformed before and after glove use.

Cleaning, linen and waste:


It is your responsibility to clean all patient care equipment that you use immediately after use. Cleaning can be completed with the blue microfibre cloths dampened with water.

Dirty linen is to be placed into linen bags at point of care, do not carry dirty linen around the department. Linen bags should be removed when they are ¾ full and should be transported on a trolley, never drag linen bags along the floor. Never place anything other than linen into a linen bag.

Ensure that you dispose of waste appropriately.


Transmission based precautions:


Transmission based precautions are used in conjunction with standard precautions, when extra practices are required to prevent transmission. These precautions are tailored to the particular infectious agent and may involve a combination of practices. When transmission based precautions are required, the patient will be placed into a single room with a door sign indicating the required precautions. Each time you enter and exit the room you must follow the steps outlined on the sign.

Contact precautions: Used when there is a known or suspected risk of transmission via touch, either directly from one person to another or indirectly from contaminated surfaces. Conditions include diarrhoea, MRSA, ESBL.

Enhanced contact precautions:Used when there is a known or suspected risk of the transmission of an organism that is resistant to most or all antibiotics.

Droplet precautions:Used when there is a known or suspected risk of transmission via droplets larger than 5 microns when the person coughs, sneezes or talks. Conditions include influenza, pertussis and rubella.

Airborne precautions:Used when there is a known or suspected risk of transmission via airborne particles that are smaller than 5 microns when the person coughs, sneezes or talks. These particles are small enough to be suspended in the air. Patients must be placed in a negative pressure room. Conditions include tuberculosis and chicken pox.

Protective precautions:Used for immunosuppressed patients with an increased risk of developing severe infections. This can be due to a medical condition or medications.

Negative pressure rooms:Rooms with the ability to supply negative pressure are available in the medical ward, MAPU, the children’s ward, endoscopy, emergency department and ICU. The fan system in these rooms forces air from the corridor into the room and ensures that the air inside the room does not go out into the corridor. The door to the corridor must be kept closed at all times, to enter and exit the room you must use the ante-room door. Negative pressure rooms must not be used for patients in protective isolation, as the ‘dirty’ air from the corridor is being forced into the room.



Single Room &Own Bathroom:

Yes Yes YesDoor closed at all times

Negative Pressure RoomDoor closed at all times.

Personal Protective Equipment (PPE):

Standard Precautions

GlovesApron/Gown

Surgical mask Standard Precautions.

N95 mask Standard Precautions.

Hand Hygiene: Before & After patient contact/ gloves use.Soap & water must be used if diarrhoea.

Before & After patient contact/ gloves use.Soap & water must be used if diarrhoea

Before & After patient contact/ glove use.

Before & After patient contact/ glove use.

Staff must: Have immunity to chickenpox, pertussis or measles (to care for these conditions).

Patients must: Use own bathroom.

Use own bathroom.

Remain in room.Be taught correct cough etiquette.

Remain in room.Be taught correct cough etiquette.

Visitors must: Clean hands on entry and exit.Use PPE if assisting with patient cares

Clean hands on entry and exit.Wear correct PPE.

Clean hands on entry and exit.Household contacts don’t require PPE (all others visitors do).Limited visitors.No children.

Clean hands on entry and exit.Household contacts don’t require PPE (all other visitors do).Limited visitors. No children.

Patient Transportation

Inform accepting areaPatients must sanitize hands when leaving room.

Inform accepting areaPatients must sanitize hands when leaving room.

Inform accepting areaPatients must wear surgical mask and sanitize hands when leaving room.

Inform accepting areaPatients must wear surgical mask and sanitize hands when leaving room.

Limit supplies & equipment in room

Yes Yes Yes Yes

Cleaning: Terminal Clean on de-isolation or discharge

Terminal Clean on de-isolation or discharge

Terminal Clean on de-isolation or discharge

Terminal Clean on de-isolation or discharge.Leave room empty with doors closed for 30min post clean.

Contact

Droplet

Enhance Airborne

Personal protective equipment:Personal protective equipment (PPE) is what you wear to protect yourself from exposure to potentially infectious agents. The type of PPE worn varies depending on the task being performed and the mode of transmission of the microorganism. When you are entering an isolation room it is important that you read the sign on the door and apply the correct PPE before entering the room and remove your PPE on exiting the room. If the room has an anteroom, this should be used as a ‘dressing room’ to put on and remove your PPE. You must never walk around the ward or perform other tasks while wearing potentially contaminated PPE and you must always preform hand hygiene before and after use.

It is important to remove PPE in the correct order to avoid contaminating yourself.

Protecting yourself:

Along with protecting patients, infection prevention and control measures are also important for your own protection. Ensuring that you are up to date with vaccinations, and having the Influenza vaccination each year is an important way to provide greater protection from preventable diseases.

If you are sick, please do not come to your placement. If you are recovering from an illness please check with the nurse manager in the department before you return, as some conditions may require an extended time away from the department.


If you have an exposure to blood or body fluids or a needle stick injury follow the guidelines in the occupational health and safety policy.

Tasks to complete during your placement:

Task Date completed

Complete the online hand hygiene quiz: Log onto the website

https://hha.southrock.com Register as a new user (you can create your

own username and password) When you are prompted to select a

learning package, select the Hand hygiene NZ Student Health Practitioners module.

Complete this module and print your certificate

Familiarise yourself with the IPC policies on the intranet:

Under the policies and guidelines banner on the Hutt Valley DHB intranet page locate the IPC policies.

In the IPC resources, familiarise yourself with the patient information brochures.

Identify who is the IPC representative in your area:

Familiarise yourself with the PPE available in your area, ensure that you know where it is stored and how to wear it correctly:

Useful resources: Immunisation advisory centre web site http://www.immune.org.nz/for information on

vaccine preventable diseases.

Hutt Valley DHB infection prevention and control policies and guidelines available on the intranet.

Regional public health website http://www.rph.org.nz for information on health promotion, infectious diseases, foodborne illnesses and immunisations.


http://www.rph.org.nz/

http://www.immune.org.nz/

https://hha.southrock.com843/

The Australian guidelines for the prevention and control of infection in healthcare, available on the national health and Medical Research Council website https://www.nhmrc.gov.au

Reference List:

NHMRC. (2010). Australian Guidelines for the Prevention and Control of Infection in

Healthcare. Commonwealth of Australia.

Wilson, J. (2006). Infection Control in Clinical Practice (3rd ed.). London, England:

Elsevier.


https://www.nhmrc.gov.au/

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