Health Occupation Student
Orientation Module 3:
Infection Prevention
Section 1
STANDARD PRECAUTIONS
Infection Prevention
Chain of Infection
How to Break the Chain of
Infection
1.
Perform hand hygiene.
2.
Surface disinfection
3.
Follow transmission based precautions.
4.
Practice injection safety.
5.
Practice safe respiratory hygiene and
cough etiquette.
Infection Prevention
Standard Precautions - Hand Hygiene

When to Clean Your Hands: use
hand sanitizer or soap and water 
Each time you enter or exit a threshold in a
patient care environment

Before and after patient contact

Before donning and after removing gloves –
gloves do not replace hand hygiene

After touching your face or hair

After using the rest room – must use soap
and water!
Infection Prevention
Standard Precautions – Hand Hygiene
How To Wash Your Hands
1.
Wet hands with warm running water.
2.
3.
Apply soap.
Rub hands for 20 seconds (If necessary, use a nail
brush to clean nails. However, the brush must be kept clean
and sanitary.)
4.
5.
Rinse hands thoroughly
Dry hands with a paper towel
6.
Turn off the tap with the paper towel
Infection Prevention
Standard Precautions - Hand Hygiene
How to Apply Hand Sanitizer
Infection Prevention
Standard Precautions – Surface Disinfection


When to Clean Equipment:

Wipe down re-useable equipment after each
patient use

Clean High touch objects daily such as
bedrails, over bed table, call light/TV remote
What to Use:

Germicidal wipe such as CaviWipes. Alert: be
sure to wear gloves with use.

Bleach Wipe for patients with clostridium
difficile and Norovirus. Alert: be sure to wear
eye protection and gloves with use.
Infection Prevention
Standard Precautions – Surface Disinfection
.
Use this
Cleaning Product
Sani Cloth
Bleach wipes
Wearing this
Required PPE
Gloves
To Clean this
Equipment
Oximeter
Wheelchair
Dynamap
Bed
WOW’s
Gurney
IVAC
Alert: Equipment for
Gloves
Safety glasses patients with C. dif or
Norovirus
Alert: Alaris pumps,
glucometers can only be
cleaned with this product
Contact Time
(wet time)
1
3
Infection Prevention
Standard Precautions – Injection Safety
Injection Safety Guidelines From CDC

Never administer medications from the same syringe to
more than one patient, even if the needle is changed.

After a syringe or needle has been used to enter or connect
to a patient’s IV it is contaminated and should not be used
on another patient or to enter a medication vial.

Never enter a vial with a used syringe or needle.

Do not use medications packaged as single-dose vials for
more than one patient.

Assign medications packaged as multi-dose vials to a single
patient whenever possible.

Do not use bags or bottles of intravenous solution as a
common source of supply for more than one patient.

Follow proper infection control practices during the
preparation and administration of injected medications.
Infection Prevention
Hospital Influenza Plan – Your Role
1.
Use respiratory etiquette education (Cough
and/or sneeze into your sleeve)
2.
Practice Hand Hygiene.
3.
Get Influenza vaccinations for seasonal flu
(October to March)

Vaccinated students must wear colored
plastic tag identifier.

Unvaccinated staff:

Sign a Declination form as required by
state law and Cal/OSHA

During flu season (October to March),
wear a surgical mask if within six feet
of a patient .
Infection Prevention
Hospital Influenza Plan – Your Role
Stay Home if Sick:

Vomiting

Diarrhea related to
Gastroenteritis

Sore throat with fever

Fever of 100 or higher and
cough

Draining wound and/or open
wound infection for staff that
provide direct patient care
Section 2
TRANSMISSION-BASED
PRECAUTIONS
Infection Prevention
Transmission Based Precautions
Personal Protective
Equipment
 Health care workers wear PPE in patient’s
room
 Patient wears PPE when outside the room
 Staff and volunteers are NOT to wear PPE
(including gloves) in the hallway unless
providing critical care during transport
 Tie BOTH neck and waist ties on the gown
 PPE is disposed in regular trash unless
grossly contaminated with a patient’s body
fluids
Wrong!
Infection Prevention
Transmission Based Precautions
How to Put
On PPE
Alert:
Both neck and
waist of gown
must be tied.
Infection Prevention
Transmission Based Precautions
How to
Remove PPE
Alert:
Do NOT Wear
PPE outside
the Patient
Room
Infection Prevention
Transmission Based Precautions
Contact Precautions:
(example diseases: MRSA, VRE,
Scabies, Lice)

Wear Personal Protective
Equipment: gloves, gowns upon
entry to patient room; remove before
leaving the room: PPE NOT required
in arc of the door
Infection Prevention
Transmission Based Precautions
Droplet Precautions:
(example diseases: Influenza,
Bacterial Meningitis)

Wear Personal Protective
Equipment: mask upon entry to
patient room; remove before leaving
the room

N95 or PAPR for high hazard
procedures
N95 Mask
PAPR
Infection Prevention
Transmission Based Precautions
Airborne Precautions:
(example diseases: TB, Novel or
Unknown Disease)

Wear Personal Protective Equipment:

N95 mask- must be fit tested

PAPR* for high hazard procedures
such as Bronchoscopy, suctioning,
SVN etc.
* PAPR = Powered Air Purifying Respirator
N95 Mask
PAPR
Infection Prevention
Other Measures
 No food or drink in patient care areas (includes
nurses’ station)
 Food and drink items must be covered when carried
through hospital hallways
 Hand hygiene before entering a patient room every
time
 Educate patients, family, and visitors about hand
hygiene (entering and exiting)
 Clean up! – examples: wrappers on floor, spilled
beverages in pantry
Infection Prevention
Student Restrictions

Students may NOT perform the
following standardized procedures:
 Vaccinations
 MRSA

screening
Students may NOT care for patients
in Airborne Isolation
Section 3
COMMUNICABLE DISEASES
Infection Prevention
Communicable Diseases
Superbugs” live on surfaces…also known as Multidrug Resistant
Organisms (MDROs). Note the survival rates for each.

MRSA Survival (Methacillin

Resistant Staph Aureus)


Formica surfaces = 14 days

Cotton blanket material = 6-9
weeks

S. aureus (MRSA) can remain
virulent and capable of causing an
infection for 10 days after
exposure to dry surfaces
VRE Survival (Vancomycin Resistant
ESBL – Extended Spectrum Beta
Lactamase


Clostridium Difficile
Survival (Not a MDRO but “Other Organism
of Concern”)

C. diff spores can live and infect
up to 5 months on environmental
surfaces

special requirements for hand
hygiene and environmental
cleaning
Enterococcus)

Bedrails = 24 hours

Telephones = 60 minutes

Gloved and ungloved hands > 60
minutes
A newly emerging MDRO
(enzymes produced by certain
bacteria that provides resistance
to certain antibiotics)
Infection Prevention
Other Communicable Diseases



About Pulmonary tuberculosis (TB)

A contagious bacterial infection that mainly
involves the lungs. State of California has a high
incidence

Annual testing (TB skin Test) for exposure is
required
Student are not allowed to provide
care of patients in Airborne Isolation
Precautions.
Type of Isolation Precautions: Airborne

N95 respirator {fit tested}

Negative air pressure – contact engineering
to turn on alarm, conduct daily pressure
testing
Infection Prevention
Other Communicable Diseases


About Meningitis:

Meningitis is among the ten most common
infectious causes of death

The major causes of community-acquired
bacterial meningitis in adults in developed
countries are Streptococcus pneumoniae and
Neisseria meningitidis

The classic symptom triad of acute bacterial
meningitis consists of fever, nuchal rigidity,
change in mental status
Type of Isolation Precautions: Droplet

Wear PPE until 24 hours after initiation of
effective treatment
Section 3
AEROSOL TRANSMISSIBLE
DISEASE
Students DO NOT Take Care of
Patients with Airborne Infection
Aerosol Transmissible Disease

What is an Aerosol
Transmissible
Disease?

A disease transmitted by
aerosols (gaseous suspension
of fine solid/liquid particles)
through sneezing or coughing
Aerosol Transmissible Disease
What Diseases Spread via
Airborne Infection Isolation (AII)?



Airborne spore release
(anthrax)
Avian influenza
Varicella disease





Chicken pox
 Shingles
 Herpes zoster
 Varicella-zoster (disseminated
disease)



Monkeypox
Severe Acute Respiratory
Syndrome (SARS)
Smallpox
Tuberculosis (Suspect/Confirmed)
Measles (Rubeola)
Novel or Unknown pathogen
Any other disease or pathogen for
which the State or local Health
Department recommends Airborne
Infection Isolation
Aerosol Transmissible Disease
What Diseases are Spread by
Droplets?

Diphtheria
Influenza (seasonal)
Meningococcal disease
Mumps
Mycoplasma pneumonia
Pertussis

Plague (pneumonic)








Rubella
Viral hemorrhagic fevers
Any other disease or
pathogen for which the
State or local Health
Department recommends
Droplet Precautions
Aerosol Transmissible Disease
Respiratory Protection

When entering an “Airborne” Isolation room
wear a N95 respirator


When assisting with High Hazard Procedures on
patients in “Airborne” Isolation diseases, wear a PAPR
during procedure and 35 minutes after while in room
When entering a “Droplet” Isolation room wear
a Surgical or Isolation Mask

When assisting with High Hazard Procedures on
patients in Droplet precautions, wear a N95 respirator
and eye protection or PAPR during the procedure (door
to remained closed during the procedure)
Students DO NOT Take Care of
Patients with Airborne Infection
Aerosol Transmissible Disease

What are Considered High
Hazard Procedures:

Any clinical, surgical & lab procedure that may
aerosolize pathogens
 Sputum induction
 Intubation & bronchoscopy

Open circuit suctioning
 Aerosolized administration of meds
 Pulmonary function testing
 Autopsies