INFECTION
CONTROL
THE INFECTION CONTROL STAFF
INTEGRIS BAPTIST
• V. Ramgopal, M.D.,
Hospital Epidemiologist
• Gwen Harington, RN, BSN,
CIC, Infection Control Specialist
• Kathy Knecht, RN,
Surveillance Coordinator
INTEGRIS SOUTHWEST
• D. Chansolme,
M.D., Hospital
Epidemiologist
• Becky Lewis, RN,
Infection Control
Specialist
Who can Place a Patient in
Isolation
• Attending MD to order isolation as indicated by the
Centers for Disease Control Guidelines.
• Hospital Epidemiologist and Infection Control
Specialist have authority to isolate and/or transfer
any patient to a private room as indicated.
• By using CDC Guidelines, the licensed nurse
responsible for the patient can institute isolation if
notified that the patient has a positive culture for
resistant organisms, i.e., MRSA, VRE, or Clostridium
difficile.
• Physician order is necessary for the discontinuation
of isolation.
Criteria for Placing Isolation
• Patients diagnosed with resistant organisms need to
remain in the same location unless they are
occupying a semi-private room, need to be transferred
to an ICU bed, or need to be transferred from an ICU
bed to a patient-care floor.
• Patients previously admitted with a positive culture
of a resistant organisms should be placed in isolation
immediately upon readmission.
• Reference: Policy #IC-112 Readmissions with
Resistant Organisms.
PERSONAL PROTECTIVE
EQUIPMENT
• This equipment is
located in Barrier
Boxes throughout
each medical center
and in the each
patient room. The
equipment is
provided to protect
employees against
exposure to blood
and body fluids.
BLOODBORNE EXPOSURE
• Report IMMEDIATELY to your
supervisor.
• Complete exposure incident
report.
• Go to Employee Health Services
ASAP.
– If after hours or on weekend,
contact House Supervisor.
– If regular clinic hours and
unable to go immediately,
contact EHS by phone to
report incident and begin
patient testing.
BLOODBORNE PATHOGENS &
TUBERCULOSIS EXPOSURE
CONTROL PLANS
• These plans are
updated annually
and are located in
the following places:
– Infection Control
Master Manual
– Integris Intranet
– Infection Control
website
– The Public Folders
PATIENT PLACEMENT
FOR TUBERCULOSIS
Any patient with positive AFB smear, probable or known
Tuberculosis, must be placed in negative pressure room.
• IBMC
Negative pressure rooms are
located on East Tower floors
7, 8, 9, & 10 East; there are
two rooms in 901 ICU. The
only exception on the West
Tower is in the 9West Cardiac
suites; this area has one
negative pressure room.
• ISMC
Negative pressure rooms are
on floors 6, 7, and 10 and in
the ICU. Jim Thorpe Rehab
Hospital has one isolation
room on the 2nd and 3rd floors.
Contact Infection Control or Environmental Health and
Safety for any problems or questions.
FIT TESTING OF
TUBERCULOSIS MASKS
• Must be fit-tested
for mask when
entering the room
for patients with
known or suspected
Tuberculosis. All fit
testing is done by
employee health.
ISOLATION
PRECAUTIONS
IN A
NUTSHELL
STANDARD PRECAUTIONS
• Use with ALL patients
regardless of diagnosis
or presumed infection.
Use when there’s a
chance of contact with:
– blood
– any body secretions or
excretions
– broken skin
– mucous membranes
STANDARD PRECAUTIONS
• Hand Washing
– BEFORE and AFTER patient contact
– BEFORE putting on or taking off
gloves
– AFTER touching blood or other body
substances, contaminated patient
equipment, broken skin, or mucous
membranes
– BETWEEN different procedures on
the same patient
– BEFORE leaving the patient’s room
– Wash your hands for 15 seconds if
using soap and water.
– When using alcohol foam rub your
hands together until hands are
completely dry.
– http://www.hhs.gov/ash/initiatives
/hai/training/
STANDARD PRECAUTIONS
• Wearing Gloves
– BEFORE any procedure that
may involve contact with
blood or other body
substances, broken skin, or
mucous membranes.
– BEFORE touching any
potentially contaminated
object.
– CHANGE gloves after
touching infective material
such as fecal material and
wound drainage.
STANDARD PRECAUTIONS
• Wearing Face and
Eye Protection
– Use a mask and face
and eye protection
when the possibility
exists that blood or
other body fluids may
be splashed or
sprayed
STANDARD PRECAUTIONS
• Wearing Gowns
– Use a gown if
splashing or
spraying of
blood, body
fluids,
secretions or
excretions is
possible.
STANDARD PRECAUTIONS
• Handling Patient-Care Equipment
– Handle patient-care equipment that is soiled with
blood, other body fluids, secretions or excretions in a
way that prevents contact with skin and mucous
membranes.
– Handle patient-care equipment in a way that prevents
contamination of clothing and the spread of microorganisms to other patients and the environment.
– Appropriately dispose of single-use equipment.
– Sterilize or disinfect reusable equipment according to
policy.
– Properly clean and disinfect equipment that is shared
by more than one patient.
Standard Precautions
• Any piece of contaminated equipment
that will not be immediately cleaned as
part of room turnover should be covered
with a blue bag labeled as “soiled”.
• Equipment that has been cleaned and
decontaminated should be covered with
a clear bag. Even if it will be used
within a short time.
STANDARD PRECAUTIONS
• Sharps
– Never recap used
needles
– Deposit sharps in
the sharps
container
immediately after
use
– Call
housekeeping to
come and
replace the
sharps
container when
it is half full
STANDARD PRECAUTIONS
• Handling Linen
– Do not put linen on
the floor.
– Drape an open plastic
bag over a chair and
place dirty linen in the
bag.
– After removing bag
with dirty linen from a
patient’s room place it
in the covered dirty
linen bin on your unit.
3 CATEGORIES OF
ISOLATION
PRECAUTIONS
TO BE USED IN ADDITION TO
STANDARD PRECAUTIONS
CONTACT PRECAUTIONS
• This category is
used for patients
known to be
infected or
colonized with
important
microorganisms
that can be
transmitted by
direct contact
with the patient.
CONTACT PRECAUTIONS
Common Conditions That Require
Contact Isolation:
MRSA
(all body sites)
VRE
(all body sites)
C. DIFFICILE
LICE
MAJOR ABSCESSES
SCABIES
CELLULITIS, DECUBITI
RSV
CONTACT PRECAUTIONS
• Private room necessary.
• Gloves MUST be worn when entering patient’s room.
• Gown MUST be worn when entering patient’s room,
if you anticipate your clothing will have substantial
contact with patient, environmental surfaces, or
items in patient’s room.
• Transport: limit movement and transport of patient
from the room for essential purposes only.
• Patient-Care Equipment: dedicate the use of noncritical patient-care equipment to a single patient to
avoid sharing between patients. In unavoidable,
clean and disinfect before using on another patient.
AIRBORNE PRECAUTIONS
• This category is
used to prevent the
spread of infectious
small particles that
remain suspended
in the air and can
be widely dispersed
by air currents.
AIRBORNE PRECAUTIONS
Common Conditions That Require
Airborne Isolation:
TUBERCULOSIS
VARICELLA
(Chickenpox)
AIRBORNE PRECAUTIONS
• Private room with NEGATIVE air pressure. KEEP
DOOR CLOSED.
• Wear respiratory protection when entering the room
of those patients with known or suspected pulmonary
tuberculosis. YOU MUST HAVE BEEN FIT-TESTED
BEFORE YOU WEAR RESPIRATORY PROTECTION
AND ENTER THE ROOM OF A PATIENT WITH
KNOWN OR SUSPECTED PULMONARY
TUBERCULOSIS.
• Patient transport: limit transport and movement to
essential purposes only. If moving patient is
necessary, place a SURGICAL MASK on the patient.
DROPLET PRECAUTIONS
• This category is
used to prevent
the spread of
large particles
that can be
created by
certain medical
procedures or by
coughing,
sneezing, or
talking.
DROPLET PRECAUTIONS
Common Diagnosis That Require
Droplet Isolation:
INFLUENZA
PERTUSSIS
HAEMOPHILUS
NEISSERIA
INFLUENZAE B
MENINGITIDIS
MENINGITIS, PNEUMONIA MENINGITIS, PNEUMONIA
AND SEPSIS
AND SEPSIS
DROPLET PRECAUTIONS
• Private room necessary
• Mask MUST be worn when working within 3
feet of the patient
• Patient transport: limit transport and
movement to essential purposes only. If
moving patient is necessary, patient MUST
wear a SURGICAL MASK
IF YOU HAVE ANY QUESTIONS,
PLEASE CALL INFECTION
CONTROL
IBMC @
949-3785
ISMC @
636-7614