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Infection Prevention 2013
Net Learning Module for all KCI/KCC Staff
Respiratory Etiquette
Influenza
Tdap Vaccine
Hand Hygiene
TB Control Plan
Mary Ellen Lesperance RN, MSN CIC
Lisa Engles MT (ASCP) CIC
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Objectives
 Understand the importance of getting an
annual influenza vaccine
 Understand the importance of getting the Tdap
vaccine
 Understand Respiratory Etiquette
 Understand the importance of proper Hand
Hygiene
 Understand the TB Control Plan
Why should I be concerned about influenza?
 I work with cancer patients.
 I care about people.
 My patients, my family, my co-workers can get the flu
from me if I am not vaccinated.
 Working with people with illness puts me at higher
risk for infection.
 Preventing influenza can save lives.
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What is Influenza?
 Influenza, also known as the flu, is a contagious viral
illness that targets the respiratory tract (nose, throat,
airways & lungs).
 Can cause serious complications, including
pneumonia and death.
 The most frequent cause of vaccine-preventable
death in the US.
Causes 24,000 deaths per year and 150,000
hospitalizations per year
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How do I know it is the Influenza?
 Influenza usually has a sudden onset, lasting about
a week, and may cause some of the following
symptoms:




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fever
headache
aching muscles & physical discomfort
dry cough
sore throat
runny nose
Nausea and vomiting are often referred to as the
stomach flu, but this is not Influenza.
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“I think I just have a cold”
Symptoms
Common Cold
Influenza
Fever
Not typical
Common; may be high
Body Aches
Mild
Common; may be severe
Headache
Not typical
Common
Fatigue/weakness
Mild
Common
Stuffy nose/ sneezing
Common
Sometimes
Sore Throat
Common
Sometimes
Cough
Mild to moderate
Common; may be severe
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How is the virus spread?
 The virus is easily spread from one person to another
through droplets formed when coughing or sneezing.
 It can also be spread from hand to hand contact or by
touching a surface that might be contaminated with
infected droplets.
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When is someone contagious?
 Persons with the flu should be considered contagious
for up to seven days after symptoms start.
 In some cases, it may be possible for flu to be
transmitted even the day before symptoms are
noticed. Studies show that healthcare workers
continue to work despite being ill, thus exposing
patients to the flu.
No
Symptoms/
Contagious
Monday
Sick/
Contagious
Tuesday
Sick/
Contagious
Wednesday
Sick/
Contagious
Thursday
Sick/
Contagious
Friday
Sick/
Contagious
Saturday
Sick/
Contagious
Sunday
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Flu Prevention at Work & Home
 Get your flu shot! Clean your hands
frequently
 Avoid touching your eyes, nose & mouth
 Keep surfaces disinfected
 Wipe down keyboards, telephones,
doorknobs & other shared surfaces with
disinfectant wipes
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Respiratory Etiquette
 Respiratory Etiquette: Cover your mouth &
nose when you cough or sneeze
 Cough or sneeze into a tissue

No tissue??? Cough or sneeze
into your sleeve

Now clean your hands
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What is the “Flu Shot” and “Who
should get it?”
 Inactivated (not live) virus is injected, usually
in the upper arm.
 All persons 6 months of age and older
should get the flu shot unless the person
has contraindications, like a severe allergy
to eggs.
 ALL STAFF ARE REQUIRED TO GET THE
FLU SHOT ANNUALLY UNLESS THEY
HAVE A DOCUMENTED
CONTRAINDICATION
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How does the vaccine work?
 Within 2 weeks, your body’s defenses
produce antibodies against the
influenza virus.
 Studies show that vaccinated
healthcare workers reduce patient
mortality.
Monday
Tuesday
FLU SHOT
Monday
Wednesday
IMMUNITY
Tuesday
Wednesday
IMMUNITY
Thursday
Friday
Saturday
Sunday
Saturday
Sunday
DEVELOPING
Thursday
Friday
DEVELOPING
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When should I get vaccinated?
 The best time to get
vaccinated is October or
November.
 But even later in the
October
Mon
Tue
Wed
Thur
Fri
Sat
Sun
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Fri
Sat
Sun
1
2
3
season, the vaccine still
provides protection.
November
Mon
Tue
Wed
Thur
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Reminding our Visitors
 Keeping our patients safe also means reminding
our visitors about signs and symptoms of the flu.
 Signage may be posted at the entrance of all
inpatient units and in Ambulatory waiting rooms.
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Flu Myth #1
 The flu is no worse than a bad cold
FALSE
 Influenza is more severe and dangerous than the
common cold. The flu can lead to pneumonia and
death.
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Flu Myth #2
 The flu shot can give you the flu
FALSE
 The vaccine contains inactivated influenza, and cannot
cause the flu.
 It is possible to experience certain uncomfortable side
effects such as soreness at the site of injection, mild fever,
body aches or headache.
 If these side effects do occur, they are mild and short-lived
in comparison with the actual flu, and are NOT
contagious.
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Flu Myth #3
 Only old people & those who are sick need a flu
shot
FALSE
 Everyone 6 months and older should get the flu shot
 This includes healthy adults, children and all persons
working in healthcare.
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Patient Safety….
Every year, 5 to 10 percent of inpatients develop
infections resulting in 98,000 deaths nationally.
98,000 deaths equals:
• More deaths than those caused by breast cancer,
colon cancer and stroke combined
• Equivalent to a 747 plane crash killing all
passengers/crew every other day
• One death every 6 minutes
What can you do to prevent this?
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Tdap Vaccine
 CDC recommends that all healthcare personnel receive
the Tdap vaccine
 This is a one time vaccine booster that helps prevents
Pertussis (Whooping cough), in addition to tetanus and
diphtheria
 Pertussis is on the rise in the United States
 Infants and immunocompromised patients are particularly
susceptible to Pertussis
 All staff are required to get the Tdap vaccine unless they
have a documented contraindication
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Patient Safety….
Clean hands reduce infections and save lives!!!
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Healthcare workers should perform hand hygiene:
• before and after direct contact with patients
• before and after removing gloves
• before handling an invasive device for patient care
• after contact with blood, body fluids or excretions,
mucous membranes, or wound dressings
• after contact with contaminated items, such as medical
equipment, medical waste, soiled linen
• after contact with objects in the immediate vicinity of
the patient, such as bedside trays, bedrails, phone, etc.
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Health care workers should perform hand hygiene:
• after sneezing, coughing, or disposing of tissues
• before and after handling medication
• before and after preparing food
• before and after using the restroom
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Healthcare workers’
hands can also
become contaminated
by contact with the
patient care
environment…
not just the patient!!!
In this study, each X shows where bacteria
were cultured in a room that had been
occupied by a patient with an infection.
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Alcohol Hand Rubs
Alcohol hand rubs
have been shown to:
• Be more effective in reducing
bacteria on hands than soap and
water
• Require less time to use
• Reduce hand irritation and
dryness with repeated use
Rub a sufficient amount of alcohol
foam over entire surface of hands
until completely dry
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Soap and Water Wash
Handwashing with soap
and water is required
when hands are visibly dirty
or visibly soiled with
blood or other body fluids.
Wash with soap and warm
water for at least 15 seconds.
Rinse with warm
water and turn off faucet
with paper towel.
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Hand Hygiene Score Card
How often do healthcare
workers
REALLY clean their hands
between patients?
Many observation studies
show that HCW use
proper hand hygiene only
of the time!
THIS ISN’T GOOD ENOUGH! WE MUST BE 100%!!
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Use ONLY Karmanos-approved hand
soaps, alcohol rubs, and lotions:
Lotions from home are not approved for
use in hospitals because:
1. They can damage the gloves you
wear and cause leaks
2. They easily become contaminated
and actually put more bacteria on
your skin
3. They interfere with the antiseptic
soaps
Karmanos-approved hand lotion
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Artificial nails hide dangerous
germs and increase the risk of
spreading bacteria between
healthcare workers and patients!
This fashion statement
can harm patients!
Karmanos policy regarding
fingernails:
•Artificial nails (including gels and
wraps) are not allowed.
• All nails should be nicely trimmed
and should not be more than
¼ inch long
• Nail polish should not be chipped
• Jewels or ornaments should not be
attached to the nails
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Tuberculosis (TB)
Control Plan
What is TB?
TB is a contagious disease caused by the bacteria
named Mycobacterium tuberculosis. TB infects
primarily the lungs. Signs and symptoms of TB
include:
• Fever
• Weight loss
• Night sweats
• Fatigue, weakness
• Prolonged cough (cough > 3 weeks) and/or blood-tinged sputum
TB is spread when infected people cough or sneeze
the bacteria into the air and others inhale the bacteria.
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TB Control Program
Protecting Staff
MI/OSHA requires that all health care facilities have a
TB Control Program to protect staff from exposure to
TB while at work.
KCC’s TB Control Program is on the Policy website in
IC 124.
Designated staff will get a TB skin test or TB
assessment annually as part of the TB Control
Program.
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References
CDC.gov/flu
CDC.gov/vaccines
CDC, Guidelines for Hand Hygiene in
Healthcare Settings, 2002
CDC, Guidelines for Preventing the
Transmission of Mycobacterium tuberculosis
in Healthcare Facilities, 2005.
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