Infection Control and OSHA

• Infection Control includes any efforts designed to prevent infection from occurring in both patients and HCP (health care providers). It is a comprehensive proactive approach to managing the risks associated with all infectious and communicable diseases
• OSHA: The Occupational Safety and Health Administration, an agency of the US government under the Department of Labor with the responsibility of ensuring safety at work and a healthful work environment. OSHA’s mission is to prevent work-related injuries, illnesses and deaths.

Infection Control: Standard Precautions

• What are standard precautions?
• A recommendation that blood and body fluid precautions be used consistently for all patients, regardless of their blood-borne infection status, is the basic tenet of standard precautions.
• Blood-borne pathogens, such as the human immunodeficiency virus (HIV) and hepatitis B virus (HBV), infect people of all ages, of all socioeconomic classes, and from all geographic areas. The application of “standard precautions” assumes all patients are infectious.

Infection Control: Personal Protective Equipment (PPE)

• Reducing exposure to and transmission of blood-borne pathogens through the use of standard precautions involves appropriate work practices, such as the use of barrier precautions.
• Appropriate barrier precautions are to be used to prevent skin and mucous membrane exposure in contact with blood or any other body fluid of any patient. Healthcare workers should wear the Personal Protective Equipment (PPE) that is most appropriate to the anticipated potential exposure.
• Barrier precautions, also known as Personal Protective Equipment (PPE), include the use of the following:
• Gloves
• Face Shields or Masks and Goggles
• Gowns or Aprons

Infection Control: Precautions – Needles

• Precautions should be taken in the following situations:
  • When cleaning used instruments, during disposal of used needles, and when handling sharp instruments after procedures.
• Needles should not be recapped, purposely bent, or broken by hand; removed from disposable syringes; or otherwise manipulated by hand.
• After use, disposable syringes and needles, scalpel blades, and other sharp items must be placed in puncture-resistant containers located as close as practical to the use area.

Infection Control: Precautions – Sharps Containers, Resuscitation, Skin Defects

• Sharps containers should not be mounted too high, but should be easily accessible. They also should not be allowed to overfill.
• To minimize the need for emergency mouth-to-mouth resuscitation, mouthpieces, pocket masks, resuscitation bags, or other ventilation devices should be available for use in areas where the need for resuscitation is predictable.
• Healthcare workers with exudative lesions or weeping dermatitis should refrain from direct patient care and from handling patient equipment until the condition resolves. All skin defects (cuts, abrasions, ulcers, etc.) must be covered with an occlusive bandage

Infection Control: Importance of Hand washing:

• Why is handwashing so important?
• The most common method of transferring pathogen from patient to patient or staff to patient is by the hands.
• Hands should be washed when entering or leaving patient care areas, before gloving and immediately after removal of gloves or other personal protective equipment, in between patient contacts, and after touching an environmental surface such as the dialysis machine without having gloved first.
• Dialysis facilities must identify and dedicate “clean” sinks used for handwashing purposes only. Care must be taken not to use the “clean” sink for draining fluids or for placing items that have been used in the course of the patient treatment
• The CDC has issued guidelines on the use of alcohol-based hand rubs as an alternative to using traditional soap and water when providing patient care: before patient contact; after contact with a patient’s intact skin, body fluids or excretions, nonintact skin, or wound dressings; and after removing gloves.
• The traditional method of handwashing with soap and water is indicated when hands are visibly dirty, contaminated, or soiled.

Handwashing:

• When handwashing with soap and water, the hands should be rubbed together for at least 15 seconds followed by a rinse.
• When decontaminating with an alcohol-based hand rub, the product should be applied to the palm of the hand and the hands rubbed together until dry.

Fingernails:

• The length of fingernails should be considered because studies have documented that long fingernails (>¼ inch) may harbor high concentrations of bacteria.
• Artificial fingernails also contribute to the spread of certain gram-negative pathogens and should not be worn when providing care to patients who have compromised immune systems. This is extremely important to keep in mind when caring for those with a high risk of developing infections.

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