Preverl|or ol lrlecl|or

Crapler 8
Crapler 8: lrlecl|or Preverl|or 1
Learn|ng 0bject|ves
escr|oe lre oas|c corcepls ol |rlecl|or preverl|or
L|sl |ey corporerls ol ur|versa| Precaul|ors
|scuss lre |rporlarce ol, ard sleps lor, rardWasr|rg
|scuss lre lypes ol persora| prolecl|ve equ|prerl
|scuss roW lo sale|y rard|e rypoderr|c reed|es ard syr|rges
escr|oe lre lrree sleps |rvo|ved |r proper process|rg ol
|rslrurerls, g|oves ard olrer |lers
|scuss roW lo sale|y d|spose ol |rlecl|ous Wasle raler|a|s
escr|oe corcepls ol posl-exposure propry|ax|s (PEP)
Crapler 8: lrlecl|or Preverl|or 2
":est|on
Crapler 8: lrlecl|or Preverl|or 3
'wral |s lre rosl corror or
lrequerl r|s| rea|lr care
Wor|ers ercourler Wr||e car|rg
lor pal|erls?
nswer
Crapler 8: lrlecl|or Preverl|or 1
|recl corlacl W|lr o|ood
ard olrer oody l|u|ds.
as|c 6oncepts of |nfect|on Prevent|on
easures lo preverl |rlecl|or |r ra|e c|rcurc|s|or
prograrres rave lWo pr|rary oojecl|ves:
Preverl |rlecl|ors |r peop|e rav|rg surgery
|r|r|ze lre r|s| ol lrarsr|ll|rg llv ard olrer |rlecl|ors lo
c||erls ard c||r|ca| slall, |rc|ud|rg rea|lr care c|ear|rg ard
rouse|eep|rg slall
Crapler 8: lrlecl|or Preverl|or 5
Pat|ent 6are
|nstr:2ent
Process|ng
Crapler 8: lrlecl|or Preverl|or Crapler 8: lrlecl|or Preverl|or
$:rg|ca|
Proced:res
6|ean|ng after
Proced:res
Crapler 8: lrlecl|or Preverl|or Z Crapler 8: lrlecl|or Preverl|or
aste 0|sposa|
Process|ng
Pat|ent
6are |te2s
Crapler 8: lrlecl|or Preverl|or 8 Crapler 8: lrlecl|or Preverl|or
ow R|sky |s ork|ng |n ny
ea|th 6are $ett|ng?
Crapler 8: lrlecl|or Preverl|or 9
|V R|sk
wral |s lre r|s| ol acqu|r|rg llv aller oe|rg sluc| W|lr a
reed|e lror ar llv-pos|l|ve pal|erl?
0.01
Crapler 8: lrlecl|or Preverl|or 10
$4:7.0: 0eroerd|rg 1990
epat|t|s V|r:s R|sk
wral |s lre r|s| ol acqu|r|rg l8v aller oe|rg sluc| W|lr a
reed|e lror ar l8v-pos|l|ve pal|erl?
2Z-3Z
Crapler 8: lrlecl|or Preverl|or 11
$4:7.0: 3eell el a|. 19Z8.
epat|t|s V|r:s R|sk (cont.}
s ||ll|e as 10-8 r| (. r|) ol l8v-pos|l|ve o|ood
car lrarsr|l l8v lo a suscepl|o|e rosl.
Ever |r lre u3, approx|rale|y 10,000 rea|lr care
prov|ders acqu|re repal|l|s.
Crapler 8: lrlecl|or Preverl|or 12
$4:7.0: 8ord el a|. 1982.
epat|t|s 6 V|r:s R|sk
wral |s lre r|s| ol acqu|r|rg lCv aller oe|rg sluc| W|lr a
reed|e lror ar lCv-pos|l|ve pal|erl?
3-10
Crapler 8: lrlecl|or Preverl|or 13
$4:7.0: Larprear 1991.
ays |nfect|on |s $pread
%re a|r
Corlacl W|lr o|ood or oody
l|u|ds:
0per wo:nds
Need|e-st|ck |nj:r|es, Wr|cr
occur:
wr||e g|v|rg ar |rjecl|or
wr||e draW|rg o|ood
ur|rg lv |rserl|or/rerova|
wr||e d|spos|rg ol srarps
ur|rg Wasle d|sposa|
wr||e sulur|rg dur|rg surgery
Eal|rg or rard||rg food
conta2|nated oy laeces or
r|croorgar|srs
Corlacl W|lr |nfected an|2a|s
or |nsects
Crapler 8: lrlecl|or Preverl|or 11
0ther Expos:res to $k|n and H:co:s
He2branes
or-|rlacl s||r (lear |r
g|ove):
oraded
Crapped
3p|asres lo rucous
rerorare
lrlacl s||r
Crapler 8: lrlecl|or Preverl|or 15
0bject|ves of |nfect|on Prevent|on |n H6
Progra2s
%o preverl |rlecl|ors Wrer prov|d|rg serv|ces
%o r|r|r|ze lre r|s| ol lrarsr|ll|rg llv lo c||erls ard
rea|lr care slall, |rc|ud|rg c|ear|rg ard rouse|eep|rg
slall
Crapler 8: lrlecl|or Preverl|or 1
&n|versa| Preca:t|ons
lard ryg|ere
Persora| prolecl|ve equ|prerl
vo|d|rg recapp|rg ol reed|es
lard||rg ard process|rg ol |rslrurerls ard olrer |lers
3ale d|sposa| ol srarps ard olrer |rlecl|ous Wasle
raler|a|s
3ale Wor| pracl|ces
Crapler 8: lrlecl|or Preverl|or 1Z
and yg|ene
'lardWasr|rg |s lre s|rg|e rosl |rporlarl
procedure lo ||r|l lre spread ol |rlecl|or.
Crapler 8: lrlecl|or Preverl|or 18
Vote: True....FaIse....
and yg|ene (cont.}
lardWasr|rg
lard arl|seps|s
rl|sepl|c rardruo
3urg|ca| scruo
Crapler 8: lrlecl|or Preverl|or 19
andwash|ng
wrer:
8elore ard aller pal|erl care
8elore ard aller us|rg g|oves
8elWeer pal|erl corlacl
wrer v|s|o|y so||ed
Prolecl rards lror dryress W|lr pelro|eur-lree crears
o arl|l|c|a| ra||s, Wraps, elc.
C|ear ra|| po||sr o|ay
Crapler 8: lrlecl|or Preverl|or 20
andwash|ng $teps
1. %rorougr|y Wel rards.
2. pp|y p|a|r soap or delergerl.
3. Ruo a|| areas ol rards ard l|rgers lor 10-15 secords.
1. R|rse rards lrorougr|y W|lr c|ear rurr|rg Waler lror a lap or
ouc|el.
5. ry rards W|lr c|ear, dry loWe|, |l ava||ao|e. ll rol ava||ao|e, a|r dry
rards (use a paper loWe| Wrer lurr|rg oll Waler lo avo|d re-
corlar|ral|rg rards).
Crapler 8: lrlecl|or Preverl|or 21
andwash|ng (cont.}
ll oar soap |s used, prov|de sra|| oars ard soap rac|s lral
dra|r.
vo|d d|pp|rg rards |rlo oas|rs corla|r|rg slard|rg Waler.
o rol add soap lo a parl|a||y erply ||qu|d soap d|sperser.
wrer ro rurr|rg Waler |s ava||ao|e, use a ouc|el W|lr a
lap lral car oe lurred oll Wr||e |alrer|rg rards ard lurred
or aga|r lor r|rs|rg; or use a ouc|el ard a p|lcrer.
Crapler 8: lrlecl|or Preverl|or 22
and nt|seps|s
3|r||ar lo p|a|r rardWasr|rg excepl |rvo|ves :se of an
ant|2|crob|a| agent
use oelore perlorrarce ol ary |rvas|ve procedures,
(e.g., p|acererl ol ar |rlravascu|ar calreler)
use Wrer car|rg lor |rrurocorpror|sed pal|erls
(preralure |rlarls or l3 pal|erls)
use Wrer |eav|rg lre roor ol pal|erls W|lr d|seases
spread v|a d|recl corlacl
Crapler 8: lrlecl|or Preverl|or 23
nt|sept|c andr:b
a|e a|coro|/g|ycer|r so|ul|or oy coro|r|rg:
2 r| g|ycer|r
100 r| 0-90 a|coro| so|ul|or
use 3-5 r| ol so|ul|or lor eacr app||cal|or
Ruo lre so|ul|or v|gorous|y |rlo rards url|| dry
Crapler 8: lrlecl|or Preverl|or 21
$:rg|ca| $cr:b
$:pp||es
rl|sepl|c
Rurr|rg Waler
3l|c| lor c|ear|rg lre
l|rgerra||s
3oll orusr or sporge lor
c|ear|rg lre s||r
%oWe|s
Crapler 8: lrlecl|or Preverl|or 25
$:rg|ca| $cr:b (cont.}
|f no ant|sept|c soap |s ava||ab|e:
wasr rards ard arrs W|lr soap/delergerl ard Waler.
C|ear l|rgerra||s lrorougr|y.
3cruo W|lr a soll orusr or sporge ard r|rse.
ry rards lrorougr|y.
pp|y rardruo lo rards ard lorearrs url|| dry.
Repeal rardruo lWo rore l|res.
Crapler 8: lrlecl|or Preverl|or 2
Persona| Protect|ve Eq:|p2ent
0|oves
as|s
EyeWear (gogg|es/ lace
sr|e|ds)
0oWr/apror
C|osed sroes
Crapler 8: lrlecl|or Preverl|or 2Z
Persona| Protect|ve Eq:|p2ent (cont.}
Crapler 8: lrlecl|or Preverl|or
28
0|oves:
ul|||ly g|oves
Exar g|oves
3urg|ca| g|oves
ouo|e g|ov|rg
$4:7.0: 0eroerd|rg 1993.
Persona| Protect|ve Eq:|p2ent (cont.}
Crapler 8: lrlecl|or Preverl|or 29
ogg|es
Face 2asks
prons
Persona| Protect|ve Eq:|p2ent (cont.}
Crapler 8: lrlecl|or Preverl|or 30
6|osed shoes
|22:n|zat|on for d:|ts
lepal|l|s
lepal|l|s 8
lrl|uerza
Preurococcus
Cr|c|er pox
%elarus, d|prlrer|a
eas|es, rurps,
ruoe||a (0errar
reas|es)
Crapler 8: lrlecl|or Preverl|or 31
. of te va..3es beIow souId every eaIt worker
re.eve to prote.t 2erseIf fro2 3fe.to3 fro2 bIood or
body fIuds?
|22:n|zat|on for d:|ts (cont.}
lepal|l|s
lepal|l|s 8
lrl|uerza
Preurococcus
%elarus, d|prlrer|a
Cr|c|er pox
eas|es, rurps,
ruoe||a (0errar
reas|es)
Crapler 8: lrlecl|or Preverl|or 32
$afe and||ng of ypoder2|c Need|es
and $yr|nges
Crapler 8: lrlecl|or Preverl|or 33
eed|es are lre rosl
corror cause ol |rjur|es
lo a|| lypes ol c||r|c Wor|ers
%|2|ng of Need|e-$t|ck |nj:r|es
lea|lr care Wor|ers are rosl oller sluc| oy rypoderr|c
reed|es d:r|ng proced:res.
C|ear|rg slall are rosl oller sluc| oy reed|es when
wash|ng so||ed |nstr:2ents.
louse|eep|rg slall are rosl oller sluc| oy reed|es when
d|spos|ng of |nfect|o:s waste 2ater|a|.
Crapler 8: lrlecl|or Preverl|or 31
%|ps for $afe and||ng of ypoder2|c
Need|es and $yr|nges
&se each need|e and syr|nge on|y once, |l poss|o|e.
o rol d|sassero|e lre reed|e ard syr|rge aller use.
0o not recap, oerd or orea| reed|es oelore d|sposa|.
ecorlar|rale lre reed|e ard syr|rge oelore d|sposa|.
|spose ol lre reed|e ard syr|rge logelrer |r a purclure-
res|slarl corla|rer.
Crapler 8: lrlecl|or Preverl|or 35
0ne-anded Need|e Recap Hethod
P|ace lre reed|e cap or a l|rr,
l|al surlace.
w|lr ore rard ro|d|rg lre
syr|rge, use lre reed|e lo
'scoop up lre cap.
%urr lre syr|rge upr|grl
(verl|ca|).
use lre lorel|rger ard lruro ol
olrer rard lo grasp lre cap ard
pusr l|rr|y doWr orlo lre ruo.
Crapler 8: lrlecl|or Preverl|or 3
and||ng Need|es and $harps
Crapler 8: lrlecl|or Preverl|or 3Z
use a sale zore lor pass|rg srarps
3ay 'pass or 'srarps Wrer pass|rg
srarps
and||ng Need|es and $harps (cont.}
use a reed|e dr|ver or
ro|der, rol your l|rgers.
use o|url reed|es Wrer
ava||ao|e.
o rol o||rd sulure.
Crapler 8: lrlecl|or Preverl|or 38
and||ng Need|es and $harps (cont.}
|Ways rerove o|ades
W|lr arolrer |rslrurerl
Crapler 8: lrlecl|or Preverl|or 39
and||ng Need|es and $harps (cont.}
use a purclure-prool
corla|rer lor slorage
ard/or d|sposa|
o rol recap a reed|e
oelore d|sposa| ur|ess
us|rg lre ore-rard
lecrr|que
Crapler 8: lrlecl|or Preverl|or 10
|nstr:2ent Process|ng
Crapler 8: lrlecl|or Preverl|or 11
3o||ed |rslrurerls ard olrer reusao|e
|lers car lrarsr|l |rlecl|or |l lrey are rol
proper|y reprocessed
|gh-Leve| 0|s|nfect:
o||
$tea2
6he2|ca|
|nstr:2ent
Process|ng
Crapler 8: lrlecl|or Preverl|or 12
$ter|||ze:
6he2|ca|
|gh-press:re stea2
0ry heat
0ry|6oo| and $tore
0econta2|nate
6|ean
0econta2|nat|on of |nstr:2ents
lrred|ale|y aller use, soak
so||ed |nstr:2ents |n a p|ast|c
conta|ner w|th .57 ch|or|ne
so|:t|on for 2|n:tes.
R|nse |nstr:2ents |22ed|ate|y
w|th coo| water lo preverl
corros|or ard lo rerove v|s|o|e
orgar|c raler|a|.
6|ean w|th soap and water ard
r|rse lrorougr|y.
Crapler 8: lrlecl|or Preverl|or 13
Need|es and $yr|nges
Re-use ol reed|es ard
syr|rges |s ro |orger
recorrerded.
%rerelore, l|usr|rg ol reed|es
ard syr|rges |s a|so rol
recorrerded.
used reed|es ard syr|rges |r
srou|d oe d|sposed ol as a
ur|l |r a purclure-prool
corla|rer.
|spose ol corla|rer Wrer |l
|s lrree-quarlers lu||.
Crapler 8: lrlecl|or Preverl|or 11
6|ean|ng
C|ear|rg srou|d oe dore after deconta2|nat|on |r order
lo:
Rerove v|s|o|e so|| ard deor|s, |rc|ud|rg o|ood or oody l|u|ds
Reduce lre ruroer ol r|croorgar|srs or so||ed |rslrurerls ard
equ|prerl
Ersure lral sler|||zal|or or r|gr-|eve| d|s|rlecl|or procedures are
ellecl|ve
K||| erdospores lral cause lelarus ard gargrere
Crapler 8: lrlecl|or Preverl|or 15
$ter|||zat|on
eslroys a|| r|croorgar|srs
used lor:
lrslrurerls
3urg|ca| g|oves
0lrer |lers lral d|recl|y core |r corlacl W|lr o|ood or olrer
sler||e l|ssues
Crapler 8: lrlecl|or Preverl|or 1
$ter|||zat|on (cont.}
elrods |rc|ude:
leal sler|||zal|or: r|gr-pressure slear (auloc|ave) or dry real
(over)
Crer|ca| sler||arl: e.g., g|ulara|deryde or lorra|deryde
Prys|ca| agerl: e.g., rad|al|or
Crapler 8: lrlecl|or Preverl|or 1Z
|gh-Leve| 0|s|nfect|on
l|gr-|eve| d|s|rlecl|or |s a process lral destroys a||
2|croorgan|s2s except so2e bacter|a| endospores
l|gr-|eve| d|s|rlecl|or |s lre on|y acceptab|e a|ternat|ve
to ster|||zat|on
Car oe acr|eved oy:
bo|||ng |r Waler,
slear|rg, or
soa||rg |r crer|ca| d|s|rleclarls.
Crapler 8: lrlecl|or Preverl|or 18
Re2e2ber.
Crapler 8: lrlecl|or Preverl|or 19
'3ler|||zed |lers W||| rol
rera|r sler||e ur|ess
proper|y
slored.
$torage of $ter|||zed |te2s
Keep lre slorage area c|ear, dry ard lree ol dusl ard ||rl.
Keep lre lerperalure ol lre area al approx|rale|y 21C,
ard lre re|al|ve rur|d|ly |ess lrar Z0, |l poss|o|e.
3lore sler||e pac|s ard corla|rers:
20-25 cr (8-10 |rcres) oll lre l|oor,
15-50 cr (18-20 |rcres) lror lre ce|||rg, ard
15-20 cr (-8 |rcres) lror ar ouls|de Wa||.
Crapler 8: lrlecl|or Preverl|or 50
$torage of $ter|||zed |te2s (cont.}
o rol use cardooard ooxes lor slorage; lrey sred dusl
ard deor|s, ard ray raroor |rsecls.
ale ard rolale lre supp||es. use a f|rst |n, f|rst o:t"
(FlF0) gu|de||re lor us|rg supp||es.
Crapler 8: lrlecl|or Preverl|or 51
L|nen Process|ng
wasr |r rol, soapy Waler
ard dry
3are |r rosp|la| or rore
Crapler 8: lrlecl|or Preverl|or 52
$afe 0|sposa| of |nfect|o:s aste
Hater|a|s
Prolecl peop|e Wro
rard|e Wasle |lers lror
acc|derla| |rjury
Preverl lre spread ol
|rlecl|or lo rea|lr care
Wor|ers ard lo lre |oca|
corrur|ly
Crapler 8: lrlecl|or Preverl|or 53
0|sposa| of 6||n|ca| aste
P|ace corlar|raled |lers
|r |ea|-prool corla|rer or
p|asl|c oag
|spose oy |rc|reral|or or
our|a|
Crapler 8: lrlecl|or Preverl|or 51
$teps for 0|sposa| of $harps
1. o rol recap lre reed|e or
d|sassero|e lre reed|e ard
syr|rge.
2. ecorlar|rale lre rypoderr|c
reed|e ard syr|rge.
3. P|ace lre reed|e ard syr|rge |r a
purclure-res|slarl srarps
corla|rer.
1. wrer lre corla|rer |s lrree-
quarlers lu||, d|spose ol |l.
Crapler 8: lrlecl|or Preverl|or 55
$teps for 0|sposa| of $harps 6onta|ner
wear reavy-duly ul|||ly g|oves.
wrer lre srarps corla|rer |s lrree-quarlers lu||, cap, p|ug or
lape lre oper|rg ol lre corla|rer l|grl|y c|osed. 8e sure lral ro
srarp |lers are sl|c||rg oul ol lre corla|rer.
|spose ol lre srarps corla|rer oy ourr|rg, ercapsu|al|rg or
oury|rg |l (see oe|oW).
Rerove ul|||ly g|oves.
wasr rards ard dry lrer W|lr a c|ear c|olr or loWe| or a|r dry.
Crapler 8: lrlecl|or Preverl|or 5
0|sposa| of aste 6onta|ners #
:rn|ng:
eslroys lre Wasle
K|||s r|croorgar|srs
8esl relrod lor d|sposa| ol corlar|raled Wasle
%r|s relrod reduces lre ou|| vo|ure ol Wasle, ard
Ersures lral lre |lers are rol scaverged ard reused
Crapler 8: lrlecl|or Preverl|or 5Z
0|sposa| of aste 6onta|ners #2
Encaps:|at|on:
Eas|esl Way lo d|spose ol srarps corla|rers
wrer srarps corla|rer |s lrree-quarlers lu||, |l |s rade
corp|ele|y lu|| oy pour|rg:
Cererl (rorlar),
P|asl|c loar, or
C|ay
ller raler|a| ras rardered, lre corla|rer |s d|sposed |r a
|ardl|||, slored or our|ed
Crapler 8: lrlecl|or Preverl|or 58
:ry|ng aste
Reslr|cl access lo lre d|sposa| s|le. 8u||d a lerce lo |eep ar|ra|s ard
cr||drer aWay.
L|re lre our|a| s|le W|lr a raler|a| ol |oW perreao|||ly (e.g., c|ay), |l
ava||ao|e.
3e|ecl a s|le al |easl 50 relers (11 leel) aWay lror ary Waler source lo
preverl corlar|ral|or ol lre Waler lao|e.
Ersure lral lre s|le:
las proper dra|rage,
ls |ocaled doWrr||| lror ary We||s,
ls lree ol slard|rg Waler, ard
ls rol |r ar area lral l|oods.
Crapler 8: lrlecl|or Preverl|or 59
Post-Expos:re Hanage2ent
|f expos:re occ:rs to the:
3||r
wasr W|lr soapy Waler
o rol use causl|c agerl or o|eacr
Eye, rose, roulr
R|rse W|lr Waler lor 10 r|rules
eed|e-sl|c| or cul:
wasr W|lr soapy Waler
||oW lo o|eed lree|y
pp|y l|rsl a|d
Crapler 8: lrlecl|or Preverl|or 0
Post-Expos:re Hanage2ent (cont.}
Posl-exposure propry|ax|s (PEP) cors|deral|ors:
Eva|uale r|s|:
3ource ol l|u|d or raler|a|
%ype ol exposure
Eva|ual|or ol exposure source pal|erl:
llv slalus
3lage ol |rlecl|or
%esl rea|lr care Wor|er lor llv aller exposure as oase||re, |l
ava||ao|e
Crapler 8: lrlecl|or Preverl|or 1
Post-Expos:re Prophy|ax|s
%realrerl, |l slarled, srou|d oe |r|l|aled |rred|ale|y aller
exposure, W|lr|r 1-2 rours.
ec|s|ors regard|rg Wr|cr ard roW rary arl|relrov|ra| agerls
lo use are |arge|y erp|r|c.
CC recorrerdal|ors:
Z|dovud|re (Zv) ard |ar|vud|re (3%C)
Lar|vud|re (3%C) ard slavud|re (d1%)
|daros|re (ddl) ard slavud|re (d1%)
Corl|rue lrealrerl lor 1 Wee|s.
o red|ca| lo||oW-up.
Crapler 8: lrlecl|or Preverl|or 2
$4:7.0: CC wR 2001.
Hak|ng the orkp|ace $afer
Corl|rue |derl|ly|rg r|s|.
Corl|rue lo use 3lardard
Precaul|ors.
%eacr pal|erls |l |s o|ay lo
rer|rd rea|lr care Wor|ers lo
Wasr rards ard use g|oves.
cl|ve|y ro|e rode| ard
supporl lP pracl|ces.
Crapler 8: lrlecl|or Preverl|or 3
$:pport|ng a $afer orkp|ace
Crapler 8: lrlecl|or Preverl|or 1
3upporl lror rosp|la|
adr|r|slralor
Pos|l|ve leedoac| lror
superv|sor
$:22ary
|r|r|ze ard preverl exposure lo |rlecl|or oy:
us|rg $tandard Preca:t|ons W|lr every pal|erl
0|spos|ng of c||n|c waste proper|y
us|rg post-expos:re care Wrer recessary
wor| logelrer lo ra|e lre Wor|p|ace saler.
%eacr pal|erls ard lre|r lar|||es roW lo reduce r|s| ol
exposure |r lre rore.
Crapler 8: lrlecl|or Preverl|or 5
Crapler 8: lrlecl|or Preverl|or
Photo credit. Dipo Otolorin