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Infection Control

Airborne Precautions

Prepared by NSW Infection Control Resource Centre, NSW Health [Insert name of presenter] [Insert title]

February 2007

Introduction

This PowerPoint presentation is designed to provide the viewer with current information to assist them apply Infection Control Precautions. The information covered in this presentation includes A definition and overview of Standard Precautions Definition of Additional (Transmission) Based Precautions Airborne Precautions ­ Application - example of poster and pathogens transmitted by this route ­ The room ­ Personal Protective Equipment (PPE) ­ Removing PPE ­ Patient management issues ­ Visitors Additional resources for information Points to remember

This presentation is part of a series and should be used in conjunction with the other components of the module and series.

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Standard Precautions Tier 1

These are the minimum standard of precautions to be applied to all people accessing health care services regardless of their diagnosis or presumed infectious status, there-by reducing the risk of transmission of organisms from both recognised and unrecognised sources. These precautions apply to blood and all body substances (except sweat) acutely or chronically non-intact skin and mucous membranes including eyes

2

Standard Precautions must be considered when

Providing direct patient care Handling blood or body substances Performing invasive procedures including cannulation or catheterisation Risk of splash or splatter to mucous membranes Providing care that can induce coughing Handling and disposal of waste or sharps Handling or preparation of food

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Additional Precautions Tier 2

These precautions are designed for patients known or suspected to be infected with pathogens for which Additional Precautions, in addition to Standard Precautions, are needed to interrupt transmission of those pathogens in health care facilities. Additional Precautions are implemented for pathogens spread by airborne or droplet or contact with people or with contaminated surfaces, or by any combination of these routes.

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Additional Precautions

Apply Additional Precautions on clinical suspicion, pending confirmation with regular review and maintain precautions until ­ evidence of pathogen is no longer present or ­ effective treatment has been implemented and continued for a specified time or ­ effective treatment time has elapsed

Additional Precautions may be combined to target multiple means of transmission of certain conditions/diseases.

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Additional Precautions - Tier 2 Airborne Precautions

Example of the poster to be placed on door of room where Airborne Precautions apply

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Airborne Precautions

These precautions are implemented when patients are known or suspected to be infected with pathogens that can be transmitted by the airborne route and are designed to reduce the risk of airborne transmission of infectious agents. Airborne transmission occurs by dissemination of either airborne droplet nuclei (small-particle residue [5 µm or smaller in size] of evaporated droplets that may remain suspended in the air for long periods of time) or dust particles containing the infectious agent.

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Airborne Precautions

Examples of pathogens spread by airborne route ­ Measles ­ Avian influenza (combined with droplet and contact transmission ­ refer to

the Pandemic Influenza Precautions Poster and PowerPoint)

­ ­ ­ ­

Norovirus (combined with contact transmission) Pulmonary tuberculosis Chicken pox (combined with contact transmission) Disseminated varicella zoster (combined with contact

transmission)

Mycobacterium tuberculosis

Chicken pox

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Airborne Precautions ­ the room

Patients requiring Airborne Precautions need to be placed into a Single Room with the door closed, access to this room must be restricted for equipment, visitors and non-essential staff. If negative pressure air-conditioning is available then that room should be utilised for a patient requiring Airborne Precautions. If not, a single room with the door closed and a window open. If windows in the room do not open, a fan may be used to direct air away from the door. En suite bathroom facilities should also be available for patient use. If not available then a dedicated bathroom should be made available for the patient to use.

This is an example of a design layout of a single room with anteroom and negative pressure air conditioning

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Airborne Precautions ­ hand hygiene

Hand hygiene facilities include ­ A dedicated handwashing sink with liquid soap or antimicrobial soap solution, disposable paper hand towel and general waste bin ­ Water free alcohol based skin cleanser Perform hand hygiene immediately before or on entry into the room

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Airborne Precautions ­ Personal Protective Equipment (PPE)

PPE should be placed in the anteroom or immediately outside the room on a trolley for staff to utilise. PPE must include ­ P2 or N95 face mask (fit check each time) ­ Protective eye wear ­ Single use disposable gloves

*

If Contact Precautions are combined then an impervious gown is added to PPE and is donned first before the face mask (refer to donning and removal of PPE)

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Airborne Precautions ­ HCW' when HCW's are leaving the patients room

Remove gloves (if used) Perform hand hygiene by either, washing hands or by using water free alcohol skin cleanser. Remove face shield or protective eye wear

OR

If Contact Precautions are combined then an impervious gown is removed before the face mask (refer to donning and removal of PPE)

Dispose of removed PPE into general waste bin and leave the patients room or anteroom. Remove the mask taking care not to touch the mask but to remove and hold the mask by the head straps. Dispose of the mask into the general waste bin Perform hand hygiene by either, washing hands or by using water free skin cleanser.

OR

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Airborne Precautions ­ the patient

Fluid resistant surgical mask to be placed onto the patient if they need to leave the room for tests or treatment. If oxygen therapy is required then it should be administered by using nasal prongs placed under a surgical mask for transport (if medical condition allows). Advise transport staff of level of precautions to be maintained and ensure they have appropriate PPE available. Educate patient on respiratory hygiene for coughing and sneezing patients suspected of having an infectious respiratory illness. Notify area receiving patient of the precautions to be implemented. Patient notes and Medical Records must not be taken into the patients room.

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Airborne Precautions - visitors

Visitors must ­ see nursing staff before entering a Restricted Access room with Airborne Precautions in place ­ wear P2 or N95 masks when entering the patients room ­ remove the mask on exiting the room and discard into general waste bin ­ perform hand hygiene on entry and exit from the room

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Where do I go for more information?

Check local Infection Control Policy Manual Check with facility or Area Infection Control Nurse NSW Health Website http://www.health.nsw.gov.au/quality/hai/

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Points to remember

Yes No

Standard Precautions apply to all patients Additional Precautions apply to specific diseases/conditions not effectively controlled by Standard Precautions Additional Precautions include airborne, droplet and contact precautions OR a combination of these. Always refer to the Additional Precautions posters before entering a room where Additional Precautions are in place and follow the instructions. With Airborne Precautions the door of the room is to remain closed at all times. P2 or N95 face masks to be worn by all HCW and visitors when entering the room. Educate patients on respiratory hygiene for coughing and sneezing.

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Information

Microsoft PowerPoint - tool_airborne.ppt

17 pages

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