Basic Infection Control And Prevention Plan For Outpatient Oncology Settings

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Performing Hand HygieneUsing Alcohol-based Hand Rub

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(containing 60-95% alcohol)

Dispense the recommended volume of product

Apply product to the palm of one hand

Rub hands together, covering all surfaces of hands and fingers until they are dry (no rinsing is required)

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Handwashing with Soap and Water

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Wet hands first with water (avoid using hot water)

Apply soap to hands

Rub hands vigorously for at least 15 seconds, covering all surfaces of hands and fingers

Rinse hands with water and dry thoroughly with paper towel

Use paper towel to turn off water faucet

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Indications for Hand Hygiene

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Before touching a patient, even if gloves will be worn

Before exiting the patient’s care area after touching the patient or the patient’s immediate environment

After contact with blood, body fluids or excretions, or wound dressings

Prior to performing an aseptic task (e.g., accessing a port, preparing an injection)

If hands will be moving from a contaminated-body site to a clean-body site during patient care

After glove removal

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Personal Protective Equipment (PPE)

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use involves specialized clothing or equipment worn by facility staff for protection against infectious materials. The selection of PPE is based on the nature of the patient interaction and potential for exposure to blood, body fluids or infectious agents.

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Gloves : Wear gloves when there is potential contact with blood, body fluids, mucous membranes, nonintact skin or contaminated equipment.

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Wear gloves that fit appropriately (select gloves according to hand size)

Do not wear the same pair of gloves for the care of more than one patient

Do not wash gloves for the purpose of reuse

Perform hand hygiene before and immediately after removing glove

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Gowns: Wear a gown to protect skin and clothing during procedures or activities where contact with blood or body fluids is anticipated.

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Do not wear the same gown for the care of more than one patient

Remove gown and perform hand hygiene before leaving the patient’s environment (e.g., exam room)

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Facemasks (Procedure or Surgical Masks)

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When there is potential contact with respiratory secretions and sprays of blood or body fluids (as defined in Standard Precautions and/or Droplet Precautions)

May be used in combination with goggles or face shield to protect the mouth, nose and eyes

When placing a catheter or injecting material into the spinal canal or subdural space (to protect patients from exposure to infectious agents carried in the mouth or nose of healthcare personnel)

Wear a facemask to perform intrathecal chemotherapy

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Goggles: Face ShieldsWear eye protection for potential splash or spray of blood, respiratory secretions, or other body fluids.

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Personal eyeglasses and contact lenses are not considered adequate eye protection

May use goggles with facemasks, or face shield alone, to protect the mouth, nose and eyes

Respirators

If available, wear N95-or higher respirators for potential exposure to infectious agents transmitted via the airborne route (e.g., tuberculosis).

All healthcare personnel that use N95-or higher respirator are fit tested at least annually and according to OSHA requirements

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Recommendations for Donning PPE

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Always perform hand hygiene before donning PPE

If wearing a gown, don the gown first and fasten in back accordingly

If wearing a facemask or respirator:Secure ties or elastic band at the back of the head and/or neckFit flexible band to nose bridgeFit snug to face and below chin

If wearing goggles or face shield, put it on face and adjust to fit

If wearing gloves in combination with other PPE, don gloves last

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Recommendations for Removing PPE

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Recommendations for Removing PPE

Remove PPE before leaving the exam room or patient environment (except respirators which should be removed after exiting the room)

Removal of gloves:Grasp outside of glove with opposite gloved hand; peel offHold removed glove in glove handSlide ungloved fingers under the remaining glove at the wrist; peel off and discard

Removal of gowns:Remove in such a way to prevent contamination of clothing or skinTurn contaminated outside surface toward the insideRoll or fold into a bundle and discard

Removal of facemask or respiratorAvoid touching the front of the mask or respiratorGrasp the bottom and the ties/elastic to remove and discard

Removal of goggles or face shieldAvoid touching the front of the goggles or face shieldRemove by handling the head band or ear pieces and discard

Always perform hand hygiene immediately after removing PPE

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Respiratory Hygiene and Cough Etiquette:

To prevent the transmission of respiratory infections in the facility, the following infection prevention measures are implemented for all potentially infected persons at the point of entry and continuing throughout the duration of the visit.

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Identifying Persons with Potential Respiratory Infection

Facility staff remain alert for any persons arriving with symptoms of a respiratory infection

Signs are posted at the reception area instructing patients and accompanying persons to:Self-report symptoms of a respiratory infection during registrationPractice respiratory hygiene and cough etiquette (technique described below) and wear facemask as needed

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Availability of Supplies

The following supplies are provided in the reception area and other common waiting areas:

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Facemasks, tissues, and no-touch waste receptacles for disposing of used tissues

Dispensers of alcohol-based hand rub

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Respiratory Hygiene and Cough EtiquetteAll persons with signs and symptoms of a respiratory infection (including facility staff) are instructed to:

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Cover the mouth and nose with a tissue when coughing or sneezing;

Dispose of the used tissue in the nearest waste receptacle

Perform hand hygiene after contact with respiratory secretions and contaminated objects/materials

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Masking and Separation of Persons with Respiratory SymptomsIf patient calls ahead:

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Have patients with symptoms of a respiratory infection come at a time when the facility is less crowded or through a separate entrance, if available

If the purpose of the visit is non-urgent, patients are encouraged to reschedule the appointment until symptoms have resolved

Upon entry to the facility, patients are to be instructed to don a facemask (e.g., procedure or surgical mask)

Alert registration staff ahead of time to place the patient in an exam room with a closed door upon arrival

If identified after arrival:

Provide facemasks to all persons (including persons accompanying patients) who are coughing and have symptoms of a respiratory infection

Place the coughing patient in an exam room with a closed door as soon as possible (if suspicious for airborne transmission, refer to Airborne Precautions in Section V.D.); if an exam room is not available, the patient should sit as far from other patients as possible in the waiting room

Accompanying persons who have symptoms of a respiratory infection should not enter patient-care areas and are encouraged to wait outside the facility

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Healthcare Personnel Responsibilities

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Healthcare personnel observe Droplet Precautions (refer to Section V.C.), in addition to Standard Precautions, when examining and caring for patients with signs and symptoms of a respiratory infection (if suspicious for an infectious agent spread by airborne route, refer to Airborne Precautions in Section V.D.)

These precautions are maintained until it is determined that the cause of the symptoms is not an infectious agent that requires Droplet or Airborne Precautions

All healthcare personnel are aware of facility sick leave policies, including staff who are not directly employed by the facility but provide essential daily services

Healthcare personnel with a respiratory infection avoid direct patient contact; if this is not possible, then a facemask should be worn while providing patient care and frequent hand hygiene should be reinforced

Healthcare personnel are up-to-date with all recommended vaccinations, including annual influenza vaccine

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Staff Communication

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Designated personnel regularly review information on local respiratory virus activity provided by the health department and CDC

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During Periods of Increased Community Respiratory Virus Activity (e.g., Influenza Season)In addition to the aforementioned infection prevention measures, the following enhanced screening measures are implemented

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When scheduling and/or confirming appointments:

Pre-screen all patients and schedule those with respiratory symptoms to come when the facility might be less crowded, if possible

Instruct patients with respiratory symptoms to don a facemask upon entry to the facility

If the purpose of the visit is non-urgent, patients with symptoms of respiratory infection are encouraged to schedule an appointment after symptoms have resolved

Encourage family members, caregivers, and visitors with symptoms of respiratory infection to not accompany patients during their visits to the facility

If possible, prepare in advance for the registration staff a daily list of patients with respiratory symptoms who are scheduled for a visit

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What does MSDS stand for?

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material safety data sheet

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what does the state regulatory agencies protect?

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client's health , safety, and welfare

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what will hospital grade and tuberculocidal disinfectants kill?

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bacteria, viruses, and fungi

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the study of microbes is called

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microbiology

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what are pus - forming bacteria that grow in clusters similar to grapes called?

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staphylococci

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tetanus, typhoid fever, tuberculosis, and diphtheria are caused by:

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bacilli

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spirilla bacteria include ?

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treponema papillida

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_________can cause food poisoning and toxic shock syndrome.

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staphylococci

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communicable or _______ diseases can be spread from one person to another.

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contagious

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formalin is a(n):

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insane material that was once routinely used by salons to fumigate implements in a dry cabinet sanitizer

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what do you risk when you mix chemicals in higher concentrations than recommended by the manufacturer?

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solution may be less effective

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OSHA guidelines address issues relating to handling, mixing, storing, and disposing of product; general safety; and your right to know the ______ in the product you use in the workplace.

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hazardous ingredients

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what do non - pathogenic bacteria do?

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break down food, protect against infection, and stimulate the immune system

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the two categories of bacteria are:

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pathogenic and non - pathogenic

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which answer best describes disinfection?

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using a chemical that kills all microorganisms on hard, non - porous surfaces

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what are dirt, oils, and microbes?

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contaminants

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what should you wear when disinfecting implements?

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goggles and gloves

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cocci are transmitted:

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in the air, in dust, or within the substance in which they settle

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universal precautions are standard infection-control practices that entail:

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assuming all tissue (even dead skin) is hazardous

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a general infection is:

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the result of a pathogen that is carried by the bloodstream to different parts of the body

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an aseptic procedures involves properly handling disinfected equipment:

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to prevent contamination before they are used on a client

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breaks in the skin, mouth, nose , eyes, or ears and unprotected sex are what?

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ways for pathogens to enter the body

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a 4th - degree burn involves injury to:

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muscles, ligaments, tendons, nerves, blood vessels, and bones

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microorganisms

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are microscopic plants or animals . also known as microbes.

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nonpathogenic

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completely harmless; do not cause disease

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pathogenic

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are considered harmful because they may cause disease or infection when they invade the body.

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cocci

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are round-shaped bacteria that appear either alone.

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staphylococci

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pus forming bacteria that grow in clusters like a bunch of grapes. they cause abscesses, pustules, and boils

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bacilii

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are short rod shaped bacteria . they are the most common bacteria and produce diseases such as lockjaw, typhoid fever, tuberculosis, and diphtheria.

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streptococci

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pus foaming bacteria arranged in curved lines resembling a string of beads. they cause infractions such as strep throat and blood poisoning

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diplococci

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spherical bacteria that grow in pairs and cause diseases such as pneumonia

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spirilla

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are spiral or corkscrew shaped bacteria. they are subdivided into subgroups such as treponema pallid, which causes syphilis, a std, or borrelia burgdorferi, which causes lyme disease.

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infection

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the presence of pus is one sign of bacterial infection

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local infection

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such as a pimple or abscess. a lesion containing pus.

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general infection

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the bloodstream carries the bacteria or virus and their poisons to all parts of the body. AIDS is an example.

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contagious or communicable

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a disease spreads from one person to another by contact. common cold, ringworm, pinkeye, and viral infections.

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virus

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microorganism that can invade plants and animals, including bacteria

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parasites

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organism that lives nor on another organism and draws its nourishment from that organism

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scabies

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contagious skin disease caused by an itch mite burrowing under the skin.

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fungi

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vegetable (plant) parasites, including molds, mildews, and yeasts.

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sanitation (lowest level)

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reduces the number of pathogens or disease-producing organisms found on a surface.

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disinfection (2nd highest level)

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nearly as effective as sterilization but does not kill bacterial spores; used on hard, nonporous surfaces.

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sterilization ( highest level)

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completely kills every organism on a nonporous surface