Toronto Public Health Presentation - Acupuncture

Infection Prevention and Control (IPAC) Best Practices for Traditional Chinese Medicine (TCM) Practitioners Presentation to the Chinese Medicine and Acupuncture Association of Canada Members and the Traditional Chinese Medicine Community Cecilia Alterman Health Promotion Consultant June 26, 2010

IPAC Best Practices for TCM Practitioners
Agenda
MOHLTC PSS Best Practices Document, Jan 2009
Routine Practices
Bloodborne Diseases
General IPAC Guidelines
Cleaning, Disinfection and Sterilization
Sharps
Blood and Body Fluid Exposure Response

Ministry of Health and Long Term Care
Infection Prevention and Control Best Practices for Personal Services Setting
January 2009
http://www.health.gov.on.ca/english/providers/program/pubhealth/oph_standards/ophs/progstds/pdfs/pssp_2008.pdf

Purpose of PSS Program:
To reduce the risk of transmission of bloodborne and other types of infection for both clients and personal service workers (PSW) during the delivery of personal services.
Blood and body fluids do not have to be visible on an instrument/equipment for an infection to be transmitted.

Routine Practices
Based on the assumption that all blood, body fluids (except sweat and tears), secretions, excretions, non-intact skin, undiagnosed rashes and areas such as the eyes, nose and mouth may be potentially infectious, even if a person shows no symptoms of illness.

Routine Practices includes:
Performing hand hygiene between clients and when hands become contaminated
Alcohol hand sanitizers (70% isopropyl alcohol) are acceptable when hands are not visibly soiled
Hand lotion (not petroleum based) is recommended
New disposable gloves are used for every client
Hand hygiene to be performed before and after glove use
Finger cots are not acceptable

Routine Practices includes:
The use of additional personal protective equipment if there is a possibility of splashing in the eyes, nose, mouth or on clothing
Proper cleaning, disinfection and sterilization of items and equipment
Proper handling and disposal of sharps

Bloodborne Diseases (BBD)
Transmitted through blood and body fluids
Hepatitis B, hepatitis C and HIV
Many who are infected with a BBD show no symptoms but are still infectious
Always assume a client is potentially infectious with a BBD, even if they tell you they are not.

General IPAC Guidelines
The Worker:
Hand hygiene
Stay home if sick
No eating, drinking, smoking while working
Proper immunizations (hepatitis B)
The Client:
Free from cuts, wounds, rash
Stay home if sick

General Work Area:
Well lit, clean and in good repair
Smooth non-absorbent work areas
At least one hand sink for handwashing, one metre away from clean/disinfected/sterile items
Linens, towels, etc. laundered between clients

Cleaning, Disinfection and Sterilization

Classification of Equipment and Instruments
The rationale for disinfecting or sterilizing equipment and instruments is based on the intended use of the item
Equipment and instruments are divided into three general categories:
Critical
Semi-Critical
Non-Critical

Table A: Classification for Methods of Disinfection/Sterilization Source: MOHLTC, BPPSS, Jan 2009: 18

Critical Items
All critical items must be sterile
Sterilization kills all forms of life, including hepatitis B, hepatitis C and HIV
Includes needles (sterile, pre-packaged, single-use), and any instrument used to manipulate a sterile item

Semi-Critical Items
High Level Disinfection (HLD) = Kills all forms of life except bacterial spores (e.g. pathogen that causes tetanus).
Use on semi-critical items with visible contamination of blood and body fluids.
OR
Intermediate Level Disinfection (ILD) = Kills most bacteria, viruses, fungi and mycobacteria.
Use on semi-critical items with no visible contamination of blood and body fluids.

Non-Critical Items
Low Level Disinfection (LLD) = Kills some viruses, fungi and bacteria

Examples
Cupping:
Used on intact skin is considered a ?? item and must be cleaned and disinfected with a ?? level disinfectant between clients
Used on non-intact skin (e.g. with an acupuncture needle), considered a ?? and must be cleaned and disinfected with a ?? level disinfectant between clients

Electro-stimulation clippers that are attached to the handle of the needle, must be cleaned and disinfected with a ?? level disinfectant between clients.
Instruments (tweezers, forceps) that come into contact with a needle after insertion into the client must be cleaned and disinfected with a ?? level disinfectant between clients.
Any item used to manipulate a sterile needle prior to insertion into a client must also be sterile.

Seven star or plum-blossom needles:
All handles must be cleaned and HLD.
If cotton is inserted in the head of the hammer, the cotton must be discarded after use.
Disposable handles, where the package indicates it is “disposable”:
The handle with a new needle can be used on the same client.
Client can take the handle and additional needle packs home.
The handle must be cleaned and HLD between client sessions until all the single-use and sterile needle packs are used for that client.
Once all the needle packs are used, the hand must be discarded.

Sharps
Needles must be pre-packaged, single-use and disposable
Ensure needles come from a reputable company that properly sterilizes their needles
Discard needles if expired or packaging is compromised

Sharps
Each individual needle must only be used on one site and for one time, on the same client
Sterile needles must not be placed on or in any non-sterile environment (tray, foam, cotton, solution)
Needles should be removed from their packaging in view of the client just prior to insertion

Sharps
Needles must discarded immediately after use into an approved sharps container
Full sharps containers (3/4 of capacity) must be securely closed and discarded appropriately (not with municipal garbage)

Blood and body fluid exposure response
The following could result in an exposure to a bloodborne disease (HBV, HCV, HIV):
A needlestick or cut from a sharp object contaminated with blood and/or body fluid
Blood and/or body fluid contact with broken skin (open cut, wound, dermatitis), or
Blood and/or body fluid contact with a mucous membrane (eyes, nose or mouth)

Procedures for blood and body fluid exposure:
Wear single-use gloves prior to handling or dressing the wound
Wash the exposed skin surface with soap and water
If bleeding, allow it to bleed
Apply a skin antiseptic and cover with a clean dressing/bandage

Procedures for blood and body fluid exposure:
Splashes to mucous membranes should be flushed thoroughly with water
The person exposed must immediately contact a physician
The PSW must document all incidents and keep records on site for a minimum of one year and on file for five years

Thank You
Additional information:
Toronto Health Connection at 416-338-7600 or visit our website at www.toronto.ca/health
Questions?

http://www.cmaac.ca	229
http://translate.googleusercontent.com	1
http://74.6.117.48	1

Toronto Public Health Presentation - Acupuncture

by CMAAC on Jun 28, 2010

Accessibility

Categories

Upload Details

Usage Rights

3 Embeds 231

Statistics

Toronto Public Health Presentation - Acupuncture — Presentation Transcript