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Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
Toronto Public Health Presentation - Acupuncture
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Toronto Public Health Presentation - Acupuncture

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  • ILD HLD Sterile
  • ILD HLD Sterile
  • Transcript

    • 1. 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
    • 2. IPAC Best Practices for TCM Practitioners <ul><li>Agenda </li></ul><ul><li>MOHLTC PSS Best Practices Document, Jan 2009 </li></ul><ul><li>Routine Practices </li></ul><ul><li>Bloodborne Diseases </li></ul><ul><li>General IPAC Guidelines </li></ul><ul><li>Cleaning, Disinfection and Sterilization </li></ul><ul><li>Sharps </li></ul><ul><li>Blood and Body Fluid Exposure Response </li></ul>
    • 3. IPAC Best Practices for TCM Practitioners <ul><li>Ministry of Health and Long Term Care </li></ul><ul><li>Infection Prevention and Control Best Practices for Personal Services Setting </li></ul><ul><li>January 2009 </li></ul><ul><li>http://www.health.gov.on.ca/english/providers/program/pubhealth/oph_standards/ophs/progstds/pdfs/pssp_2008.pdf </li></ul>
    • 4. IPAC Best Practices for TCM Practitioners <ul><li>Purpose of PSS Program: </li></ul><ul><li>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. </li></ul><ul><li>Blood and body fluids do not have to be visible on an instrument/equipment for an infection to be transmitted. </li></ul>
    • 5. IPAC Best Practices for TCM Practitioners <ul><li>Routine Practices </li></ul><ul><li>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. </li></ul>
    • 6. IPAC Best Practices for TCM Practitioners <ul><li>Routine Practices includes: </li></ul><ul><li>Performing hand hygiene between clients and when hands become contaminated </li></ul><ul><ul><li>Alcohol hand sanitizers (70% isopropyl alcohol) are acceptable when hands are not visibly soiled </li></ul></ul><ul><ul><li>Hand lotion (not petroleum based) is recommended </li></ul></ul><ul><li>New disposable gloves are used for every client </li></ul><ul><ul><li>Hand hygiene to be performed before and after glove use </li></ul></ul><ul><ul><li>Finger cots are not acceptable </li></ul></ul>
    • 7. IPAC Best Practices for TCM Practitioners <ul><li>Routine Practices includes: </li></ul><ul><li>The use of additional personal protective equipment if there is a possibility of splashing in the eyes, nose, mouth or on clothing </li></ul><ul><li>Proper cleaning, disinfection and sterilization of items and equipment </li></ul><ul><li>Proper handling and disposal of sharps </li></ul>
    • 8.  
    • 9.  
    • 10.  
    • 11.  
    • 12. IPAC Best Practices for TCM Practitioners <ul><li>Bloodborne Diseases (BBD) </li></ul><ul><li>Transmitted through blood and body fluids </li></ul><ul><li>Hepatitis B, hepatitis C and HIV </li></ul><ul><li>Many who are infected with a BBD show no symptoms but are still infectious </li></ul><ul><li>Always assume a client is potentially infectious with a BBD, even if they tell you they are not. </li></ul>
    • 13. IPAC Best Practices for TCM Practitioners <ul><li>General IPAC Guidelines </li></ul><ul><li>The Worker: </li></ul><ul><li>Hand hygiene </li></ul><ul><li>Stay home if sick </li></ul><ul><li>No eating, drinking, smoking while working </li></ul><ul><li>Proper immunizations (hepatitis B) </li></ul><ul><li>The Client: </li></ul><ul><li>Free from cuts, wounds, rash </li></ul><ul><li>Stay home if sick </li></ul>
    • 14. IPAC Best Practices for TCM Practitioners <ul><li>General Work Area: </li></ul><ul><li>Well lit, clean and in good repair </li></ul><ul><li>Smooth non-absorbent work areas </li></ul><ul><li>At least one hand sink for handwashing, one metre away from clean/disinfected/sterile items </li></ul><ul><li>Linens, towels, etc. laundered between clients </li></ul>
    • 15. IPAC Best Practices for TCM Practitioners <ul><li>Cleaning, Disinfection and Sterilization </li></ul>
    • 16.  
    • 17.  
    • 18. IPAC Best Practices for TCM Practitioners <ul><li>Classification of Equipment and Instruments </li></ul><ul><li>The rationale for disinfecting or sterilizing equipment and instruments is based on the intended use of the item </li></ul><ul><li>Equipment and instruments are divided into three general categories: </li></ul><ul><ul><ul><li>Critical </li></ul></ul></ul><ul><ul><ul><li>Semi-Critical </li></ul></ul></ul><ul><ul><ul><li>Non-Critical </li></ul></ul></ul>
    • 19. Table A: Classification for Methods of Disinfection/Sterilization Source: MOHLTC, BPPSS, Jan 2009: 18
    • 20. IPAC Best Practices for TCM Practitioners <ul><li>Critical Items </li></ul><ul><li>All critical items must be sterile </li></ul><ul><li>Sterilization kills all forms of life, including hepatitis B, hepatitis C and HIV </li></ul><ul><li>Includes needles (sterile, pre-packaged, single-use), and any instrument used to manipulate a sterile item </li></ul>
    • 21. IPAC Best Practices for TCM Practitioners <ul><li>Semi-Critical Items </li></ul><ul><li>High Level Disinfection (HLD) = Kills all forms of life except bacterial spores (e.g. pathogen that causes tetanus). </li></ul><ul><li>Use on semi-critical items with visible contamination of blood and body fluids. </li></ul><ul><li>OR </li></ul><ul><li>Intermediate Level Disinfection (ILD) = Kills most bacteria, viruses, fungi and mycobacteria. </li></ul><ul><li>Use on semi-critical items with no visible contamination of blood and body fluids. </li></ul>
    • 22. IPAC Best Practices for TCM Practitioners <ul><li>Non-Critical Items </li></ul><ul><li>Low Level Disinfection (LLD) = Kills some viruses, fungi and bacteria </li></ul>
    • 23.  
    • 24.  
    • 25. IPAC Best Practices for TCM Practitioners <ul><li>Examples </li></ul><ul><li>Cupping: </li></ul><ul><li>Used on intact skin is considered a ?? item and must be cleaned and disinfected with a ?? level disinfectant between clients </li></ul><ul><li>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 </li></ul>
    • 26. IPAC Best Practices for TCM Practitioners <ul><li>Electro-stimulation clippers that are attached to the handle of the needle, must be cleaned and disinfected with a ?? level disinfectant between clients. </li></ul><ul><li>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. </li></ul><ul><li>Any item used to manipulate a sterile needle prior to insertion into a client must also be sterile. </li></ul>
    • 27. IPAC Best Practices for TCM Practitioners <ul><li>Seven star or plum-blossom needles: </li></ul><ul><li>All handles must be cleaned and HLD. </li></ul><ul><li>If cotton is inserted in the head of the hammer, the cotton must be discarded after use. </li></ul><ul><li>Disposable handles, where the package indicates it is “disposable”: </li></ul><ul><ul><li>The handle with a new needle can be used on the same client. </li></ul></ul><ul><ul><li>Client can take the handle and additional needle packs home. </li></ul></ul><ul><ul><li>The handle must be cleaned and HLD between client sessions until all the single-use and sterile needle packs are used for that client. </li></ul></ul><ul><ul><li>Once all the needle packs are used, the hand must be discarded. </li></ul></ul>
    • 28. IPAC Best Practices for TCM Practitioners <ul><li>Sharps </li></ul><ul><li>Needles must be pre-packaged, single-use and disposable </li></ul><ul><li>Ensure needles come from a reputable company that properly sterilizes their needles </li></ul><ul><li>Discard needles if expired or packaging is compromised </li></ul>
    • 29. IPAC Best Practices for TCM Practitioners <ul><li>Sharps </li></ul><ul><li>Each individual needle must only be used on one site and for one time, on the same client </li></ul><ul><li>Sterile needles must not be placed on or in any non-sterile environment (tray, foam, cotton, solution) </li></ul><ul><li>Needles should be removed from their packaging in view of the client just prior to insertion </li></ul>
    • 30. IPAC Best Practices for TCM Practitioners <ul><li>Sharps </li></ul><ul><li>Needles must discarded immediately after use into an approved sharps container </li></ul><ul><li>Full sharps containers (3/4 of capacity) must be securely closed and discarded appropriately (not with municipal garbage) </li></ul>
    • 31. IPAC Best Practices for TCM Practitioners <ul><li>Blood and body fluid exposure response </li></ul><ul><li>The following could result in an exposure to a bloodborne disease (HBV, HCV, HIV): </li></ul><ul><ul><li>A needlestick or cut from a sharp object contaminated with blood and/or body fluid </li></ul></ul><ul><ul><li>Blood and/or body fluid contact with broken skin (open cut, wound, dermatitis), or </li></ul></ul><ul><ul><li>Blood and/or body fluid contact with a mucous membrane (eyes, nose or mouth) </li></ul></ul>
    • 32. IPAC Best Practices for TCM Practitioners <ul><li>Procedures for blood and body fluid exposure: </li></ul><ul><ul><li>Wear single-use gloves prior to handling or dressing the wound </li></ul></ul><ul><ul><li>Wash the exposed skin surface with soap and water </li></ul></ul><ul><ul><li>If bleeding, allow it to bleed </li></ul></ul><ul><ul><li>Apply a skin antiseptic and cover with a clean dressing/bandage </li></ul></ul>
    • 33. IPAC Best Practices for TCM Practitioners <ul><li>Procedures for blood and body fluid exposure: </li></ul><ul><ul><li>Splashes to mucous membranes should be flushed thoroughly with water </li></ul></ul><ul><ul><li>The person exposed must immediately contact a physician </li></ul></ul><ul><ul><li>The PSW must document all incidents and keep records on site for a minimum of one year and on file for five years </li></ul></ul>
    • 34.  
    • 35. IPAC Best Practices for TCM Practitioners <ul><li>Thank You </li></ul><ul><li>Additional information: </li></ul><ul><li>Toronto Health Connection at 416-338-7600 or visit our website at www.toronto.ca/health </li></ul><ul><li>Questions? </li></ul>

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