Bird Flu, Avain Influenza

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Bird Flu, Avain Influenza

  1. 1. Dr. Ram Sharan Mehta Medical-Surgical Nursing Department College of Nursing 8/29/2013 1
  2. 2. RS MEHTA 2 “Hospital should do the sick no harm” – Florence nightingale.
  3. 3. 8/29/2013 3
  4. 4.  Avian influenza, more commonly known as bird flu, is a growing concern.  Human can contract it from contact with infected birds (often Poultry) or there secretions or excrement. 8/29/2013 4
  5. 5.  Transmission from human to human is rare; but is also a potential concern.  Symptoms of it are similar to influenza but complications can be more severe and deadly. 8/29/2013 5
  6. 6. 8/29/2013 7
  7. 7. 8/29/2013 8
  8. 8. 9  Healthcare facilities would be overwhelmed including shortage of  hospital staff  beds  ventilators  supplies
  9. 9. 8/29/2013 10
  10. 10. • Isolate patients with droplet or airborne spread diseases from other patients • Separate wards, areas, or establish rooms for infectious patients where isolation facilities do not exist • Only those patients with epidemiological and clinical information suggestive of a similar diagnosis should share rooms • Separate patients by at least 1 meter Patient Accommodation 8/29/2013 11
  11. 11. Health care facility staff must quickly identify and separate potential sources of infection from susceptible hosts 8/29/2013 12
  12. 12. Rapid identification of Patients with Epidemic- or Pandemic:  Clinical indications  Severe acute febrile respiratory illness (e.g., fever > 38°C, cough, shortness of breath)  Exposure history  Epidemiological indications  History of travel to area affected  Possible occupational exposure  Unprotected contact with patient(s) 8/29/2013 13
  13. 13. 14 Steps Example Determine type and severity of illness Does Patient has pneumonia or other complications. Assess level of care needed Does the patient need: Anti-virals? Oxygen? A ventilator? Assess available health care resources Does the health care facility have a ventilator? Advise on patient referral and transport Does a nearby facility have a ventilator? Can the patient make the trip? 8/29/2013
  14. 14.  Adults and adolescents > 12 years of age – from time of admission until 7 days after symptoms resolved  Infants and children ≤ 12 years of age – from time of admission until 21 days after symptoms resolved 8/29/2013 15
  15. 15. •Environmental cleaning: Use appropriate procedures for the routine cleaning and disinfection of environmental and other frequently touched surfaces •Waste disposal: Treat waste contaminated with blood, bodily fluids, secretions and excretions as clinical waste, in accordance with policy Environmental Cleaning & Waste Disposal 8/29/2013 16
  16. 16.  Use Standard Precautions  Gloves and hand washing  Gown + Eye protection  Avoid aerosolization  Prevent spills and leaks  Double bag if outside of bag is contaminated  Incineration is usually the preferred method 8/29/2013 17
  17. 17. 1. Floor 2. Spills of blood/ body fluids on floor 3. Walls & curtains 4. Furniture
  18. 18. 5. Surgical instruments 6. Fans & light 7. Cheatle forceps 8. Mattress/pillows 9. Toilet care 10. Fumigation 11. Ventilator 12. Infusion pump
  19. 19.  Follow standard PPE procedures for autopsies  Anyone handling a corpse should follow standard precautions for blood and body fluids 20
  20. 20.  Apply standard precautions routinely in all health-care settings  Place all patients (suspected or confirmed) in a room or area separate from other patients  Practice both standard and droplet precautions when caring for patients with infectious 8/29/2013 21
  21. 21. HCP who develop fever and respiratory symptoms should be:  Instructed not to report to work, or if at work, to stop patient-care activities, put facemask, and promptly notify their supervisor. 8/29/2013 22
  22. 22.  Excluded from work until at least 24 hours after they no longer have a fever (without the use of fever- reducing medicines).  If symptoms such as cough and sneezing are still present, HCP should wear a facemask during patient-care activities. 8/29/2013 23
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  25. 25. 8/29/2013 28 Hospital air as a source
  26. 26. 8/29/2013 29
  27. 27. • Previously called Universal Precautions • Assumes blood and body fluid of ANY patient could be infectious • Recommends PPE and other infection control practices to prevent transmission in any healthcare setting • Decisions about PPE use determined by type of clinical interaction with patient PPE Use in Healthcare Settings8/29/2013 30
  28. 28. • Gloves – Use when touching blood, body fluids, secretions, excretions, contaminated items; for touching mucus membranes and non-intact skin • Gowns – Use during procedures and patient care activities when contact of clothing/ exposed skin with blood/body fluids, secretions, or excretions is anticipated PPE Use in Healthcare Settings8/29/2013 31
  29. 29. • Mask, goggles or a face shield – Use during patient care activities likely to generate splashes or sprays of blood, body fluids, secretions, or excretions PPE Use in Healthcare Settings8/29/2013 32
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  32. 32.  Used in addition to Standard Precautions  Contact Precautions  Gloves  Gown  Droplet Precautions  Medical mask  Airborne Precautions  Particulate respirator + 8/29/2013 35
  33. 33. Protective barriers 8/29/2013 36
  34. 34. • Giving a bed bath? • Suctioning oral secretions? • Transporting a patient in a wheel chair? • Responding to an emergency where blood is spurting? • Drawing blood from a vein? • Cleaning an incontinent patient with diarrhea? • Irrigating a wound? • Taking vital signs? PPE Use in Healthcare Settings8/29/2013 37
  35. 35. • Giving a bed bath? • Generally none • Suctioning oral secretions? • Gloves and mask/goggles or a face shield – sometimes gown • Transporting a patient in a wheel chair? • Generally none required • Responding to an emergency where blood is spurting? • Gloves, fluid-resistant gown, mask/goggles or a face shield • Drawing blood from a vein? • Gloves • Cleaning an incontinent patient with diarrhea? • Gloves w/wo gown • Irrigating a wound? • Gloves, gown, mask/goggles or a face shield • Taking vital signs? – Generally none PPE Use in Healthcare Settings8/29/2013 38
  36. 36. Personal protective equipment (gloves, gowns, shoe covers, face shields, goggles, surgical masks)
  37. 37. • Expanded Precautions include –Contact Precautions –Droplet Precautions –Airborne Infection Isolation PPE Use in Healthcare Settings8/29/2013 40
  38. 38. • Gown and gloves for contact with patient or environment of care • In some instances these are required for entering patient’s environment PPE Use in Healthcare Settings 8/29/2013 41
  39. 39. • Surgical masks within 3 feet of patient 8/29/2013 42
  40. 40.  Masks, help block large-particle droplets, splashes, sprays or splatter that may contain germs from reaching your mouth and nose.  Facemasks may also help reduce exposure of the wearer's saliva and respiratory secretions to others. 8/29/2013 43
  41. 41.  A respirator is used to reduce the wearer's risk of inhaling hazardous airborne particles (including dust particles and infectious agents), gases, or vapors.  A commonly used respirator is a filtering face-piece respirator (often referred to as an N95). 8/29/2013 44
  42. 42. • Airborne Infection Isolation – Particulate respirator Negative pressure isolation room also required 8/29/2013 45
  43. 43. • Don before contact with the patient, generally before entering the room • Use carefully – don’t spread contamination • Remove and discard carefully, either at the doorway or immediately outside patient room; remove respirator outside room • Immediately perform hand hygiene PPE Use in Healthcare Settings
  44. 44. • Required for Standard and Expanded Precautions • Perform… – Immediately after removing PPE – Between patient contacts • Wash hands thoroughly with soap and water or use alcohol-based hand rub PPE Use in Healthcare Settings8/29/2013 47
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  47. 47. Good Better Best Plain Soap Antimicrobial soap Alcohol-based hand rub
  48. 48. Health care personnel as a source
  49. 49. ■ Keep hands away from face ■ Limit surfaces touched ■ Change gloves when torn or heavily contaminated ■ Perform hand hygiene 8/29/2013 52
  50. 50. 1. Methyl spirit – 70% 2. Betadine – 5%, 7.5% 3. Gluteraldehyde (cidex) 4. Hydrogen peroxide 3% 5. Bleaching powder
  51. 51. 6. Sodium hypochlorite 1% 7. Phenolics (carbolic acid) 8. Lysol – 2.5% 9. Dettol 4% 10. Savlon: 3% for 2min (non infectious) & 5% for 20min (infectious)
  52. 52.  FlOOR -Wet mopping -2% carbolic acid is recommended  FURNITURE -Bed ,tables ,chairs etc should be cleaned with detergent and (2% carbolic acid )routinely.  TOILET -Cleaned with detergent & phenol.
  53. 53.  FANS AND LIGHTS -Wet moping with detergent weekly. MATTRESS/PILLOW -cover with plastic and clean with disinfectant FUMIGATION -For 1000sq ft, 500ml formalin & 1000ml water for 24 hours.
  54. 54. 8/29/2013 57
  55. 55. 8/29/2013 58 Thank you

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