Infection Control in the Emergency Department
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Infection Control in the Emergency Department
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Infection Control in the Emergency Department
- 1. Infection Control in ED Gaby Hutchinson ED Clinical Nurse Specialist June 2017
- 2. Objectives Briefly discuss standard precautions V’s Transmission Based precautions Differentiate between contact, droplet and airborne precautions Where to find further information
- 3. Standard Precautions Work practices required for the basic level of infection control Recommended for the treatment and care of all patients regardless of perceived infection status
- 4. Standard Precautions Hand Hygiene Safe use and disposal of sharps
- 5. Cough Etiquette Linen and waste management Environmental cleaning Personal Protective equipment
- 6. PPE Essential component of both standard and transmission based precautions The type of PPE used will vary depending on the level of precaution (e.g. standard, contact, droplet or airborne)
- 7. Transmission Based Precautions (TBP) Used in addition to standard precautions Used for patients that are suspected or confirmed to be infected by organisms transmitted by the contact, droplet or airborne routes
- 8. In ED, patients requiring TBP will have a trolley outside their cubicle. The trolley will have PPE required to care for the patient as well as a with a coloured sign highlighting the level of precaution required.
- 11. Contact Transmission For infections spread through physical touch direct or indirect Patients requiring include: MRSA (micro alert C and B) VRE Gastroenteritis Clostridium Difficile Herpes Zoster
- 12. Other considerations.. Patients will require single rooms on the ward…. In ED, distance from immunocompromised patients as able. Limit equipment in cubicle.
- 14. Droplet transmission Close proximity is required as droplets do not remain suspended in the air
- 15. Types of infections Influenza Parainfluenza RSV Meningococcal meningitis Mumps Pertussis Rubella
- 16. ILI Any patient presenting with a documented fever of (>38˚C), or a hx of chills and shakes PLUS: cough and/or sore throat in the absence of other Dx. Will receive a surgical mask ASAP and placed onto Droplet precautions from triage.
- 17. Special considerations… Patients require single room when admitted to the hospital At least 1m between patients Avoid aerosol generating procedures (i.e. inhalers instead of nebs) Limit personnel access
- 19. Airborne Transmission Airborne droplet nuclei can remain suspended in the air for long periods. Patients presenting with suspected/confirmed: Pulmonary TB Chicken Pox Measles MERS
- 20. Special Considerations.. Patient needs to be cared for in an Airborne infection isolation room (AIIR) ED has 1 isolation room, the hospital has a further 5 AIIRs Staff required to use N95 (P2) mask Limit Personnel
- 21. What happens if we miss it? A case study:
- 23. Contact Tracing… Over 50 patients by Infection control Over staff by OSH
- 24. Further Information ChIPS → Departments→ Infection Prevention and Control Sir Charles Gairdner Hospital Infection Prevention and Control Policy Standard and Transmission Based Precautions Policy #02 On-call Microbiologist
- 26. Summary Standard precautions apply to all patients Transmission-Based precautions include contact, droplet and airborne depending on mode of transmission of suspected illness Information and help is available