SAFE PRACTICES CARING COVID 19 PATIENTS by Dr.T.V.Rao MD

1. SAFE PRACTICES
CARING COVID 19
PATIENTS
Dr.T.V.Rao MD
Dr.T.V.RaoMD @ Infectioncare 1

2. IMPACT OF INFECTIOUS DISEASES ON
HEALTH CARE WORKERS
•Infectious diseases are caused by pathogenic
microorganisms, as bacteria, viruses, parasites or
fungi; the diseases can be spread, directly or
indirectly, from one person to another. Zoonotic
diseases are infectious diseases of animals that can
cause disease when transmitted to humans. The
world has seen much progress and empowerment
with controlling treating and preventing the
infectious diseases.
Dr.T.V.RaoMD @ Infectioncare 2

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4. Nurses are Venerable to Infections
higher than many ?
•Many times
nurses becomes
the targets to get
infected and may
end up with loss
of once own life
Dr.T.V.RaoMD @ Infectioncare 4

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7. DO REMMEBER THERE ARE NO
SHORT CUTS TO PREVENT
COVID 19
Dr.T.V.RaoMD @ Infectioncare 7

8. Our Polices on COVID19 to be Human
Dr.T.V.RaoMD @ Infectioncare 8

9. How to organise education to
prevent Covid 19
•Create an easy-to-
read reminder sheet
about safety
precautions, such as
these from the CDC
that can be posted at
workstations, in exam
rooms and waiting
areas Dr.T.V.RaoMD @ Infectioncare 9

10. Available options to followed without
fail
• Wash hands often with soap and water for at least 20 seconds
• If soap and waterare not available, use an alcohol-based hand
sanitizer with at least 60 percent alcohol
• Avoid close contact with people who are sick
• Avoid touching your eyes, nose, and mouth
• Cover your cough or sneeze with a tissue, then throw the tissue
in the trash, and wash your hands
• Clean and disinfect frequently touched objects and surfaces
• Stay home when you are sick
Dr.T.V.RaoMD @ Infectioncare 10

11. RETHINK ON TRAINING NURSING
PROFESSIONALS
• In spite of many advances in Medical education, and
Technology, one grey area remains with training the
manpower to care control and prevention of Infectious
diseases, If we analyze the real time events the great
responsibility fall on the Nurses who are on round the clock
associatedwith the patients, and certainly it is challenging
to be a part of critical care, and intensive care, as it happens
with changing trends we need more nurses to train in
community nursing proving that we have to revamp on
matters related to handle the Infectious diseases,
Dr.T.V.RaoMD @ Infectioncare 11

12. Nurses are front line workers
• An important part the health
care system, nurses are front-
line workers whose care can be
absolutely essential for the
well-being of patients. Policies
and procedures have been
developedto help protect
nurses from infectious diseases
as well as to ensure the quality
care of patients who suffer from
such illnesses.
Dr.T.V.RaoMD @ Infectioncare 12

13. HOSPITAL SITE MANAGMENT
•Assign One or More
Individuals with
Training in Infection
Control to Provide
On-SiteManagement
of the IPC Program.
Dr.T.V.RaoMD @ Infectioncare 13

14. CORE PRACTICES
• This should be a full-time role
for at least one person in
facilities that have more than
100 residents or that provide on-
site ventilator or hemodialysis
services. Smaller facilities should
consider staffing the IPC
program based on the resident
population and facility service
needs identified in the facility
risk assessment
Dr.T.V.RaoMD @ Infectioncare 14

15. Educate and train HCP,
Educate on objects we use in Hospital
• Educate and train HCP, including
facility-basedand consultant
personnel (e.g., wound care,
podiatry, barber) and
volunteerswho provide care or
services in the facility. Including
consultantsis important, since
they commonly provide care in
multiple facilities where they
can be exposed to and serve as
a source of COVID-19.
Dr.T.V.RaoMD @ Infectioncare 15

16. Occupational Health
Requirements
• Medical counseling is required
before starting work with
clinical samples at BSL-2 with
enhancementsand with SARS-
CoV-2 at BSL-3. Researchers in
the BSL-3 program working with
SARS-CoV-2are required to
adhere to the requirements in
the medical management plan
and complete their specific
daily symptom attestation.
Dr.T.V.RaoMD @ Infectioncare 16

17. Reinforce sick leave policies, and remind
HCP not to report to work when ill.
Dr.T.V.RaoMD @ Infectioncare 17

18. Following carry the Top priority
in saving self and all around us
•Reinforce adherence
to standard IPC
measures
including hand
hygiene and selection
and correct use of
personal protective
equipment (PPE).
Dr.T.V.RaoMD @ Infectioncare 18

19. Trainthe Health care workerson
Puttingon PPE’s
•Have HCP
demonstrate
competency with
putting on and
removing PPE and
monitor adherence by
observing their
resident care
activities.
Dr.T.V.RaoMD @ Infectioncare 19

20. Safe Work Practices
• Perform as many tasks as
possible in areas away from a
patient with suspected or
confirmed COVID-19 (e.g., do
not remain in an isolation area
to perform charting; use closed-
circuittelevisionsystems to
communicate with patients in
an isolation area when a worker
does not need to be physically
present).
Dr.T.V.RaoMD @ Infectioncare 20

21. Cautionin Case of Covid 19 Infections
CONTACTPRECAUTIONS
• Workfrom clean to dirty (i.e.,
touchingclean body sites or
surfacesbeforetouchingdirty or
heavilycontaminated areas)and
limit opportunitiesfor touch
contamination(e.g., adjusting
glasses, rubbingthe nose, or
touchingface with glovesthat
havebeen in contactwith
suspectedor confirmedCOVID-19
patientsor
contaminated/potentially
contaminatedsurfaces).
Dr.T.V.RaoMD @ Infectioncare 21

22. Stop Spreadingthe Infectiousdiseases
• Also, prevent touch
contamination by
avoiding unnecessary
touching of
environmental surfaces
(such as light switches
and door handles) with
contaminated gloves.
Dr.T.V.RaoMD @ Infectioncare 22

23. Handlingthe Biohazard waste in Covid19
• Differentiate clean areas (e.g.,
where PPE is put on) from
potentially contaminatedareas
(e.g., where PPE is removed);
• Handle waste and other
potentially infectiousmaterials;
and
• Clean, disinfect, and maintain
reusable equipment and PPE.
Dr.T.V.RaoMD @ Infectioncare 23

24. Handlingthe Needlesand Needlestickinjuries
•Use caution when
handling needles or
other sharps, and
dispose of
contaminated sharps in
puncture-proof, labeled,
closable sharps
containers.
Dr.T.V.RaoMD @ Infectioncare 24

25. DO NOT TOUCH IN COVID 19 AND
OTHERINFECTIONS
• Workers should avoid
touching their faces,
including their eyes,
noses, and mouths,
particularly until after
they have thoroughly
washed their hands
upon completing work
and/or removing PPE.
Dr.T.V.RaoMD @ Infectioncare 25

26. Train and Retrain on Biosafety
•Train and retrain
workers on how to
follow established
protocols in Universal
Health care
precaution and
implement OSHA
guidelines
Dr.T.V.RaoMD @ Infectioncare 26

27. Personal Protective Equipment
• Healthcare workers must use proper PPE when exposed to a patient
with suspectedor confirmed COVID-19 or other sources of SARS-
CoV-2 (See OSHA's PPE standards at 29 CFR 1910 Subpart I).
• OSHA recommends that healthcare workers with exposure to
suspectedor confirmed COVID-19 patients wear:
• Gloves
• Gowns
• Eye/face protection (e.g., goggles, face shield)
• NIOSH-certified,disposable N95 filter facepiece respirators or better
Dr.T.V.RaoMD @ Infectioncare 27

28. RespiratoryProtectionin Covid19
• Use respiratory protection
as part of a comprehensive
respiratory protection
program that meets the
requirements of OSHA's
Respiratory Protection
standard (29 CFR 1910.134)
and includes medical
exams, fit testing, and
training.
Dr.T.V.RaoMD @ Infectioncare 28

29. How to Remove N95 Masks
•When removing
potentially
contaminated PPE
such as an N95
respirator, do not
touch the outside of
the respirator without
wearing gloves.
Dr.T.V.RaoMD @ Infectioncare 29

30. Follow the OSHA guidelines on
Use of Masks in Govid19
• Use respiratory protection
as part of a comprehensive
respiratory protection
program that meets the
requirements of OSHA's
Respiratory Protection
standard (29 CFR 1910.134)
and includes medical
exams, fit testing, and
training.
Dr.T.V.RaoMD @ Infectioncare 30

31. ARE WE TRAINNG THE
NURSES?
• Yet in many nursing schools and
evenupgraded colleges,there is
no dedicated attention on this
matter in relation handling the
infectiouspatients and are not
taught as special courses
forgetting Infectious diseases are
the second leading cause of
death and the leading cause of
disability-adjustedlife years
worldwide
Dr.T.V.RaoMD @ Infectioncare 31

32. Educate the Nurses and Health care personal with
CDC guidelines Educate HCP about any new policies
or procedure
• CDC has created
training modules for
front-line staff that
can be used to
reinforce
recommended
practices for
preventing
transmission of SARS-
CoV-2 and other
pathogens.
Dr.T.V.RaoMD @ Infectioncare 32

33. Implement Source Control
Measures.
• HCP should wear a facemask at all
timeswhile they are in the
facility.When available,facemasks
are generallypreferredovercloth
face coveringsfor HCP as
facemasksoffer both source
controland protectionfor the
weareragainst exposureto
splashesand sprays of infectious
materialfrom others. Guidance on
extendeduse and reuse of
facemasksis available
Dr.T.V.RaoMD @ Infectioncare 33

34. Use of Mask for Public utility
• Residentsshould wear a cloth face
coveringor facemask (if tolerated)
wheneverthey leave their room,
includingfor proceduresoutside
the facility. Cloth face coverings
shouldnot be placed on anyone
who has trouble breathing,or
anyonewho is unconscious,
incapacitated,or otherwise
unableto removethe mask
withoutassistance. In addition to
the categoriesdescribedabove
cloth face coveringsshould not be
placedon childrenunder 2.
Dr.T.V.RaoMD @ Infectioncare 34

35. Strategies for optimizing the
supply of PPE,
• In addition to the PPE
considerationsfor all workers and
employers of workers at increased
risk of occupational exposure, CDC
has developed strategiesfor
optimizingthe supply of PPE,
includingspecificallyfor:
• Gowns
• Eye protection
• Face masks
• N95 respirators
Dr.T.V.RaoMD @ Infectioncare 35

36. Cleaning and disinfection in
healthcare:
• Routine cleaning and disinfection procedures (e.g., using cleaners and
water to pre-clean surfaces before applying an EPA-registered,
hospital-grade disinfectant to frequently touched surfaces or objects
for appropriate contact times as indicated on the product’s label) are
appropriate for SARS-CoV-2 in healthcare settings, including those
patient-care areas in which aerosol-generating procedures are
performed.
• Refer to List N on the EPA website for EPA-registered disinfectants
that have qualified under EPA's emerging viral pathogens program for
use against SARS-CoV-2.
Dr.T.V.RaoMD @ Infectioncare 36

37. Follow standard practices for
disinfection
• Follow standard practices
for disinfection and
sterilization of medical
devices contaminated
with COVID-19, as
described in the
CDC Guideline for
Disinfection and
Sterilization in Healthcare
Facilities, 2008. Dr.T.V.RaoMD @ Infectioncare 37

38. TRAINING THE NURSES ON MATTERS
OF INFECTION A PRIORITY
• The 21st century will see an
ever-increasing emphasis on
infectiousdiseases, both
because of the certainty that
emerging and reemerging
diseases will continue to
challenge us and because
globalizationhas led to an
increasedawareness of and
commitment to addressing the
terrible burden of infectious
diseases in developing nations.
Dr.T.V.RaoMD @ Infectioncare 38

39. ABOVE MANY MATTERS – HAND
WASHING THE GREATEST PRIORITY
• Handwashing can help
preventillness. It involves five
simple and effective steps
(Wet, Lather, Scrub, Rinse,
Dry) you can take to reduce
the spread of diarrhealand
respiratoryillness so you can
stay healthy. It’s quick, it’s
simple, and it can keep us all
from getting sick.
Handwashing is a win for
everyone,except the germs.
Dr.T.V.RaoMD @ Infectioncare 39

40. Hand Washing continues to be Simple
practice certainly reduce Infections
•Regular handwashing,
particularly before and
after certain activities,
is one of the best ways
to remove germs, avoid
getting sick, and
prevent the spread of
germs to others.
Dr.T.V.RaoMD @ Infectioncare 40

41. Great Your Hand washing Prctices
are Saving many Lives in the
Hospital
•It’s quick, it’s
simple, and it can
keep us all from
getting sick.
Handwashing is a
win for everyone,
except the germs.
Dr.T.V.RaoMD @ Infectioncare 41

42. The Training of Nurses to be formulated to save the
Lives of patients and the self protection too
Important
• This may include
informing others
about how certain
infectious agent
spread, along with
how to protect
themselves and others
from contamination.
Dr.T.V.RaoMD @ Infectioncare 42

43. Nurses Can Be an At-Risk
Population
• As part of the front-line
of health care
practitioners, nurses can
be at risk both for
spreading or catching
infectious disease, which
is one reason taking
precautions against
infection is so important.
Dr.T.V.RaoMD @ Infectioncare 43

44. Cross Infection is a great threat to
Nurses and Health care Workers
• This can occur when someone
with an infection coughs or
sneezes or in the midst of
some medical procedures
such as intubation or
suctioning. It is immediately
apparentthat nurses and
other health care
professionals would be
among those at a high risk for
catchinginfections in this
way, unless
Dr.T.V.RaoMD @ Infectioncare 44

45. Caring the Patients With Personal
Protection Equipment
• Nurses should take care to
understandand follow these
policies.Some things for
hospitalsand health care
professionalsto consider when
dealing with infection control
are the proper use of personal
protective equipment(PPE),
proper cleaning and disinfecting
procedures,and learning how
to identify and properly isolate
infectiousdisease cases.
Dr.T.V.RaoMD @ Infectioncare 45

46. BEST PRACTICES IN INFECTION
PREVENTION -
• In the event of a possible
widespread contamination,an
infection control nurse will
often need to take steps to
contain the infection. To do
this, they may need to isolate
infected individuals so they do
not come in contact with
healthy individuals. In some
cases,
Dr.T.V.RaoMD @ Infectioncare 46

47. Protecting Self with Equipment
• The wearing of protective
equipment can be especially
important when treating
certaintypes of illnesses. The
equipment may include
gowns, masks, gloves, goggles
or even respirators.
Sometimes wearing certain
types of protective
equipment will be required.
Dr.T.V.RaoMD @ Infectioncare 47

48. Soap Water and Common Sense
( William Osler )
Continues to be best practice
•When it’s not, nurses
must sometimes use
their common sense
to determine if they
feel it would be
helpful in a given
health care situation
to wear PPE.
Dr.T.V.RaoMD @ Infectioncare 48

49. Continuing Education
Opportunities
• If a nurse is not sure about
the proper protective gear, it
would be a wise idea to
consult a superior and the
hospital’s policy manual. A
manualwill likely also help
detail in what order
protectiveequipment should
be put on and the proper way
to take it off and discardit.
Dr.T.V.RaoMD @ Infectioncare 49

50. Savingthe Livesof immunosuppressedpatients
DONOTFORGETTO WASHHANDS
•Designed to protect
immunosuppressed
patients Wash hands
before entering
room Standard
precautions for
allour patients
Dr.T.V.RaoMD @ Infectioncare 50

51. Infection Control NURSES are Resource
Persons
to save Lives of our Patients
• Infection control nurses
may also be responsible for
informing government
agencies, such as the
Centers for Disease Control
and Prevention (CDC), of
outbreaks and collaborate
with these agencies to
bring outbreaks under
control
Dr.T.V.RaoMD @ Infectioncare 51

52. Droplet Precautions –
•Wear a surgical
mask before
entering the room.
Remove mask and
wash orfoam
hands before
leaving
Dr.T.V.RaoMD @ Infectioncare 52

53. Airborne Precautions
DO NOT ENTER WITHIUT SELF
PROTECTION
Trained staff enter with an
• N-95 respirator mask
Patients with known
ortransmitted by small droplet
nuclei such as tuberculosis,
chickenpox,shingles and
communicable viral infections
Patients are preventedfrom
moving out of isolation rooms
Dr.T.V.RaoMD @ Infectioncare 53

54. Workers who perform cleaning and
disinfection must be familiar with
• Note that workers who perform cleaning and disinfection in
healthcare may require PPE and/or other controls to protect them
simultaneously from chemical hazards posed by disinfectants and
from human blood, body fluids, and other potentially infectious
materials to which they have occupational exposure in the healthcare
environment. Employers may need to adapt guidance from this
Healthcare Workers and Employers section, the Environmental
Services Workers and Employers section, and the interim guidance for
workers and employers of workers at increased risk of occupational
exposure, to fully protect workers performing cleaning and
disinfection activities in healthcare workplaces.
Dr.T.V.RaoMD @ Infectioncare 54

55. 3 Important suggestions which can save
us from COVID 19
HAND WASHING
Dr.T.V.RaoMD @ Infectioncare 55

56. Wearning a Mask great Option to
save self and Others
Dr.T.V.RaoMD @ Infectioncare 56

57. Keep a Safe Distance
Dr.T.V.RaoMD @ Infectioncare 57

58. References
• Occupational Safety and Health Administration Healthcare Workers
and Employers United states Departmenbt of Labour
• CDC updates on Covid 19
Dr.T.V.RaoMD @ Infectioncare 58

59. Infection Control is Everyone's Business
Preventing Covid 19 a great priority
Dr.T.V.RaoMD @ Infectioncare 59

60. THANKYOU ALL
• I am thankful to all the friends
professionalsDoctorshealth care
workerswho are supportingme
to reach many cornersin the
worldto spread the knowledge on
Infectiousdiseases
• The Covid 19 brings in great
challengenot just to patientsor
patientsbut everyliving and
ecosystem welive
• PhotoDr.T.V.RaoMD @ Mansa General
HospitalRepublic ofZambia
Dr.T.V.RaoMD @ Infectioncare 60

61. •Program Created by Dr T.V.Rao MD Benefit of
Medical Nursing and Health care Personal in
the Developing World in prevention of Covid19
•Email
• doctortvrao@gmail.com
Dr.T.V.RaoMD @ Infectioncare 61