Infection Control Strategy in HD Unit_david.pptx

Strategy methods

1. Pencegahan dan Pengendalian Infeksi di Unit Hemodialysa I Komang Widarma Atmaja, S.Kep ., Ners, M.Kes

2. Definisi : PPI Penerapan prinsip-prinsip epidemiologi , ilmiah dan analisis statistik untuk pencegahan atau pengurangan infeksi nosocomial (HAIS) Pengendalian Infeksi : Tanggung Jawab Surveilans : rumah sakit  luas atau tertarget Pendidikan: Pencegahan infeksi Pembersihan , disinfeksi , dan sterilisasi peralatan & pembuangan Limbah Investigasi wabah Kesehatan karyawan rumah sakit ( berkaitan dengan paparan infeksi ) Penggunaan antibiotika Pengembangan kebijakan dan prosedur (SPO)

3. Hais di unit HD Nama Area Agen Pathogen yang umum diindentifikasi Burn Unit Semua bakteri gram negatif Bakteri gram positif berbentuk batang Jamur ICU atau Unit Paska Operasi Mikroorganisme apapun Ruang Perawatan Stap . Aureus Group B Streptococcus E. Coli Strep. Pneumoniae Order gram-negative bacilli Viruses i.e. Rotavirus Dialysis Unit Hepatitis dan virus lainnya Bacteri Jamur Mikroorganisme penyebab HAIs di area RS

4. Why Infection Control is important in HD unit? Ketahanan tubuh yang rendah Sering Paparan Lingkungan Unit Tidak Bersih Healthcare Association Infections (HAIs) Bertujuan untuk menyiapkan lingkungan yang BERSIH dan AMAN untuk pasien dan staf

5. Musuh-musuh di Unit HD

6. Cleaning, Disinfectant and Antiseptics

7. Common Disinfectant and Antiseptics in the Health care setting COMPOUND USE & RESTRICTIONS Alcohol Ethyl (70%) Isoprolol (70%) Antiseptic for skin Antiseptic for skin Chlorine Chloramine Hypochlorite solution Disinfectant for wound Disinfectant Ethyline oxide Disinfectan (toxic) Formaldehyde Disinfectan (noxious fumes) Glutaraldehyde Disinfectan (toxic) H2O2 Antiseptic for skin Iodine Tincture Iodophors Antiseptic for skin (can be irritating) Antiseptic for skin (less stable) Phenolic compounds 1-2% phenols Chlorophenol Chlorhexidine Hexylresorcinol Disinfectant Disinfectant (toxic) Antiseptic for skin Antiseptic for skin Quaternary ammonium compounds Antiseptic for skin (ingredient in many soap)

8. Chain of infection is a process of infection that begins when an agent leave its reservoir through portal of exit and is conveyed by mode of transmission then enters through an appropriate portal of entry to infect a susceptible host Or Chain of infection is a process in which a favorable condition is required for microorganism to spread or transfer from reservoir a susceptible host Chain of Infection

9. Chain of Infection

10. Pathogens of concern at HD unit are: HBV HCV TB AMR microorganism Varicella General wound or Access infections C-Diff Pathogen/Agent at HD unit

11. Source Issues at HD unit

12. Mode of Transmission

13. Who is susceptible at HD unit? (Host) All dialysis patient are immune compromised Change that occur with renal failure hinder the body’s immune mechanisms The susceptible dialysis patient All dialysis patient have acces area: open area, frequently cannulated All dialysis patient have comorbid disease conditions

14. Breaking the Chain of Infection

15. Breaking the Chain of Infection

16. Breaking the Chain of Infection

17. Video

18. Infection control in HD unit

19. Infection control in HD unit STAFF

20. Methods of Protection in HD unit

21. Be careful at termination Risk of Blood spill Be careful while dealing with blood line Transport Waste

22. Waste Management

23. Allow the site to bleed Wash generously with soap and water Cleanse with alcohol wipes Cover with appropriate bandages Sharp injury/Body fluid exposure First Aid: needlestick/sharp injury First Aid: body fluid exposure Remove contaminated clothing Irrigate affected area with copious amounts of water Fill out the hospital system report Report for medical assessment EHC or ER

24. Do not recap or manipulate or dissemble (use one handed methode or mechanical device) Dischard sharp at point of use Pass instruments on a tray Verbalize actions when passing sharp items Handle as little as possible Do not pick up sharps by the handful Prevention strategy

25. Hand hygiene Use of aseptic techniques for all invasive procedur Use of PPE Safe handling and disposal of sharps Proper handling contaminated items Appropriate handling and disposal of infection waste Collection and handling of lab specimens STANDARD PRECAUTION

26. WHY To remove transient and resident organism HAND HYGIENE HOW Soap and water (transient bugs) Antiseptic soap (resident/resistant bugs) Antiseptic waterless hand rubs

27. Hand washing Is the single most effective means of preventing transmission of infectious microorganisms For effective handwashing , follow theses steps: Remove excess jewelry Wet hands, apply soap Rub hands together to work up a lather Use friction over all hands to remove soilage Interlock fingers and rub webbing of fingers Rinse hands, dry hands with paper towel Turn faucet off with used paper towel This takes 60 seconds HAND HYGIENE

28. Video Langkah dan Teknik HH

29. Antiseptic Hand rubs Use on visibly clean hands Use sufficient amount Rub hands together Interlock and rub webbing of fingers This takes 20-30 seconds Allow to dry on hands HAND HYGIENE

30. Specialized clothing or equipment worn by an employee for protection against a hazard General work clothes not intended to function as protection against a hazard are not considered to be PPE PERSONAL PROTECTIVE EQUIPMENT Not PPE

31. LANGKAH PELEPASAN APD

32. Gloves must be worn at all times when working in any dirty area of the unit Gloves must be worn when answering machine alarm Remember all time

33. ENVIRONMENT AND FACILITY

34. Dialysisi machine Guidelines for HD machine assignment and patient placement for infection precaution Designated HD machines for HBV, negative hepatitis and unknown HBV “screening machine” Standardize and record disinfection procedur

35. Water treatment system Periodic auto flush & regeneration function of RO system during standby mode prevent bacterial growth in stagnant water WATER TREATMENT & HD FACILTY