Precaution

PRECAUTION FOR INFECTION PREVENTION IS JUSTIFIED...

1. CME On Standard Work Precautions Date: 21.03.2015 DMRCH BARGARH

2. Objective: Standard Work precautions are designed to reduce the risk of transmission of blood borne pathogens (blood and body fluids) and are applied to ALL patients regardless of their known or presumed status.

3. Components of the Standard Work precautions: Promoting hand hygiene and use of PPE. Providing appropriate needle and sharps disposal methods. Documenting the quality of sterilization for all medical equipment. Waste disposal policy. Post exposure management. Ensuring compliance and adherence to Standard Work precautions amongst all levels of staff.

4. Universal work precaution is not only protection for Health care provider but also an essential part of strategies to prevent stigma and discrimination against HIV infected patients by health care providers.

5. Dr. M works in a s urgical OPD. The building is very old and none of the sinks are located in or near surgical OPD room . Dr . M examines > 25 patients during the day, Dr . M does not routinely wash his hands before or after examining them. Dr . M finds washing his hands inconvenient and his hands don’t look dirty .

6. Is this an appropriate practice? If Yes ,Why? If No , Why? What are the barriers to appropriate hand hygiene for Dr. M ? What are some suggestions for how to improve Dr . M ’s compliance?

7. Hand Hygiene 1. Always wash hands before/after removing gloves , after handling all materials known or suspected to be contaminated. 2. Good hand washing= 15seconds with running water , soap & friction. 3. Gloves are not the substitute for Hand Washing 4. Gloves need to be removed between patients

8. Hand washing recommendations Arriving at and before leaving work Before and after patient contact Before and after eating After removing gloves After using restroom After coughing, sneezing, blowing nose Whenever hands are soiled or contaminated

9. HANDWASHING FOR PATIENT CARE Friction/lather 10-15 seconds; rinse and dry thoroughly “Waterless agent” (alcohol based)- apply to hands, rub together Chlorhexidine gluconate - Active ingredient in hospital approved soap

10. Area commonly missed in hand washing Effective Hand Washing SWP & BM Waste Management 8

11. Effective Hand Washing

12. 1. Transmission of health-care related pathogens from one patient to another via the hands of a health-care staff is a common , but preventable problem. 2.A common mistake is to use gloves rather than take the time to wash hands . 3. Always wash and dry your hands after removing gloves. 4.The germs on your hands will grow well in a hot moist environment ( under the gloves) and the amount of germs will increase while you wear gloves. 5.Gloves often develop tears so germs enter and contaminate the hands . 6.Used utility gloves should be considered as being heavily contaminated inside and out, and hands should be washed after wearing them.

13. “ How do you ensure that staff follow Standard Work precautions in your facility?” Give staff reminders to complete their Hepatitis B vaccination schedule. Regular use of single use disposable injection equipment. Discard of all used sharps immediately after use. Document the quality of sterilization for all medical equipment . Promote hand hygiene and use of PPE. Ensure regular supply of protective gear; prevent stock-outs. Ensure hand washing facilities at easy access points.

14. : “How do you ensure that staff follow Standard Work precautions in your facility?” Give reminders to staff on Standard Work Precautions policies and procedures (this could be done by posting information and reminders in areas frequented by staff). Training on Standard Work precautions should be provided to ALL levels of staff. In addition all new staff orientations should include this information. Disinfect instruments and other contaminated equipment.

15. Next…….. Post Exposure Prophylaxis………..