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Infection ControlCertificate of Competence in Administrating

Intravenous Injections

Paola Griffiths

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OverviewInfections ControlHospital Acquired InfectionsCycle of InfectionCommon InfectionsRisk ElementsHand washingAseptic techniqueSharps

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Infection ControlHealthcare Associated Infections are

infections that are acquired in Hospitals or as a result of healthcare interventions.

There are a number of factors that can increase the risk of acquiring an infection, BUT high standards of infection control practice will minimise the rise of occurrence.

http://www.hpa.org.ukhttp://www.epic.tvu.ac.uk/EPIC2 guidelines

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Hospital Acquired Infections (HAIs)In recent years HAIs have received media

attention, funding and in depth investigation.Appears a recent phenomena but in 1740 Sir

John Pringle, a physician in the British Army introduced sanitary reforms in military hospitals.

Florence Nightingale in the Crimean War set out to raise standards of cleanliness and reduce wound infections

In 2007 Chapman suggested that up to 10% of patient acquire a HAI.

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Cycle Of Infection

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Cycle Of InfectionInfection Agent: What is the organism?

Bacteria, virus, parasite, or fungi? The type of organism informs you of the types of disinfectants, antiseptics and antimicrobials to use. Is it aerobic or anaerobic?

The Reservoir: Where do you find the organism or what is the source of the infection? A reservoir can be environmental, the hospital setting or the water supply, or in a living organism, a rodent, bird or even snail. Humans are the only reservoir for many human pathogens.

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Common Infection AgentsVirus - can only grow and reproduce within a living cell i.e. Influenza

Bacteria- single cell micro-organism can live independently or on host i.e. Streptococci

Fungi- uni or multi cellular i.e. Candida

Prion-is composed of protein in a misfolded form i.e. Bovine spongiform encephalopathy

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Cycle Of InfectionPortal of Exit: How does the organism leave

the reservoir? Does it leave in faeces, blood or mucus; in contaminated water.

Transmission: How is the organism transmitted from one host to the next host? Can it be passed human to human, it is transmitted by respiratory droplets, blood contact or other secretions? Is it transmitted on the hands of health care workers or the hospital ventilation system? Hand-to-mouth is a common mode for gastrointestinal pathogens.

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Cycle Of InfectionPortal of Entry: How does the organism enter

the body? Does it come through inhalation, a break in the skin or mucus membrane, an insect bite, contaminated food? Portal of entry tells you what type of personal protective equipment (PPE) to use to keep health care workers, family and visitors safe.

Susceptible Hosts: Who is most vulnerable to this organism? Paediatrics, the elderly, and the immune suppressed (due to genetics, transplant drugs, malnutrition, or viral infection like HIV).

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Personal Protective EquipmentAir Bourn- Face MaskFluids- Gloves, Goggles, Face Mask and

Aprons

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Cycle Of Infection

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Six LinksThe interaction between the 6 elements of

the chain determine whether an infection will results

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Healthcare WorkersDeal with large number of patients Handling tasks (clean and soiled)Patients with different needs and illnessesPost surgicalImmune suppressed patientsInterventional procedures

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Risk ElementsFollow the Infection Control Policy and

Procedure in place of workHand washingPersonal Protective Equipment (PPE)Asceptic techniquesSafe Disposal of Sharps

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Hand Washing

Hands main source of spread of infection

Radiographer duties often require brief contact with large number of patient-Potential risk of cross-contaimination

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Hand Washing –When? (5mins)

Before and after all invasive proceduresWhen moving from one patient to anotherAfter using the toiletBefore handling food or drinkAfter handling any body fluidAfter removing protective glovesBefore starting and after finishing your shift

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Breaking the Chain of Cross InfectionRemove watches and ringsWet hands and apply soapRub hands and wrists for 10-15 secsInclude fingers tips, thumbs and websThrough rinse and dry

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Areas most commonly Missed

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GlovesAlways used for IV InjectionsMust be worn as single use itemsMust be put on immediately before patient

contact or treatmentAre not an alternative to hand hygieneMust be disposed of as clinical wasteDon’t need to be sterile, just a good fit!

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Aseptic techniquesWash hands and wear glovesDon’t touch any part of devices entering

patient or connected to syringe.Don’t allow any contact with non sterile areasClean area with alcohol wipeClean up any blood spills with suitable

decontaminating fluid.Wash hands

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Handling SharpsDon’t dispose sharps for anyone elseDon’t re-sheath needlesDon’t separate needle from syringe, discard

as a whole unitUse a tourniquetWear glovesDon’t balance any items on the patients

tummy.....

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Risk of Infection from Needle stickThe average risk of transmission of blood

borne viruses following a single percutaneous exposure from an infected person, in the absence of appropriate post exposure prophylaxis

Hepatitis B virus (1 in 3)Hepatitis C (1-50)HIV (1 in 300)

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Needle stick injuries –what to doEncourage the wound to bleed (hot water)Wash with soap and running waterDispose of the contaminated itemInform line managerCompete the needle-stick notification

paperwork or incident reportMay require blood sample to be takenMay require prophylactic anti-virals if source

to be shown inoculation risk.

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Sharps DisposalUsed sharps container (BS 7320 standard)Keep within arms reach during procedure for

accessNot over fillStored out of reach of childrenPut together correctly.Signed for all stagesSend for clinical waste disposal

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OverviewInfections ControlHospital Acquired InfectionsCycle of InfectionCommon InfectionsRisk ElementsHand washingAseptic techniqueSharps

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Infection ControlThank you

Any Questions?

Paola Griffiths