1. Dr. Ram Sharan Mehta
Medical-Surgical Nursing Department
College of Nursing
8/29/2013 1

2. RS MEHTA 2
“Hospital should do the sick no harm”
– Florence nightingale.

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4.  Avian influenza, more commonly
known as bird flu, is a growing
concern.
 Human can contract it from
contact with infected birds (often
Poultry) or there secretions or
excrement.
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5.  Transmission from human to
human is rare; but is also a
potential concern.
 Symptoms of it are similar to
influenza but complications can
be more severe and deadly.
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9. 9
 Healthcare facilities would be
overwhelmed including shortage of
 hospital staff
 beds
 ventilators
 supplies

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11. • Isolate patients with droplet or airborne
spread diseases from other patients
• Separate wards, areas, or establish rooms
for infectious patients where isolation
facilities do not exist
• Only those patients with epidemiological and
clinical information suggestive of a similar
diagnosis should share rooms
• Separate patients by at least 1 meter
Patient Accommodation
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12. Health care facility staff must
quickly identify and separate
potential sources of infection
from susceptible hosts
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13. Rapid identification of Patients with
Epidemic- or Pandemic:
 Clinical indications
 Severe acute febrile respiratory illness
(e.g., fever > 38°C, cough, shortness of breath)
 Exposure history
 Epidemiological indications
 History of travel to area affected
 Possible occupational exposure
 Unprotected contact with patient(s)
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14. 14
Steps Example
Determine type and severity
of illness
Does Patient has pneumonia
or other complications.
Assess level of care needed
Does the patient need:
Anti-virals? Oxygen?
A ventilator?
Assess available health care
resources
Does the health care facility
have a ventilator?
Advise on patient referral and
transport
Does a nearby facility have a
ventilator? Can the patient
make the trip?
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15.  Adults and adolescents > 12 years of age –
from time of admission until 7 days after
symptoms resolved
 Infants and children ≤ 12 years of age –
from time of admission until 21 days after
symptoms resolved
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16. •Environmental cleaning: Use appropriate
procedures for the routine cleaning and
disinfection of environmental and other
frequently touched surfaces
•Waste disposal: Treat waste contaminated
with blood, bodily fluids, secretions and
excretions as clinical waste, in accordance with
policy
Environmental Cleaning &
Waste Disposal
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17.  Use Standard Precautions
 Gloves and hand washing
 Gown + Eye protection
 Avoid aerosolization
 Prevent spills and leaks
 Double bag if outside of bag is
contaminated
 Incineration is usually the preferred
method
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18. 1. Floor
2. Spills of blood/
body fluids on floor
3. Walls & curtains
4. Furniture

19. 5. Surgical instruments
6. Fans & light
7. Cheatle forceps
8. Mattress/pillows
9. Toilet care
10. Fumigation
11. Ventilator
12. Infusion pump

20.  Follow standard PPE procedures
for autopsies
 Anyone handling a corpse should
follow standard precautions for
blood and body fluids
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21.  Apply standard precautions routinely in all
health-care settings
 Place all patients (suspected or confirmed) in a
room or area separate from other patients
 Practice both standard and droplet precautions
when caring for patients with infectious
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22. HCP who develop fever and
respiratory symptoms should be:
 Instructed not to report to work, or if
at work, to stop patient-care activities,
put facemask, and promptly notify
their supervisor.
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23.  Excluded from work until at least
24 hours after they no longer have
a fever (without the use of fever-
reducing medicines).
 If symptoms such as cough and
sneezing are still present, HCP
should wear a facemask during
patient-care activities.
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Hospital air as a source

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30. • Previously called Universal Precautions
• Assumes blood and body fluid of ANY
patient could be infectious
• Recommends PPE and other infection
control practices to prevent
transmission in any healthcare setting
• Decisions about PPE use determined by
type of clinical interaction with patient
PPE Use in Healthcare Settings8/29/2013 30

31. • Gloves – Use when touching blood, body
fluids, secretions, excretions, contaminated
items; for touching mucus membranes and
non-intact skin
• Gowns – Use during procedures and
patient care activities when contact of
clothing/ exposed skin with blood/body
fluids, secretions, or excretions is
anticipated
PPE Use in Healthcare Settings8/29/2013 31

32. • Mask, goggles or a face shield –
Use during patient care activities
likely to generate splashes or sprays
of blood, body fluids, secretions, or
excretions
PPE Use in Healthcare Settings8/29/2013 32

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35.  Used in addition to Standard Precautions
 Contact Precautions
 Gloves
 Gown
 Droplet Precautions
 Medical mask
 Airborne Precautions
 Particulate respirator
+
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36. Protective barriers
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37. • Giving a bed bath?
• Suctioning oral
secretions?
• Transporting a
patient in a wheel
chair?
• Responding to an
emergency where
blood is spurting?
• Drawing blood
from a vein?
• Cleaning an
incontinent patient
with diarrhea?
• Irrigating a
wound?
• Taking vital signs?
PPE Use in Healthcare Settings8/29/2013 37

38. • Giving a bed bath?
• Generally none
• Suctioning oral secretions?
• Gloves and
mask/goggles or a face
shield – sometimes
gown
• Transporting a patient in a
wheel chair?
• Generally none required
• Responding to an emergency
where blood is spurting?
• Gloves, fluid-resistant
gown, mask/goggles or
a face shield
• Drawing blood from a vein?
• Gloves
• Cleaning an incontinent patient
with diarrhea?
• Gloves w/wo gown
• Irrigating a wound?
• Gloves, gown,
mask/goggles or a face
shield
• Taking vital signs?
– Generally none
PPE Use in Healthcare Settings8/29/2013 38

39. Personal protective equipment
(gloves, gowns, shoe covers, face
shields, goggles, surgical masks)

40. • Expanded Precautions include
–Contact Precautions
–Droplet Precautions
–Airborne Infection Isolation
PPE Use in Healthcare Settings8/29/2013 40

41. • Gown and gloves for contact with
patient or environment of care
• In some instances these are required
for entering patient’s environment
PPE Use in Healthcare Settings
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42. • Surgical masks within 3 feet
of patient
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43.  Masks, help block large-particle
droplets, splashes, sprays or
splatter that may contain germs from
reaching your mouth and nose.
 Facemasks may also help reduce
exposure of the wearer's saliva and
respiratory secretions to others.
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44.  A respirator is used to reduce the
wearer's risk of inhaling hazardous
airborne particles (including dust
particles and infectious agents), gases,
or vapors.
 A commonly used respirator is a
filtering face-piece respirator (often
referred to as an N95).
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45. • Airborne Infection Isolation
– Particulate respirator
Negative pressure
isolation room also
required
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46. • Don before contact with the patient,
generally before entering the room
• Use carefully – don’t spread contamination
• Remove and discard carefully, either at the
doorway or immediately outside patient
room; remove respirator outside room
• Immediately perform hand hygiene
PPE Use in Healthcare Settings

47. • Required for Standard and Expanded
Precautions
• Perform…
– Immediately after removing PPE
– Between patient contacts
• Wash hands thoroughly with soap and
water or use alcohol-based hand rub
PPE Use in Healthcare Settings8/29/2013 47

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50. Good Better Best
Plain Soap Antimicrobial
soap
Alcohol-based
hand rub

51. Health care personnel as a source

52. ■ Keep hands away from face
■ Limit surfaces touched
■ Change gloves when torn or
heavily contaminated
■ Perform hand hygiene
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53. 1. Methyl spirit – 70%
2. Betadine – 5%, 7.5%
3. Gluteraldehyde (cidex)
4. Hydrogen peroxide 3%
5. Bleaching powder

54. 6. Sodium hypochlorite 1%
7. Phenolics (carbolic acid)
8. Lysol – 2.5%
9. Dettol 4%
10. Savlon: 3% for 2min (non infectious) & 5% for
20min (infectious)

55.  FlOOR
-Wet mopping
-2% carbolic acid is
recommended
 FURNITURE
-Bed ,tables ,chairs etc should be
cleaned with detergent and
(2% carbolic acid )routinely.
 TOILET
-Cleaned with detergent &
phenol.

56.  FANS AND LIGHTS
-Wet moping with
detergent weekly.
MATTRESS/PILLOW
-cover with plastic and
clean with disinfectant
FUMIGATION
-For 1000sq ft, 500ml
formalin & 1000ml
water for 24 hours.

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Thank you