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MARYLAND PLASTIC SURGERY CENTER

Universal Precautions / Infection Control Training

 

INSTRUCTIONS:

  1. Please study the educational materials.
  2. After reading the materials, take the quiz found on the last page or online.

 

Three or more incorrect answers will result in an incomplete application and you will be asked take the quiz again. Unanswered questions are counted as incorrect.

INFECTION CONTROL

  1. What is the bloodborne pathogen standard? A regulatory document published by the Occupational Safety and Health Administration (OSHA). These regulations require health care facilities to protect its workers through training, availability of protective equipment, creating a safe work environment, and providing a plan for accidental exposure to blood and body fluids.
  1. What type of training do I need? Healthcare workers involved in at-risk activities are required to complete bloodborne pathogen training within 10 days of employment, when job activities or responsibilities are changed, and annually. The training includes information about Standard Precautions, biohazardous waste handling, the post-exposure policy, and the Hepatitis vaccine. Your manager is responsible for reviewing department specific procedures with you.
  1. What are Standard Precautions? Standard precautions is a management program that requires the blood and body fluids of all patients to be treated as potentially infectious with bloodborne pathogens including human immunodeficiency virus (HIV) or hepatitis.
  1. What is personal protective equipment and when should I wear it? Personal protective equipment (PPE) is clothing or equipment that protects you from a hazard. What to use depends upon the anticipated exposure.
    • Gloves are worn whenever you anticipate contact with blood and/or body fluids. For example, when inserting, removing, or manipulating a venous or arterial line, handling specimens before placed in a specimen bag and when giving an injection. Select the appropriate size glove for your use.
    • Gowns are worn when visible contamination of clothing is expected.
    • Masks and eye protection or full face shields are worn when splashing or aerosolization of body fluids is anticipated. Depending upon the degree and type of anticipated exposure, protection for the face consists of a surgical mask, goggles or eye glasses with solid side shields, or a protective face shield. Examples for use include suctioning or intubating a patient, inserting or removing venous and arterial lines, phlebotomy procedures and wound irrigation. All PPE must be removed as soon as possible after contamination has occurred.
    • Resuscitation devices (CPR pocket masks) may be used during a resuscitation event.
  2. What are engineering controls? Engineering controls are environmental devices that reduce hazards and minimize employee exposure to blood and body fluids. This includes needleless devices, shielded needle devices, plastic capillary tubes, and sharps disposal containers. Proper work practices include no-hands procedures in handling contaminated sharps.
  3. How do I appropriately dispose of sharps? Sharps are needles, syringes with and without needles, scalpels, lancets, broken glass – any item that can cause a puncture or laceration. ALL sharps are disposed of in approved sharps containers. The inner container is a puncture resistant white plastic box with a white lid. The inner containers are placed in puncture proof, locked, hard plastic enclosures. The outer container must remain locked unless the inner sharps container requires removal and replacement. Sharps containers are removed when they are no more than 3/4 full. Do not dispose of sharps in any other way or in any other container. Never attempt to recap, bend, or break a contaminated sharp unless using a no-touch technique.
  4. Why are there different waste receptacles garbage cans available? Biohazardous waste, also referred to as medical, regulated, or red bag waste, is defined as any waste item contaminated with blood or body fluids. This waste is segregated at the point of use. All biohazardous waste is placed in a waste can (either labeled as “biohazardous” or red in color) lined with a red bag and sealed when it is between ½ – ¾ full. General waste, such as food items, flowers, plants, newspapers, and Styrofoam is placed in a waste can lined with a clear garbage bag.
  5. When should I use soap and water vs alcohol hand rub for hand hygiene? Adequate hand hygiene is the single most important prevention activity that reduces transmission of infections. Hands must be washed thoroughly with soap and water when visibly soiled and at the beginning of your workday. If hands are not visibly soiled, an alcohol-based hand rub may be used. Hand hygiene is to be performed before and after each patient contact, glove use, food handling and contact with potentially contaminated patient care environments. Soap and water is indicated when caring for patients with known or suspected C. difficile because alcohol does not deactivate spores. Wearing gloves is not a substitute for adequate hand hygiene.
  6. Why can’t I wear my artificial fingernails at work? Direct patient care givers are prohibited from wearing artificial nails because they harbor bacteria and fungi and have been linked to infections and other untoward events in patients.
  7. What do I do if I am exposed to blood or body fluids? Wash the affected area with soap and water (eye splashes – irrigate with cool water), notify your supervisor, and complete all recommended follow up.
  8. Why is eating and drinking prohibited in patient care areas including nursing stations? Eating and drinking in patient care areas is not safe due to potential contamination of food and beverages.
  9. What is Hepatitis B and how do I protect myself? Hepatitis B is a bloodborne virus with an unpredictable course of illness/symptoms. Healthcare workers are 20 times more likely than the general public to contract Hepatitis B through occupational exposure. Transmission can occur from needlesticks, through sexual contact, and from any surface contaminated with infected blood. The virus is not spread through casual contact. In addition to following Standard Precautions, there is a Hepatitis B vaccine available for the healthcare worker who has exposure to blood and body fluids. The vaccine is a series of 3 shots given over a 6 month period of time and is offered by the Center.
  10. What about decontamination and disinfection of work surfaces? When a work surface becomes contaminated with blood, body fluid, and/or tissue, decontamination and disinfection procedures must be followed. Visible contamination requires cleaning the area with soap and water to remove the biologic hazard. This is followed with disinfecting the surface. 
    • If a bleach solution is used, a fresh solution must be made every 24 hours. The container must be labeled with the product name. After removal of organic material, an approved pre-moistened disposable towelette may be used to disinfect surfaces. Follow manufacturer guidelines for required contact time of the disinfectant to the surface (generally 5-10 minutes before the disinfectant can be wiped clean and the surface can be utilized). Contact time for a diluted bleach solution is generally considered to be the time it takes the product to air dry
    • Alcohol is not an approved disinfectant for any surface or any patient care equipment.
  11. What is the appropriate use of multidose vials and syringes? Check expiration dates prior to using any medication. Verify the medication name and dose before opening the vial. After uncapping the vial, an alcohol wipe must be used to clean the rubber stopper every time prior to accessing the vial. Multidose vials may be accessed multiple times for one patient but are not to be used for more than one patient. Syringes used to draw up medications for transfer to another location (IV tubing, irrigation pan, etc) may only be used for one patient.

 

TUBERCULOSIS (MTB)

  1. What is MTB and how is it spread? Mycobacterium tuberculosis (Mtb) is bacteria that is transmitted through the air when persons who have active lung disease sneeze, cough, or laugh. MTB continues to be a public health concern worldwide.
  2. What can I do to prevent exposure to Mtb? Infection control practices include: 
    • Instructing patients who are coughing and sneezing to cover their mouth with a tissue. 
    • The Center does not admit or treat patients with MTB. If MTB is suspected, they should be referred to their primary care physician or public health center. 
    • Public health services should be notified of patients with MTB according to current law. 
    • Complying with the annual TB skin testing requirements of the Corporate Health Service Department.

ISOLATION

  1. Why do some patients require isolation precautions? Patients with communicable diseases may require isolation precautions in order to contain an infectious process. Patients undergoing surgical procedures require isolation to prevent infection. Isolation precautions do not replace Standard Precautions.
  2. What categories of isolation do we use? The three categories of isolation used at the Center include:
    • FULL (mask, glove, gown)
    • CONTACT (glove, gown)
    • RESPIRATORY (mask)
  3. How are infectious isolation categories communicated? A large 8.5×11 inch sign is placed on the patient’s room door and on the chart with the isolation items needed to enter the room or visit the patient. If transported, the receiving area must also be verbally notified of the patient’s isolation requirements.
  4. Where should I dispose of the gowns and my gloves? Disposable items should be disposed of in the general waste container unless visibly contaminated with blood or other body fluids.

RESPIRATORY ETIQUETTE

What is a “Respiratory Etiquette”? “Respiratory Etiquette” is a common sense plan to decrease the risk of spreading airborne infectious diseases including the common cold and the flu (also vaccine preventable). Respiratory etiquette practices include:

  • Do not report for work if you are ill, especially if you are coughing
  • Cover your nose and mouth when you sneeze or cough
  • Cough and sneeze into a tissue and throw it away in a waste basket
  • If you do not have a tissue, cough or sneeze into your upper sleeve, not your hand
  • After coughing or sneezing, clean your hands with soap and water or alcohol hand rub
  • Do not share eating utensils, drinking cups, water bottles, towels or other personal items including lip balm, lipstick, toothbrushes etc.

To whom does the Respiratory Etiquette apply? Following these basic infection prevention procedures applies to everyone, including staff, patients, visitors and contract workers.
Where can I get materials for Respiratory Etiquette? Alcohol hand gel and tissue are placed in appropriate areas throughout the Center.