Protecting healthcare workers

(HCW) from infections

Protecting the patients
It all begins with Data

• Leadership – Knows infectious risks?

• Resources: IT/ Staff/ Training
• Supplies
• Immunization programs
• Management of exposures
• Healthcare records of personnel

• Policies
• Periodic medical evaluations
• Screening of risks : TB, HIV, Hep B
• Vaccines
• Risk reduction strategies and education
• Infectious outbreaks: Virus, C. Difficile, MRSA
• Sick leaves…
Prevention
Transmission Based
Universal Precautions
precautions
•in the 1980s,
•contact-, droplet-, and airborne-
•to protect workers from HIV, HBV, and
transmissible diseases augment SP
other bloodborne pathogens in human
•additional controls - may not be blood and body fluids, regardless of a
completely interrupted using SP alone.3 patients’ infection status.2
•The different types of TBP are applied •human body fluids are treated as if they
based on what is known or suspected are known to be infectious.
about a patient’s infection.

Standard precautions
•also pathogens present in body fluids to
which UP does not apply.
•SP includes hand hygiene; the use of
certain types of PPE based on
anticipated exposure;
•safe injection practices; and safe
management of contaminated
equipment and other items in the
patient environment.
•SP is applied to all patients even when
they are not known or suspected to be
infectious.
 PPE Food: Cafeteria and workplace Surface and fomites cleaning
Testing on use Availability of disinfectants and contact
Adequate: Goggles/Dress/Goggles times
respirator and testing Telephones, Keyboards, stethoscopes
Location Jewelry, Nails, neckties
Sharps

Adequate containers Safety engineered sharps

They are made with puncture-resistant plastic or
metal.
They have specially designed lids that only allow
sharps to be deposited.
They are too small for a hand to enter.
It is important to place sharps disposal
containers in areas where needed and making
sure they are not overfilled
 • Immunizations
• Our duty and our protection: Keep
healthcare (HCW) workers safe to keep
patients safe
• Influenza vaccines
• Increase rates strategies: Push and
pull POD
• Legislation
The difficult points • OPPE
• Now a JCI standard: Data and
for hospital Staff improvement plan
• Hepatitis B: Policy suggestions
• Varicella
• Tdap
• MMR
• PEP plans: Meningitis, unvaccinated
varicella, HIV, Hep B
• S. Typhi risk
• Polio risk
Tuberculosis

• Tuberculosis:
• Risk assessment in the organization,
• Patient Management policies
• Negative risk patient
• Isolation types
• Respirator use training
• Staff screening upon hire
Occupational exposure to legionella
MRSA

• In 127 investigations, the average MRSA carriage rate

among 33 318 screened health-care workers was 4·6%;
• 5·1% had clinical infections.
• Risk factors included chronic skin diseases, poor hygiene
practices, and having worked in countries with endemic
MRSA.
• Both transiently and persistently colonised health-care
workers were responsible for several MRSA clusters.
• Transmission from personnel to patients was likely in 63
(93%) of 68 studies that undertook genotyping.