OBJECTIVES (39 QUESTIONS)

Develop and review infection prevention and control policies and procedures

Collaborate with public health agencies in planning community responses to biological agents (eg, anthrax, influenza)

Identify and implement infection prevention and control strategies

PART I

POLICIES & PROCEDURES

POLICY REVIEW

IP is responsible for development and review of IPC guidelines and policies

Purpose is to protect the patient and healthcare workers in a cost efficient environment

Use national references such at APIC, SHEA, CDC, HICPAC, AORN

CMS requires using nationally recognized guidelines for policy development National Guideline Clearinghouse

BIOLOGICAL AGENTS

PREPAREDNESS FOR BIOLOGICAL EVENTS

Assess hazards and vulnerabilitiesDevelop plansIncorporate syndromic

surveillanceEducate all involvedPractice the plan

MITIGATION/INFECTION PREVENTION PROCEDURES

Follow the principles of an outbreak investigation

Report unusual infectionsTriage quicklyQuarantineProphylaxis, vaccination,

treatmentDecontaminationPost mortem care

POTENTIAL BIOTERRORISM AGENTS

Category AAnthraxBotulismPlaqueSmallpoxTularemiaViral hemorrhagic fevers

Category B have moderate morbidity and low mortality

HAND HYGIENE

HAND HYGIENE

Standardized definition of hand hygiene

Product standardization, dispenser location, indication for hand hygiene, and technique

Surgical hand antisepsis requires persistent activity (CHG and alcohol is best)

Develop monitoring programs to comply with accreditation

CLEANING, DISINFECTION & STERILIZATION

DEFINITIONS

Cleaning Removal of visible soil

Sanitizing Reduction in microbial population to a safe or

relatively safe level Decontamination

Rendering the object safe for handling Disinfection

Elimination of many or all pathogenic organisms, except bacterial spores

Sterilization Complete elimination, destruction of all microbial

life

SPAULDING CLASSIFICATION

CriticalEnters sterile tissue or vascular

systemSemi-critical

Touches mucous membranes or non-intact skin

Non-criticalTouches intact skin

CLEANING

Goal is to render item safe for handling

Follow manufacturer’s instructions for use

Enzymatic cleaner (dilution)UltrasonicWasher (quality monitoring)

STERILIZATION

SteamGravityPre-vacuum

Ethylene OxideLow-temperature hydrogen

peroxide gas plasmaOzoneDry-heatLiquid sterilant (peracetic acid)

MONITORING OF STERILIZATION SYSTEMS

Mechanical indicators: recording charts Chemical indicators: impregnated

paper or strips. The Bowie Dick checks to see if the air has been removed from the chamber and the efficiency of the vacuum pump

Biological indicators: use first load of every day but at least once a week and with all implantables

HIGH LEVEL DISINFECTION

Pasteurization (time + heat) Glutaraldyde Stabilized hydrogen peroxide Peracetic acid Ortho-phthalaldehyde (OPA)

HIGH LEVEL DISINFECTION

Assure that the solutions and strips are marked with expiration date after opening

Assure that the temperature of the solution is monitored for each soaking

Assure that the QC for the strips and the solution are documented

LOW LEVEL DISINFECTION

Quaternary Ammonia productsQUATs (4th generation)Most common in hospitals

Phenolics Never use in nurseries due to

associated neurotoxicity to infants Chlorine-releasing agents Accelerated hydrogen peroxide

RECALLS

CONTAMINATED EQUIPMENT/SUPPLIES

Intrinsic Contaminated during production

Extrinsic Contaminated during use

Notify the FDA and CDC if a contaminated or defective product, device, or medication us suspected as the cause of an outbreak

Immediately remove from use Initiate an outbreak investigation