CSMC Infection Prevention

& Control Unit

Prepared by:

JUNE MARK R. ALFEREZ, RN

Nurse III-Infection Prevention & Control Nurse
Topics:
1. Hand Hygiene
2. Isolation Precautions
3. Principles of Decontamination, Disinfection and
Sterilization
4. Hospital Waste Management
5. Needle Stick Injury: Blood and Body Fluid Exposures
6. Donning and Doffing of PPE
BACKGROUND/RATIONALE

This course consisting of instructions on the infection prevention and

control guidelines, activities and procedures, was assembled by the IPC
Committee based on the DOH manual. This course is design to assist both
frontline and administrative workers to gain basic knowledge on and
consistently practice IPC measures. Strict adherence to IPC measures helps in
halting infections and is the learning intervention created by CSMC to ensure
preparedness for possible incidence.
General Objectives:

After 3-5 hours of varied teaching-learning activities, the participants will be able to:

1. Discuss Hand Washing Practices, demonstrate the Hand Hygiene techniques.

2. Identify the principles of decontamination, disinfection, sterilization.
3. Adherence to hospital waste management.
4. Identify preventive measures on Needle stick prevention, Promptly reporting of Needle Stick injuries,
Determine the proper storage and transportation of sharps, Identify Healthcare Worker Infection Risks,
Prevention and Immunization.
5. Demonstrate the proper way of Donning and Doffing of PPE.
6. Identify the different types of isolation precautions.
7. Brief discussion on Tuberculosis, HIV, Hep B disease (Blood borne diseases).
8. Overview of Nosocomial Infections
EPIDEMIOLOGY
• The study of the distribution or occurrence of a disease
or event in a given population or geographical area
including the factors that contributed to these.
INFECTION
• The state or condition in which the body or part of the
body is invaded by a pathogenic agent (bacteria, virus,
parasites etc.) which under favorable conditions multiplies
and produces injurious effects
NOSOCOMIAL INFECTION
• latin word “nosocomium” meaning hospital
• synonymous to hospital-acquired infection
• infection acquired 48 hours after admission to hospital (not
present or incubating at the time of admission)
• acquired while in the hospital and may have developed
after discharge
Common Sites of Nosocomial
Infections:
Factors Promoting Nosocomial
Infection:
• Age
• Duration of hospitalization
• Surgery (type of operation)
• Immune Status: Chemotherapy,
radiation therapy, malignancy
• Diagnostic technique/ procedure
• Environment
• Personnel
The of Nosocomial Infection
PATIENT: INSTITUTIONS:

1. Need for hospitalization 1. Loss of revenue

2. Income loss 2. Extra Duty
3. Pain and suffering 3. Liability insurance
4. Disfigurement/Disability 4. Malpractice
5. Death 5. Reputation
CHAIN OF INFECTION Infectious Agents- includes not only
bacteria but also viruses, fungi, and parasites.
The virulence of these pathogens depends on
their number, their potency, their ability to
enter and survive in the body, and the
susceptibility of the host.
Reservoir- is any person, animal, arthropod,
plant, soil or substance in which an infectious
agent normally lives and multiplies.
Portal of Exit- is the means by which a
pathogen exits from the reservoir.
Mode of Transmission- refer to how an
infectious agent, also called pathogen, can be
transferred from one person, object, or animal,
to another.
Portal of Entry- infectious agents get into
the body through various portal of entry,
including the mucous membranes, non-intact
skin, and the respiratory, gastrointestinal, and
genitourinary tracts.
Susceptible Host- the final link in the chain
of infection, someone at risk of infection.
How do infections occur in hospital setting?
 Sources of Agents of Nosocomial
Infections:
EXOGENOUS ENDOGENOUS
• Hands • Oropharynx
• Instruments •
•
Respiratory
Catheters
• Respiratory equipments
• Gastrointestinal
• Transfusions • Skin
• IV system
• Linen
• Air
 Sources of Agents of
Nosocomial Infections:
Factors Promoting Endogenous Infections
• Operations/procedures
• Catheters
• Foreign bodies
• Chemotherapy
• Immunosuppression
• Pre-existing disease
MEANS of Transmission of
Nosocomial Infections
CONTACT -direct or indirect
AIRBORNE -measles, varicella, TB
DROPLET -Meningococcemia
VECTOR VEHICLE -Insects or animals
-food, water, blood, medication
MEANS of Transmission of Nosocomial
Infections
CONTACT
-Most common means of transmitting microorganism from one person to
another

A. Direct Contact
-occurs when one person touches another
-direct contact is an ongoing process in the hospital
-best vehicle: HANDS
B. Indirect Contact
-occurs when a person touches an inanimate object (fomite)
contaminated by an infected patient.
Factors that increase Host Susceptibility to
Nosocomial Infections
• Chronic underlying diseases
• Immune deficiency states
-Malignancies
-Therapeutic measures
-Immunosuppression
-Antibiotic Therapy
• Invasive devices
• Surgery
• Age
Breaking the Chain of Infection
The hands should be washed
after handling infectious
materials (e.g. bed linen,
dressings, secretion and
excretions).
The skin of the patient should
be disinfected before
invasive procedures
Breaking the Chain of Infection
 Breaking the Chain of Infection
Use of disposable supplies and All instruments and equipments should be
equipments in an attempt to clean and dry. Invasive items should be
limit the spread of infection by sterilized and items in contact with mucous
this means membranes, body fluids and potentially
infectious materials should be disinfected.
 Breaking the Chain of Infection
All infectious materials (e.g. linen, clinical The environment should be HOSTILE to
waste, sharps) should be safety contained, the multiplication of pathogens i.e. clean,
decontaminated or destroyed dry, exposed to light and well ventilated
 Breaking the Chain of Infection
Food should be hygienically prepared, properly
cooked and stored at low temperatures until used
 Breaking the Chain of Infection

 Isolation techniques based on method of spread

 Protective or Reverse Isolation
Rationale: decreasing the contact of the
immunocompromised host to potential pathogens
 Breaking the Chain of Infection
 Use of Personal Protective  Control of insect and rodents that
Equipment serve as vectors in the spread of
microorganisms
 Breaking the Chain of Infection
 Rational Use of Devices
 Susceptible pts. or sites should be protected
-avoiding or removing factors that impair
from pathogenic microorganism: i.e aseptic
host defenses.
technique practice during wound dressing, o
-invasive devices should be avoided or
procedures.
should be removed as soon as possible
 Breaking the Chain of Infection
Immunotherapy, immunizations and other methods of
reconstituting patients immune response maybe
attempted

 Early recognition and

treatment of infections
➢The Health Care Worker (HCW) should be aware of
how infection is transmitted and the factors involved in
the process
➢The HCW should be able to implement the MOST
effective and applicable measures to prevent and
control infection in his place of work
➢The HCW should have the proper attitude of infection
control
HAND HYGIENE
 HAND HYGIENE
The Most Important Way to Prevent Transmission of
Microorganisms and Infection
DOH National Standards in Infection Control for
Healthcare Facilities
DEFINITIONS:
Hand hygiene
– Performing handwashing, antiseptic handwash, alcohol-based
handrub, surgical hand hygiene/antisepsis.
Handwashing
– Washing hands with plain soap and water.
Antiseptic handwash
– Washing hands with water and soap or other detergents containing
an antiseptic agent.
Alcohol-based handrub
– Rubbing hands with an alcohol-containing preparation.
Surgical hand hygiene/antisepsis
– Handwashing or using an alcohol-based handrub before operations
by surgical personnel.
What Lives on our HANDS?
Transient flora:
Resident flora:  Superficial
 Transferred with ease to and
 Is our “normal skin flora” from hands
 Deep seated  Important cause of cross
 Difficult to remove infection
 Part of body’s natural  Easily removed with good hand
defense mechanism hygiene.
 Generally survive on the skin
 Associated with infection of the hands for less than 25
following hours
surgery/invasive
procedures.
Point-of-care:
refers to the place where
three elements occur
together: the patient, the
health-care worker, and care
or treatment involving
patient contact (within the
patient zone)
5 Stages of Hand Transmission
 Handwashing Stations Common Requirements
 Deep basins to prevent splashing
– shall not be less than 144 sq. in
– minimum 9-in width or length.
 The discharge point of the faucet shall be at
least 10 inches above the bottom of the
basin.
 Sink-to-patient bed ratio should be of
1:10.
 Basins or countertops shall be made of
porcelain, stainless steel, or solid surface
materials.
 Other Things Needed for Hand Hygiene
Paper Towel / Jet Air Dryer
Running Clean Water
Trash bin

Soap
Poster
Alcohol-based Hand Rub (AHBR)
STORAGE:
■ The WHO–recommended formulation handrub should not be
produced in quantities exceeding 50 L.
LOCATION OF DISPENSERS:
■ Handrub dispensers should not be placed above or close to
potential sources of ignition.
■ Handrub dispensers should not be sited in any corridor that forms
part of a means of escape (i.e. outside the ward). If dispensers are
placed in a circulation area within a ward
(e.g. outside bedded areas) it is recommended that they
are at least 1.2 metres apart, the circulation area is at
least 2 metres wide and the maximum container size is 1
litre.
Alcohol-based Hand Rub (AHBR)
Alcohol solutions containing 60 –80% alcohol are most
effective, with higher concentrations being less potent.
Fragrance
Products with strong fragrance may lead to discomfort and
respiratory symptoms.
Consistency / Texture
Handrubs are available as gels, solutions, or foams:
■ Gels–may produce a feeling of humectant “build-up”, or
the hands may feel slippery or oily with repeated use.
■ Solutions–consistency similar to water. Often dry more
quickly
■ Foams–less frequently used and more expensive, may
produce stringer “build-up” and may take longer to dry.
Antimicrobial Activity and Summary of Properties of Antiseptics Good
used= +++
in Hand Hygiene
Moderate = ++
Poor = +
Variable = ±
None = –
HR: handrubbing;
HW: handwashing
*Activity varies with concentration.
a Bacteriostatic.
b In concentrations used in
antiseptics, iodophors are not
sporicidal.
c Bacteriostatic, fungistatic,
microbicidal at high concentrations.

d Mostly bacteriostatic.
e Activity against Candida spp., but
little activity against filementous
fungi.
Your 5 Moments of Hand Hygiene
Before Patient Contact
Direct Contact with Patients

Before Aseptic Task

Putting on gloves, before any procedures.

After Body Fluid Exposure Risk

Contact with blood, Body Fluids, secretions,

excretions, wound exudates.

After Touching Patient

Direct Contact with Patients

After Touching Patient Surroundings

Medication Preparations, food preparations, removal
of other personal equipment.
The 5 Moments apply to any setting where health care involving direct
contact with patients takes place
 MEDICAL and SURGICAL HAND HYGIENE
Long sleeves must be
Wristwatches, bracelets rolled up to above the
(except Kara) & all rings elbow. If applicable, try to
(except for a PLAIN wedding adopt a “Nothing Below the
band) must be removed. Elbows” policy.

Fingernails should be:

• Short (1/4 inch in length)
• Clean
• Free from nail varnish
Remove jackets/ • Free from nail art
cardigans/ jumpers/ • Free from nail extensions
coats & hang them • Free from artificial
up in a designated fingernails
secure area.
 AREAS “MISSED SPOTS

1. Webs of fingers, 2. Thumbs, 3. Palms, 4. Nails, 5. Backs of fingers & hands, 6.Wrists
HOW to HAND WASH & HAND RUB
HOW to HAND WASH & HAND RUB
HOW to SURGICAL HAND WASH
 COMMON REASONS for NON-COMPLIANCE to HAND HYGIENE
BARRIERS TO HAND HYGIENE:
■ Inaccessible hand hygiene supplies
■ Skin irritation caused by hand hygiene agents
■ Hand washing and hygiene products thought to be harmful to the
skin
■ Priority of care (the patient’s need takes priority over hand hygiene)
■ Lack of knowledge of the guidelines
■ Lack of feedback to encourage compliance
■ Insufficient time for hand hygiene
■ Forgetfulness
■ High workload and understaffing
■ Lack of scientific information about healthcare- related infection
rates
 STRATEGIES TO IMPROVE HAND HYGIENE COMPLIANCE
■ More convenient sink locations
■ Performance feedback, policy reviews, memo
■ Posters, films, brochures, stickers
■ Lectures and demonstrations
■ Alcohol-based hand rub made available
■ Announcement of observations (compared to covert observation at
baseline)
■ Focus group discussion (FGD)
■ Voice prompts if failure to handrub
■ Introduction of wearable personal handrub dispensers
■ Education
■ Administrative support
 ISOLATION
PRECAUTION
S
STANDARD Vs. TRANSMISSION-BASED Precautions

Standard Precautions: apply to ALL care

activities regardless of suspected or confirmed infection
status

Transmission-Based Precautions: added

measures to prevent the spread of disease from patients
with known or suspected disease
 TRANSMISSION-BASED Precautions
“Transmission-Based Precautions” used to reflect
infection control measures, in addition to STANDARD
PRECAUTIONS that are needed to prevent
transmission of highly transmissible or
epidemiogically important infectious agents.

 Contact Precautions
 Droplet Precautions
 Airborne Infection Isolation
(AII)
 Types of TRANSMISSION-BASED Precautions
Contact Precautions
Methods used to contain diseases that are spread by:

– Direct Contact: Contact with the patient

– Indirect Contact: Contact with the patient’s
environment

Known or suspected infection or others that are

“epidemiologically important”

Patients at risk of contaminating their environment

Gown and gloves at entry point, before contact with a patient or
patient’s environment
Potentially contaminated objects include:
– Objects, such as tray tables and bedrails
– Medical equipment (e.g. Blood Pressure cuff)
Dedicated patient equipment is preferred
PPE removed at the point of exit, prompt hand hygiene
 Types of TRANSMISSION-BASED Precautions
Droplet Precautions
Prevents transmission of diseases spread by
large respiratory droplets through coughing,
sneezing, or talking

Examples of conditions requiring Droplet

Precautions include seasonal influenza and B.
pertussis
A face mask is worn upon entry into the patient room. Use
Standard Precautions when handling items contaminated with
respiratory secretions
PPE must be removed at the point of exit; do not reuse face
masks
Hand hygiene follows PPE removal
 Types of TRANSMISSION-BASED Precautions
Airborne Infection Isolation
Prevents transmission of infectious agents that are
very small and remain viable and suspended in the
air over long distances

Examples include measles, M. tuberculosis,

chicken pox

Patient placed into a negative pressure isolation

room
Particulate respirator (e.g. N95) or powered air purifying
respirator (PAPR) worn before entry
With a particulate respirator, perform a fit-check before
entering an area where they may be airborne infectious disease
 CLEANING,
DECONTAMINATION,
DISINFECTION and
STERILIZATION
 CLEANING, DECONTAMINATION,
DISINFECTION and STERILIZATION
CLEANING • The first and the most important step in
Removal usually with detergent and water or decontamination is thorough cleaning
and rinsing.
enzyme cleaner and water , Of adherent visible
soil, blood, protein substances microorganisms and • To remove all visible debris from an
other debris from the surfaces, crevices, serrations, item and to reduce the number of
particulates, microorganisms and
joints, and lumens of instruments, devices, and potential pyrogenes.
equipment by a Manual or mechanical process that
prepares the items for safe handling and or further
decontamination.
 CLEANING, DECONTAMINATION,
DISINFECTION and STERILIZATION
CLEANING METHODS
1. Manual Cleaning – Recommended for delicate
or complex medical devices.
Example:
Microsurgical instruments, air powered drills.

2. Mechanical Cleaning – Removes soil and

microorganisms through an automated
cleaning and rinsing process.
Examples:
Washer sanitizers/disinfectors
Ultrasonic Cleaners.
 CLEANING, DECONTAMINATION,
DISINFECTION and STERILIZATION
DECONTAMINATION
The use of physical or chemical means to remove,
inactivate, or destroy blood borne pathogens in
surface or item to the point where they are no
longer capable of transmitting infectious
particles and the surface of the item is rendered
safe for handling use, use or disposal of all
pathogenic organisms.

Cleaning and Decontamination should begin as

soon as possible after items have been used .
Adequate cleaning is the first step in the
decontamination and reuse process.
 CLEANING, DECONTAMINATION,
DISINFECTION and STERILIZATION
DISINFECTION
Thermal or Chemical destruction of
pathogenic and other types of
microorganisms.

Less lethal than sterilization because it

destroys recognized pathogenic
microorganisms but not necessarily all
microbial forms (Bacterial Spores)
 CLEANING, DECONTAMINATION,
DISINFECTION and STERILIZATION
The choice of level of disinfection depends on the risk
category of instruments
Three Spaulding Categories:

1. Critical Devices – are instruments or objects that are 3. Non-critical devices – are
introduced directly into the human body, either into or in contact instruments or objects that usually
with the bloodstream or other normally sterile fluid pathways. contact only the intact skin of the
Ex. Surgical instruments, needles, cardiac catheters, patient.
implants. Ex. Blood pressure cuffs,
2. Semi-critical devices – are instruments or objects that electrodes
contact mucous membrane or non-intact skin of the patient during
use, but do not usually penetrate the blood barrier or other normally
sterile areas of the body.
 CLEANING, DECONTAMINATION,
DISINFECTION and STERILIZATION
DISINFECTANT
Usually a chemical agent (but sometimes a Before Sterilization
physical agent) that destroys disease – causing and High Level
pathogens or other harmful microorganisms but
might not kill bacterial spores Disinfection can be done:
MUST decontaminate
MUST clean and rinse
Examples:
instruments and
equipments
 CLEANING, DECONTAMINATION,
DISINFECTION and STERILIZATION
STERILIZATION METHOD OF STERILIZATION
Is the destruction of all living  Moist and Heat
microorganisms by exposure to physical or  Hot air Oven
chemical agents  Ionizing radiation
 Ethylene Oxide
 Low Temperature steam and formaldehyde
 Chemical disinfection sterilization
STERILIZATION PROCESS
 Cleaning
 Inspection/ assembly
 Packaging
 Sterilizer loading
 Sterilization
 Storage
 Method of Sterilization
◘ Chemical Sterilization
• Sporicidal disinfectant
(sterilant)
• 2% Glutaraldehyde used for
heat
sensitive equipment 3 to 10
hours Sterilization Process
• Decontamination
• Inspection / assembly
• Packaging
• Sterilizer loading
• Sterilization
• Storage / distribution
/documentation
 HOSPITAL
WASTE
MANAGEMENT
HOSPITAL WASTE MANAGEMENT

Includes all waste generated by health care

establishments, research facilities, &
laboratories
Categories HOSPITAL WASTE MANAGEMENT
• General waste
• Infectious waste
• Pathological waste
• Sharps
• Pharmaceutical waste
• Genotoxic waste
• Waste with high content of heavy metal
• Pressurized container
• Radioactive waste
GENERAL WASTE INFECTIOUS WASTE
• Comparable to domestic waste • Contains pathogens (bacteria, viruses,
• Does not pose special handling problems or parasites, or fungi) in sufficient
hazards to human health or to the environment amount
• Mostly from administrative & housekeeping • 10% to 15% of hospital waste
functions of health care establishments, e.g., COLLECTION/DISPOSAL
office paper, food waste • Should be placed in yellow leakproof
container
• Collected by
PATHOLOGICAL WASTE SHARPS WASTE
Needles, syringes scalpels,
Human tissues or fluids (e.g., body parts, saws, blades, broken glass,
blood or other body fluids, fetuses) infusion sets, knives, nails,
& other items that can
cause a cut or punctured
wounds
• Considered as highly
hazardous HCW
NON-INFECTIOUS INFECTIOUS WASTE NON-INFECTIOUS WET
WASTE( B L A C K ) (YELLOW) WASTE (GREEN)
• Help control nosocomial disease, • Easily and cost-effectively address
complementing the protection health care worker safety issues,
effect of proper hand washing including reducing the risk of
• Reduce community exposure to needlestick injuries
multi-drug resistant bacteria • Prevent illegal repackaging & resale
• Dramatically reduce HIV/AIDS of contaminated needles
sepsis and hepatitis transmission • Avoid negative long-term health
from dirty needles & other effects, e.g., cancer from the
improperly cleaned/ disposed environmental release of toxic
medical items substances such as dioxin, mercury
• Control zoonoses (disease passed to & others
humans through insects, birds, rats
& other animals)
• Cut cycles of infection
Let the waste of the “sick” not contaminate the lives of “The Healthy”
SHARP AND NEEDLE
STICK INJURY AND
EXPOSURE
MANAGEMENT
Objectives:
1. Differentiate needle stick injury and sharp injury
2. Identify preventive measures on Needle stick prevention
3. Identify control measures in preventing needles stick and sharp injury
4. Knows the procedure on Safe Sharps Management & Safe Handling of sharps
5. Identify Healthcare Worker Infection Risks, Prevention and immunization.
6. Present the procedures in reporting needles stick and sharp injury
7. Present the management of needle stick and sharp injury
8. Conduct orientation in filling up the Incident Accident Report and Incident Report
for Percutaneous Injury and Exposure.
 Sharps
 Definition: any needles, syringes with needles,
scalpels, blades, broken ampules or other articles
that could cause wounds or punctures to personnel
handling them.
 Must be discarded into special containers without
risk to disposal personnel.
 Sharps Injury

 Is any injury caused by

object and is
contaminated by Blood or
other potentially
infectious material.
 Needlestick Injury
 Is a penetrating stab
wound from a needle that
may result in exposure to
blood or other bloody
fluids
 OCCUPATIONAL EXPOSURE
 A reasonably anticipated skin, eye, mucous membrane, or parenteral contact with
blood or other potentially infectious materials that may result from the
performance of employee’s duties
Risk Posed by Sharps

 Transmission of blood borne pathogens to someone

injured by the sharp.
 Between 600,00 and 800,00 sharp injuries occur among
healthcare workers annually according to OSHA.
 Blood Borne Pathogen Transmission
Sharps injuries can be associated with occupational transmission of
more than 20 blood borne pathogens:
 Most common pathogens:
• Hepatitis B (HBV)
• Hepatitis C (HCV)
• Human immunodeficiency virus (HIV)
 Sharps injuries can lead to serious or fatal infections.

 Culture of Safety
• About ½ of sharp injuries go unreported.
• A culture of safety should be promoted by:
 Reporting injuries and hazards.
 Supporting involvement of staff in selection of sharps injury
prevention devices.
 Providing education and training on sharps injury prevention.

Sharps that Frequently Cause Injury
 Hypodermic Needles
 Blood collection Needles
 Suture needles
 Needles used in IV delivery systems
 Glass capillary tubes
 Used disposable razors

 Who is at RISK?
 Physicians
 Nurses • 18% of medical
trainees sustain a
 Lab Technicians percutaneous exposure
annually.
 Phlebotomists • Long work hours, sleep
 Mid-level providers deprivation resulting in
fatigue is associated
 Housekeepers with an increased risk
 Laundry personnel of needlestick injuries.

 
And others
 Procedures LINKED to Injuries
1. Drawing blood
2. IM injections
3. IV access
4. Suturing
5. Handling laundry
6. Collecting filled sharps containers
7. 
And more…
 Bloodborne Pathogen Standard
Healthcare facilities must:
 Develop and periodically review an exposure control plan.
 Offer safer medical devices to reduce or eliminate exposure
incidents.
 Seek employee input in selection of safer medical devices and
implementation of work practice controls.
 Offer the Hep B vaccine to workers.

 Methods to REDUCE Exposure

• Follow standard precautions.

• Use engineering and work practice controls.
• Wear personal protective equipment.
• Avoid recapping, bending or breaking of needles
and sharps.

CEBU SOUTH MEDICAL CENTER
Needlestick Injury Report

(2021-2023)
 CSMC Needlestick Summary Report 2021
Medial
Techonol- Doctor
ogist 8%
17%

Nurse
25%

Utility
33%
Nursing At-
tendant
Midwife 8%
8%

Doctor Nurse Nursing Attendant Midwife

Utility Medial Techonologist Other
 CSMC Needlestick Summary Report 2022

Other
6% Doctor
Medical Intern 18%
12%
Medial
Techonologist Nurse
12% 12%

Nursing At-
tendant
Utility 12%
29%

Doctor Nurse Nursing Attendant Midwife Utility Medial Techonologist Medical Intern Other
 CSMC Needlestick Summary Report 2023

MedicalStudent Nurse Doctor

Intern 7% 7%
7%

Nurse
27%
Utility
20%

Nurse
Trainee
Midwife Nursing 7%
20% Atten-
Doctor Nurse Nurse Trainee Nursing Attendant Midwife Utility dant
Medial Techonologist Medical Intern
Student Nurse 7%
Prevention of NEEDLESTICK and SHARP
INJURIES
A. ADMINISTRATIVE Control
1. Conduction of Orientation on handling and safe
disposal of needles and sharps
2. Purchase devices with safety features as hospital
budget allows.
3. Ensure timely reporting and timely follow up of
report.
B. HEALTHCARE WORKERS
CONTROL
1. Attendance to orientation
2. Help in selection and
evaluation of device with
safety features
3. Observance of safe
handling and disposal
Innovation in Safe Sharps Technology to prevent NSI
 Standard Precautions
• CDC recommends standard precautions:
 Assume all blood and body fluids are infectious.
 Every patient is treated as potentially infected with a bloodborne
pathogen.
 All healthcare workers must use standard precautions whenever
there is a chance of exposure to blood to blood or other potentially
infectious materials.
 Workers must use hand hygiene.

Safe Practices

 Avoid recapping, bending or breaking needles and sharps.

 Use a one hand technique if medical procedure requires recapping.
 Place used sharps immediately into puncture-resistant containers.
 Carry sealed specimen containers in an outer container.
 Avoid touching contaminated broken glass with bare hands.

 Safe Medical Device

 A protective device that can be used to protect healthcare

workers from accidental needlesticks and other sharps injuries.
 Generally take the same form and are used for the same
application as their traditional non-safety counterparts.
 Protective devices are designed to prevent personnel from
coming into contact with an exposed needle or other sharp.

 Two Types of Safer Medical Devices
 Needleless systems, such as needleless
IV line connectors.
 Sharps with engineered sharps injury
protection, such as self-sheathing
needles on syringes.

Now You See It. Now
You Don’t.
 Needleless Systems

 Device that does not use a needle for :

• Collection of body fluids
• Administration of medication/fluids; or
• Any other procedure with potential percutaneous
exposure to a contaminated sharp.

Needleless Systems
 Engineered Sharps Injury Protection
• Non-needle sharps or needle devices with built-in
safety features or mechanisms that reduce the risk of
exposure incidents.
• Uses:
-Withdrawing body fluids
-Accessing a vein or artery

-Administering medications or other fluids
Example of Hypodermic Syringe with Retractable
technology
Example of Phlebotomy Needle with Self-blunting Feature
Needleguard Safety Feature
 Personal Protective Equipment

• PPE
• Equipment worn to minimize exposure to
infectious materials or chemicals.
• Required by the Bloodborne Pathogens Standard
if exposure to blood and other potentially
infectious materials is anticipated.

 Protective Clothing
• Know where protective wear is stored
• Gloves, gowns, mask, face protector, etc.

 Risks of Glass Capillary Tubes
• Used to collect blood
• Break when inserted into putty
• Break during centrifugation
• Replace with non-glass material or
• Wrap in puncture-resistant film or
• Look at products that can measure Hematocrit without

a centrifuge.
 Sharp Disposal Containers
 All contaminated sharps must be discarded in a sharps
container.
 Place sharps in container immediately after use.
 Place containers in patient rooms.
 Do not overfill container.
 Follow your practice’s procedures for disposal of
sharps and container.

 Reporting of Needlestick and Sharps Injuries

Wash Hand with Soap and Water Report to immediate

Supervisor/IPCU within 24 hours

Fill up the Incident

Accident Report Form
 Reporting of Needlestick and Sharps Injuries

Medical Treatment or Vaccination

if necessary HIV/HEPA B/ HEPA C Post exposure Prophylactic
Examination as Recommended Treatment as Recommended
 Exposure Incident

 An exposure incident has occurred if

-Blood or other potentially infectious material (not
your own) has come into direct contact with your eyes,
mouth, mucous membranes or open wounds; or
-You have punctured your skin with a contaminated
sharp object.

 Exposure Incident
• Report all exposures
• Complete necessary paperwork to help document
exposure.
• Employer will provide a medical evaluation
counseling, treatments, information, etc. as needed for
you.

 Post-exposure

• Hepatitis vaccine is recommended if you have

not been vaccinated.
• Post-exposure prophylaxis should be started if
clinically indicated. E.g.. HIV should be started
within hours after exposure.

 Management to Staff with Needle prick or
Sharp Injury
1. Exposure and Risk Assessment
Management to Staff with Needle prick or Sharp
Injury
 Management to Staff with Needle prick or
Sharp Injury
2. Counselling 3. HIV Testing & Prophylaxis
 Management to Staff with Needle prick or
Sharp Injury
4. Serologic Testing

The screening test and schedules

for the following blood borne
infections are recommended for
hospital personnel after
occupational exposure to HIV,
hepatitis B, and Hepatitis C.
 Management to Staff with Needle prick or
Sharp Injury
4. HEPA B Vaccination
 Management to Staff with Needle prick or
Sharp Injury
Hepatitis C

 Baseline anti-HCV and ALT testing for shall be done for the exposed personnel.
 Follow-up testing of anti HCV and ALT activity after 4 month and 6 months from
the time of exposure.
 Conduct HCV RNA test after 4 and 6 month from the time of exposure.
 If an injured personnel tested anti-HCV positive and has a high level of ALT, refer
to Infectious Disease Specialist.
Management to Staff with Needle prick or
Sharp Injury
Management to Staff with Needle prick or
Sharp Injury
 Incident Accident Report
Form & Incident Report for
Percutaneous Injury
 Incident Accident Report
Form & Incident Report for
Percutaneous Injury
 Incident Accident Report
Form & Incident Report for
Percutaneous Injury
 Proper Donning and
Doffing of Personal
Protective Equipment
(PPE)
 Personal Protective Equipment (PPE)

 Refers to protective clothing, helmets, gloves, face

shields, goggles, facemasks and/or respirators or
other equipment designed to protect the wearer
from injury or the spread of infection or illness.
 Effective use of PPE includes properly removing
and disposing of contaminated PPE to prevent
exposing both the wearer and other people to
infection.
 Types of PPE Used in Healthcare Settings

 GLOVES – protect hands

 GOWNS/ APRONS – protect skin and/or clothing
 MASKS and RESPIRATORS – protect mouth/ nose
- protect respiratory tract from airborne
infectious agents.
 GOGGLES – protect eyes
 FACE SHIELDS – protect face, mouth, nose, and eyes
Mask
A term that applies collectively to items used to cover the nose and
mouth and includes both procedure masks and surgical masks.

1. Procedure Mask
A covering for the nose and mouth that is intended for use in
general patient care situations. These masks generally attach to the face
with ear loops rather than ties or elastic.
2. Surgical Mask
A device worn over the mouth and nose by operating room
personnel during surgical procedures to protect both surgical patients
and operating room personnel from transfer of microorganisms and body
fluids.
What is the TRUTH behind
this?
 How do I know that the mask is on correctly?
•The metal nose piece is at the top.
•The white, or smoothest side, is on the
inside against the wearer’s skin; the color
always faces out.
•The pleats fall downwards and away from
the nose (called a “waterfall” pleat).
3. Respirator
A personal protective device worn by healthcare personnel to
protect them from inhalation exposure to airborne infectious agents that
are <5um in size.
• N95 disposable particulate, air purifying, respirator is the
type used most commonly by healthcare personnel.
• N-99
• N-100 particulate respirators
• Powered air-purifying respirators (PAPRS) with high efficiency
filters
• Non-powered full-facepiece elastomeric negative pressure
respirators.
 Goggles
These are tight-fitting eye protection that completely
cover the eyes, eye sockets and the facial area
immediately surrounding the eyes and provide
protection from impact, dust and splashes.

Face Shields
These transparent sheets of plastic extend from the eyebrows to
below the chin and across the entire width of the employee’s head.
Face shields protect against nuisance dusts and potential splashes or
sprays of hazardous liquids but will not provide adequate protection
against impact hazards.
 Gloves
• Natural (Latex) Rubber Gloves
They feature outstanding tensile strength, elasticity and temperature resistance.
Latex gloves have caused allergic reactions in some individuals and may not be
appropriate for all employees. Hypoallergenic gloves, glove liners and powderless gloves
are possible alternatives for workers who are allergic to latex gloves.

• Nitrile Gloves
Are made of a copolymer and provide protection from chlorinated solvents such as
trichloroethylene and perchloroethylene.
They offer protection when working with oils, greases, acids, caustics and alcohols but
are generally not recommended for use with strong oxidizing agents, aromatic solvents,
ketones and acetates.
Gown
“Fluid-resistant Gown” apply to protective
clothing tested against water as the liquid
challenge.

“Impermeable Gown” materials that have

demonstrated blockage of microorganisms
using a recognized standard test method.
 Gown  Although Coveralls typically provide 360-degree
protection because they are designed to cover the
 Surgical gowns rated for high levels of barrier whole body, including back and lower legs and
protection may include the high-performance sometimes head and feet as well, the design of
barrier materials in only certain portions of surgical/isolation gowns do not provide continuous
the gown (sleeves and front panel). This is whole-body protection(e.g., possible openings in the
especially important when contact from back, coverage to the mid-calf only).
hazardous/contaminated fluids can come
from multiple directions.
Sample 2
SUMMARY

• Use devices with safety features. Know how to

use them.
• Never recap needles.
• Always dispose of used and contaminated
sharps immediately in the proper container.
• Be aware of hazards of non-needle sharps:
-Broken glass, scalpels, blades, etc.

-Report all sharp related injuries.
 Resources

• OSHA Bloodborne Pathogens Fact Sheet:

• https://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact01.pdf
A
:
• CDC:
• http://www.cdc.gov/sharpssafety/pdf/sharpssafety_poster3.pdf