Infection Prevention and Control – Objectives of this package
After reading this section on Infection Control, you will be able to:
Apply the concepts of Routine Practice / Standard Precautions in your practice.
Recognize the importance of proper handwashing technique and compliance to hand
Recognize the risks from sharps injuries and list the appropriate interventions, including
Identify the resources available to aid in solving Infection Control issues.
Outline when isolation is used and how to determine which patients require isolation
1. What is Infection Control?
It is a field involving:
Epidemiology & Statistics
Management & Communications
Disinfection, Sterilization & Sanitation
Patient Care Practices.
Our goal is to prevent and control of the spread of nosocomial
(hospital-acquired) infections from occurring in patients, staff and
2. Who makes up the Infection Prevention and Control Team?
We are a diverse team made up of a Manager certified in Infection Control, 8 Infection Control
Practitioners (ICP) who are Registered Nurses, Registered Medical Lab Technologists or
Respiratory Therapists certified in Infection Control or pursuing it. In addition the team also has a
data analyst and secretary who support the ICPs. We are active members of Community and
Hospital Infection Control Association (CHICA), Hamilton and Neighbouring Districts Infection
Control (HANDIC), Hamilton Prevention and Control committee (HIPCC) and American
Practitioners of Infection Control (APIC).
3. What does the Infection Control team do?
The Infection Control service supports all areas in the hospital. The Infection Prevention and
Control (IP&C) policies and procedures are mandated under the Health and Safety Act and are
found on the Hamilton Health Sciences intranet under the Policy Library. The policies and
procedures are written to ensure there is compliance with legislation, national and provincial
guidelines. The ICPs perform clinical surveillance rounds based on previous statistics and problem
areas. Surveillance by objectives, education & consultation is provided to patients, staff, physicians,
visitors, outside agencies and the community.
Orientation Revised April 2007
4. Who are the members of the Infection Control Team:
Manager, Infection Prevention & Control (IP&C.) Service, Lee Ramage ext. 42011.
Medical Director, Dr. Mark Loeb
Secretary, Infection Prevention & Control, Margaret Renda ext. 42007
Chedoke and McMaster:
Mary-Catharine Orvidas, ext. 76310, pager 7517
Connie Gittens-Webber, ext. 75407, pager 7138
Simona Dalgleish, ext. 75400, pager 7252
Cathy Dixon, ext. 46189, pager 7556
Shelley Schmidt, ext 46115, pager 7101
Patricia Perry, ext. 46141, pager 7081
Jennifer Blue, ext. 42056, pager 7004
Cindy O’Neill, ext. 43534, pager 7051
Or visit the Infection Control Intranet at http://corpweb/infectioncontrol/
**After 17:00 there is one ICP on call for all sites and they can be contacted through paging .
5. Where can I find the Infection Control Policies and Procedures?
The Infection Control policies and procedures are on-line. They can be accessed through the
HHS Intranet by selecting Policy Library >Infection Control > choose specific Policy and
Procedure. Also any updated information or new standards will be outlined on the Infection
6. Are there differences at the four sites?
Due to the distinct nature of the patient populations at all four sites, some differences in
practice may occur. Every effort is made to ensure that the basic principles of Infection Control
are used in consistent decision-making. Where you see variations in protocol, which are
difficult to understand, please contact your Infection Control Practitioner for clarification or
Remember ...not all “bacteria” are harmful. In an effort to protect you and our patients,
remember to please take the time to wash your hands for 15 seconds after all patient contact
and after handling of contaminated items.
Waterless handwash products are the best and most efficient method to wash hands.
Handwashing is a #1 priority
15 seconds before and after patient contact or
touching their environment.
Before and after applying gloves.
Wear gloves for one task then remove.
Use anti-bacterial hand lotion provided in hospital.
No artificial nails – direct patient care or food
Gently pull the tip of the nozzle with the fingers to
dispense a small amount of Quik-Care™ foam (the size
of a quarter) into the palm of your cupped hand.
****Rub hands together until completely dry before
Organisms are spread by modes of transmission. All isolation and disinfection practices are based
on the 6 modes of transmission.
Modes of Transmission
iss 1. Contact- Touch, person –to-person spread. Handling contaminated equipment
rv Tr 2. Droplet- Large droplets sprayed one meter around patient from coughing/sneezing
o ir s of
Mo 3. Airborne - Small particles dispersed into the air and remain in the air.
4. Vehicle – Common source e.g. Food contaminated with bacteria.
5. Vector – Spread by vector e.g. West Nile virus spread by mosquito.
6. Parenteral – Needlestick injuries – bloodborne pathogens
Whether Infection Occurs Depends Upon………
Length of the exposure
Nature of the exposure
Type of exposure (micro-organism)
Inoculum (how much substance got into patient/you)
Virulence of the substance
Mode of transmission
Your health status, risk factors, immunity or susceptibility
Potential Pathogens PPE
AIRBORNE Tuberculosis, Varicella, Disseminated shingles N95 Respirator
Surgical facemask or fluid
DROPLET Neisseria meningiditis disease. Rubella resistant procedure mask
with eye protection.
Surgical facemask or fluid
Influenza, RSV, pneumonia, patients with fever & resistant procedure mask
DROPLET/CONTACT respiratory illness with eye protection.
Gown and Gloves
Scabies/lice, draining wound not contained in dressing,
diarrhea, Antibiotic Resistant Organisms (AROs)
including Multi-resistant Staphylococcus aureus
CONTACT (MRSA), Vancomycin Resistant Enterococci (VRE),
Extended-spectrum Bacterium Lactamase (ESBL), Gown and Gloves
Multi-resistant pseudomonas aureus, Strep pneumoniae
resistant to Penicillin
How to put on Personal Protective Equipment (PPE)
How to remove Personal Protective Equipment (PPE)
No Doctor’s order needed to isolate refer to Infection Control policies and
procedures Communicable Disease Index and Febrile Respiratory Illness (FRI)
policy on intranet.
Look up signs and symptoms/ diagnosis/ organism on Communicable
disease index to determine who should be isolated.
Follow and wear the appropriate Personal Protective Equipment (PPE) as
outlined on patient’s door & use the supplies outside door
Discard apparel appropriately - gown and gloves in room, face masks and eye
protection at door after handwashing
Dishes and Linen - no special precautions * Just wash hands after removing PPE
Waste – infectious waste goes into YELLOW plastic bags
Airborne isolation requires negative pressure room and/or High Efficiency
Particulate Air filter (HEPA) – door must be kept CLOSED at all times.
Standard Precautions (Routine Practices)
Treat all blood and body fluids as potentially infectious and apply the appropriate PPE
according to the task you will be performing.
As a healthcare professional, you are responsible to assess what procedures you are
about to perform, then don (apply) the most appropriate PPE. Any procedure where
there is even a remote chance of exposure to blood or body substance spray – a
facemask and eye protection must be worn.
Notifying Infection Control
CALL your Infection Control Practitioner at your site for Infection Control
Inform patient name and diagnosis for any patient who has suspect or known
Respiratory symptoms, positive chest x-ray, rashes, post operative
infected wounds, IV or central line infections, diarrhea
When isolating patient or discharge isolation
When consultation is needed
Exposed to Meningitis?
What type of meningitis did the patient have?
If Meningococcal - Yes, then ask
Did I do mouth-to-mouth?
Did I intubate patient?
Did I suction patient?
Was I directly in contact with patient while they were vomiting?
If the answer is “No”, no further follow-up is required
Was I wearing a facemask? - If answered “Yes” – No follow-up is required
In any case, you should report to Occupational Health
What Is a Needlestick or Mucosal Injury?
Puncture, cut or jab - breaking your skin caused by a contaminated sharp object
eg. needle, scalpel
Mucosal splash is a spray of blood or contaminated body fluid into eyes, nose or
Immediate First Aid following Needlestick/Sharp Injury
Briefly induce bleeding from wound
Wash wound 10 minutes with soap and water or antiseptic
(Do not use chlorine bleach on your skin)
Remove foreign objects from wound
Report to Employee Health or when closed, report to ER immediately
Immediate First Aid - Non-intact Skin or Eye Exposure
Wash area of skin with soap and water or antiseptic soap
If splash to eye, irrigate copiously with tap water, sterile saline, sterile water for
Report to Employee Health or when closed, report to Emergency Room
Need to be assessed for Post Exposure Prophylaxis (PEP). If patient is HIV+,
need to start Anti-virals as soon as possible after injury no later than 8 hours.
Your Hepatitis B status- Have you been immunized? Must have Anti-HB > 10
If source positive HBsAg+ - You need Hepatitis B Immunoglobulin
If source negative for HBsAg – You need a vaccine
Need Anti-Hepatitic C Virus checked. If this turns positive within 3-6 months, you
may need treatment
You are Responsible and A Role Model For
Following good handwashing practices.
Wearing proper PPE and removing it carefully as per Isolation signs and
Standard Routine Precautions.
Follow the Infection Control policies and procedures, when in doubt ask
Complying with Infection Control practices
Reporting your exposures and any infectious illness (i.e. febrile respiratory
illness) or Communicable Disease to Employee Health
Maintaining your immunizations and obtaining your
Annual Flu shot
Hepatitis B vaccine