Infection Prevention in the Workplace

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Infection Prevention in the Workplace
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COURSE OUTLINE

• 1. Disease Definitions
• 2. Infectious Disease Examples
• 3. Highlight Influenza
• 3.1 What is Influenza
• 3.2 Types of Influenza
• 3.3 Transmission and symptoms
• 3.5 Influenza vs. Common Cold
• 4. Routes of Exposure
• 5. Types of Transmission
• 6. Infection Prevention in the University
  Setting
• 6.1 Watch for Signs and Symptoms
• 6.2 Hand Hygiene
• 6.3.1 Easy to Miss Spots
• 6.3.2 Proper Handwashing Technique
• 6.2.3 Alcohol-Based Waterless Hand
  Sanitizers
• 6.2.4 When to use Hand Hygiene
• 6.2.5 Disinfection
• 7. Review

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INTRODUCTION

• The School of Rural Public Health at the Texas
  AM Health Science Center cares about keeping
  employees and students healthy. No one likes to
  catch a respiratory illness or other infectious
  disease from someone at work.
• Germs can spread rapidly in an office or other
  workplace setting so it is very important to stay
  informed and active in protecting yourself and
  others from the common cold, flu, and other
  infectious diseases.
• We all know that simple steps like hand washing
  are most important in preventing infection but
  sometimes it is easy to forget exactly how to
  stay healthy, especially with increased stress at
  work and school.
• This course is intended to be a reminder about
  how to prevent the spread of infectious diseases
  and maintain a healthy environment in the
  university setting.

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• DISEASE DEFINITIONS
• Infectious Disease
• a disease that is caused by microorganisms such
  as bacteria, fungi, viruses, protozoa, and
  parasites that can successfully spread, invade,
  establish, and grow within a hosts tissues
• Contagious Disease
• an infectious disease that is easily transmitted
  from one person to another

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INFECTIOUS DISEASE EXAMPLES

• Influenza
• Cold
• Tuberculosis
• Chicken Pox
• Meningitis
• Severe Acute Respiratory Syndrome (SARS)
• Salmonellosis and other foodborne illnesses
• Human Immunodeficiency Virus (HIV)
• Hepatitis A, B and C

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HIGHLIGHT INFLUENZA

• What is Influenza?
• An acute illness caused by the influenza virus
  from the family Orthomyxoviridae, much different
  than the common cold virus
• Highly infectious disease that can spread
  rapidly from person to person through airborne
  droplets of saliva or other body fluids as well
  as from contaminated surfaces or objects
• Some strains cause more severe illnesses than
  others

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TYPES OF INFLUENZA

• There are three types of influenza that we hear
  about today
• Seasonal Flu mild to severe respiratory illness
  caused by the influenza virus. It is easily
  transmitted from human to human. Most people have
  some immunity. The best protection against
  seasonal flu is vaccination. 30,000 people die
  each year from seasonal flu.
• Avian Flu (Bird Flu) an infection caused by the
  avian influenza virus that occurs naturally among
  birds worldwide.
• Pandemic Flu global outbreaks of a new strain
  of influenza. Three pandemics occurred within the
  last century the worst killed 20-40 million
  people worldwide. There is no way to predict what
  the strain will be or to create vaccinations
  until it appears.

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EPIDEMIC VS. PANDEMIC

• Epidemic
• Serious disease outbreak in a single community,
  population, or region.
• Example Meningitis outbreak within a high school
• Pandemic
• Epidemic spreading around the world affecting
  hundreds of thousands of people, across many
  countries.
• Example HIV/AIDS

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• TRANSMISSION AND SYMPTOMS
• Influenza is easily passed from person to person
  and is transmitted through breathing in virus
  containing droplets that are produced when an
  infected person talks, coughs, or sneezes.
• You may also spread the flu virus through
  touching an infected person or surface
  contaminated with the virus and then touching
  your own or someone elses face.
• Sudden onset of symptoms include fever, headache,
  aching muscles, severe weakness and respiratory
  symptoms, i.e. cough, sore throat, difficulty
  breathing.
• Incubation estimates vary. The range is
  generally from 1 to 14 days
• with most in the range of 2 to 3 days.

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INFLUENZA VS. COMMON COLD
The flu and common cold are respiratory illnesses
with shared symptoms but are caused by different
viruses. Influenza is a more severe illness than
the common cold.

http//www.tamiflu.com/consumer_recognizing.asp
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EXPOSURE

• Infectious diseases can be transmitted (or
  spread)
• through four routes of exposure
• INGESTION
• INHALATION
• CONTACT
• DIRECT
• INDIRECT
• INJECTION

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ROUTES OF EXPOSURE INGESTION

• Ingestion
• Taking an infectious agent into the mouth by
  consuming contaminated food or water or through
  hand to mouth route.
• Example eating unwashed fruit or vegetables

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ROUTES OF EXPOSURE INHALATION

• Inhalation
• Breathing in droplets of an infectious agent
• Example Invisible droplets from the cough of an
  employee infected with influenza are inhaled by a
  coworker

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ROUTES OF EXPOSURE CONTACT

• Contact
• Direct Contact contact of eyes, nose, mouth,
  genitals, skin, cut, or other open wound with an
  infectious agent or an infected persons blood,
  or other body fluid
• Indirect Contact infectious agent on inanimate
  object such as a desk, keyboard, or phone is
  picked up and introduced into the body

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ROUTES OF EXPOSURE INJECTION

• Injection
• Introduction of an infectious agent by way of
  syringe or needle stick contaminated with
  infected blood or body fluid, or some other means
  of skin puncture

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TRANSMISSION

• There are three types of transmission
• Direct Transmission Infectious agents can be
  spread directly from person to person, animal to
  person, or through droplet transmission (Ex
  Infected person coughs or sneezes).
• Indirect Transmission Infectious diseases can
  be transmitted via vector borne transmission (Ex
  bite from a mosquito transmits Malaria) or
  vehicle borne transmission (Ex bacteria on a
  pencil is ingested when pencil is placed to
  lips).
• Airborne Transmission - Spread of infectious
  agents through tiny aerosol particles that are
  smaller than droplet particles and can remain
  suspended in the air for long periods of time
  (Ex Tuberculosis and Chicken Pox).

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PREVENTION
MAINTAINING A CLEAN AND INFECTION FREE
ENVIRONMENT IN THE UNIVERSITY SETTING
High traffic surfaces in a university setting can
be a source of many growing pathogens. Main
areas should be cleaned when visibly soiled and
on a regular basis

• Kitchen, food preparation areas, and bathrooms
  should be cleaned daily.
• Spills should be cleaned up immediately.
• Common or break areas should be cleaned at least
  weekly.
• Desk, keyboard, mouse, door handles or other
  furniture should be cleaned occasionally or when
  needed.

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PREVENTION CONTINUED

• Employees and students should make good choices
  about personal hygiene and illness prevention.
• Keep a clean living environment at home
• Bathe regularly
• Do not share eating utensils, glassware, or
  personal toilet articles such as combs, razors,
  towels, or toothbrushes
• Wash clothes on a regular basis
• Use appropriate respiratory etiquette cover
  your cough or sneeze with a tissue, or cough or
  sneeze into your upper sleeve if you do not have
  a tissue
• Wash hands regularly
• Avoid touching eyes, nose, and mouth
• Practice other good health habits
• Avoid close contact with people who are sick
• Stay at home when you are sick
• Receive flu shots when available

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DO NOT BE A TRANSMITTER OF INFECTIOUS DISEASE!

• Hand hygiene is extremely important in preventing
  the spread of infectious diseases.
• Cleanse your hands regularly and encourage
  frequent handwashing among everyone.
• Wash hands using soap and water 15-20 seconds
  several times a day.
• Use alcohol-based waterless hand sanitizer when
  soap and water are not available.
• Practice good personal hygiene at work and at
  home.
• Always follow sanitary practices when preparing
  food.

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WATCH FOR SYMPTOMS OF INFECTIOUS DISEASES

• Fever
• Chills
• Extreme exhaustion
• Bad cough or inflamed throat
• Open sore(s)
• Skin rash
• Vomiting
• Diarrhea
• Use discretion when experiencing these or other
  symptoms of sickness. It is more beneficial to
  stay home and recover than to provoke symptoms
  further or spread disease to others.

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HAND HYGIENE
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EASY TO MISS
Many adults tend to minimize the importance of
handwashing but this is one of the best defenses
against the spread of infectious disease. Using
proper technique is essential to sanitizing hands
effectively. Inadequate handwashing can cause
significant areas of the hands to be missed. It
is important to cover all areas of your fingers,
hands, and wrists.
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MOST FREQUENTLY MISSED AREAS
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hapter2
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PROPER HANDWASHING
Handwashing is the most important step to prevent
the spread of infectious agents. Proper
handwashing has three necessary ingredients

• Soap
• Water
• Friction

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PROPER HANDWASHING TECHNIQUE

• Wet hands with warm water
• Add soap
• Rub hands vigorously for at least 15-20 seconds
  (as long as it takes to sing the Happy Birthday
  song twice). Wash all surfaces backs of hands,
  wrists, between fingers, finger tips, and under
  fingernails. Remember, jewelry can harbor
  microorganisms.
• Rinse well under running water
• Dry with clean towel
• Use towel when turning off water and opening door
  to avoid recontamination

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WATERLESS ALCOHOL BASED HAND PRODUCTS

• Use when soap and water are not available
• Not effective in cleaning hands that are visibly
  dirty
• Convenient for keeping at your work station
• Apply product in the palm of one hand, rub hands
  together, covering all surfaces of hands and
  fingers, as when washing hands, until hands are
  dry

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WHEN TO USE HAND HYGIENE

• Before preparing, serving, handling, or eating
  food
• After using the bathroom
• After handling raw meat, poultry, or fish
• After coughing, sneezing, or blowing your nose
• Frequently any time you are sick
• Before and after touching eyes, nose, or mouth
• After handling an animal or animal waste
• After handling garbage

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WHEN TO USE HAND HYGIENE

• Before preparing medication
• Before and after treating a cut or wound
• After handling unwashed clothing or bedding
• Before and after providing assistance to someone
  ill
• After working outside
• Any time hands appear soiled
• When you arrive at work/school, before and after
  going on break, and before leaving work/school

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DEFINITIONS

• MICROORGANISMS - living agents such as bacteria,
  fungi, viruses, protozoa, and parasites that can
  cause infectious diseases
• CLEANING - to remove dirt
• DISINFECT - to remove or destroy microorganisms
• DISINFECTANT - chemical that removes or destroys
  microorganisms
• DETERGENT - cleaning agent that removes dirt and
  debris

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DISINFECTION TECHNIQUE

• Spray
• Wipe
• Spray
• Air dry

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• RULES FOR DISINFECTION
• If you are responsible for cleaning in the
  university setting, or if you choose to do extra
  disinfecting of your own workspace, it is
  important to be informed about the correct usage
  of disinfectants and cleaners.
• Too weak of a solution will be ineffective. A
  stronger solution than is recommended is wasteful
  and may lead to problems of corrosion with
  equipment and surfaces, as well as health
  problems. Residue may also harm feet, eyes, and
  other sensitive areas.

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RULES FOR DISINFECTION CONTINUED

• Equipment and receptacles used with
  disinfectants should be thoroughly cleaned and
  rinsed after use. Any organic material present
  may reduce the effectiveness of the disinfectant.
• A disinfectant should have no substance other
  than water added. Combination of chemicals can
  negate the effect of active ingredients in
  products as well as produce harmful fumes or
  cause corrosion.

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CONCLUSION

• It is vital to live a healthy lifestyle to
  protect against illness. This includes eating
  nutritious foods, getting enough rest, and
  exercising in addition to the infection
  prevention and hygiene training presented in this
  lesson.

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REVIEW

• Keeping a safe and clean environment is important
  in preventing the growth and spread of infectious
  organisms.
• The close quarters situation in many university
  settings creates a perfect environment for the
  spread of infectious diseases.
• An infectious disease is one that is caused by a
  microorganism such as a bacterium, virus, fungus,
  protozoa or other parasite. Examples include
  Influenza, SARS, HIV/AIDS, Chicken Pox,
  Meningitis, and the common cold.
• Many infectious diseases are contagious, meaning
  they can be passed from human to human.

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REVIEW CONTINUED

• Influenza is a highly contagious disease that is
  spread through droplets of saliva transmitted
  through coughs, sneezes, close contact, and
  contaminated surfaces. Influenza exists in
  various forms.
• Seasonal Flu - mild to severe respiratory
  illness transmitted human to human each year.
  The best protection against seasonal flu is
  vaccination.
• Avian Flu - caused by the avian Influenza
  (bird flu) virus that occurs naturally among
  birds worldwide.
• Pandemic Flu - global outbreaks of a newly
  emerged strain of Influenza.
• An epidemic is a serious outbreak in a single
  community, population, or region. A pandemic is
  an epidemic that exists worldwide, affecting
  people across many countries.

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REVIEW CONTINUED

• Infectious agents can be taken into the body
  through four routes of exposure ingestion,
  inhalation, contact, or injection.
• There are three types of transmission direct
  transmission, indirect transmission, and airborne
  transmission.
• Direct transmission is the spread of Infectious
  agents directly from person to person, animal to
  person, or through droplet transmission.
• Infectious agents can be spread through indirect
  transmission via vector borne transmission (i.e.
  mosquito bite) or vehicle borne transmission
  (i.e. contaminated object).
• Airborne transmission is the spread of infectious
  agents through tiny aerosol particles that are
  smaller than droplet particles and can remain
  suspended in the air for long periods of time.

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REVIEW CONTINUED

• Clean hands are the most important step in
  staying free of infectious disease.
• Proper hand hygiene includes washing hands for 15
  to 20 seconds under warm running water and
  scrubbing in between and around fingers, finger
  tips and nails, palms, backs of hands, and
  wrists.
• Waterless alcohol-based products are effective
  when soap and water are not available and hands
  are not visibly dirty. Hand sanitizers work well
  while on the job and should be rubbed entirely in
  to cover hands, fingers, and wrists in the same
  manner as when washing hands.

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REVIEW CONTINUED

• Highly frequented areas should be routinely
  disinfected to reduce lingering microbes.
  Employees and students should maintain good
  hygiene, practice proper cough and sneeze
  etiquette, wash hands frequently, and take
  measures to recover when ill.
• Hand hygiene should be performed before eating or
  handling food, after using the bathroom, after
  coughing, sneezing, or blowing your nose after
  handling wastes, garbage, or raw foods and any
  other time hands appear dirty or reasonably in
  need of cleaning.
• To disinfect is to remove or destroy
  microorganisms such as bacteria, fungi, viruses,
  protozoa, and parasites that can cause infectious
  diseases.
• Chemicals should always be used as described by
  the manufacturer. Mixing different chemicals is
  ineffective and can be very dangerous.

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POST TEST

• 1. All of the following are examples of
  infectious diseases except for
• Tuberculosis
• HIV/AIDS
• Cancer
• Meningitis
• Influenza
• When is it a good idea to wash your hands?
• After using the bathroom
• After touching your eyes or mouth
• When you are sick
• Before touching food
• All of the above

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POST TEST CONTINUED
3. True or False? To accomplish a safer level
of disinfection you should combine two powerful
cleaners such as bleach and ammonia. 4. True
or False? There has been no instance of a
pandemic flu within the past two centuries.
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POST TEST CONTINUED

• 5. Which of the following choices is true about
  alcohol-based hand sanitizers
• a) They are an ineffective way to reduce
  the spread of infection at the university.
• b) They should be rubbed into hands,
  covering all surfaces until dry.
• c) They are a better method of hand
  disinfection than soap and warm water.
• d) They work well in removing visible dirt
  from hands.
• e) They should be washed off with water at
  the sink.

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POST TEST CONTINUED

• 6. Which area is usually cleaned most efficiently
  in typical routine
• handwashing by adults?
• a) Finger tips
• b) Under finger nails
• c) Back of hands
• d) Between fingers
• e) Palms

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POST TEST CONTINUED

• 7) Match the following with the appropriate
  description
• 1. INGESTION a) Agent on inanimate object is
  introduced to the body by the object
• 2. INHALATION b) A pathogen is contacted,
  invades, and infects an open wound
• 3. INDIRECT CONTACT c) Introduction of an
  infectious agent by way of a syringe or some
  other means of skin puncture
• 4. INJECTION d) Breathing in the infectious
  agent
• 5. DIRECT CONTACT e) Consumption of an
  infectious agent by mouth

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ANSWER KEY

• 1) C
• 2) E
• 3) F
• 4) F
• 5) B
• 6) E

• 7)
• 1) E
• 2) D
• 3) A
• 4) C
• 5) B