Infection Prevention & Control for Patient

Transporters

Vydia NankoosinghKyla Van Dusen

Infection Prevention & ControlOctober 5, 2010

Outline• Chain of infection

• Routine practices & additional precautions

• Corporate policy change

• Transporting a patient

Chain of Infection

Routine Practices & Additional Precautions In All Health Care Settings. PIDAC Aug 2009

Chain of InfectionVRE

GI TRACT

STOOL

CONTACT

MUCOUS

MEMBRANES

HOSPITALIZ

ED

PERSON

Break the Chain

• Routine Practices:– Hand hygiene– Personal Protective

Equipment– Environmental cleaning

& disinfecting

Routine Practices• Infection prevention and control practices that are to

be followed with all patients, all the time, regardless of diagnosis to prevent and control transmission of infections.

• Elements of routine practices that apply to transport staff are hand hygiene , use of personal protective equipment and cleaning of multi-use equipment between patients.

Hand Hygiene• Single most important practice for preventing the

transmission of infection• Responsibility of all individuals involved in health

care• There are two methods of killing/removing

microorganisms on hands:–Alcohol based hand rub–Washing with soap & water

When do I clean my hands?• Before and after contact with any patient, their body

substances or items contaminated by them • Before putting on gloves• After taking off gloves • After using the washroom • After sneezing, coughing or blowing your nose • Any time hands are dirty

Routine Practices:Personal Protective Equipment

Would you wear PPE?

Routine Practices:Personal Protective Equipment

• Assess the risk of exposure and protect yourself with:

– Gown– Gloves– Hand hygiene

Routine Practices:Personal Protective Equipment

• Wear gloves to handle soiled linen and bags of linen

• Remove gloves, perform hand hygiene before pushing cart throughout the hospital

Do you wear PPE to push the cart?

Do you wear PPE to push the cart?

• The preferred method is to use hand hygiene

• Hand hygiene kills 99.9% of germs in 15 seconds

• Hand hygiene protects you while also protecting others

Routine Practices:Disinfecting Equipment

• Hospital approved disinfectant is Virox wipes

– Wear gloves as per label

• Multi-use equipment must be cleaned and disinfected between each patient

– Stretcher, wheelchair

– High touch surfaces

Can you tell which patient has an infection?

Additional Precautions• Used in addition to routine practices when a

patient has a suspected or definite diagnosis of infection

– Contact– Droplet/Contact– Airborne

Additional Precautions• A patient’s isolation

status could change at any time

– Microbiology results– Symptoms of concern– Contact with a positive

patient

Additional Precautions:Disinfecting Equipment

• Hospital approved disinfectant is Virox wipes

– Wear gloves as per label

• Multi-use equipment must be cleaned and disinfected between each patient

– Stretcher, wheelchair– High touch surfaces

Iceberg Effect• The tip of the iceber g is the

patients with known infections

• The bottom represents the patients with infections that have not been identified yet

• The patients in the bottom of the iceberg are a source of transmission to others

Corporate Policy ChangeGoal: Consistent and appropriate cleaning and

disinfecting of all shared patient equipment

• A high level of clean on a routine basis decreases the risk of transmission of infection in unidentified patients

• Eliminates dirty equipment being left in halls or being used accidentally by other staff/patients/visitors

Corporate Policy Change• Shared equipment are cleaned and disinfected by

all staff between use with patients• Transport staff will clean all high touch surfaces of

the stretcher/wheelchair with virox wipes• Designated clean holding areas identified on unit • Visibly soiled transport equipment will be cleaned

by housekeeping as appropriate• Porter to notify HK by using the bed tracking

system• Porter to identify equipment as dirty by using

signage

Sanitation Stations• Assigned location on

all units

• Porters to use for cleaning/disinfecting of high touch surfaces

High Touch Surfaces-Stretcher

• Handles• Side rails• Intravenous pole• Bumper

High Touch Surfaces-Wheelchair

• Handles• Seat• Back rest• Arm rests • Intravenous pole• Wheel lock handles

and leg calf support

Clean Equipment Holding Areas

• Designated areas on all units

• Separate wheelchair & stretcher holding areas

• Signage on wall and tape outline on the floor

Clean Stretcher Holding Area

What do you think about this?

Mode of Transmission?• Not always this visible

that a piece of equipment is dirty or has not been cleaned

Clean or Dirty?

Clean or Dirty?• Just because it ‘looks’

clean it does not mean it is clean

• Some bacteria and viruses survive for weeks or months on dry surfaces

Is this Okay?

Is this Okay?• Wear gloves for as short

a time as possible • Do not walk from room

to room and other areas of the hospital wearing the same pair of gloves

• Hands are often contaminated in the process of glove removal

• Always perform hand hygiene before & after removal of gloves

• Does not replace hand hygiene

Is this Okay?• Gloves worn in common

areas contaminate the environment

• Puts patients/visitors/staff at risk

• Hand hygiene kills 99.9% of germs in 15 seconds

• Hand hygiene protect s you while also protecting others

Moving a patient on Routine Practices

• Perform hand hygiene• Assist patient onto clean wheelchair or stretcher in

the patient's room• If any PPE was worn to move the patient, remove it

all and perform hand hygiene• PPE, including gloves should NOT be worn while

transporting patients• If the patient is coughing/sneezing, the nurse will

provide them with a surgical mask, the transporter does not need to wear one

• Practice good hand hygiene

Moving a patient on Additional Precautions

• Perform hand hygiene• Wear the appropriate PPE while assisting patient to a

clean wheelchair or stretcher in the patient's room• Remove all PPE apparel, including gloves and perform

hand hygiene after moving the patient and prior to transport

• PPE, including gloves should NOT be worn while transporting patients

• If the patient is coughing/sneezing, the nurse will provide them with a surgical mask, the transporter does not need to wear one (exception: airborne isolation)

• Practice good hand hygiene

Moving a patient from ICU• Patients are moved in their hospital beds• Perform hand hygiene• Wear the appropriate PPE while in the patient’s

room to prepare them for transfer• Wipe down all high touch surfaces of the hospital

bed with a virox wipe before leaving the unit• Remove all PPE apparel, including gloves and

perform hand hygiene prior to transport• The nurse may wear PPE during transport due to the

possibility that they may need to intervene quickly (code blue situation)

Contact PrecautionsNo PPE for transporterNo PPE for patientPorter to carry chart or

put it in a plastic bag on patients lap

Hand hygiene

Droplet/Contact PrecautionsNo PPE for transporterPatient to wear surgical

maskPorter to carry chart or

put it in a plastic bag on patients lap

Hand hygiene

Airborne PrecautionsPorter to wear N95

maskPatient to wear surgical

maskPorter to carry chart or

put it in a plastic bag on patients lap

Hand hygiene

Don’t be a risk!

• Use PPE appropriately

• Protect yourself

• Protect others

• Don’t forget to perform hand hygiene!