Health care risk management assignment week 5

Chapter 12: Risk management for Infection Control Programs

Goal of Infection Control

• To prevent the transmission of infections to patients, visitors and healthcare personnel

• In the United States, infection control programs are required by various agencies: – OSHA – CMS – TJC – State and Local Depts. of Health

Infection Control Program

A formalize infection control program includes

• Procedures for determining the risk of transmission of infectious agents

• Enforcement or procedures

• Protocols to manage the risk

The organization’s leadership is responsible for implementing these programs.

Healthcare Associated Infections (HAIs)

• HAIs are infections that occur in patients while they are at a healthcare institution to receive care

• HAIs are one of the leading causes of death in the US

• According to the CDC – 20% of HAIs are preventable – 1 in 20 hospitalized patient contracts an HAI

Infections in Healthcare Personnel

• Generally associated with unprotected exposure to the blood and bodily fluids of infected patients

• The OSHA Blood-borne Exposure Standard requires employers of personnel who may come in contact with infected blood/bodily fluids to provide: – Training to prevent exposures – Policies for staff to utilize personal protective

equipment – Vaccination against Hepatitis B free of charge

Risk of Infection in Healthcare Settings

• Infections are naturally concentrated in healthcare settings

• Infection Control Risk Management is a proactive process and includes the following: – Identification of risk of exposure – Assessment of frequency and severity of exposure – Elimination of risks as possible – Minimization of risks which cannot be eliminated

• Major infection control risk management procedure: Hand Hygiene

Bloodstream Infection Risk

• A vascular catheter is a tube inserted directly into the patient’s vein and are utilized to give the patient medication, blood or nutrition.

• A central catheter or line is an intravascular catheter that terminates at or close to the heart or a great vessel

• Infections in the central line are called known as Central Line-Associated Bloodstream Infections (CLABSI) and can be lethal

CLABSI Prevention

• Proper management of the central line can minimize the risk of CLABSI

• Insertion procedure: – Use of sterile barrier technique – Use of proper hand hygiene – Use of chlorhexidine for disinfecting the skin – Avoid the femoral insertion site

• Management once inserted: – Monitor insertion site – Use of recommended sterile technique – Scrub the port when entering the catheter to deliver

medication – Monitor the patient and remove catheter when no longer

needed.

Transmission of HIV

• Casual, everyday contact does note expose one to HIV which is transmitted through exposure to blood and certain bodily fluids

• Main risk of HIV transmission to healthcare personnel is through accidental injuries from needles or other sharp instruments

• Use of universal precautions and personal protective equipment can minimize the risk of transmission of HIV

Pneumonia Infection Risk

• Pneumonia is inflammation of the lungs which is not common in healthy individuals who are usually able to fight the infection

• Sick individuals, however, are more susceptible due to their weakened state and may contract hospital-acquired pneumonia which can be lethal

• It is imperative that healthcare personnel recognize the symptoms which can mimic the flu and begin proper treatment as soon as possible

Risk for Tuberculosis

• Tuberculosis (TB) is caused by a bacteria that is spread from person to person through the air

• Healthcare personnel should maintain a high level of suspicion when working with a patient with signs and symptoms of TB – Place patient on airborne isolation – Utilize personal protective equipment at all times – Follow-up and evaluate staff that may have been

exposed

Multidrug-Resistant Pathogens

• Multidrug-Resistant Pathogens (MDROs) are microorganisms that are resistant to one or more classes of antibiotics.

• In other words, they are difficult to treat as there are no effective antibiotics available. – MRSA – VRE – ESBLs – C. difficile

Outbreaks in Healthcare Settings

• Risk Managers monitor infection data to identify outbreaks (abnormal level of infection)

• Common causes of outbreaks include – Noncompliance with infection control protocols – Environmental sanitation – Contaminated equipment or supplies – Inadequate cleaning of equipment – Vaccinations

Implications of Effective Infection Control

• Reduced risk of malpractice litigation

• Improved safety for patients, visitors and healthcare personnel

Summary

• Infection Control is an important function of risk management and is mandated by various federal and state agencies

• Effective infection control can reduce the risk of malpractice litigation and improve the safety of patients, visitors and healthcare personnel