MICRO 5 – Introduction to Infection Control Aspects of Occupational Health Flashcards
What is Occupational Health?
Traditionally defined as the specialty concerned with the:
effects of work on health &
how health affects an individual’s capacity to work
What is the Complex web encompassing of Occupational Health?
work and work environment
life and lifestyle
health and ill health
What is healthy worker effect?
HWE refers to the consistent tendency for actively employed people to have a more favorable mortality experience than the population at large.
Name the positive effects of work on health health
Creates a sense of wellbeing through: >Achievement of job satisfaction >Provision of means of income >Social interaction >Potential to interact with worksite health promotion activities
What are the negative effects of work on health?
Specific physical job hazards Accidents at work Long working hours Job insecurity Excessive demands
Name the work place hazards
Physical +ergonomic
Biological
Chemical
Physical /human
Give the example of physical +ergonomic work hazards
Noise Radiation Trip hazards Manual handling Ergonomic
What are the possible chemical work place hazards?
Solvents
Irritants
Carcinogens
Name the biological work place hazards
Bacteria
Fungus
Other micro-organism
What does an occupational healthcare service provide?
Risk assessment and risk control Pre-employment + periodic assessments Management of occupational illness and injury Post-illness / absence reviews Vaccination + post-exposure prophylaxis Management of staff (infections, dermatitis etc) Health education Counselling Advice
Who may be at risk at a health facility?
Nurses Doctors Laboratory staff Dentists/hygienists HSCP Morticians Staff of residential institutions Students Porters Contract cleaners
What are the examples of work related ill health in the health service?
Musculoskeletal disorders Psychological illness / stress Dermatitis Accidents (including NSI) Infectious disease Asthma
How can occupational health affect infection control?
Knowledge of legislative backdrop and sometimes competing needs and demands
Understanding of management structure and responsibilities / limitations
Competent at risk assessment and risk communication
Awareness of health / medical issues as well as human factors
Can provide impartial advice without compromising confidentiality
State Infection Control Objectives of an Occupational Health Programme
- Education
- Risk Assessment
- Risk Control
- Evaluation
What topics are healthcare staff educated on?
Standard and transmission-based precautions
Consequences of non-compliance
Exposures to potentially infectious hazard
*Prevention
*Action to take and management if exposed
Explain legislation in relation to occupational hazards
> Employees are protected by law from exposure to occupational hazards
The Biological Agents Regulations (2013) require the prevention of exposure of employees to a biological agent in a place of work. Schedule 4 specifies:
-Offer vaccine (FOC)based on risk assessment
-Inform re benefits and drawbacks
-Vaccination certificate may be drawn up
The Health & Safety Act (2005) includes microorganisms in its definition of substances. Therefore, protection against microorganisms is given the same legal standing as protection against other hazards in the workplace
EU Sharps Directive 2013
What are the employee responsibilities (HSA)?
Co-operate with your employer and others.
Do not take chances with your life or your colleagues.
Tell your employer if you think something is dangerous.
Do not interfere with or misuse safety equipment.
Use equipment correctly.
Attend training.
Use protective equipment and clothing provided.
Write down risk assessment procedure
> Identify the potentially infectious hazard
in the workplace
(something that can cause harm)
Determine level of occupational risk for each hazard (ie the risk of exposure to the particular hazard)
Risk = hazard X frequency
Identify what controls are necessary using the hierarchy of risk controls = Risk Control
What knowledge is required in the risk assessment?
- The workplace, its hazards, consequences
- Likelihood of exposure
- Individual vulnerability
- Epidemiology
- Clinical manifestations
- Routes of transmission
- Respiratory: droplets, aerosols
- Contact: Patient handling /contaminated equipment Percutaneous / mucocutaneous: contact with blood or body fluids
Biological Agents are classified into 4 groups. State this groups
Group 1 agents are the least hazardous
Group 4 are the most hazardous
Group 2&3:…include most of the vaccine preventable pathogens encountered in healthcare.
State the basis of the classification of the 4 groups of biological agents
Whether;
>The agent is pathogenic to humans
>The agent is a hazard to employees
>The agent is transmissible to the community
>There is effective treatment or prophylaxis available
Explain risk control
Eradication or minimisation of the risk of exposure to the potentially infectious hazard
Prevention of staff exposure to the risk
Management of staff exposure to the risk
Policies, procedures and programmes to prevent / manage exposures including outbreak management
Explain healthcare worker vaccination
Healthcare workers, usually healthy adults, are likely to have excellent response to vaccination unlike some patients
Hospitalised patients can acquire influenza from infected healthcare workers, visitors or other patients
About 30% of people infected with influenza are asymptomatic but can still be infectious
Influenza can kill a vulnerable patient
How do we protect ourselves from influenza?
Inactivated virus should be given each year in advance of the influenza season (Sept/Oct)
Why is influenza vaccine administered every year?
Antigenic Drift” Minor antigenic change
Transcription errors by the viral DNA polymerase result in amino acid substitutions in surface glycoproteins of the influenza virus
Partial immunity in population (Little in infants, some cross-reacting immunity in adults) = YEARLY EPIDEMICS
What are the determinants of influenza vaccination uptake amongst Hospital staff?
Age Belief in vaccine efficacy Belief in prior prevention of illness by vaccine Knowledge of illness not a predictor No gender difference
What have other countries used?
Visible evidence of compliance: Coloured lanyard Wearing surgical mask during season Declination tool Mandatory vaccination
How are staff exposed to biological risk managed?
Assess what happened (the incident)
Type of exposure + method of transmission
Compliance with infection control precautions (including PPE)
Assess the source of exposure (usually a patient)
Diagnosis of infection and how infectious they are
Assess the staff member
Determine immune status
Management of the staff member
>Diagnose infection
>Post-exposure prophylaxis or treatment if infected
>Counselling
>Work restriction/return to work
>Contact tracing
What is a blood borne virus?
One that is transmitted parenterally;
Sharing equipment used by injecting drug users,
Haemodialysis, non-sterile glucometer equipment,
Sharing personal care items (toothbrushes, razors)
Needle stick injuries,Ear-piercing, tattooing, acupuncture
(hepatitis Bhepatitis CHIV*)
What is the Risk of Blood borne Viral Transmission to Healthcare staff?
The risk of developing infection after blood exposure depends on:
Exposure type (sharps injury versus splash)
Exposure severity (depth of injury, amount of blood involved etc.)
((Rule of 3’s:
Hepatitis B + source = 1:3
Hepatitis C + source = 1:30
HIV+ source (percutaneous) = 1: 300
HIV+ source (mucocutaneous) = 1:9000
))
What is a significant exposure?
It’s one from which transmission of A BLOOD BORNE VIRUS may result)
Percutaneous injury (cuts, abrasions or puncture wounds) with needles or other sharp instruments contaminated with blood or body fluids
or
Mucous membrane or non-intact skin contact with blood or body fluids (e.g., Splashes of blood etc into the eyes, nose or mouth)
or
Human bites where contact occurs between non-intact mucous membrane and broken skin.
Explain how one deals with needle stick injuries
First AID ASAP
Decide if a significant exposure has happened
Assess the risk of transmissionTake bloods from both source and recipient
Treat the recipient
Follow up of recipient
What are the precautions to ensuring it’s prevented
Safe systems of work HEPATITIS B VACCINATION AND KNOW YOUR STATUS Standard precautions Gloves + wash hands Cover any wounds or skin lesions Clean any spillages immediately Sharp safety *NEVER RESHEATH NEEDLES *DISPOSE YOUR OWN SHARPS IN THE SHARPS BOX – DON’T LEAVE THEM AROUND FOR SOMEBODY ELSE Protective eyewear
What are some reasons for breach in good Infection control practice?
Lack of information
Information available but ignored
Information available but not practised as routine
Good practice forgotten / overlooked in particular situation…distracted, in a hurry etc.
Good practice slips over time because of poor supervision, monitoring etc.
Explain the 3P’s used in prevention
1.Prepare: Adequate training for procedure? Anticipate problems. Use correct equipment. Get assistance if needed-uncooperative pt.
2.Protect: Must remember basics of good infection control: cover cuts, protect myself and others, vaccines up to date,
Personal protective equipment.
3.Proceed: Ignore distractions. Do not resheath. Immediate disposal of sharp in CIN bin
What is the progress rate of Hepatitis B over a decade?
Risk of hepatitis B down by >90%;
-Standard precautions
- Vaccine
<100% vulnerable staff immunised
Research: no significant change in the epidemiology of sharps injuries between 1998–2000 and 2008–2010 in an Irish teaching hospital.
Hepatitis B immunity in sharps injury recipients was relatively low (87%)
Resheathing had reduced significantly (p= <0.05)
