Risk Management In Ipc
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When you have completed this chapter you should:
- Understand how to perform a risk assessment
- Be able to stratify risk
- Understand how to manage risk
- Be familiar with standard and transmission-based precautions
- Understand when and how to use personal protective equipment
- Be familiar with injection safety initiatives and re-use prevention devices
- Be able to describe the purpose and types of care bundles.
Assessment Tool By Setting
Note: For Outpatient settings, the Guide to Infection Prevention for Outpatient Settings and its companion Checklist are consistent with the Outpatient Settings Infection Control Assessment Tool. While the same infection prevention elements are included in both the checklist and assessment tool, the facility demographics sections differ slightly. The assessment tool is intended for health department use whereas the checklist is intended primarily for healthcare facility use.
Infection Control Assessment Tools
ICAR: Infection Control Assessment and Response Program
IP: Infection Prevention
Healthcare Personnel IP Competency: The proven ability to apply essential knowledge, skills, and abilities to prevent the transmission of pathogens during the provision of care.
Healthcare Personnel IP Competency-Based Training: The provision of job-specific education, training, and assessment to ensure that healthcare personnel possess IP competency.
Competency Assessment: The verification of IP competency through the use of knowledge-based testing and direct observation. If direct observation is not included as part of a competency assessment, an alternative method to ensure that healthcare personnel possess essential knowledge, skills, and abilities should be used.
Audit: Direct observation or monitoring of healthcare personnel adherence to job-specific IP measures.
Feedback: A summary of audit findings that is used to target performance improvement.
The basic elements of an infection prevention program are designed to prevent the spread of infection in healthcare settings. When these elements are present and practiced consistently, the risk of infection among patients and healthcare personnel is reduced.
The Infection Control Assessment Tools were developed by CDC to assist health departments in assessing infection prevention practices and guide quality improvement activities . These tools may also be used by healthcare facilities to conduct internal quality improvement audits.
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Best Practices In Healthcare Construction
The Mid-America Carpenters Regional Council is leading the way in developing innovative training and techniques that teach our expert craftspeople how to reduce the risks of contamination while working in busy hospitals and clinics. We are taking a proactive stance on construction-related nosocomial infection through our 24-hour Construction Infection Risk Assessment training program. This training program addresses critical construction practices in pathogen containment, airflow control and protection while performing the necessary construction work. This course includes 16 hours of classroom training about why this work is critical, and 8 hours of shop time, where the carpenters learn how to protect patients, facility administration and staff, and themselves.
With ICRA-certified union tradespeople on your project, Infection Preventionists and Facility Directors have one less thing to worry about. Although we are not Infection Control Practitioners, we are a key piece of the puzzle.
Our goal: Deliver a workforce of construction professionals who understand how to protect the patients and staff during a building project, while not disturbing daily activities. We see ICRA training as a new standard in the healthcare construction industry.
Infection Control Risk Assessment 20
The use of infection control risk assessments during hospital design and construction projects has been evolving for the past several decades. In July 2020, ASHE put together a multidisciplinary team consisting of infection prevention and control, industrial hygiene, construction, facility management specialists and authorities having jurisdiction to evaluate the existing ICRA matrix and to see how it could be improved to better serve health care organizations. This team met on a weekly basis throughout 2020 and into the first quarter of 2021 to accomplish this objective.
While the foundation of the ICRA, The IC Matrix – Class of Precautions matrix, remains the fundamental process of the ICRA 2.0 one of the key improvements the team made was to expand on the descriptive language throughout all portions of the ICRA. The team spent several months discussing the various changes to ensure that all aspects of the tables were considered. This provides greater clarity in the application of the ICRA.
Because of the critical nature of comprehensive infection prevention, ASHE has made the ICRA 2.0 tool and permit available to the general public.
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Ashe Publishes Revised Infection Control Risk Assessment Guide
The ICRA 2.0 includes several improvements and clarifications to help in prevention planning for construction projects
The use of ICRAs during health care facility design and construction projects has been evolving for several decades.
The use of infection control risk assessments during hospital design and construction projects has been evolving for the past several decades, according to the publication Using the Health Care Physical Environment to Prevent and Control Infection, published by the American Society for Health Care Engineering and other professional groups and associations in cooperation with the Centers for Disease Control and Prevention .
The first formal ICRA was introduced in the 1996 edition of the Facility Guidelines Institutes Guidelines for Design and Construction of Hospital and Healthcare Facilities, although earlier editions required construction and renovation assessments related to specific risks. The goal of the assessment was to describe how an organization determines the risk for transmission of various infectious pathogens through a multidisciplinary committee.
A subsequent effort was undertaken by ASHE with other organizations and experts in the field to clearly spell out what would be included in the ICRA process. In 2020, ASHE assembled another group of experts to update these guidelines, which is being called ICRA 2.0.
What Additional Precautions Should Be Taken To Prevent Surgical Site Infection
- Get patients to do a chlorhexidine bath or shower before surgery
- Clean the skin site with an antimicrobial agent
- Remove pubic hair at the surgical site, only if necessary and preferably with clippers or depilatory agents. Razors should not be used for hair removal because they irritate or cut the skin and make it easier to develop an infection
- Ensure diabetic patients have good blood glucose control in the peri-operative period.
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What Can The Healthcare Workers Do To Reduce The Risk Of Surgical Site Infection
Comply with good surgical practice:
- Take care to clean the hands and arms up to their elbows with an antiseptic agent just before the surgery
- Wear personal protective equipment consistently and properly hair covers, masks, gowns, and gloves during surgery
- Keep the surgery area clean
- Practise good hand hygiene on the ward.
What Other Factors Are Important For Preventing Ca
- Practise hand hygiene immediately before insertion of the catheter
- Practise hand hygiene before and after any manipulation of the catheter site or apparatus
- Use gloves, a drape, and antiseptic solution for cleaning the urethral meatus
- Use a single-use packet of sterile lubricant jelly for insertion
- Select the appropriate catheter size and technique for catheter insertion
- Secure the catheter well
- Maintain a sterile closed system
- Do not allow the catheter bag to lie on the floor and do not lift the bag above the level of the bladder .
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What Practices And Policies Should Be Followed To Prevent Surgical Site Infection
- Thorough cleaning and sterilisation of equipment
- Thorough cleaning and disinfection of the operating theatre environment
- Traffic control in operating theatres
- Maintain operating theatre under positive pressure ventilation
- The operative site should be prepared and disinfected properly
- Adherence to hand hygiene should be strictly followed.
What Are The Key Elements Of Contact Precautions For Such Cases
- Use clean, non-sterile gloves for all episodes of direct patient contact
- Change the gloves after each patient contact
- Use gowns or disposable aprons for each patient contact
- Use dedicated specific equipment for a single patient
- Limit patient contact with other patients by isolating the child OR
- Cohort the patient in a room with other patients who have rotavirus infection.
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Construction Videos Safety And Icra
The ICRA matrix as described above and promoted by the the Association for Professionals in Infection Control and Epidemiology and the American Society for Healthcare Engineering is available in 2 training videos one directed to healthcare professionals and one for construction personal, with availability in English and Spanish. Go to www.EnvisionInc.net.