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Infection Control

Hi I'm Jill, Chief Safety Officer with Vivid Learning Systems. I'm a former OSHA inspector and I'm here to help you identify and correct workplace safety hazards.

For this series we're at the University of Louisville in beautiful Kentucky to show you no matter where you work safety is for everyone.

Welcome to the University of Louisville vaccine and international travel clinic. Today I am with Dr. Ruth Carrico associate professor and the division of infectious diseases and a family nurse practitioner board-certified in infection control. Dr. Carrico thank you for being with us. Thanks for the invitation. We are talking about infection control today and one of the things that employers I think sometimes get mixed up on is that complying with blood-borne pathogen laws and protecting employees from blood-borne pathogens is the same as infectious agents but that's really not the case.

So can you explain the difference between the two? Sure well I think when we think about blood-borne pathogens that really means coming in contact with blood or body fluids that contain blood or blood cells. We really didn't start to think about that until the 1980s, when we began to be concerned with HIV. Then at that point that kind of changed everything changed everybody's perspective, but when you think about diseases and transmission. Transmission associated with blood or body fluids is really only a small portion of infectious diseases and infection transmission we all know about influenza and when that occurs and so we need to think about. Yes we have blood-borne pathogens but all of us breathe and so there are many diseases that are transmitted just by the act of inhaling and exhaling so when we look at the larger component of infectious too it really is much broader than simple the blood or blood body fluids.

So there's various workplace settings like emergency medicine, and law enforcement, and hospitals, and clinics, and dental settings and mortuary sciences and lab settings and they all have potential exposure to infectious agents as well. What are some of those core practices that employees and employers can implement to protect themselves from infectious agents? Well I think anywhere where care is delivered where anytime anyplace where there's going to be the delivery of health care and in any respect we have to think about. Well so what type of care is provided, what are the issues involved in care, what are the risks involved in care, and then we work backwards and we think: Okay what is done in these settings what are the likelihood of individuals coming in contact with individuals, patients, body fluid, respiratory acts, or respiratory secretions. Coughing sneezing and that that sort of thing then we think about well how does that relate to the activities that are involved? And then how can we then protect people from that type of contact?

Now we know with any infectious disease there's some basics, some core practices as you mentioned there you have to think about those those foundational things. The first thing that comes to mind always is going to be hand hygiene you know these ten things are associated with transmission of infections infectious agents pathogens more commonly than most anything else. So the first thing we want people to think about is I want to keep my hands clean, the second thing that we want them to think about is how do I make sure that I don't come in contact with blood or body fluids of another person, another patient, a co-worker anyone. So with I'm talking with students I'll say you want to keep this really simple and that is remember if it's wet and not yours don't touch unless you have some type of barrier precaution that could be gloves or a gown or or whatever. And then the third consideration is thinking about how the environment itself could be involved in transmission, so it could be a contaminated countertop or a contaminated piece of equipment and then how we make sure then that those items are cleaned and disinfected before they're used or before they are contacted by another person.

And so what thank you for that what are some of the core elements of an exposure control plan because that's a piece of an employer's responsibility as well. Right so again we kind of work backwards and we say knowing the type of care or the contact that occurs between a patient and individual and a healthcare worker how do we minimize that how do we recognize the risks then how do we take steps to begin to mitigate or prevent those risks and those things generally happen through several routes.

Number one what are the types of policies and procedures that we can put in place that kind of guides for what you should do. Then how do we approach this from human factors almost an engineering perspective and that how we make it difficult for people to hook themselves. So in healthcare some of those examples are safe needle devices so you know a safety needle so it makes it hard for me to stick myself or cut myself and then how do I then control the environment itself so that it becomes difficult for that individual to become infected or exposed. So we look at all three of those programs but I think you know everything requires thought requires leadership and requires just some sort of a method because the safe workplace doesn't just magically happen. It happens because people come together they think about what is involved and then they plan and they say you know the number one thing in a workplace is safety whether it's our workers or whether it's our patients and with infection control it's implementing the same safety engineering principles that we would for any piece of workplace safety.

You mentioned SOPs which is administrative control. You mentioned safe needle devices which is an engineering control method and then of course we have personal protective equipment as well so it's it's very similar across any piece the workplace safety.

What about the role you mentioned communication? What about the role of communication in infection control? Yeah it's always funny isn't it that we talk about communication very cavalierly but that is probably the most important thing that helps them promote the idea of what needs to happen. How do I make sure it happens do I convey the information in an act that is so simple just that simple communication and listening to each other sharing information oftentimes is one of the genesis of the foundation of many of the problems, so communication is critical  I've got to make sure that we understand what the risks are. That we talk about those risks that we share information new knowledge as it as it comes forward. And then kind of I think of the basis is recognizing that each of us has a role in safety and prevention in communication it kind of takes us back to our days in Sunday School where we are reminded when we are our in a workplace we're really our brother's keeper that it is our responsibility to work together and be concerned about the person that is working alongside us.

Wonderful Dr. Carrick. Oh thank you so much for the information that you shared with us today I really appreciate it. Great to have that chance. Yeah right. So infection control if you haven't been approaching this in your workplace and talking about it now is the time to start implementing infection control procedures.

I hope you gained a safety skill today. If you know someone who needs this go ahead and pass it on.

Safety is everyone's business.