Page 19
beverages in patient care areas (PIDAC, 2012b, p. 48) • Staying home from work when ill with symptoms of fever, chills, cough, malaise and/or nausea, vomiting or diarrhea Scenario You wake up at 0400 with fever, chills and a cough. You are scheduled to begin your shift in the NICU at 0700. What do you do? You should call in sick because going to work puts others (specifically your patients) at risk. Institutional outbreaks involving staff have been reported, particularly with hepatitisA, cryptosporidiosis and norovirus. (PIDAC, 2012b, p. 47) Staff who consume food or beverages in care areas (client/patient/resident environment, nursing station, charting areas) are at increased risk for acquiring serious foodborne gastrointestinal infections. Page 7 Organizational Accountabilities: All health care settings should establish a clear expectation that staff do not come into work when ill with symptoms that are of an infectious origin, and support this expectation with appropriate attendance management policies. Staff carrying on activities in a health care setting who develop an infectious illness may be subject to some work restrictions (PIDAC, 2012b, p. 22). www.crto.on.ca Infection Prevention and Control CBPG Page 8 Immunizations Appropriate vaccine use protects the health care provider, colleagues and the patient/client (PIDAC, 2012, p. 23). Examples of vaccines that may be necessary to protect RTs and their patient/clients: • annual influenza • measles, mumps, rubella (MMR) • varicella • pertussis • hepatitis A, B • tetanus/diphtheria Infection Prevention and Control CBPG www.crto.on.ca RE S O U RCE Immunize Canada has an app to assist in recording vaccines information and accessing immunization schedules. PIDAC states that vaccines appropriate for susceptible health care providers include annual influenza vaccines (PIDAC, 2012b, p.40). Professional Accountabilities: Health care workers (HCW), including hospital employees, other staff who work or study in hospitals (e.g., students in health care disciplines, contract workers, volunteers) and other health care personnel (e.g., those working in clinical laboratories, nursing homes, home care agencies and community settings) are at risk of exposure to communicable diseases because of their contact with patients/clients (diagnosed or undiagnosed) or their environment. There is also a risk that HCW could transmit an undiagnosed vaccine-preventable disease to others. Some health care institutions and jurisdictions are moving towards making vaccination a condition of employment for HCW. – Public Health Agency of Canada, 2013 Each link in the chain represents a factor related to the spread of microorganisms. Transmission of infectious agents does not take place unless all six of the elements in the chain of transmission are present. (PIDAC, 2012b, p.1). The links in the Chain of Transmission can be broken through a careful Risk Assessment and consistent application of Routine and Additional Precautions, where indicated. Public Health Ontario has a set of free infection prevention andcontrolelearningmodules. IPAC Core Competencies Course Page 9 www.crto.on.ca Infection Prevention and Control CBPG The Six Links in the Chain of Transmission & Breaking the Chain of Transmission ©Queen’s Printer for Ontario, 2011. Adapted with the permission of Public Health Ontario. Links in the Chain of Transmission are: Breaking the Chain of Transmission by Assessing: INFECTIOUS AGENT the micro-organisms capable of producing infection (e.g., bacteria, viruses) the pathogenicity/virulence of the infectious agent RESERVOIR the placesin which the infectious agent lives (e.g., humans, animals, water) the patient/client’s environment (e.g., shared facilities, such as multi-bed rooms) Page 10 Infection Prevention and Control CBPG www.crto.on.ca Links in the Chain of Transmission are: Breaking the Chain of Transmission by Assessing: PORTAL OF ExIT the point where the agent leaves the reservoir(e.g., blood,secretions) the potential for exposure to blood, body fluids, secretions and excretions (e.g. splashing, patient coughing considering the duration of exposure (e.g., sterile gown for central line insertions) MODES OF TRANSMISSION