Infection Control During the Pandemic-Ohio AAP has the Experts, Education and Resources for You!

Ohio AAP is teaming up with AAP and the CDC to stop the spread of infectious disease threats—including COVID-19 through education, resources and social media. Anyone working in a healthcare facility needs a foundational knowledge of infection control and must understand and be ready to implement infection control protocols and procedures throughout their work day, including during every patient care activity and healthcare interaction.

Join us on March 19, 2021 from 12:15-1:15 pm for our kick-off webinar, featuring the topics below:

• Intro – What is Project Firstline?
• Basics of Infection Transmission
• Recognizing Risk in Your Daily Work
• Using PPE Safely
• Wrap-Up and Resources

Lead Faculty: Nick Newman, DO, MS, FAAP

Cincinnati Children’s Hospital Medical Center, Attending Physician, Division of General and Community Pediatrics, Medical Director, Pediatric Environmental Health and Lead Clinic, Pediatric Primary Care Center and Assistant Professor, UC Department of Pediatrics

*Additional faculty to be announced.

Registration link: http://oldsite.ohioaap.org/ohio-aap-project-first-line-webinar/

Please spread this link to your networks, staff and anyone you feel would benefit from this training.

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COVID-19 and Infection Control: The Basics

What makes COVID-19 a unique healthcare infection control challenge and concern? 

Key Message: The way COVID-19 spreads, how it makes people sick, and the tools we have available to respond to it all affect the choices we make about infection control.

• COVID-19 is tricky because people can spread it to others even when they don’t feel or look sick: before they show symptoms – when they are “pre-symptomatic” – and even if they never show any symptoms at all – when they are “asymptomatic.”
• SARS-CoV-2, the virus that causes COVID-19, is a new virus. We are learning more about it every day, but we’re just beginning to develop vaccines and treatments.
• Most of us are still at risk, so when it affects large numbers of people, that can cause our healthcare facilities to be overwhelmed with sick patients.
• Seasonal flu causes severe illness in some people every year, and it spreads in a similar way, but we have vaccines and antiviral treatments for it, and many people are at least partly immune, so it’s not likely to overwhelm our hospitals with sick patients.
• While we continue to learn more every day, good infection control practices will help keep this infection from spreading; and those all depend on us: every healthcare worker can take action to help prevent the spread of COVID-19.

 COVID-19 Spread 

• COVID-19 spreads very easily from person to person, including from people who don’t seem sick. Like the flu, COVID-19 spreads mainly between people when they are close to each other – through respiratory droplets produced when an infected person coughs, sneezes, or talks. These droplets can land in the mouth, nose, or eyes of people who are nearby, and can be inhaled into the lungs.
• In general, the closer a person interacts with others and the longer that interaction is, the higher the risk that COVID-19 will spread.
• Being with others in an enclosed space without good ventilation, especially where people are close together and breathing hard, shouting or singing, can increase the risk of infection.

Why do we use specific Infection Control practices for COVID-19? 

Key Message: Each infection control action has a reason and a function.

• We know infection control works and is always a critical tool to protect people from infectious diseases, including COVID-19, especially when vaccines and treatments are not yet available.

• Each infection control strategy and action –source control, triage and screening, use of PPE, environmental and hand hygiene – individually provides some protection. But their greatest effect is when they’re used together, correctly, and consistently.

Brief introduction of infection control strategies 

PPE (personal protective equipment)

• PPE is an important tool for infection control.
• How well PPE works depends on you – no matter how busy you are, you should take time to use the right equipment, the right way, at the right time.
• The key to choosing the right PPE and using it properly is understanding: what you might be exposed to, and how you could be exposed, based on what you’re about to do.

PPE for care of suspected COVID-19 patients

• SARS-CoV-2 spreads primarily through respiratory secretions (saliva, snot, phlegm, etc.) released by an infected person, e.g., when they cough, sneeze, sing or talk. Large and small droplets are produced; some can be inhaled into the lungs, others might land in the eyes, mouth, or nose of people nearby. The recommended PPE includes protection of those parts of your face (mucous membranes), as well as respirators that keep you from inhaling small droplets. We’ll describe each of these types of PPE next.

• PPE that’s recommended for caring for patients with known or suspected COVID-19 include barriers that provide eye, nose, and mouth (or “mucous membrane”) protection; filtering respirators to prevent inhalation; and gloves and gowns to make it easy to remove infectious secretions you might have touched and keep from spreading them around the environment, where they can infect others.
• Your PPE only works if you use it correctly every time. An N95 that doesn’t have a good seal on your face, or gloves that aren’t removed carefully, immediately after use defeat the purpose of PPE.

Respirator (N95)

• Respirators, aka “N95”, filter out particles that in the air so you don’t inhale them. They also provide a barrier against splashes to the nose and mouth. Respirators also keep the person wearing them from breathing out infectious particles, protecting other people nearby.
• Respirators must fit super-tight against your face, so you breathe through the filter and not around the edges through gaps. Fit-testing is used in work settings to make sure the size and model of respirator is right for you.

Eye protection

• Eye protection blocks splashes that might land in your eyes. You need coverage straight in front of you, and on the sides of your face. If you’re doing something that might cause a splash to fly upwards, like pouring out a bucket of dirty water or cleaning a patient’s wound, then you need protection from below, too.
• You can use goggles or face shields. If they’re reusable, they need to be cleaned and disinfected before reuse.

• Eyeglasses or contact lenses will not protect your eyes. Also, safety or trauma glasses with gaps between the glasses and your face don’t provide good splash protection for infection control purposes.

Gown

• Your gown protects your clothes from splashes and contact with soiled things, so you don’t have to change your clothes every time something gets on you at work – you can take off the dirty gown instead.
• Promptly removing a dirty and/or wet gown is the key to using it effectively.

Gloves

• Gloves protect your hands from exposures through a cut or a hangnail, or through irritated skin, like from eczema.
• Don’t put dirty hands into a box of clean gloves; you should always clean your hands before putting on gloves.
• When you take your gloves off correctly, you can quickly and effectively get rid of germs that might be on them.
• Even when they’re being careful, people often contaminate their own hands when they’re removing used gloves. After removing your gloves, always clean your hands right away. That keeps you from accidentally spreading germs to other people and the environment you work in.

Source control 

• The term “source control” for COVID-19 refers to all the ways we can prevent germs from moving from an infected person – the “source” – into the environment, where it can infect others.
• Source control for COVID-19 focuses on wearing a mask to cover your nose and mouth any time you might be near other people. This cuts down on the amount of virus that is introduced into the surrounding environment.
• Everyone makes respiratory droplets that travel into the air when they breathe, cough, sneeze, or talk. When people who are infected wear a mask to contain or block their own respiratory droplets — they’re less likely to infect the people around them.
• Source control isn’t just for healthcare facilities. CDC recommends that everyone wear a mask when they leave their home, especially in public places and when it’s hard to keep your distance from others.
• Using source control on a regular basis, along with actions like keeping physical distance from others and cleaning your hands often, will help reduce the spread of COVID-19 and other infections. It’s another way you can protect your patients and coworkers, and your family and community.

 Mask use 

• Masks are recommended for everyone in a healthcare facility, even if they don’t have symptoms of COVID-19, because people can have COVID-19 and spread it but not show symptoms.
• As someone on the front lines of healthcare, you should wear a mask at all times when you’re at work. You never know when you might bump into someone, like when you’re going into a room or coming out of an elevator.

• You should wear a mask in break rooms and other spaces where you might get close to your coworkers or other people. When you remove your mask to eat or drink, make sure you clean your hands and keep physical distance from others!
• A mask is especially important if you are not able to stay physically distanced from others.
• Wearing a mask and physical distancing are recommended not just for patients and visitors, but also for you and your coworkers, throughout your facility, all the time. Remember that in addition to protecting yourself during patient care and your daily work, germs can also spread from asymptomatic or pre-symptomatic coworkers in break rooms or other common areas.

Limiting access to facilities 

• Reducing the number of people who are in the facility at one time, and who are coming and going, is a great way to help everyone stay apart and reduce the chance that they will be around someone who has COVID-19.
• Some facilities limit visitors or restrict visitors completely. Facilities can schedule patient visits so that multiple people aren’t in waiting areas at the same time, and ask that people wait in their cars, or a separate space, for a phone call when it’s their turn to come in for their appointment.

 Triage and screening 

Triage

• Evaluating patients with COVID-19 symptoms before they come in – in their cars or a separate area, or on the phone – limits the number of people inside a facility at one time and reduces the risk that they will expose others, while making sure they get the care that they need.

Screening

• Screening everyone, including healthcare personnel, for signs and symptoms of COVID-19 before they enter a facility helps identify people whose symptoms increase their ability to spread the virus to others.
• Everyone who enters the facility – patients, visitors, staff – are asked questions about whether they have signs and symptoms consistent of COVID-19, and if they could have been around someone with a confirmed case of COVID-19. This approach isn’t perfect, because there will be people with COVID-19 who aren’t showing symptoms or don’t know that they were exposed, but it will at least identify some people who might spread the virus.
• Identifying people with symptoms quickly and removing them from common areas can help protect others from getting COVID-19.
• If patients are admitted to stay at the hospital, they need to continue to be checked for COVID- 19 signs and symptoms because they might not have had symptoms when they arrived but they could develop them during their stay. If this happens, it could cause them to spread it to other patients and to healthcare workers.

Environmental Hygiene 

“Environmental hygiene” includes the things we do to keep the physical environment clean and safe, and it’s an important part of infection control in healthcare.

• Like other germs, COVID-19 can be found on surfaces around you. The routine cleaning and disinfection practices that should already be used at your facility are effective against COVID-19.

• In some situations, parts of the facility might need to be cleaned and disinfected more often, using the same routine processes.

Hand Hygiene 

• Hand hygiene, which includes using alcohol-based hand sanitizer or washing your hands with soap and water, is one of the best ways to protect yourself and keep others from getting sick.
• Hand hygiene is an important part of infection control all the time, not just for COVID-19.
• When you clean your hands, you remove or destroy germs on your hands that you could spread to other people, the environment, and yourself.
• The virus that causes COVID-19 is inactivated by detergents like soap and water, and by the alcohol in alcohol-based hand sanitizer.

Why routine procedures for cleaning and disinfection and hand hygiene work against COVID-19 

• SARS-CoV-2 belongs to a family of viruses that are considered easy to kill. That is because it has a protective, fatty layer surrounding it that can be dissolved by soap and water and destroyed by alcohol. When this protective layer is dissolved or destroyed, the virus is not able to infect people.

For more information, watch the CDC’s Facebook Vlog Inside Infection Control episode #1 focused on the goal of infection control: https://www.youtube.com/watch?v=25vxNZ2WWtc&list=PLvrp9iOILTQZQGtDnSDGViKDdRtIc13VX&index=1

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