Infection Prevention & Control for Patient
Transporters
Vydia NankoosinghKyla Van Dusen
Infection Prevention & ControlOctober 5, 2010
Outline• Chain of infection
• Routine practices & additional precautions
• Corporate policy change
• Transporting a patient
Chain of Infection
Routine Practices & Additional Precautions In All Health Care Settings. PIDAC Aug 2009
Chain of InfectionVRE
GI TRACT
STOOL
CONTACT
MUCOUS
MEMBRANES
HOSPITALIZ
ED
PERSON
Break the Chain
• Routine Practices:– Hand hygiene– Personal Protective
Equipment– Environmental cleaning
& disinfecting
Routine Practices• Infection prevention and control practices that are to
be followed with all patients, all the time, regardless of diagnosis to prevent and control transmission of infections.
• Elements of routine practices that apply to transport staff are hand hygiene , use of personal protective equipment and cleaning of multi-use equipment between patients.
Hand Hygiene• Single most important practice for preventing the
transmission of infection• Responsibility of all individuals involved in health
care• There are two methods of killing/removing
microorganisms on hands:–Alcohol based hand rub–Washing with soap & water
When do I clean my hands?• Before and after contact with any patient, their body
substances or items contaminated by them • Before putting on gloves• After taking off gloves • After using the washroom • After sneezing, coughing or blowing your nose • Any time hands are dirty
Routine Practices:Personal Protective Equipment
Would you wear PPE?
Routine Practices:Personal Protective Equipment
• Assess the risk of exposure and protect yourself with:
– Gown– Gloves– Hand hygiene
Routine Practices:Personal Protective Equipment
• Wear gloves to handle soiled linen and bags of linen
• Remove gloves, perform hand hygiene before pushing cart throughout the hospital
Do you wear PPE to push the cart?
Do you wear PPE to push the cart?
• The preferred method is to use hand hygiene
• Hand hygiene kills 99.9% of germs in 15 seconds
• Hand hygiene protects you while also protecting others
Routine Practices:Disinfecting Equipment
• Hospital approved disinfectant is Virox wipes
– Wear gloves as per label
• Multi-use equipment must be cleaned and disinfected between each patient
– Stretcher, wheelchair
– High touch surfaces
Can you tell which patient has an infection?
Additional Precautions• Used in addition to routine practices when a
patient has a suspected or definite diagnosis of infection
– Contact– Droplet/Contact– Airborne
Additional Precautions• A patient’s isolation
status could change at any time
– Microbiology results– Symptoms of concern– Contact with a positive
patient
Additional Precautions:Disinfecting Equipment
• Hospital approved disinfectant is Virox wipes
– Wear gloves as per label
• Multi-use equipment must be cleaned and disinfected between each patient
– Stretcher, wheelchair– High touch surfaces
Iceberg Effect• The tip of the iceber g is the
patients with known infections
• The bottom represents the patients with infections that have not been identified yet
• The patients in the bottom of the iceberg are a source of transmission to others
Corporate Policy ChangeGoal: Consistent and appropriate cleaning and
disinfecting of all shared patient equipment
• A high level of clean on a routine basis decreases the risk of transmission of infection in unidentified patients
• Eliminates dirty equipment being left in halls or being used accidentally by other staff/patients/visitors
Corporate Policy Change• Shared equipment are cleaned and disinfected by
all staff between use with patients• Transport staff will clean all high touch surfaces of
the stretcher/wheelchair with virox wipes• Designated clean holding areas identified on unit • Visibly soiled transport equipment will be cleaned
by housekeeping as appropriate• Porter to notify HK by using the bed tracking
system• Porter to identify equipment as dirty by using
signage
Sanitation Stations• Assigned location on
all units
• Porters to use for cleaning/disinfecting of high touch surfaces
High Touch Surfaces-Stretcher
• Handles• Side rails• Intravenous pole• Bumper
High Touch Surfaces-Wheelchair
• Handles• Seat• Back rest• Arm rests • Intravenous pole• Wheel lock handles
and leg calf support
Clean Equipment Holding Areas
• Designated areas on all units
• Separate wheelchair & stretcher holding areas
• Signage on wall and tape outline on the floor
Clean Stretcher Holding Area
What do you think about this?
Mode of Transmission?• Not always this visible
that a piece of equipment is dirty or has not been cleaned
Clean or Dirty?
Clean or Dirty?• Just because it ‘looks’
clean it does not mean it is clean
• Some bacteria and viruses survive for weeks or months on dry surfaces
Is this Okay?
Is this Okay?• Wear gloves for as short
a time as possible • Do not walk from room
to room and other areas of the hospital wearing the same pair of gloves
• Hands are often contaminated in the process of glove removal
• Always perform hand hygiene before & after removal of gloves
• Does not replace hand hygiene
Is this Okay?• Gloves worn in common
areas contaminate the environment
• Puts patients/visitors/staff at risk
• Hand hygiene kills 99.9% of germs in 15 seconds
• Hand hygiene protect s you while also protecting others
Moving a patient on Routine Practices
• Perform hand hygiene• Assist patient onto clean wheelchair or stretcher in
the patient's room• If any PPE was worn to move the patient, remove it
all and perform hand hygiene• PPE, including gloves should NOT be worn while
transporting patients• If the patient is coughing/sneezing, the nurse will
provide them with a surgical mask, the transporter does not need to wear one
• Practice good hand hygiene
Moving a patient on Additional Precautions
• Perform hand hygiene• Wear the appropriate PPE while assisting patient to a
clean wheelchair or stretcher in the patient's room• Remove all PPE apparel, including gloves and perform
hand hygiene after moving the patient and prior to transport
• PPE, including gloves should NOT be worn while transporting patients
• If the patient is coughing/sneezing, the nurse will provide them with a surgical mask, the transporter does not need to wear one (exception: airborne isolation)
• Practice good hand hygiene
Moving a patient from ICU• Patients are moved in their hospital beds• Perform hand hygiene• Wear the appropriate PPE while in the patient’s
room to prepare them for transfer• Wipe down all high touch surfaces of the hospital
bed with a virox wipe before leaving the unit• Remove all PPE apparel, including gloves and
perform hand hygiene prior to transport• The nurse may wear PPE during transport due to the
possibility that they may need to intervene quickly (code blue situation)
Contact PrecautionsNo PPE for transporterNo PPE for patientPorter to carry chart or
put it in a plastic bag on patients lap
Hand hygiene
Droplet/Contact PrecautionsNo PPE for transporterPatient to wear surgical
maskPorter to carry chart or
put it in a plastic bag on patients lap
Hand hygiene
Airborne PrecautionsPorter to wear N95
maskPatient to wear surgical
maskPorter to carry chart or
put it in a plastic bag on patients lap
Hand hygiene
Don’t be a risk!
• Use PPE appropriately
• Protect yourself
• Protect others
• Don’t forget to perform hand hygiene!
