Prevention and Care of Airborne Infections in TB/HIV Settings
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Session 11: Prevention and Care of
Airborne Infections
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By the end of this session participants should be
able to:
•
Explain why infection prevention and control is
important in TB/HIV care
•
Identify three levels of prevention in airborne
infections
•
Identify infection, prevention and control
strategies to prevent TB transmission in the
healthcare setting
•
Explain seven steps of patient management to
prevent transmission of TB in health care settings
H
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i
s
T
B
S
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a
d
?
•
Person-to-person through air by droplet nuclei
that produced when a person with pulmonary
or laryngeal TB coughs, sneezes or sings
T
B
S
p
r
e
a
d
•
PLHIV may become infected / re-infected with TB
•
can progress rapidly from TB infection to disease due
to immune suppression
•
Health care workers are also at high risk of TB
infection due to frequent exposure to patients
with infectious TB disease
•
Rising incidence of multidrug-resistant
tuberculosis (MDR-TB) and extensively drug-
resistant tuberculosis (XDR-TB) have led to a
stronger focus on TB infection control
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:
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Infectiousness of person with TB
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Environment in which exposure occurred
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Duration of exposure
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Virulence of the M tuberculosis strain
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(
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(
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•
Strategies aimed to protect health workers,
patients and community from acquiring
nosocomial infections such as TB infection
•
Intended to help health managers and workers
minimise risk of TB transmission
•
Clinics and Community Health Centres should
have at least one person responsible for
overseeing Infection Prevention and Control
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P
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(
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)
(
2
)
•
The World Health Organisation divides ICP
into:
•
Administrative/managerial and work practice
controls
•
Environmental Controls
•
Personal Respiratory Protection
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(
1
)
•
Have the greatest impact on preventing TB
transmission - first priority in any setting
regardless of available resources
•
Aimed to provide a framework for TB infection
control interventions at all levels and settings
•
Designed to support and facilitate
implementation, operation, maintenance and
evaluation of all TB infection control activities
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(
2
)
Framework for TB infection Control
•
First line of defence:
•
Respiratory hygiene/cough etiquette
•
Screening, investigation and referral
•
Written policies and practices developed to
reduce risk of TB transmission by preventing
generation of droplet nuclei
•
Infection Prevention and Control Plan
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C
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1.
Administrative support, including quality assurance
2.
Further reduce spread of infection
3.
Isolation of patients with PTB:
4.
Educate, train, and counsel HCWs about TB
5.
Educate people to increase community awareness
6.
Patients should be taught on cough etiquette
7.
Always do sputum collection in fresh air space
8.
Coordinate, communicate with TB programmes;
referrals
9.
Write this in an infection prevention and control plan
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B
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S
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s
•
Refer to pages 200 - 201 of your participant
manual to see a chart outlining these steps
E
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n
t
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l
C
o
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t
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s
•
Second line of defence in preventing spread of TB
•
Only effective if administrative controls in place and
include ventilation and filtration
•
V
e
n
t
i
l
a
t
i
o
n
•
Movement of air inside with air from outside to reduce or
remove nuclei droplets from air
•
Movement must ensure directional airflow
•
F
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p
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s
•
High Efficiency Particulate Air (HEPA) filters
•
U
l
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G
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(
U
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I
)
:
•
TB bacteria can be killed by ultra violet light
P
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P
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o
t
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t
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v
e
E
q
u
i
p
m
e
n
t
•
Use of respirators that contain a special filter
material that protects wearer from inhaling
bacilli
•
A respirator is a device for personal respiratory
protection that:
•
covers mouth and nose and
•
is certified to have specific filtration capacity
H
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w
t
o
U
s
e
N
9
5
R
e
s
p
i
r
a
t
o
r
s
•
Be sure your respirator
is properly fitted!
•
Should fit snugly at
nose
•
Respirator should
cover chin and create a
seal
•
Don’t forget to wear it!
W
h
e
n
t
o
F
i
t
T
e
s
t
•
Before wearing respirator in the work place
•
If person has:
•
Any facial changes
•
Significant weight change
•
Change in respirator size, make, model
F
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R
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p
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a
t
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r
S
e
a
l
•
Facial Hair
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Facial Bone Structure
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Dentures
•
Facial Scars
•
Eyeglasses
•
Excessive make up
F
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t
t
i
n
g
a
n
N
9
5
R
e
s
p
i
r
a
t
o
r
(
1
)
•
Cup respirator in your hand, with nosepiece at
fingertips, allowing headbands to hang freely
below hand
•
Position respirator under chin with nosepiece up
•
Pull top strap over head so it rests high at back of
head
•
Pull bottom strap over head and position it
around neck, below ears
•
Use fingertips from both hands to mould metal
nosepiece to shape of nose by pushing inward
down both sides of nosepiece
F
i
t
t
i
n
g
a
n
N
9
5
R
e
s
p
i
r
a
t
o
r
(
2
)
•
Prior to each use, perform a user seal check
by placing both hands completely over
respirator and exhale
•
If you feel air leaking around the nose, readjust
nosepiece
•
If air leaks at edges of the respirator, work straps
farther back along sides of your head
A
n
y
Q
u
e
s
t
i
o
n
s
?
Thank you!
In this session, participants will learn the importance of infection prevention and control in TB/HIV care, levels of prevention in airborne infections, strategies to prevent TB transmission in healthcare settings, and patient management steps to prevent TB transmission. The spread of TB, risks of transmission, and prevention measures including primary, secondary, and tertiary prevention strategies are discussed to enhance understanding and implementation of effective infection control measures.
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Presentation Transcript
Basic HIV Course for Health Professionals Session 11: Prevention and Care of Airborne Infections
Learning Objectives By the end of this session participants should be able to: Explain why infection prevention and control is important in TB/HIV care Identify three levels of prevention in airborne infections Identify infection, prevention and control strategies to prevent TB transmission in the healthcare setting Explain seven steps of patient management to prevent transmission of TB in health care settings
How is TB Spread? Person-to-person through air by droplet nuclei that produced when a person with pulmonary or laryngeal TB coughs, sneezes or sings
TB Spread PLHIV may become infected / re-infected with TB can progress rapidly from TB infection to disease due to immune suppression Health care workers are also at high risk of TB infection due to frequent exposure to patients with infectious TB disease Rising incidence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug- resistant tuberculosis (XDR-TB) have led to a stronger focus on TB infection control
Risk of TB Transmission of Infection is Determined by: Infectiousness of person with TB Environment in which exposure occurred Duration of exposure Virulence of the M tuberculosis strain
Prevention of Airborne Infection Levels of TB Prevention Level Interventions Infection control measures in health settings to prevent transmission to patients and staff Isoniazid therapy to prevent progression to TB disease Intensified case finding Early diagnosis and treatment BCG vaccination does not prevent infection with TB, but does prevent severe forms of childhood TB Diagnosis and treatment before complications develop Primary Prevention: Preventing TB infection Secondary Prevention: Preventing TB Disease Tertiary Prevention: Preventing TB morbidity and mortality
Infection Control Practises (ICP) (1) Strategies aimed to protect health workers, patients and community from acquiring nosocomial infections such as TB infection Intended to help health managers and workers minimise risk of TB transmission Clinics and Community Health Centres should have at least one person responsible for overseeing Infection Prevention and Control
Infection Control Practises (ICP) (2) The World Health Organisation divides ICP into: Administrative/managerial and work practice controls Environmental Controls Personal Respiratory Protection
Administrative/Managerial and Work Place Controls (1) Have the greatest impact on preventing TB transmission - first priority in any setting regardless of available resources Aimed to provide a framework for TB infection control interventions at all levels and settings Designed to support and facilitate implementation, operation, maintenance and evaluation of all TB infection control activities
Administrative/Managerial and Work Place Controls (2) Framework for TB infection Control First line of defence: Respiratory hygiene/cough etiquette Screening, investigation and referral Written policies and practices developed to reduce risk of TB transmission by preventing generation of droplet nuclei Infection Prevention and Control Plan
Main Goals of Work Practice and Administrative Controls 1. Administrative support, including quality assurance 2. Further reduce spread of infection 3. Isolation of patients with PTB: 4. Educate, train, and counsel HCWs about TB 5. Educate people to increase community awareness 6. Patients should be taught on cough etiquette 7. Always do sputum collection in fresh air space 8. Coordinate, communicate with TB programmes; referrals 9. Write this in an infection prevention and control plan
Seven Steps for Patient Management to Prevent Transmission of TB in Health Care Settings Refer to pages 200 - 201 of your participant manual to see a chart outlining these steps
Environmental Controls Second line of defence in preventing spread of TB Only effective if administrative controls in place and include ventilation and filtration Ventilation Movement of air inside with air from outside to reduce or remove nuclei droplets from air Movement must ensure directional airflow Filtration mechanical way of taking out particles High Efficiency Particulate Air (HEPA) filters Ultraviolet Germicidal Irradiation (UVGI): TB bacteria can be killed by ultra violet light
Personal Protective Equipment Use of respirators that contain a special filter material that protects wearer from inhaling bacilli A respirator is a device for personal respiratory protection that: covers mouth and nose and is certified to have specific filtration capacity
How to Use N95 Respirators Be sure your respirator is properly fitted! Should fit snugly at nose Respirator should cover chin and create a seal Don t forget to wear it!
When to Fit Test Before wearing respirator in the work place If person has: Any facial changes Significant weight change Change in respirator size, make, model
Factors Affecting Respirator Seal Facial Hair Facial Bone Structure Dentures Facial Scars Eyeglasses Excessive make up
Fitting an N95 Respirator (1) Cup respirator in your hand, with nosepiece at fingertips, allowing headbands to hang freely below hand Position respirator under chin with nosepiece up Pull top strap over head so it rests high at back of head Pull bottom strap over head and position it around neck, below ears Use fingertips from both hands to mould metal nosepiece to shape of nose by pushing inward down both sides of nosepiece
Fitting an N95 Respirator (2) Prior to each use, perform a user seal check by placing both hands completely over respirator and exhale If you feel air leaking around the nose, readjust nosepiece If air leaks at edges of the respirator, work straps farther back along sides of your head
Any Questions? Thank you!
