new york state healthcare - lisha.org · (bankaitis and kemp, 2003‐ 2005) what is the goal of...
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Part Two of Three
New York State Infection Control for Hearing Healthcare
Denise Passerieux, AuD., [email protected]
June 8, 2020
CODE OF ETHICS OF AUDIOLOGYCODE OF ETHICS OF AUDIOLOGY
“Individuals shall exercise all reasonable precautions to avoid injury to person in the
delivery of professional services or execution of research.”
American Academy of Audiology Part 1, Principle 2, Rule 2b
What is Infection Control?What is Infection Control?
Infection control is a process that involves the conscious management of the clinical environment for the specific purposes of minimizing the potential spread of disease.
(Bankaitis and Kemp, 2003‐2005)
What is the Goal of Infection Control
Reduce or eliminate opportunities
for direct or indirect transmission of
microorganisms from person toperson
(Kemp & Bankaitis 2000a, Kemp & Bankaitis 2000b)
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Immune System Review
First line of defense from attack • Skin, mucus, stomach acid
• Non‐specific immune response• Responds the same way each time it is attacked regardless of what is attacking
• Not 100% effective
Adaptive Immune System
Neutralize and kill the invading antigen• Second line of body defense• More complex system• Actively identifies, seeks and destroys antigens
Natural Immune System
B ce l l sMass produce antibody specific to the antigen
identified by T cellsPortion are left as memory cells that remain in
circulation
T ce l l s
Finds antigen and attaches itself Sends out signal to B cells to release antibody
Lymphocy tes ac t i vated
T cells B cells
Mic robe enters body
Immune system recognizes antigen
Contact Transmission‐ Direct ContactContact Transmission‐ Direct Contact
•Direct body surface to body surface contact • Physical transfer of microorganism between an infected or colonized person to another person by touch.
HandshakeSkin to skin contact• Draining ear• Contaminated cerumen • Body secretions
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Contact Transmission ‐ Indirect ContactContact Transmission ‐ Indirect Contact
Contact between a person and a contaminated object
• Handle or re‐use a contaminated object• Not cleaning the ‘bell’ of the stethoset between uses on different hearing aids.
• Touch contaminated doorknob
Contact Transmission‐ Droplet TransmissionContact Transmission‐ Droplet Transmission
Infectious microbes transmitted through water droplets through the air
• Speaking• Coughing
• Sneezing
Microbes come into direct or indirect contact with linings of eye, nose or mouth
Transmitted by droplet: COVID‐19, influenza, colds, respiratory syncytial virus (RSV) and some organisms causing pneumonia.
• Coughing• Sneezing
Modes of Disease Transmission ‐ AirborneModes of Disease Transmission ‐ Airborne• Microorganisms remain suspended in the air for long
periods of time and can be dispersed widely by air
currents.
• Risk that all the air in a room may be contaminated.
Microbe travels through air as droplet/dust particles from one person to another
Enters through respiratory system
Tuberculosis, Measles are transmitted airborne
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Modes of Disease Transmission‐Vehicle
Transmission of pathogens through water, food, and air.
Transmitted by contaminated items including food or water
Ingest or exposed to the contaminated microbe
• Transmitted through:• Contaminated water
• Contaminated food
• Contaminated blood
Modes of Disease Transmission‐ Vector BorneModes of Disease Transmission‐ Vector Borne
• Mosquito• Tick• Rat• Insect
We are coming to get you!!
Microbes transmitted to humans by an infected animal or blood‐feeding
insect
Factors That Increase The Transmission of Infection:Factors That Increase The Transmission of Infection:
• Inadequate hand washing
• Inadequate sterilization/disinfection of patient care equipment
• Inadequate cleaning/ disinfecting surfaces
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Factors Increase Susceptibility to InfectionFactors Increase Susceptibility to Infection
• Age• Heredity• Cultural Practices• Nutrition• Stress• Rest, exercise and personal health habits
• Inadequate defenses • Environmental
• Immunization history
•Medications and medical therapies
• Diabetes• Immunocompromised• HIV/AIDS• Tuberculosis• Diabetic
PathogenPathogen
•Primary‐• Microorganisms that cause diseases in healthy individual.
•Opportunistic (Secondary)‐• Microorganisms only cause disease when a person has immunocompromised system.
a microorganism that causes disease
Bacterial Infectious Diseases Bacterial Infectious Diseases •Millions of bacteria are located throughout body, both good and bad.
• Infection is caused by microscopic organisms that are pathogenic.
• Harmful bacteria may also emit toxins that damage the body.
• Tuberculosis, Meningitis, Streptococcal bacteria, H‐Pylori, E‐Coli, Salmonella
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Viral Infectious Diseases Viral Infectious Diseases
o Virus is a living organism that cannot survive/replicate without host organism/cell (parasitic relationship)
o There is no cure, but there are vaccinations to reduce chance of spreading and reduce change of contracting.
o COVID‐19, SARS, Measles, Mumps, Influenza, N1H1, HIV, Herpes, Hepititis (A,B,C), CMV, Zika
What are Coronaviruses?
Group of viruses that can cause a wide range of disease. • Cause the common cold.
• SARS
• A “novel” coronavirus is a new type of coronavirus that has not been previously identified in humans,
• Current outbreak is due to a new coronavirus named:Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2)
Is referred to as COVID‐19
Who are most at risk for COVID‐19?
Highest risk of infection is in those who are aged 30 and older
Pre‐existing chronic illnesses◦ heart disease
◦ Diabetes
◦ Chronic lung disease
◦ Cancer
Risk of death increased with age
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Fungal Infectious DiseasesFungal Infectious Diseases
•Caused by fungi in the environment• There are approximately 1.5 million different species of fungi on Earth, but only about 300 make people sick.•Ringworm, Otitis Externa, Candidia species (Thrush)
Breaks the chain of infection…..Establishing an Infection Control Plan
OSHA REQUIREMENTS ‐Infection Control
•OSHA mandates that a written infection control plan is implemented for every health care office
• Important for safety in the workplace for employees and patients
•Audiology practice/hearing aid dispensing office is regarded as a health care setting• Every audiological setting must have an infection control plan
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Written Plan for Infection Control
1) Employee Classification
2) Hepatitis B Vaccination
3) Training
4) Accidental Exposure
5) Implementation Records
6) Post Exposure Plan and Records
1) Written Plan: Employee Classification
• Category I• Highest potential of exposure to infectious agents• Example: Hospital, physician’s office• Clinical audiologist• Hearing aid dispenser
• Category II • Slightly less risk to exposure• Example: Hearing aid dispensing office• Clinical audiologist, hearing aid dispenser, audiologist assistant
• Category III• Lowest risk to exposure• Administrative staff, front office staff, persons not in direct contact with patients
2) Written Plan: Hepatitis B vaccination
• Hepatitis B (HBV)• Vaccination plan• Records
• All Category I and II employees who have contact with blood and bodily fluids must be offered the HBV vaccination in the office at no charge
• Employer needs to maintain records of the vaccination for the full duration of their employment plus another 30 years
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3) Written Plan : Training • Initial training
• Offered when begin in the position
• Fully trained individual on office policies
• No minimum time limit
• Annual training • Can be as sort as a 10 minute update
• Re‐classification• Must undergo training within 90 days of re‐classification
• Change in procedure (new or updated)• Everyone must undergo training to know how to conduct the procedure
Written Plan: What should be Covered in Training
• OSHA standards for training content
• Modes of Transmission• Information on HBV vaccine• Location & use of protective equipment• Hand hygiene
4) Written Plan: Accidental Exposure & Follow up4) Written Plan: Accidental Exposure & Follow up
If someone is exposed to an infectious agent:
•Map out a plan in case of accident : • Someone exposed to potentially infectious agent• Steps taken if exposure occurs
• Implement treatment for specific exposure
• Record of incident• Include circumstances of exposure, route of exposure, treatment plan and outcome.
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6) Written Plan: Post Exposure Plan and Records6) Written Plan: Post Exposure Plan and Records
• Any exposure to blood borne pathogens require follow up
• If any exposure has occurred, the office must document that:
• 1) Treatment due to exposure was received
• 2) Outcome of treatment
• Goal of follow up is to confirm that disease has or has not been transferred.
5) Written Plan: Implementation5) Written Plan: Implementation
FIRST: Assess how each clinical procedure is currently delivered• Develop a comprehensive list of all services offered
SECOND: Identify how each procedure needs to be modified to meet the goal of an effective infection control plan to minimize the spread of disease
Each clinic is different. Examination of types of services must occur to assess implementation of infection control procedures for each service provided.
Protocols: Typical Everyday Clinical ProceduresProtocols: Typical Everyday Clinical Procedures
DIAGNOSTICS• Otoscopy• Air Conduction• Bone Conduction• Immittance testing
• Vestibular evaluations• Electrophysiological testing
• Cerumen removal
• Intraoperative monitoring
• Toys
HEARING AIDS
• Earmold impressions
• Custom earmold modifications
• Listening checks
• Dispensing hearing aids
• Loaner hearing aids
• Assistive devices
• Hearing aid drop off
• Cochlear Implant mapping
FRONT OFFICE
Check in
Waiting room set up
Scheduling
Patient PPE
Walk ins
Website
Waiting room toys
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Guidelines for Standard
Precautions in Developing
an Infection Control Plan
Isolation precautions ‐ use of personal protective equipment (e.g., gloves, gowns, masks),
Hand Hygiene *
Safe injection practices (not audiology related)
Safe handling of potentially contaminated equipment or surfaces in the patient environment,
Respiratory hygiene/cough etiquette.
• To protect skin and clothing during procedures or activities where contact with splash, blood or body fluids may be possible
Gown
• Masks are recommended during all procedures with direct patient contact.
• Face shield/Goggles: During procedures with splash risks: ENG, cerumen management, irrigation, OR suite
Masks, Face Shield, Goggles
• Wash hands prior to contact with patient
• Wash hands immediately after removing and disposing of PPEHand hygiene
• Used with all contact with patients
• Change gloves after each patient
• Last item to put on, first item to removeGloves
Use of Protective Personal Equipment (PPE)‐ Professional Staff
Use of PPE‐ Office Staff
• All Staff should wear face mask during the day
• AT LEAST one facemask per staff member per day
• Consider clear mask for use for hearing impaired persons (if available)
FACE MASK
• Gloves need to be changed following each patient, not necessary if practice washing hands between patients
GLOVES
• Wash hands following contact with each patient after remove gloves
• Use of soap/water
• Use of alcohol based products
HAND HYGENE
• Plexiglass barrier at front desk
• Plastic covering of all keyboards for easier disinfection
CLEAR BARRIERS
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Standard Precautions ‐ Hand Hygiene
•Hand hygiene is most important practice to prevent spread of infections organisms in healthcare industry• First line of defense against germs1. Hand washing with soap & water before and after each
patient• Wash with soap and water for at least 20 seconds• SING HAPPY BIRTHDAY X 2
2. Use of alcohol‐based products that do not require the use of water.
• According to CDC MUST HAVE GREATER THAN 60% ETHANOL OR 70% ISOPROPANOL in healthcare settings
Standard Precautions ‐ Hand Hygiene
• Before and after each patient
• Before/after glove removal
• If hands are visibly dirty
• After handling or touching objects that have possibility to be contaminated
Recommended Hand Hygiene Technique
Hand sanitizers
• Use 60% alcohol based sanitizer
• Apply to palm of one hand, rub hands together
• Cover all surfaces of hands and rub until dry
• Volume of product needed: based on manufacturer
• If hands visibly dirty, wash hands with soap
Handwashing
• Wet hands with water, apply soap and lather, rub hands together for at least 20 seconds
• remember under the nails
• Use liquid soap
• Rinse and dry with disposable towel
• Use towel to turn off faucet
Guideline for Hand Hygienen Health‐care Settings. MMWR 2002; vol. 51, no. RR‐16.
There is no real standard for how many times you can use hand sanitizer before you should wash your hands.HOWEVER, with today’s heightened precautions you should sanitize your hands multiple times during your contact with a patientAND wash your hands after gloves are removed.
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• Jewelry
• Recommended to remove jewelry/rings from under gloves
• Able to harbor pathogens
• Potential to tear gloves
Artificial nails and Jewelry in healthcare
Artificial or long nails• Individuals wearing artificial nails
have been shown to harbor more pathogenic organisms on the nails and in the subungual area than those with natural nails.
• Not recommended for health care professionals working with high risk patients
• Natural nail length should not exceed ¼ inch
Guideline for Hand Hygiene in Health‐care Settings. MMWR 2002; vol. 51, no. RR‐16.
Self‐Reported Factors for Poor Adherence with Hand Hygiene
• Handwashing agents cause irritation and dryness• Sinks are inconveniently located and/or lack of sinks• Lack of soap and paper towels• Too busy/insufficient time • Understaffing/overcrowding• Patient needs take priority• Low risk of acquiring infection from patients
Adapted from Pittet D, Infect Control Hosp Epidemiol 2000;21:381‐386
Use of PPE
in Audiology
Use of PPE
in Audiology
GLOVES ‐• Latex:
• Need to ask if patient has an allergy• Be aware if using lotions‐ petroleum based lotions weaken latex gloves• Do not use with impression material
• Nitrile‐ preferred in audiology setting • Able to use with impression material• Less permeable and resistant to chemicals
• Vinyl‐• Thinner material
GLOVES ARE THE
LAST PPE TO BE
PUT ONAND
FIRST PPE
TO BE REMOVED
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Are you wearing the
correct size
glove?
Are your gloves fitting
correctly?
A B C
https://www.cdc.gov/vhf/ebola/pdf/poster‐how‐to‐remove‐gloves.pdf
https://www.cdc.gov/coronavirus/2019‐ncov/downloads/A_FS_HCP_COVID19_PPE.pdf
Full PPE recommended for splash/aerosol situations
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐• Vestibular testing• Cerumen
management• OR
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Use of PPE in Audiology
Use of PPE in Audiology
Facemasks
Face shield
Eye protection/Goggles
Scrubs – has been suggested to has specific clothing for seeing patients. Changes out of when leaving office.
Audiologists should prepare
to use mask and gloves for
all patients
Used for all patient contact.
Standard Precautions‐Safe handling of contaminated items
Treat everything as contaminated, especially bodily fluids: Cerumen, Mucus• Use disinfectant wipes or tissue
• Throw away in designated garbage can for contaminated items • infectious waste remains present once item is disposed of
Assign one specific trash bin for contaminated items• Do not want to run the risk of anyone going through the garbage and risk contamination
Standard Precautions‐ Safe handling of contaminated items
• Items must be disposed of separately
• Should have a dedicated garbage can lined with plastic liner
• Double bag contaminated item immediately
• Set aside to be discarded
Excessive cerumen, vomit, mucus, blood
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Respiratory Hygiene/Cough Etiquette
CDC states Cough Etiquette:
• Implement measures to prevent the spread of respiratory infections from anyone in a health care setting with signs or symptoms.
• Post signs at entrances asking patients with symptoms of respiratory infection to:• Cover your mouth and nose when coughing or sneezing.• Use tissues and throw them away.• Wash your hands or use a hand sanitizer every time you touch your mouth or nose.
• Provide tissues and no‐touch receptacles for their disposal.• Provide resources for performing hand hygiene in or near waiting areas.
• Offer masks to symptomatic patients when they enter the dental setting.
• Provide space and encourage symptomatic patients to sit as far away from others as possible. Facilities may wish to place these patients in a separate area, if available, while waiting for care.
https://www.cdc.gov/oralhealth/infectioncontrol/faqs/respiratory‐hygiene.html
You now have a written infection control plan
Now you need to implement it
Be sure to CLEAN everything prior to disinfecting or sterilizing
• Cleaning removes the gross contamination of an object without killing germs
• Must clean an item prior to disinfecting or sterilizing
• Wipe down counters, chairs, tables, desk, workspaces, testing areas after each patient.
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DISINFECTION• Kills a specific number of germs
• Number of germs killed is determined by the disinfectant used.
• Audiology practice settings should use a HOSPITAL GRADE disinfectant. (Rutala, 1990)
• According to CDC hospital grade disinfectant is appropriate for killing COVID 19 • Towelette, spray, or soaking
o Be aware! • Some commercial products will affect integrity of the plastic, silicone rubber and acrylic • Not recommended for hearing aids, TDH‐39
o EPA List N are good for disinfecting against COVID‐19 and other pathogens
o https://www.epa.gov/pesticide‐registration/list‐n‐disinfectants‐use‐against‐sars‐cov‐2
o Coronaviruses can be efficiently inactivated “by surface disinfection procedures with 62‐71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute.
• The amount of time a disinfectant/sterilant must be in contact with AND visibly wet on a surface
•Dwell time is product specific.
•Check the label for the dwell times of the products in the office.
Need To Be Aware of Dwell Time for Proper Disinfection
https://www.directsupply.comhttps://www.directsupply.com/blog/covid‐19‐dwell‐times‐for‐effective‐disinfection/ blog/covid‐19‐dwell‐times‐for‐effective‐disinfection/
DWELL TIMES FOR DISINFECTION
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Clean, DISINFECT or sterilize??
What should I disinfect??
EVERYTHING patient touches should be CLEANED and then DISINFECTED after each patient.
Also if:
• If item does not touch blood
• If item does not touch infectious substances
• Does not or cannot potentially break the skin
Clean
, DISIN
FECTor
Sterilize??• ALL Patient touch areas
• Entire examination room, chair/armrest, exam table, desks, door knobs, reception counters, waiting room chairs, pens, headphones, bone conduction
• Toys • ALL Toys should be non‐porous • Plastic toys
• NOT WOOD OR FUZZY TOYS is easier to disinfect than wood, fuzzy toys, metal surfaces
• Toys should be disinfected after each pediatric patient• At this time there should be no waiting room toys
• Hearing aid work areas• Repair benches• Where hearing aids/ear molds are cleaned • Disinfect Before and after each hearing aid is modified
ALL SURFACES SHOULD BE DISINFECTED AFTER EACH PATIENTClean
, DISIN
FECTor
Sterilize??
oHearing aid listening stetho‐sets o bell & ear tips
oHA’s prior to attaching to coupler
oRear Ear Coupler after measurements
oEarmolds
oHearing Aids
oSupra‐aural headphones
oABR/ENG electrodeso That are not contaminated with body fluids
oHearing aid cleaning tools o brushes, wax loops
DISPOSABLE: Fun Tac, Probe tips, insert earphones
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Clean, Disinfect or Sterilize??
What should I Sterilize??Any item comes into contact with a patient with:
•Potential infectious substance
•Cerumen, body fluid, blood, mucus, bodily fluid
•Open wound
•Any items that could break the skin
•Specula, Curette, wax loop
Steriliztion kills 100% of the vegetative microorganisms and their endospores 100% of the time.
(Infection Control in Audiology Practice, 2003)
• Uses high pressure saturated steam (121°C/249°F) for 15‐20 minutes• Can melt many items and instruments used in an audiology practice
Types of Sterilization in Audiology
• Heat under pressure‐ Autoclave • Cold Sterilization
• Chemicals approved for
Sterilization
• Soak instruments in either:
• 2% glutaraldehyde
• 7.5% hydrogen peroxide
Types of Cold Sterilization
• Wavicide‐ Glutaraldehyde solution
• Re‐used for 28 Days
• 10 hour soaking time
• Does not need to be mixed
• Store in tightly covered tray
• Porous items cannot be soaked
• Use gloves when handling
• Sporax ‐ Hydrogen peroxide solution (>7.5% concentration)
• Reused for 21 days
• 6 hours soaking time
• Less hazardous than Wavicide
• Porous items cannot be soaked
• Uses gloves when handling
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MSDS SHEETSWHERE DO I GET THEM?
• Obtained from manufacturer of the chemical.
WHERE NEED TO KEEP THEM?• OSHA requires that forms are stored near to the chemicals
Required by OSHA to have MSDS Sheets for each item in office
• Impression material, earmold glues, Wavicide, Sporax, Otoease, hand sanitizer, etc.
Infection control begins prior to the patient’s visit
1) Spread your schedule out
• Need time in between patients to thoroughly clean/disinfect all surfaces in waiting room and patient rooms
2) Pre‐screen and inform patients prior to appointment
• Prescreening Questions:
• “Have you lost your sense or taste/smell, even if temporarily?”
• ”Do you have a fever at or above 100.4? Within the past 2 weeks?”
• ”Have you come into contact with someone that has been ill within the past 2 weeks?”
• Make sure patient aware of office policies
• Must wear mask, wait in car, only one person with them, etc.
3) Establish an office policy on bringing others to the appointment.
• Bring someone only if need for accompaniment?
• Only person who appointment is for will be allowed in?
4) Establish if you want patients in the waiting area prior to appointment
• Want to call the office when arrive?
5) All patients must wear a mask
COVID‐19 has changed the way we look at infection control
OFFICE SET UP•Waiting room‐ recommended all chairs to be at least 6 feet apart
• Consider a clear partition between staff and patients
• All staff should wear masks
• Gloves may be necessary
• Provide easily accessible hand sanitizer, tissues, trash cans for staff and patients.
• Enforce policy that all patients wear masks.
• Place signs and posters providing instruction on hand hygiene, respiratory hygiene, and cough etiquette
• Disinfect all areas following patient leaving office prior to next scheduled appointment
• Consider plastic covering of all keyboards (easy disinfection)
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https://www.cdc.gov/coronavirus/2019‐ncov/downloads/stop‐the‐spread‐of‐germs.pdf
Example of Office Signage
https://www.apple.com/covid19/
Prior to appointment‐Screen your patients
Online screening tools are available for your patients.
Audiological Testingo All surfaces in the booth and equipment that touches the patient should be wiped down with
a disinfectant. o Includes wiping the surfaces and equipment in the audiologist test area of the booth as
well (audiometers, immittance, otoscope, computer keyboard) o Consider Plastic covering over buttons for equipment for easy disinfection (without
worrying about ruining equipment)o Use of headphone coverso Use disposable items whenever possible (probe tips, insert earphones)
o Booth manufacturers are recommending leaving the booth empty with the door closed for a period between patients to allow for one full cycle of air exchange in the booth.
o This assumes the booth is attached to the HVAC system of the building (the preferred set‐up).
o If your booth is not attached to the HVAC system and uses fans, then the time for complete air exchange will be longer. Check with booth manufacturer to see complete cycle/refresh time https://www.audiology.org/print/3915
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Suggestions made by audiologists for Easier Infection Control Implementation
https://allcleanuv‐c.com/about‐uv‐c
Designed for sanitizing using UV‐C light:• headphones and headband• bone vibrators• otoacoustic emission probes, • headsets used in impedance testing• insert earphones• response buttons • Also be used with other frequently used type of headsets (audiologist headset, regular phone headset)
• Do not have to unplug KEEP IN MIND THIS IS LINE OF SIGHT DISINFECTIONMUST BE CLEANED PRIOR
Options Available for Sanitization of Audiological Equipment
According to the manufacturer, the UV‐C lamp kills approximately 99.9% of most common viruses and bacteria.
Disinfecting cycle is 90 seconds.
ENG/VNG TestingPreparation: Personal Protective Equipment (PPE)
This evaluation has higher risk regarding transmission with direct contact.o Disposable gown over your scrubs/clothes. These are removed and disposed of between
patients. o Wear gloves and change these between patients.o Surgical mask or N95 mask should always be used (many areas do not have enough N95s
at this time, so you may need to use a surgical mask). o Face shields should be used given that a risk of aerosolized material is entry though the
eyes. This could be a mask/shield combination, a separate face shield or plash rated goggles.
o Consider to wear designated work clothing (ie scrubs) on days performing vestibular testing that can changed out of when completed.
o Consider wearing shoes that can be washed (rubber is one option) or wiped clean and remove these before entering your home.
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ENG/VNG Testing• Consider using a bouffant cap over patient’s hair.• Patient must wear a mask• VNG Goggles:
• Concern is for of transmission of COVID to the eyes as it is a vulnerable entry point for the virus• The Velcro should not make contact with the patient. • If available, use disposable foam goggle pads.
•DISINFECTION of goggles after each patient•Use EPA‐approved list N disinfectant for silicone/rubber and strap
•(you can coat the strap with duct tape since it is a porous surface).• Lenses cannot be cleaned with disinfectant solvent due to infrared coating.
•Wash with a solution of mild soap and warm water using a cotton ball. Rinse and dry with a cotton ball.
• Use a microfiber cloth to remove any remaining lint. •Clean between patients and at the end of day, return goggles to drawer only when they are cleaned.
•All equipment and surfaces that comes in contact with the patient and/or audiologist must be cleaned between patients.
Hearing Aids Hearing Aids
NEVER accept a hearing aid from a patient with bare hands.
Always use gloves, small cup or tissues
Disinfection of Hearing Aids
•Wipe once with disinfecting wipe to clean the surface from debris, cerumen, etc.
•Wipe again more thoroughly (with different part of wipe or a new wipe) to fully disinfect the aid(s)
• Sanitize with UV‐C light• Remember UV is only line of sight disinfection
• What the light doesn’t touch, it does not disinfect
• Remove battery prior to usage
• If rechargeable, contact manufacturer if safe for usage
• Consult hearing aid manufacturer what is recommended
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Perfect Dry LUX System.Combination of a forced‐air fan drying system and UV‐C rays for disinfection.
.
D‐Dry+Drying and CleaningUV‐C light kit for all types of hearing systems and earmolds.
Electronic Kapak Ultra Violet C
Types of UV‐C Sanitizers
Infection control is not just audiologist’s responsibility.
Patients should be instructed proper cleaning regimen for their hearing
aids. Patients must be instructed how to
clean and disinfect their hearing aids/ear molds daily
Where to get infection control materials…
Oaktree ProductsWestoneWarner Tech‐Care Products Inc
(formally Hal‐Hen)
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References
• IInfection Control in the Audiology Clinic, 2nd Edition by A.U. Bankaitis, PhD and Robert J. Kemp, MBA
• nfection Control in Audiology Practice. (2003) Audiology Today, 15:5,
• Rutala, W.A. (1990). APIC guideline for selection and use of disinfectants. American Journal of Infection Control, 17:52, 99‐117.
• American Academy of Audiology Code of Ethics‐ Part 1, Principle 2, Rule 2B
• http://www.cdc.gov/fungal/diseases/index.html
• Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008www.cdc.gov/hicpac/disinfection_sterilization/2approach.html
• Infection Control: Best Clinical Practices, Course #20864, Audiology Online
• GUIDE TO INFECTION PREVENTION FOR OUTPATIENT SETTINGS: Minimum Expectations for Safe Care. Website: www.cdc.gov/HAI/pdfs/guidelines/Outpatient‐Care‐Guide‐withChecklist.pdf
• www.en.wikipedia.org/wiki/Cryptococcus_neoformans
• http://en.wikipedia.org/wiki/Candida_%28fungus%29
References• Bolyard, Elizabeth A, RN MPH, Ofelia C. Tablan, MD, Walter W. Williams, MD, Michele L. Pearson, MD, Craig N. Shapiro, MD, Scott D. Deitchman, MD, and The Hospital Infection Control Practices Advisory Committee Guideline for infection control in health care personnel, 1998 www.cdc.gov/hicpac/pdf/InfectControl98.pdf
• Bankaitis, A (2014, October). Infection Control‐ What to do and How to do it. Audiology Online, Article 12953. Retrieved from Audiology Online.
• Bankaitis, A. (2012, June). Infection Control Part II: What Audiologists Need to Do. Retrieved from Audiology Online.
• Guideline for Hand Hygiene in Health‐Care Settings Recommendations of the Healthcare Infection Control Practices Advisory Committee and the CPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. October 25, 2002/Vol. 51/ No. RR‐16. http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf
• Infection Control. Frequently asked Questions. Hand Hygiene. www.cdc.gov/oralhealth/infectioncontrol/faq/hand.htm
• Bankaitis, A.U.. Infection Control – Why Do Audiologists Need to Care. Audiology Online. www.audiologyonline.com/articles/infection‐control‐why‐audiologists‐need‐12916.
• http://www.rnpedia.com/nursing‐notes/fundamentals‐in‐nursing‐notes/asepsis‐and‐infection‐control/#
References• Sample infection control plan. http://eo2.commpartners.com/users/audio/downloads/Sample_Infection_Control_Plan_Handout.pdf#page=1&zoom=auto,‐74,798
• Sporox v. Glutaraldehyde. Q & A. Retrieved from Audiology Online. www..audiologyonline/ask‐the‐experts/sporoxv‐glutaraldehyde
• Ballachanda, B., Roeser, R., Kemp, R. (1996). Control and Prevention of Disease Transmission in Audiology Practice. American Journal of Audiology • Vol. 5 • No. 1, March 1996.
• http://www.encognitive.com/node/1114
• http://www.nlm.nih.gov/medlineplus/immunesystem.html
• Guide to Prevention and Control of Infectious Diseases in the Workplace (2007). British Columbia Public Service Agency, British Columbia Government and Services Employees Union.
• http://aubankaitis.com/?p=2496
• https://www.youtube.com/watch?v=TxU8c4vEHWk
• Adapted from Pittet D, Infect Control Hosp Epidemiol 2000;21:381‐386.
• https://www.cdc.gov/oralhealth/infectioncontrol/faqs/respiratory‐hygiene.html
• https://www.phonak.com/us/en/support/getting‐started/maintenance‐for‐hearing‐aids/cleansing‐and‐care‐line.html
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Covid Referenceshttps://www.audiology.org/practice‐management/covid‐19‐resources
https://www.audiology.org/news/vestibular‐testing‐safety‐covid‐19‐and‐beyond
https://www.cdc.gov/coronavirus/2019‐ncov/hcp/hand‐hygiene.html
https://journals.lww.com/ear‐hearing/Abstract/9000/COVID_19_Return_to_Work_Guidance_and.98654.aspx
https://www.c dc.gov/coronavirus/2019‐ncov/hcp/infection‐control‐faq.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019‐ncov%2Finfection‐control%2Finfection‐prevention‐control‐faq.html
https://allcleanuv‐c.com/faqs
https://www.cdc.gov/handwashing/when‐how‐handwashing.html
COVID‐19 Return to Work Guidance and Recommendations for Vestibular Clinicians Rizk,H.G. , Strange C. , Atallahs, S , Massingale, S and Clendaniel, R. Ear and Hearing(ahead of printing). DOI: 10.1097/ AUD.0000000000000903
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