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Communicable disease policies

Vaccination/immunity

All students are required to be immunized according to the Public Hospital Act and students may be asked to show proof of immunization status.
 

Reporting of exposures

You are required to report to Occupational Health (or the ER) if:

  • You have suffered a needle stick or other injury with a contaminated sharp
  • You have had a mucous membrane or skin exposure to blood/body fluids
  • You have been exposed at work or home to someone with an infectious disease (e.g. meningitis, tuberculosis)
  • You have diarrhea or vomiting at work, or which is due to an infection that you think might have been
    acquired at work
  • You have a febrile respiratory illness in which the fever has lasted longer than 72 hours
  • You have been asked to do so by a member of the infection control department
     
Work restriction

You are required to stay out of the hospital if you have:

  • Acute onset of vomiting or diarrhea – until 24 hours after vomiting/diarrhea have stopped, or until cleared by occupational health
  • Acute febrile respiratory illness – you are expected to take your temperature at least twice per day if you have an acute respiratory illness, and to exclude yourself from work until you have been afebrile for 48 hours
  • Any other illness which you recognize may be infectious (e.g. isolated sore throat, which may be streptococcal) – until symptoms have resolved, or you have been cleared to return to work by occupational health or infection control.

The Occupational Health and Safety Department is located in the basement of 60 Murray Street (phone: 586-1572), and is open from 0700-1600 Monday to Friday. At other times report exposures and injuries to the Emergency Department.
 

Hand Hygiene

Consistent hand washing/hand disinfection is the most important measure to protect staff and patients. Alcohol hand wash is as effective as soap and water, as long as hands are not soiled. Hands should be disinfected or washed:

  • before contact with all patients
  • after contact with all patients
  • after removing gloves
  • when moving from a contaminated body site (e.g. a draining wound) to a clean body site (e.g. a central line dressing)

Alcohol handwash is available outside each patient room in in-patient areas.

Hand cream can be easily contaminated, please use the hospital hand cream (the pump bottles minimize contamination, and the cream has a bacteriostatic agent to prevent bacterial overgrowth).

Stethoscopes, and other equipment that touches patients may potentially transmit pathogens, and should be wiped off with alcohol or other disinfectant between patient uses (disinfectant wipes are present outside patient
rooms).

Please review the information on the intranet in General Manual section once you've started your clinical placement.
 

Routine Practices

Routine practices are the standard at Mount Sinai Hospital for protecting staff and patients from transmission of infection. Routine practices requires all health care workers to consider all body substances (blood, body fluids, secretions, excretions, drainage, breast milk) from all patients as potentially infectious.

Routine practices mandate that, in addition to hand washing/hand disinfection:

  • Gloves should be worn when there is a risk of contact of your hands with mucous membranes, nonintact skin, moist body substances, and undiagnosed rashes.
  • Gowns, fluid resistant masks, goggles, and/or face shields should be worn if you are at risk of being splashed with moist body substances, or exposed to respiratory droplets (e.g. during suctioning, intubation, or bronchoscopy)
  • Handling of sharps should prevent needlestick injury. All sharps should be discarded immediately in a sharps container. If recapping is necessary, use a one-handed technique to avoid injury. Sharps should never be left on procedure trays, and must be passed in a way to avoid injury.
  • Laboratory specimens must be closed securely and placed in a sealed bag prior to transport. Specimens with attached needles will not be processed.

 

Resources

Please review the following intranet sites when you commence your clinical placement. These intranet sites can be assessed from any computer within Mount Sinai Hospital:

  • Additional precautions are necessary for pathogens that are spread by the airborne route and for some pathogens where transmission cannot be contained by hand disinfection alone.
  • Airborne precautions are required for patients with infections spread by the airborne route (most commonly at MSH: tuberculosis, chickenpox, disseminated herpes zoster). See:
    http://info/microbiology/InfectionControl/tb/tb.htm
    http://info/microbiology/InfectionControl/InfectionControlEducation/precautions/airborne.html
  • Droplet and contact precautions:
  • Contact precautions are used to prevent transmission of infection from patients infected or colonized with pathogens that contaminate the environment or may be present in such high concentration that hand washing alone is insufficient to control spread. See: http://info/microbiology/InfectionControl/InfectionControlEducation/precautions/contact.html
  • MRSA precautions:
    http://info/microbiology/InfectionControl/InfectionControlEducation/precautions/mrsa.html
  • VRE precautions:
    http://info/microbiology/InfectionControl/InfectionControlEducation/precautions/vre.html
  • Clostridium difficile:
    http://info/microbiology/InfectionControl/InfectionControlEducation/precautions/cdiff.html