Transcript Infection

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Preventing Infection
1. Define infection prevention and discuss types of infections
Define the following terms:
infection prevention
the set of methods practiced in healthcare facilities to prevent
and control the spread of disease.
microorganism/microbe
a living thing or organism that is so small that it can be seen
only under a microscope.
infection
the state resulting from pathogens invading the body and
multiplying.
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Preventing Infection
1. Define infection prevention and discuss types of infections
Define the following terms:
pathogens
microorganisms that are capable of causing infection and
disease.
localized infection
an infection that is limited to a specific location in the body
and has local symptoms.
systemic infection
an infection that is in the bloodstream and is spread
throughout the body, causing general symptoms.
healthcare-associated infection (HAI)
an infection acquired within a healthcare setting during the
delivery of medical care.
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Preventing Infection
1. Define infection prevention and discuss types of infections
It is important to observe and report the following signs and
symptoms of localized infections:
• Pain
• Redness
• Pus
• Swelling
• Drainage (fluid from a wound or cavity)
• Heat
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Preventing Infection
1. Define infection prevention and discuss types of infections
It is important to observe and report the following signs and
symptoms of systemic infections:
• Fever
• Body aches
• Chills
• Nausea, vomiting
• Weakness
• Headache
• Mental confusion
• Drop in blood pressure
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Preventing Infection
2. Describe the chain of infection
Define the following terms:
chain of infection
a way of describing how disease is transmitted from one
being to another.
causative agent
a pathogenic microorganism that causes disease.
reservoir
a place where a pathogen lives and grows.
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Preventing Infection
2. Describe the chain of infection
Define the following terms:
portal of exit
any body opening on an infected person that allows
pathogens to leave.
mode of transmission
the method of describing how a pathogen travels.
direct contact
a way of transmitting pathogens through touching the
infected person or his or her secretions.
indirect contact
a way of transmitting pathogens from touching something
contaminated by the infected person.
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Preventing Infection
2. Describe the chain of infection
Define the following terms:
portal of entry
any body opening on an uninfected person that allows
pathogens to enter.
mucous membranes
the membranes that line body cavities that open to the
outside of the body, such as the linings of the mouth, nose,
eyes, rectum, or genitals.
susceptible host
an uninfected person who could get sick.
transmission
passage or transfer.
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Preventing Infection
2. Describe the chain of infection
Define the following terms:
infectious
contagious.
medical asepsis
refers to practices such as handwashing that reduce, remove,
and control the spread of microorganisms.
surgical asepsis
the state of being free of all microorganisms; also called
sterile technique.
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Transparency 5-1: The Chain of Infection
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Preventing Infection
2. Describe the chain of infection
REMEMBER:
If even one link in the chain of infection is broken, the spread of
infection is stopped.
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Preventing Infection
2. Describe the chain of infection
Think about these questions:
What is an example of each link in the chain of infection?
How could that link be broken?
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Handout 5-1: Infection Prevention Definitions
Microorganism: Microorganisms are single-celled organisms that only can be
viewed with the aid of a microscope. Microorganisms can be divided into five
basic categories—bacteria, viruses, fungi, protozoa, and helminthes. Most
microorganisms are harmless—some are even beneficial. Others are capable of
causing infection or disease. Microorganisms are often classified as either
pathogenic or nonpathogenic.
Nonpathogenic microorganism: A nonpathogenic microorganism is a type of
microorganism that is incapable of causing or unable to cause infection or
disease.
Pathogenic microorganism: A pathogenic microorganism is a type of
microorganism that is capable of causing infection or disease; it is also called a
pathogen.
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Handout 5-1: Infection Prevention Definitions (cont’d)
Bacteria: Bacteria are single-celled microorganisms that lack nuclei and
organized cell structures. Bacteria can exist independently (on their own) or as
parasites, dependent upon a host for life. Bacteria can be found in three basic
shapes—round, rod, or spiral. While some bacteria are capable of causing
disease, most are non-infectious and many have critical roles in decay,
fermentation, and nutrient recycling.
Bacteria help people digest food. Some bacteria destroy disease-causing cells,
and some produce important vitamins in the gastrointestinal tract. Bacteria also
play a role in food processing, such as in the production of yogurt and cheeses.
Pathogenic bacteria can cause cell damage or death by producing substances
known as toxins. Other cell damage can occur when the host’s immune system
produces substances to eliminate bacteria, and these substances damage the
infected cells and adjacent cells.
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Handout 5-1: Infection Prevention Definitions (cont’d)
Virus: Viruses are small packages of DNA or RNA encased in protein shells that
invade a cell (host cell) and incorporate themselves into the host cell’s DNA.
When the infected host cell begins to produce (replicate) new viral particles, the
infected cell dies.
Fungi: Fungi are multi-celled or single-celled organisms. They can be pathogenic,
causing infections in healthy persons, or opportunistic, causing infections in
people with weakened immune systems. Fungi can be nonpathogenic as well, and
some types of fungi are even beneficial, such as those used to make antibiotics. A
few types of fungi are considered delicacies, such as truffles and edible
mushrooms.
Yeasts and molds are examples of fungi. Fungi are the most common causes of
disease in crops and plants. Fungi receive their nourishment by secreting
enzymes that break down surrounding cells. When this happens on living tissue,
it is irritating and uncomfortable.
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Handout 5-1: Infection Prevention Definitions (cont’d)
Parasite: A parasite is an organism that lives on or in an organism of a different
species—a host.
Infection: An infection occurs when microorganisms enter and multiply within
the tissue of a host, causing damage to that tissue. Symptoms may be apparent,
or the host may display no symptoms.
Disease: A disease occurs when tissue that has been damaged due to the entry
and multiplication of microorganisms results in clinical signs and symptoms of a
recognizable process.
Host: A host is an organism or cell on or in which a microorganism lives or feeds.
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Preventing Infection
3. Explain why the elderly are at a higher risk for infection
Define the following terms:
malnutrition
poor nutrition due to improper diet.
dehydration
a serious condition resulting from inadequate fluid in the
body.
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Preventing Infection
3. Explain why the elderly are at a higher risk for infection
The following factors place the elderly at a higher risk for
infection than the general public:
• Weakened immune systems
• Decreased circulation
• Slow wound healing
• Malnutrition
• Dehydration
• Limited mobility
• Hospitalization
• Difficulty swallowing
• Incontinence
• Feeding tubes and other tubing
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Preventing Infection
4. Explain Standard Precautions
Define the following terms:
Occupational Safety and Health Administration (OSHA)
a federal government agency that makes rules to protect
workers from hazards on the job.
Centers for Disease Control and Prevention (CDC)
a government agency under the Department of Health and
Human Services (HHS) that issues information to protect the
health of individuals and communities.
isolate
to keep something separate, or by itself.
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4. Explain Standard Precautions
Define the following terms:
Standard Precautions
a method of infection prevention in which all blood, body
fluids, non-intact skin, and mucous membranes are treated
as if they were infected with an infectious disease.
sharps
needles or other sharp objects.
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4. Explain Standard Precautions
The CDC defines body fluids as including the following
substances:
• Saliva
• Sputum (mucus coughed up)
• Urine
• Feces
• Semen
• Vaginal secretions
• Pus or other wound drainage
• Vomit
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Preventing Infection
4. Explain Standard Precautions
Think about this question:
Why should Standard Precautions be followed with every resident
in an NA’s care?
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4. Explain Standard Precautions
REMEMBER:
It is impossible to tell from looking at a person whether he or she
has an infectious disease.
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4. Explain Standard Precautions
Standard Precautions include the following measures:
• Wash hands.
• Wear gloves.
• Remove gloves immediately when finished with a procedure.
• Immediately wash skin surfaces.
• Wear a disposable gown.
• Wear a mask and goggles.
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4. Explain Standard Precautions
Standard Precautions (cont’d):
• Wear gloves when handling sharp objects.
• Never attempt to recap needles or sharps.
• Avoid nicks and cuts.
• Bag all contaminated supplies.
• Clearly label body fluids.
• Dispose of contaminated waste properly.
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Preventing Infection
5. Explain hand hygiene and identify when to wash hands
Define the following terms:
hand hygiene
washing hands with either plain or antiseptic soap and water
and using alcohol-based hand rubs.
antimicrobial
an agent that destroys, resists, or prevents the development
of pathogens.
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Preventing Infection
5. Explain hand hygiene and identify when to wash hands
REMEMBER:
It is very important to wash hands with soap and water. NAs
should not rely solely on alcohol-based rubs.
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Preventing Infection
5. Explain hand hygiene and identify when to wash hands
NAs should wash their hands at the following times:
• When first arriving at work
• Any time they are visibly soiled
• Before, between, and after all resident contact
• Before putting on gloves and after removing gloves
• After contact with body fluids, mucous membranes, non-intact
skin, wound dressings
• After handling contaminated items
• After contact with objects in resident’s room
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5. Explain hand hygiene and identify when to wash hands
Times to wash hands (cont’d):
• Before and after touching meal trays or handling food
• Before and after feeding residents
• Before getting clean linen
• Before and after using the toilet
• After touching garbage or trash
• After picking up things from the floor
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Preventing Infection
5. Explain hand hygiene and identify when to wash hands
Times to wash hands (cont’d):
• After blowing nose or sneezing into hand
• Before and after eating
• After smoking
• After touching areas on the body
• Before and after applying makeup
• After any contact with pets/pet care items
• Before leaving facility
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Preventing Infection
5. Explain hand hygiene and identify when to wash hands
REMEMBER:
Hand-washing is the single most important thing an NA can do to
prevent the spread of disease.
Washing hands (hand hygiene)
Equipment: soap, paper
towels
1.
Turn on water at sink.
Keep your clothes dry,
because moisture breeds
bacteria.
2.
Wet hands and wrists
thoroughly.
3.
Apply soap to your
hands.
Washing hands (hand hygiene)
4.
Keep your hands lower
than your elbows and
your fingertips down.
Rub hands together and
fingers between each
other to create a lather.
Lather all surfaces of
wrists, fingers, and
hands, using friction for
at least 20 seconds.
Friction helps clean.
5.
Clean your nails by
rubbing them in the
palm of your other hand.
Washing hands (hand hygiene)
6.
Being careful not to
touch the sink, rinse
thoroughly under
running water. Rinse all
surfaces of your hands
and wrists. Run water
down from wrists to
fingertips. Do not run
water over unwashed
arms down to clean
hands.
Washing hands (hand hygiene)
7.
Use a clean, dry paper
towel to dry all surfaces
of your hands, wrists,
and fingers. Do not wipe
towel on unwashed
forearms and then wipe
clean hands. Dispose of
paper towel into waste
container without
touching the container.
If your hands touch the
sink or wastebasket,
start over.
Washing hands (hand hygiene)
8.
Use a clean, dry paper
towel to turn off the
faucet then dispose of
paper towel into waste
container. Do not
contaminate your hands
by touching the surface
of the sink or faucet.
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6. Discuss the use of personal protective equipment (PPE) in
facilities
Define the following terms:
personal protective equipment (PPE)
equipment that helps protect employees from serious
workplace injuries or illnesses resulting from contact with
workplace hazards.
don
to put on.
doff
to remove.
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6. Discuss the use of personal protective equipment (PPE) in
facilities
Define the following terms:
perineal care
care of the genitals and anal area.
non-intact skin
skin that is broken by abrasions, cuts, rashes, acne, pimples,
lesions, surgical incisions, or boils.
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Preventing Infection
6. Discuss the use of personal protective equipment (PPE) in
facilities
PPE must be worn when a caregiver might come into contact with
any of the following:
• Body fluids
• Mucous membranes
• Open wounds
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6. Discuss the use of personal protective equipment (PPE) in
facilities
REMEMBER:
NAs must wear gowns, masks, goggles, and face shields any
time splashing or spraying of body fluids or blood could occur
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6. Discuss the use of personal protective equipment (PPE) in
facilities
NAs should remember these points about gowns:
• Gowns protect exposed skin
• They prevent soiling of clothing
• They should fully cover the torso, and the sleeves should fit
snugly.
Putting on (donning) and removing (doffing) gown
1.
Wash your hands.
2.
Open the gown. Hold out
in front of you and allow
gown to open/unfold. Do
not shake it. Facing the
back opening of the
gown, place your arms
through each sleeve.
3.
Fasten the neck opening.
4.
Reaching behind you,
pull the gown until it
completely covers your
clothing. Secure gown at
waist.
Putting on (donning) and removing (doffing) gown
5.
Use a gown only once
and then remove and
discard it. If gown
becomes wet or soiled
during care, remove it.
Check your clothing, and
put on a new gown.
OSHA requires nonpermeable gowns—
gowns that liquids
cannot penetrate—when
working in a bloody
situation.
6.
Put on your gloves after
putting on gown. The
cuffs of gloves should
overlap the cuffs of the
gown.
Putting on (donning) and removing (doffing) gown
7.
When removing a gown,
remove and discard
gloves properly (see
procedure later in the
chapter). Unfasten gown
at neck and waist.
Remove the gown
without touching the
outside of gown. Roll the
dirty side in, while
holding gown away from
your body. Dispose of
gown properly and wash
your hands.
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Preventing Infection
6. Discuss the use of personal protective equipment (PPE) in
facilities
NAs should remember these points about masks and goggles:
• Masks are worn when the resident has a respiratory illness.
• Masks should fully cover the nose and mouth.
• Masks should fit snugly over nose and mouth.
• It is important to change masks between residents.
• Goggles should fit snugly over eyes or eyeglasses.
Putting on (donning) mask and goggles
1.
Wash your hands.
2.
Pick up the mask by top
strings or elastic strap.
Do not touch the mask
where it touches your
face.
3.
Pull elastic strap over
your head, or if mask
has strings, tie top
strings first, then bottom
strings. Do not wear a
mask hanging from only
the bottom tie or strap.
Masks must always be
dry or they must be
replaced
Putting on (donning) mask and goggles
4.
Pinch the metal strip at
the top of the mask (if
part of the mask) tightly
around your nose so that
it feels snug.
5.
Put on the goggles over
your eyes or eyeglasses.
Use the headband to
secure them to your
head. Make sure they
are on snugly.
6.
Put on gloves after
putting on mask and
goggles.
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6. Discuss the use of personal protective equipment (PPE) in
facilities
Gloves must be worn in the following situations:
• If the NA might touch blood or any body fluid
• During mouth care or care of any mucous membrane
• During perineal care
• When providing personal care on non-intact skin
• When providing personal care if NA has cuts on hands
• When shaving resident
• When disposing of soiled linens, gowns, dressings, and pads
• When touching contaminated surfaces or equipment
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Preventing Infection
6. Discuss the use of personal protective equipment (PPE) in
facilities
Gloves must be changed in these situations:
• Immediately before contact with mucous membranes or
broken skin
• If gloves become soiled, worn, or damaged
Putting on (donning) gloves
1.
Wash your hands.
2.
If you are right-handed,
slide one glove on your
left hand (reverse if lefthanded).
3.
Using your gloved hand,
slide the other hand into
the second glove.
4.
Interlace fingers to
smooth out folds and
create a comfortable fit.
5.
Carefully look for tears,
holes, or discolored
spots. Replace the glove
if needed.
Putting on (donning) gloves
6.
If wearing a gown, pull
the cuff of the gloves
over the sleeves of the
gown.
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6. Discuss the use of personal protective equipment (PPE) in
facilities
Gloves should be removed
• After use
• Before caring for another resident
• Before touching non-contaminated items or surfaces
Removing (doffing) gloves
1.
Touch only the outside
of one glove. With one
gloved hand, grasp the
other glove at the palm
and pull the glove off.
2.
With the fingertips of
your gloved hand, hold
the glove you just
removed. With your
ungloved hand, slip two
fingers underneath cuff
of the remaining glove at
wrist. Do not touch any
part of the outside of
glove.
Removing (doffing) gloves
3.
Pull down, turning this
glove inside out and over
the first glove as you
remove it.
4.
You should now be
holding one glove from
its clean inner side and
the other glove should
be inside it.
5.
Drop both gloves into
the proper container
without contaminating
yourself.
6.
Wash your hands.
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Preventing Infection
6. Discuss the use of personal protective equipment (PPE) in
facilities
The proper order for donning PPE is as follows:
• Wash hands.
• Put on gown.
• Put on mask.
• Put on goggles or face shield.
• Put on gloves.
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6. Discuss the use of personal protective equipment (PPE) in
facilities
The proper order for doffing PPE is as follows:
• Remove and discard gloves.
• Remove goggles or face shield.
• Remove and discard gown.
• Remove and discard mask.
• Wash hands.
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7. List guidelines for handling equipment and linen
Define the following terms:
clean
in health care, a condition in which objects are not
contaminated with pathogens.
dirty
in health care, a condition in which objects have been
contaminated with pathogens.
disinfection
process that kills pathogens, but not all pathogens; it reduces
the pathogen count to a level that is considered not
infectious.
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7. List guidelines for handling equipment and linen
Define the following terms:
sterilization
a method used to decrease the spread of pathogens and
disease by destroying all microorganisms, including those
that form spores.
disposable
only to be used once and then discarded.
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7. List guidelines for handling equipment and linen
NAs should follow these guidelines regarding equipment, linen,
and clothing:
• Prevent skin/mucous membrane contact.
• Prevent contamination of clothing.
• Prevent transfer of disease to other residents or
environments.
• Do not use reusable equipment until it has been cleaned
properly.
• Dispose of all single-use equipment properly.
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7. List guidelines for handling equipment and linen
Guidelines regarding equipment, linen, and clothing (cont’d):
• Clean and disinfect all environmental surfaces, beds, bedrails,
bedside equipment, and all frequently touched surfaces (such
as doorknobs and call lights).
• Handle, transport, and process soiled linens and clothing in a
way that prevents skin and mucous membrane exposure,
contamination of clothing (hold linen away from uniform), and
transfer of disease to other residents and environments.
• Bag soiled linen at point of origin.
• Sort soiled linen away from resident care areas.
• Place wet linen in leak-proof bags.
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8. Explain how to handle spills
NAs should follow these guidelines for cleaning spills involving
blood, body fluids, or glass:
• Put on gloves (industrial strength).
• Use proper product to absorb spill.
• Scoop up absorbed spill and dispose of it in designated
container.
• Apply disinfectant.
• Use proper cleaning solution.
• Use tools, never hands, to pick up glass.
• Properly bag waste.
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8. Explain how to handle spills
REMEMBER:
It is important the absorb a spill and remove the fluid before
treating the area with disinfectant. If the spilled fluid is not
absorbed and removed first, it may neutralize the disinfectant on
contact.
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9. Explain Transmission-Based Precautions
Define the following terms:
Transmission-Based Precautions
method of infection prevention used when caring for persons
who are infected or suspected of being infected with a
disease.
multidrug-resistant organisms (MDROs)
microorganisms, mostly bacteria, that are resistant to one or
more antimicrobial agents that are commonly used for
treatment.
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9. Explain Transmission-Based Precautions
REMEMBER:
Transmission-Based Precautions are always used in addition to
Standard Precautions.
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Transparency 5-2: Airborne Diseases
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9. Explain Transmission-Based Precautions
Airborne diseases spread when pathogens are transmitted
through the air after being expelled. The pathogens can remain
floating for some time. The following illnesses are caused by
airborne pathogens:
• Tuberculosis (TB)
• Measles
• Chicken pox
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9. Explain Transmission-Based Precautions
The following precautions can help prevent the spread of airborne
diseases:
• Using a face mask
• Wearing a gown
• Handwashing
• Proper ventilation
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Transparency 5-3: Droplet Diseases
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9. Explain Transmission-Based Precautions
Droplet diseases spread when pathogens are transmitted through
droplets in the air. The droplets normally do not travel more than
three feet, but they may travel further. The following illnesses
are examples:
• Mumps
• Influenza
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9. Explain Transmission-Based Precautions
The following precautions can help prevent the spread of droplet
diseases:
• Using a face mask
• Covering nose and mouth when sneezing or coughing
• Handwashing
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9. Explain Transmission-Based Precautions
The CDC recommends the following measures (part of Standard
Precautions) to prevent the transmission of respiratory illnesses
in healthcare settings:
• Alerts should be posted instructing patients and visitors to
inform staff of respiratory symptoms and to practice
respiratory hygiene/cough etiquette, which includes
• Cover noses/mouths with a tissue when coughing or
sneezing
• Dispose of used tissues in nearest waste container after
use
• Wash hands after contact with respiratory secretions or
contaminated objects
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9. Explain Transmission-Based Precautions
CDC measures for respiratory etiquette (cont’d):
• Healthcare facilities must make these items available to staff,
patients, and visitors:
• Tissues and no-touch receptacles for disposal
• Conveniently located hand rub dispensers and
handwashing supplies
• During times of increased respiratory infections, masks should
be offered to anyone who is coughing and coughing people
encouraged to sit at least three feet away from others.
• Healthcare personnel should observe droplet precautions, in
addition to Standard Precautions, when interacting with a
patient with symptoms of a respiratory infection.
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Transparency 5-4: Contact Diseases
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9. Explain Transmission-Based Precautions
Contact diseases can be spread when an uninfected person
comes into contact with the skin, wound, or infection of an
infected person. The following illnesses are spread by contact:
• Conjunctivitis (pink eye)
• Clostridium difficile
• Lice
• Scabies
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9. Explain Transmission-Based Precautions
The following precautions can help prevent the spread of contact
diseases:
• Using PPE
• Washing hands with antimicrobial soap
• Not touching infected surfaces without gloves
• Not touching uninfected surfaces with contaminated gloves
• Not sharing towels, linens, and clothing
• Using disposable equipment when possible
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9. Explain Transmission-Based Precautions
When isolation precautions are required, the NA should
remember these points:
• Transmission-Based Precautions always used in addition to
Standard Precautions
• Nurses will set up the isolation unit.
• Use PPE as instructed. Do not wear PPE outside resident’s
room, and perform hand hygiene following removal of PPE.
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Preventing Infection
9. Explain Transmission-Based Precautions
Guidelines for isolation precautions (cont’d):
• Do not share equipment between residents.
• Wear proper PPE when serving food and drink.
• Follow Standard Precautions in dealing with body waste
removal.
• Wear proper PPE required to take specimen.
• Reassure residents that the disease, not the person, is being
isolated.
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10. Define bloodborne pathogens and describe two major
bloodborne diseases
Define the following terms:
bloodborne pathogens
microorganisms found in human blood, body fluid, draining
wounds, and mucous membranes that can cause infection
and disease in humans.
human immunodeficiency virus (HIV)
the virus that attacks the body’s immune system and
gradually disables it; eventually can cause AIDS.
hepatitis
inflammation of the liver caused by certain viruses and other
factors, such as alcohol abuse, some medications, and
trauma.
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10. Define bloodborne pathogens and describe two major
bloodborne diseases
Define the following terms:
jaundice
a condition in which the skin, whites of the eyes, and mucous
membranes appear yellow.
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Preventing Infection
10. Define bloodborne pathogens and describe two major
bloodborne diseases
Bloodborne diseases may be transmitted in the following ways:
• Infected blood
• Infected semen or vaginal secretions contacting mucous
membranes
• Sexual contact
• Needle sharing
• Infected mothers
• Contact with infected blood or certain other body fluids in
healthcare setting
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Preventing Infection
10. Define bloodborne pathogens and describe two major
bloodborne diseases
REMEMBER:
It is safe to touch and spend time with residents who have
bloodborne diseases. Residents with these illnesses need the
same thoughtful, personal attention NAs give to all their
residents.
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11. Explain OSHA’s Bloodborne Pathogens Standard
Define the following terms:
Bloodborne Pathogens Standard
federal law that requires that healthcare facilities protect
employees from bloodborne health hazards.
exposure control plan
plan designed to eliminate or reduce employee exposure to
infectious material.
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11. Explain OSHA’s Bloodborne Pathogens Standard
The Bloodborne Pathogens Standard designates the following as
a significant exposure:
• Needle stick
• Mucous membrane contact
• Cut from an object containing potentially infectious body fluid
• Contact with non-intact skin
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11. Explain OSHA’s Bloodborne Pathogens Standard
Employers must take the following steps to protect employees
from bloodborne pathogens:
• Maintain a written exposure control plan
• Provide proper PPE
• Provide biohazard containers for disposal of sharps and other
infected waste
• Offer free hepatitis B vaccine to employees
• Affix warning labels to waste containers, refrigerators, and
freezers that contain potentially infectious material
• Keep a log of injuries from contaminated sharps
• Provide in-service training on the Bloodborne Pathogens
Standard
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Preventing Infection
12. Define tuberculosis and list infection prevention guidelines
Define the following terms:
tuberculosis (TB)
a highly contagious lung disease caused by a bacterium that
is carried on mucous droplets suspended in the air.
latent TB infection
type of tuberculosis in which the person carries the disease
but does not show symptoms and cannot infect others.
TB disease
type of tuberculosis in which the person shows symptoms of
the disease and can spread TB to others.
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Preventing Infection
12. Define tuberculosis and list infection prevention guidelines
Define the following terms:
multidrug-resistant TB(MDR-TB)
type of tuberculosis that can develop when a person with TB
disease does not take all the prescribed medication.
resistant
a state in which drugs no longer work to kill specific bacteria.
phlegm
thick mucus from the respiratory passage.
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Preventing Infection
12. Define tuberculosis and list infection prevention guidelines
NAs should be familiar with these signs and symptoms of TB
disease:
• Fatigue
• Loss of appetite
• Weight loss
• Slight fever and chills
• Night sweats
• Prolonged coughing
• Coughing up blood
• Chest pain
• Shortness of breath
• Trouble breathing
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Preventing Infection
12. Define tuberculosis and list infection prevention guidelines
When caring for residents with tuberculosis, NAs should follow
these guidelines:
• Follow Standard Precautions and Airborne Precautions.
• Wear PPE as instructed.
• Handle sputum or phlegm carefully.
• Ensure proper ventilation.
• If resident is in AIIR isolation room, open and close door
slowly.
• Follow isolation procedures if ordered.
• Help resident remember to take medications.
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Preventing Infection
13. Discuss MRSA, VRE, and C. Difficile
Define the following terms:
MRSA (methicillin-resistant Staphylococcus aureus)
an infection caused by specific bacterial that have become
resistant to many antibiotics.
Vancomycin-resistant enterococcus (VRE)
bacteria (enterococci) that have developed resistance to
antibiotics as a result of being exposed to vancomycin.
Clostridium difficile (C. diff, C. difficile)
bacterial illness that can cause diarrhea and colitis; spread by
spores in feces that are difficult to kill.
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Preventing Infection
13. Discuss MRSA, VRE, and C. Difficile
There are two types of MRSA:
• Hospital-associated MRSA (HA-MRSA)
• Community-associated MRSA (CA-MRSA)
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Preventing Infection
13. Discuss MRSA, VRE, and C. Difficile
REMEMBER:
MRSA can be spread by direct and indirect contact. Handwashing
is the single most important measure to control the spread of
MRSA.
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Preventing Infection
13. Discuss MRSA, VRE, and C. Difficile
REMEMBER:
VRE can be spread by direct and indirect contact. Prevention of
VRE is very important, and proper handwashing is an important
part of prevention.
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Preventing Infection
13. Discuss MRSA, VRE, and C. Difficile
C. Difficile is spread in the following ways:
• By spores via direct contact
• When intestinal flora is altered due to enemas, nasogastric
tube, GI tract surgery, or overuse of antibiotics
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Preventing Infection
13. Discuss MRSA, VRE, and C. Difficile
REMEMBER:
Proper handwashing and proper handling of wastes can help
prevent C. Difficile. Soap and water must be used each time
hand hygiene is performed. Disinfecting surfaces and limiting
antibiotic use can also help.
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Preventing Infection
14. List employer and employee responsibilities for infection
prevention
The following are an employer’s responsibilities regarding
infection prevention:
• Establish procedures and exposure control plan.
• Provide in-service education.
• Have written procedures for exposures.
• Provide proper PPE.
• Provide HBV vaccination.
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Preventing Infection
14. List employer and employee responsibilities for infection
prevention
The following are an employee’s responsibilities regarding
infection prevention:
• Follow Standard Precautions.
• Follow facility’s policies and procedures.
• Follow care plans and assignments.
• Use PPE.
• Take advantage of free hepatitis B vaccine.
• Report any exposure immediately.
• Participate in education programs.
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Preventing Infection
Exam
Multiple Choice. Choose the correct answer.
1. Infection prevention is
(A) The way in which infections occur
(B) An infection that is prevented from traveling from one part of the body
to another
(C) A set of methods used to prevent the spread of disease
(D) An object that has been prevented from being contaminated with
pathogens
2.
The following are necessary links in the chain of infection. When an NA
wears gloves, which link is broken, thus preventing the spread of disease?
(A) Reservoir (place where the pathogen lives and grows)
(B) Mode of transmission (a way for the disease to spread)
(C) Susceptible host (person who is likely to get the disease)
(D) Causative agent (pathogenic microorganism that causes disease)
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Preventing Infection
Exam
3.
The following are necessary links in the chain of infection. When an NA gets
a vaccination shot for hepatitis B, which link will be affected and thus
prevent hepatitis B infection?
(A) Reservoir (place where the pathogen lives and grows)
(B) Mode of transmission (a way for the disease to spread)
(C) Susceptible host (person who is likely to get the disease)
(D) Portal of entry (body opening that allows pathogens to enter)
4.
A nursing assistant (NA) will come into contact with microorganisms
(A) Only in high-traffic areas of the facility
(B) Only during direct contact with residents
(C) Only during personal care procedures
(D) Every time the NA touches something
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Preventing Infection
Exam
5.
The single most important thing the NA can do to prevent the spread of
disease is to
(A) Carry dirty linen close to her uniform so as not to spread contaminants
(B) Wash and dry her disposable gloves before reusing them
(C) Remove gloves before cleaning spills
(D) Wash her hands
6.
The
(A)
(B)
(C)
(D)
elderly are at a higher risk of infection because
They have strong immune systems
They are rarely hospitalized
They are always well-nourished
They may have limited mobility
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Preventing Infection
Exam
7.
With whom should an NA use Standard Precautions?
(A) With residents who have infectious diseases
(B) With residents he suspects might have infectious diseases
(C) With every resident in his care
(D) With residents who request that they be used
8.
Under Standard Precautions, the term “body fluids” includes
(A) Sweat
(B) Water
(C) Juice
(D) Urine
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Preventing Infection
Exam
9.
Hand hygiene is
(A) Washing hands with either plain or antiseptic soap and water or using
alcohol-based hand rubs
(B) Washing hands with soap and water only
(C) Using alcohol-based hand rubs only
(D) Wearing gloves when performing care procedures
10. When washing hands, an NA should use friction for
(A) At least 25 seconds
(B) At least 20 seconds
(C) At least 15 seconds
(D) At least 5 seconds
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Preventing Infection
Exam
11. Which of the following is true of wearing gloves?
(A) Disposable gloves can be washed and reused.
(B) Gloves should be changed before contact with mucous membranes.
(C) After giving care, gloves are not contaminated.
(D) Gloves can continue to be worn if they are torn as long as the hole is
covered.
12. Which of the following is the proper order to don PPE?
(A) Put on mask and goggles, gown, and gloves.
(B) Put on gloves, gown, and mask and goggles.
(C) Put on mask and goggles, gloves, and gown.
(D) Put on gown, mask and goggles, and gloves.
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Preventing Infection
Exam
13. Which of the following statements is true of disinfection?
(A) Disinfecting an item means that all pathogens on the item are
destroyed.
(B) Disinfection is carried out with an autoclave.
(C) Disinfection kills some pathogens but not all of them.
(D) Disinfection can be accomplished with regular soap and cold water.
14. If an NA needs to clean up a spill, what is the first step that she should
take?
(A) Put the waste directly into the nearest trash can.
(B) Spray bleach solution on the spill.
(C) Put on gloves.
(D) Vacuum the spill.
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Preventing Infection
Exam
15. Which of the following is true of Transmission-Based Precautions?
(A) An NA does not need to practice Standard Precautions if he practices
Transmission-Based Precautions.
(B) They are exactly the same as Standard Precautions.
(C) They are practiced in addition to Standard Precautions.
(D) They will not be listed in the care plan so as not to alarm anyone.
16. What is one way that bloodborne pathogens can be transmitted?
(A) By hugging an infected person
(B) By contact with blood or body fluids
(C) By standing too close to an infected person when he coughs
(D) By touching something an infected person has touched
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Preventing Infection
Exam
17. Which of the following statements is true of hepatitis B (HBV)?
(A) HBV is a relatively minor disease and poses no real threat to healthcare
workers.
(B) The vaccine for HBV helps prevent the disease.
(C) More people in the U.S. have HIV than have HBV.
(D) HBV causes some unpleasant symptoms but cannot cause death.
18. The Bloodborne Pathogen Standard requires that
(A) Employers educate a select group of employees who will be in contact
with residents with bloodborne diseases
(B) Employers provide hepatitis B vaccinations to employees at a reduced
cost
(C) Employers keep one set of personal protective equipment on hand for
visitors to use
(D) Employers have an exposure control plan
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Preventing Infection
Exam
19. Tuberculosis may be transmitted
(A) Through a protective mask
(B) By dancing
(C) By wearing gloves
(D) By coughing
20. Tuberculosis is
(A) A bloodborne disease
(B) A sexually transmitted disease
(C) An airborne disease
(D) Completely eradicated (no longer exists)
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Preventing Infection
Exam
21. A person with TB disease
(A) Can spread it to others
(B) Does not show symptoms
(C) Cannot infect others
(D) Has what is called latent TB
22. How is MRSA most often spread?
(A) By direct physical contact
(B) By indirect contact
(C) By being in enclosed spaces
(D) Through the air
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Preventing Infection
Exam
23. What is the best way to control the spread of MRSA?
(A) By taking medication
(B) Through proper handwashing
(C) By using masks
(D) By taking vancomycin
24. What is the best way to control the spread of C. difficile?
(A) By limiting contact of the infected person with others
(B) By using more powerful antibiotics
(C) By giving more enemas to clean out the GI tract
(D) Through proper handwashing and handling of contaminated wastes
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Preventing Infection
Exam
25. Which of the following is an NA responsibility related to infection
prevention?
(A) Deciding which residents need Transmission-Based Precautions
(B) Telling all visitors which patients have bloodborne diseases
(C) Following Standard Precautions in caring for all residents
(D) Capping needles and other sharps before disposing of them in the trash