Transcript Lancaster High School Shelly Carpenter

Lancaster High School
Shelly Carpenter
Chapter 14 Preventing Infection
Objectives
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Define the key terms listed in this chapter
Identify what microbes need to live and grow
List the signs and symptoms of infection
Explain the chain of infection
Describe nosocomial infection and the persons at risk
Describe the practices of medical asepsis
Describe disinfection and sterilization methods
Explain how to care for equipment and supplies
Explain Standard and Transmission-Based Precautions
and the Bloodborne Pathogen Standard
□ Explain the principles and practices of surgical asepsis
□ Perform the procedures described in this chapter
APPLICATION
Defining Infection
INTRODUCTION
□ Infection is a major safety and health
hazard.
□ Infants, older persons, and disabled
persons are at great risk.
□ The health team protects patients,
residents, visitors, and themselves from
infection.
MICROORGANISMS
□ A microorganism (microbe)
□ microscopic plant or animal
□ Microbes are everywhere.
□ pathogens. =harmful and cause infections
□ non-pathogens =do not usually cause
infection
□ TYPES
Microbes
□ Bacteria
□ a form of plant life that multiplies rapidly (often called
germs).
□ Fungi
□ plants that live on other plants or animals
□ mushrooms, yeasts, and molds
□ Protozoa
□ one-celled animals.
□ Rickettsiae
□ found in fleas, lice, ticks, and other insects.
□ spread to humans by insect bites.
□ Viruses
□ Grow in living cells.
□ Cause many diseases.
MICROBES
□ Requirements
□ reservoir (host) to live and grow.
□ People
□ Plants
□ Animals
□ Soil
□ food and water
□ oxygen
□ warm and dark environment
□ grow best at body temperature.
□ destroyed by heat and light.
MICROBES
□ Normal flora
□ microbes that live and grow in a certain
area.
□ in or on a natural reservoir=nonpathogens.
□ transmitted from its natural site to another
site or host=pathogen.
MultiDrug-Resistant Organisms
□ Resist the effects of anitibiotics
□ Microbes Change in structure thus
harder to kill
□ Caused by
□ prescribing antibiotics when they aren’t
necessary.
□ Improper use of antibiotics-not taking the
complete dose prescribed.
Common types of MDRO
□ Methicillin-resistant Staphylococcus
aureus (MRSA)
□ Commonly called “staph”
□ Normally found in the nose and on skin
□ Causes wound and bloodstream
infections and pneumonia
Common types of MDRO
□ Vancomycin rsistant Enterococcus (VRE)
□ Normally in intestines and feces
□ Transmitted by
□ contaminated hands
□ toilet seats
□ care equipment
□ other contaminated items
□ Causes
□ urinary tract
□ wound
□ pelvic
INFECTION
□ a disease resulting from invasion and
growth of microbes in the body.
□ local infection
□ occurs in a body part.
□ systemic infection
□ involves the whole body.
Focus on older persons: infection
□ The immune system protects the body from disease
and infection.
□ Changes occur in the immune system with aging.
□ When an older person has an infection:
□ may not show the signs and symptoms in chapter
□ Confusion and delirium may occur (Chapter 35).
□ can become life threatening before signs/symptoms
appear.
□ be alert to minor changes in behavior or condition.
□ Report concerns to the nurse at once.
APPLICATION
On the paper given, recall
aseptic practices used in your
daily activities to help prevent
infection and the spread of
microbes.
CHAIN OF INFECTION
Reservoir
Source
Portal of exit
Portal of entry
Transmission
The Chain of Infection
□ Process needing□ Source
□ A pathogen
□ Reservoir
□ where the pathogen can grow and multiply
□ Humans
□ animals
□ no signs and symptoms of infection
indicates carriers.
The chain of infection
□ Portal of exit
□ the pathogen must leave the reservoir
□ respiratory
□ GI
□ urinary and reproductive tracts
□ breaks in the skin
□ blood
The chain of infection
□ Method of transmission
□ Direct contact
□ =contact with infectious substance
□ ex. Hepatitis B
□ Airborne=through air to the host who inhales it
□ ex. tB
□ Droplet=from infected person into mouth, nose,
eyes
□ doesn’t remain in the air
□ fall to an object either inanimate or animate
The Chain of Infection
Method of transmission
□ Common vehicle-food, fluid, equipment,
medication contaminated with pathogen
□ ex. Salmonella
□ Animal transmission-bite from infected
animal
□ can harbor pathogen that only harms human
not the animal
□ Mosquitoes=malaria
□ deer ticks=lyme diease
□ mosquitoes=west nile virus
The chain of infection
□ Portal of entry
□ how the pathogen enters the body
□ Portals of entry and exit are the same.
□ needs Susceptible host (a person at risk
for infection)
The chain of infection
□ factors influencing how a host receives an
infection
□ age
□ gender
□ another disease that decreases the immune
system
□ heredity
□ nutrition
□ lifestyle
□ vaccinations
Nosocomial infection
□ an infection acquired during a stay in a health
agency.
□ caused by normal flora or microbes transmitted to
the person from another source.
□ can enter through equipment used
□ Staff can transfer microbes
□ Common sites
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The urinary system
The respiratory system
Wounds
The bloodstream
Hospital Aquired infection
□ most common to occur=bacterial
□ staphylococcus aureus
□ pseudomonas aerginasa ( is resistant to
antibiotic therapy)
□ vancomycin resistant enterococci
Hospital Aquired infection
□ prevented by:
□ Medical asepsis
□ Surgical asepsis
□ Isolation Precautions
□ Bloodborne Pathogen Standard
How do we prevent the
spread of Infection?
MEDICAL ASEPSIS
□ Asepsis
□ free of disease-producing microbes.
□ Medical asepsis (clean technique) is the
practices used to:
□ Remove or destroy pathogens
□ Prevent their spread from one person or place
to another person or place
Common Aseptic Practices
□ Washing hands
□ After urinating or after a bowel movement
□ After changing tampons or sanitary pads
□ After contact with your own or another person’s blood,
body fluids, secretions, or excretions
□ After coughing, sneezing, or blowing your nose
□ Before and after handling, preparing, or eating food
□ Cover your nose and mouth when coughing,
sneezing, or blowing your nose.
□ Bathe, wash hair, and brush your teeth regularly.
□ Wash fruits and raw vegetables before eating or
serving them.
□ Wash cooking and eating utensils with soap and
water after use.
Hand Hygiene
□ Hand hygiene
□ easiest and the most important way to
prevent the spread of infection.
□ DONE before and after giving care.
□ rules of hand hygiene
□ SEE TEXT
Hand Washing
□ See procedure in the book.
□ Demonstrate and practice
Surgical Asepsis
□ Surgical asepsis
□ keeps equipment and supplies free of microbes.
□ Also called sterile technique
□ Sterile means the absence of all microbes (pathogens
and non-pathogens).
□ Sterilization is the process that destroys all microbes
(pathogens and non-pathogens).
□ Contamination is the process of becoming unclean.
□ A sterile item or area is contaminated when
pathogens or non-pathogens are present.
ISOLATION PRECAUTIONS
□ Blood, body fluids, secretions, and
excretions can transmit pathogens
□ Barriers to prevent spread
□ Isolation Precautions
□ prevent the spread of communicable or
contagious diseases.
□ based on clean and dirty
□ Clean areas or objects are free of pathogens.
□ Dirty areas or objects are contaminated with
pathogens.
□ also depend on how the pathogen is spread.
ISOLATION PRECAUTIONS
□ CDC guidelines for two types of
Isolation Precautions
□ Standard Precautions
□ Transmission-Based Precautions
ISOLATION PRECAUTIONS:
standard precautions
□ reduce the risk of spreading pathogens and
known and unknown infections.
□ used in the care of all persons.
□ prevent the spread of infection from:
□ Blood
□ All body fluids, secretions, and excretions
(except sweat), even if blood is not visible
□ Non-intact skin
□ Mucous membranes
ISOLATION PRECAUTIONS
Transmission-Based Precautions
□ must understand how certain
infections are spread to apply
□ Airborne, Droplet, Direct contact
□ Airborne
□ Closed door
□ Private room
□ Respiratory mask
□ Pt to wear mask if moved from the room
□ Standard precautions
ISOLATION PRECAUTIONS
Transmission-Based Precautions
□ Droplet
□ Private room
□ Standard precautions
□ Mask if within three feet of the pt
□ Pt to wear a mask if transported
ISOLATION PRECAUTIONS
Transmission-Based Precautions
□ Direct contact
□ Microbes from indirect and direct
□ Private room
□ Standard precautions
□ Use of mask, gloves and gown
□ Removal of equipment before leaving the
room
Protective measures
□ Agency policies may differ from those in this text.
□ wearing gloves, a gown, a mask, or protective
eyewear.
□ Removing items from the room may require
double-bagging.
□ Special measures are needed to collect
specimens and to transport persons.
PURPOSE OF GLOVES
□ Protect you from pathogens in the
person’s blood, body fluids, secretions,
and excretions
□ Protect the person from microbes on your
hands
PROTECTIVE MEASURES
RULES FOR USING GLOVES
□ easier to put on when your hands are dry
□ a new pair for every person.
□ Remove and discard torn, cut, or punctured gloves at once.
□ Practice hand hygiene, and put on a new pair.
□ Wear gloves once; discard them after use.
□ Put on clean gloves before touching mucous membranes or
non-intact skin.
□ Put on new gloves when become contaminated
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□ Change gloves when moving from a contaminated body site to a
clean body site.
cover your wrists.
cover the cuffs of a gown
Remove so the inside part is on the outside.
Decontaminate hands after removing gloves.
Removing Gloves
□ Demonstrate the procedure for
removing gloves.
□ Have each student practice and
perform a return demonstration of the
procedure.
Masks and respiratory protection
**prevent the spread of microbes from the
respiratory tract.
□ used for Airborne and Droplet Precautions.
□ disposable.
□ A wet or moist mask is contaminated.
□ fits snuggly over your nose and mouth.
□ hand hygiene before putting on a mask.
□ To remove touch only the ties.
Protective apparel
Wearing a Gown
□ Gowns, plastic aprons, shoe covers, boots, and leg
coverings
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□ prevent the spread of microbes.
□ also protect against splashes and sprays.
must completely cover clothing.
opens at the back.
tied at the neck and waist.
inside and neck are clean.
outside and waist strings are contaminated.
used once.
Disposable gowns are discarded after use.
APPLICATION
□ Donning and Removing a Gown,
mask, and gloves
□ Demonstrate the procedure for
donning and removing a gown.
Protective apparel
EYE PROTECTION
□ Eyewear and face shields
□ Goggles and face shields protect your
eyes, mouth, and nose from splashing
or spraying of blood, body fluids,
secretions, or excretions.
Protective apparel
EYE PROTECTION
□ protect your eyes, mouth, and nose
from splashing or spraying of blood,
body fluids, secretions, or excretions.
□ Discard disposable eyewear after use.
□ Reusable eyewear is cleaned before
reuse.
Bagging items
□ Contaminated items are bagged to
remove them from the person’s room.
□ Leak-proof
□ labeled with the “BIOHAZARD” symbol.
□ Melt-away bags are common.
□ Tie the bag securely.
□ Double-bagging is not needed unless the
outside of the bag is soiled.
Bagging items Double Bagging
□ See text for procedure
Meeting basic needs
□ Patient Rights
□ How do you promote these rights for
persons on Isolation Precautions ?
□ How do you meet the person’s love,
belonging, and self-esteem needs ?
□ How do you meet the special needs of
children and older persons?
Meeting basic needs
the pathogen is undesirable, not the person.
□ respect, kindness, and dignity for all patients
□ Provide reading matter.
□ Provide hobby materials if possible.
□ Place a clock in the room.
□ Encourage to phone family and friends.
□ Provide a current TV program guide.
□ Organize your work so you can visit
□ Say “hello” from the doorway often.
Meeting basic needs
□ Focus on children: Isolation Precautions
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Infants and children do not understand isolation.
Eyewear, masks, and gowns may scare them.
Parents and staff look different.
toys and comfort items may be kept from the
child.
prepares the child and family for isolation.
Simple explanations
the child is given PPE to play
Show your face before putting on a mask and
eyewear.
Say “Hello” to the child, and state your name.
Meeting basic needs
□ Focus on older persons: Isolation
Precautions
□ Let persons see your face.
□ State your name and tell what you are
doing
BLOODBORNE PATHOGEN
STANDARD
□ a regulation of OSHA
□ intended to protect the health team
from exposure to blood borne
pathogens
□ Blood borne pathogens
□ Those found or spread through blood
□ human immunodeficiency virus (HIV)
□ hepatitis B virus (HBV)
□ See Box 14-7
BLOODBORNE PATHOGEN
STANDARD: Exposure control plan
□ must have an exposure control plan.
□ identifies staff at risk for occupational
exposure to blood or OPIM.
□ actions to take for an exposure incident.
□ receive free training:
□ At the beginning of employment and yearly
□ For new or changed procedures and tasks
involving exposure to blood-borne pathogens
BLOODBORNE PATHOGEN
STANDARD
□ Training
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An explanation of the standard and where to get a copy
The causes, signs, and symptoms of blood-borne diseases
How blood-borne pathogens are spread
explanation of the exposure control plan and where to get
a copy
How to know which tasks might cause exposure
use and limits of safe work practices, engineering controls,
and personal protective equipment
Information on the hepatitis B vaccination
Who to contact and what to do in an emergency
reporting an exposure incident, post-exposure evaluation,
and follow-up
warning labels and color-coding
Preventive Measures
□ reduce the risk of exposure.
□ Hepatitis B vaccination
□ vaccination involves three injections
□ receive within 10 working days of hire
□ The agency pays for the vaccination.
□ You can refuse the vaccination
Preventive Measures
□ Engineering and work practice controls
□ reduce exposure risk in the workplace.
□ Work Practice controls
□ Tasks or procedures to prevent spread of or exposure to
BBP
□ PPE
□ handwashing
□ Engineering controls
□ Equipment used to reduce the risk of exposure
□ Sharps containers
□ Special needles
Surgical Asepsis
Sterile Gloving
□ See procedure in book