Transcript Infection Control - Respiratory Therapy Files

Infection Control
Infection Control

Hospital-acquired infections (HAIs)
account for 2 million infections and
90,000 excess deaths annually.

About 5% of all patients admitted develop
an HAI.
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About 25% of mechanically ventilated
patients develop pneumonia, and 30% (of
those 25%) will die.
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Infection Control

Infection control procedures aim to
◦ Eliminate the sources of infectious agents
◦ Create barriers to their transmission
◦ Monitor the effectiveness of control

All health care workers must take
responsibility and follow procedures
carefully.
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Spread of Infection

Three elements must be present for
infection to spread:
◦ Source of pathogens
◦ Susceptible host
◦ Route of transmission
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Spread of Infection
Sources of Infectious Agents
 Humans are the primary source.
 Inanimate objects (e.g., contaminated
medical equipment) can spread infection.
 Individuals in the hospital capable of being
the source include workers, visitors, and
patients.
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Spread of Infection
Susceptible Hosts
 Resistance to infection varies greatly from
one person to the next.

Host factors that increase the chance of
infection are
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Poorly controlled diabetes
Increased age
Chemotherapy
Placement of tubes and catheters
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Spread of Infection
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Nosocomial Infections are those acquired in
the hospital.
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Most nosocomial pneumonias occur in
patients having chest or abdominal surgery.
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Those with a history of COPD, cigarette
smoking, or obesity and with advanced age
have the greatest risk for nosocomial
pneumonia following major surgery.
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Infection Control Strategies
1.
Decreasing host susceptibility
- Immunizations and chemoprophylaxis
2.
Eliminating the source of the pathogens
3.
Interrupting routes of transmission
- Barrier/isolation precautions
- Special equipment handling
- Disposable equipment
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What is the single best way to
prevent the spread of infection?

Staphylococcus aureus
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Standard Precautions
With Every Patient!

Handwashing
◦ Before patient contact
◦ After any patient contact even if gloves are
used
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Gloves
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Standard Precautions
With Every Patient!

Handwashing
◦ Before patient contact
◦ After any patient contact even if gloves are
used

Gloves
◦ If hands may become soiled with blood, body
fluids, secretions, or excretions
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Masks, Goggles, Face Shields
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Standard Precautions
With Every Patient!

Handwashing
◦ Before patient contact
◦ After any patient contact even if gloves are used
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Gloves
◦ If hands may become soiled with blood, body
fluids, secretions, or excretions

Masks, Goggles, Face Shields
◦ If mucous membranes of the eyes, nose, and
mouth may be splashed with blood, body fluids,
secretions, or excretions
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Gown
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Standard Precautions
With Every Patient!

Handwashing
◦ Before patient contact
◦ After any patient contact even if gloves are used

Gloves
◦ If hands may become soiled with blood, body fluids,
secretions, or excretions

Masks, Goggles, Face Shields
◦ If mucous membranes of the eyes, nose, and mouth
may be splashed with blood, body fluids, secretions, or
excretions

Gowns
◦ If skin and clothing may be splashed with blood, body
fluids, secretions, or excretions
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Isolation Cart
Contact Precautions
 Droplet Precautions
 Airborne Precautions

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Contact Transmission
Most frequent route for the spread of
nosocomial infections
 Direct transmission

◦ Person to person transfer
◦ Staphylococcus

Indirect transmission
◦ Fomites
◦ Pseudamonus aeruginosa
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Routes of Infectious Disease
Transmission
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Contact Precautions
Room:
Private
 Hand washing: Standard precautions
 Gloves:
Upon entry
Remove before exiting
 Gown:
Upon entry
Remove before exiting
 Mask:
Standard precautions
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Droplet Transmission
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Large contaminated liquid droplets
◦ Coughing, sneezing, or talking
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Procedures
◦ Suctioning
◦ Bronchoscopy

Can not travel more than 6 feet
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Routes of Infectious Disease Transmission
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Droplet Precautions
Room:
Private
 Hand washing: Standard precautions
 Gloves:
Standard precautions
 Gown:
Standard precautions
 Mask:
Standard precautions & within 6 feet
 Transport:
Patient must wear a mask

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Airborne Transmission
Small contaminated droplet nuclei (<
5μm)
 May remain suspended for a long period
of time
 May be carried by air currents
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Routes of Infectious Disease Transmission
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Airborne precautions
Room:
 Hand washing:
 Gloves:
 Gown:
 Mask:
 Transport:
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Private negative-pressure room
Standard precautions
Standard precautions
Standard precautions
NIOSH* approved upon entry
Patient must wear NIOSH* mask
•NIOSH: National Institute for Occupational Safety and Health
•N95 mask
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NIOSH* Approved
N95 Mask
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Protective Isolation

Immunocompromised patients
◦ Private room
◦ Standard precautions
◦ Contact isolation

Burn Patients
◦ Strict contact isolation
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Disinfection and Sterilization
Cleaning
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Cleaning is the first step in all equipment
processing.
It involves removing dirt and organic material.
Failure to clean equipment properly can render
all subsequent processing efforts ineffective.
Soaps or detergents and water need to be used.
If the item cannot be immersed in water it must
be disinfected using a 70% ethyl alcohol
solution.
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Disinfection and Sterilization (cont.)

Disinfection can involve either chemical or physical methods.
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Disinfection and Sterilization (cont.)
Chemical Disinfection
 Chemical disinfection involves the application of
chemical solutions to contaminated equipment or
surfaces.

Equipment must be immersed in the solution for a set
period of time.
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Disinfection and Sterilization (cont.)
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Sterilization

Destroys all microorganisms

Can be achieved with physical and chemical approaches

Steam sterilization is most common and easiest.

Low-temperature sterilization technologies include
ethylene oxide, a colorless and toxic gas.
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Equipment Handling Procedures
SMALL-VOLUME NEBULIZERS (SVNs)
 Between treatments on the same patient, disinfect, rinse
with sterile water, and air-dry SVNs.
 Between patients, replace SVNs with sterile or highlevel disinfected units.
 Use only sterile fluids for nebulization and dispense
these fluids aseptically.
 When possible, use single-use medication vials. If using
multidose vials, handle, dispense, and store them
according to manufacturer's instructions and checking
expiration dates.
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Equipment Handling Procedures
LARGE-VOLUME NEBULIZERS
 Always fill nebulizers with sterile distilled water.
 Fill fluid reservoirs immediately before use. Do not add
fluid to replenish partially filled reservoirs. If fluid is to
be added, discard the remaining old fluid first.
 Drain tubing condensate away from the patient and
discard as contaminated waste; do not allow condensate
to drain back into reservoir.
 Sterilize or high-level disinfect large-volume nebulizers
between patients and after every 24 hours of use on
the same patient.
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Equipment Handling Procedures
OXYGEN THERAPY DEVICES
 Humidifiers are not needed with flows less than 4
L/min.
 When needed and whenever possible, prefilled, sterile
disposable humidifiers should be used.
 The tubing and oxygen delivery device should be
changed between patients; prefilled, sterile, disposable
humidifiers do not need to be changed between
patients in high-use areas such as the recovery room.
 Prefilled, disposable humidifiers can be used safely for up
to 30 days.
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Equipment Handling
Disposable Equipment

An important alternative to continually reprocessing
equipment

Three major issues
◦ Cost
◦ Quality
◦ Reuse (raises significant safety concerns)
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