Transcript Isolation Class 10

Isolation Class 10
Last Class
Preventing the spread of
infection
• What do we do when a client
has a highly infectious disease?
Specific Infection
Control Policies
• Isolation – the principle is to
create a physical barrier that
prevents the transfer of
microorganisms.
What are appropriate
barriers? Depending on • Organism Transmission
• Airborne
• Vehicle
• Contact
• Direct
• Indirect
• Droplet
Types of Barriers
• PPE (personal protective
equipment)
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Gowns
Gloves
Masks
Eyewear
• Each institution is required to
have infection control policies
and guidelines.
What about when we
don’t know?
• 3 systems
• Universal precautions
• Body substance precautions
• Standard precautions
Precautions to guard
against the unknown
• Apply to everyone
• General public
• May or may not carry an
infection
History Lesson
• Initially concerned with patient
to patient
• Followed by concern for health
care professionals
• 1970 – Hepatitis B
• 1987 – HIV
• Universal precautions by Center
for Disease Control (CDC)
Universal precautions
Stated :
All blood & body flds should be
treated as potentially
infectious.
Body Substance
Isolation (BSI)
• Infection control practitioners
in Seattle and SanDiego
• Canada adopted policy but
renamed it Body Substance
Precautions (BSP)
Standard Precautions
• 1996- newest guidelines by CDC
combined the major features of
universal precautions & BSP
2 Tier System
• 1996 CDC new guidelines
1st Tier – Standard
Precautions
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Most important
Universal precautions + BSP
Applies to everyone
Primary strategies for
prevention of infection
• Standard precautions
• Blood, body flds., nonintact skin,
mucus membranes
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2
Tier
• Specific infections/diagnosis
• Droplet, airborne, contact with
contaminated surface
3 Types Transmission
Based Precautions
• Airborne, droplet, contact
• Some infections combination
(chicken pox)
• These extra precautions are in
addition to Standard
Precautions
Airborne
• Travels on small particles
• Air currents
• Portal of entry – nose, mouth,
mucus membranes
• Measles, chicken pox, TB
Requirements for
Airborne
• Negative pressure room – door
closed
• TB = HEPA filter
• Do not enter if not immune to
measles/chickenpox
• Client wears mask when
required to leave room
Droplet
• Large droplets of moisture
• Coughing, sneezing, talking
• Travels 3 ft. or less
• Enters nose / mouth
• Mumps, pertusis, influenza
• Private room
• Staff regular mask for 3 ft.
• Client mask for transport
Contact
Dry skin to dry skin = Direct
Dry skin to object = Indirect
Impetigo, herpes zoster, scabies
Gloves – for direct care or
touching anything in the room
• Private room or semi if cohort
has same diagnosis
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• Remove gloves prior to exiting
and wash hands
• Gown for
• patient contact
• Changing linen
• Handling objects in the room
• Remove gown prior to exiting
• Wash hands
• Careful clothing does not touch
room surfaces
Protective Isolation /
Reverse isolation
• Compromised or suppressed
immune system
• Highly susceptible to infections
• Protection from environmental
pathogens
Protective Isolation /
Reverse isolation
What do you need ?
• Private room – door closed
• Gown, mask, gloves if direct
contact
• Wash hands
• No plants / flowers
Procedure
• Before instituting
• EXPLAIN to client & family
• Disease
• Purpose of isolation
• Steps to follow
• Time frame
Room Preparation
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Private with BR facilities
Sign on door
Isolation cart outside door
Laundry hamper in room
Waste basket with plastic bag
Thermometer, B/P cuff, stethoscope
in room
• Sharps receptacle
• Be organized
• Gather equipment prior to
entering room
• Remove rings and wash hands
• Don PPE
• Gown usually disposable
• Gloves up over cuff of gown
• Put your watch in a plastic bag
if no clock in room
• Linen is placed in a water
soluble bag & then
cream/yellow bag
• No special treatment for dishes
/ trays
Exiting Room
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Untie gown at waist
Remove gloves properly
Remove mask
Untie gown at neck, drop over
shoulders, don’t touch outside,
fold inwards, and discard
Exiting Room
• Wash hands
• Use paper towel on door handle
• Wash hands again outside room
Important to do as much client
care as you can while you are in
the room….CLUSTER ACTIVITY.
Basic Principles
• Wash hands prior to entering &
exiting room
• Careful disposal of
contaminated materials
• Knowledge of disease and mode
of transmission
• Protection of client and public
during transport
Client Consideration
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Isolation
Loneliness
Self – esteem, body image
Boredom
Sterile Technique /
Surgical Asepsis
Purpose – to eliminate all
microorganisms from objects
that come into contact with the
tissues of the body that are
normally sterile.
Practice Areas
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Operating room
Labor and delivery
Major diagnostic area
At the bedside in 3 main
situations
1. Procedures requiring intentional
perforation of the skin
2. When the skin’s integrity is
broken due to surgery or burns
3. During procedures involving
insertion of devices into normally
sterile body cavities
• Any break in technique could
result in contamination
increasing clients risk for
infection.
Methods of Sterilization
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Steam – most common
Dry heat
Ethylene oxide gas
Chemicals
Indicator of sterility –
• tape on pkg. turns color or forms
lines
• Expiration Date
Examples of
sterilization processes
• Moist heat /steam
• Radiation
• Autoclaveinstruments,
parental solutions,
dressings
• Drugs, foods, heat
sensitive items
Examples of
sterilization processes
• Chemicals
• All types
microorganisms
• Rapid action
• Work with water
• Stable in heat &
light
• Inexpensive
• Not harmful to
body tissue
• Instruments
• Glass
thermometers
• Ex. Chlorine –
used to disinfect
water & for
housekeeping
purposes
Examples of
sterilization processes
• Ethylene oxide
gas
• Destroys
microorganisms
by altering cells’
metabolic
processes.
• Rubber
• Plastic
Examples of
sterilization processes
• Boiling water
• Cheap
• Imp. – bacterial
spores andsome
viruses resist
boiling. Not used
in hospitals!
• Items should be
boiled for at
least 15 min.
Practical Exam
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Prepare a sterile field
Add an item
Add a liquid
Don sterile gloves