Transcript PN1lab notes\Hand Washing, Routine Practices and Disease

Hand Washing, Routine
Practices and Disease
Specifics
Practical Nursing Diploma
Program Skill Labs 1
Chain of infection
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Infectious agent – bacteria, virus, fungi
Reservoir – where an infection can
grow: humans, animals, food, water,
inanimate objects, “carriers”
Portal of exit – how the infectious agent
is transmitted: respiratory, GI, GU, skin
breaks, blood, tissue
4.
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Means of transmission:
Contact: direct/indirect
Vehicle: blood, food, water, inanimate
objects
Vector: mosquito, lice, ticks
Airborne: droplets
5.
6.
Portal of entry – how the infectious
agent gets into the host
Susceptible host – the young, elderly,
sick
Breaking the Chain…
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The chain can be broken at any ring
Most important thing you can do is to wash
your hands!!!
Make sure that you are generally healthy, take
precautions for example the flu shot
Assess skin; intact skin and mucous
membranes will resist infection
Reduce use of invasive medical devices
Noscomial infections
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Hospital acquired infections
Significant cost to the health care system
Highly preventable but can have huge
costs
Nurses have a significant role in
preventing the development of
nosocomial infections
Medical Asepsis
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Clean techniques
Practices that reduce the number and
transfer of pathogens
Principles of Medical Asepsis
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Wash hands
Keep soiled items away from uniform
Keep items off the floor – linen, drainage
bags
Cover mouth when coughing, sneezing
etc. Then wash your hands!
Clean equipment away from you
Wash from clean to dirty
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Dispose of soiled items promptly and
following proper procedure
Pour dirty liquids directly into drain to
avoid splash back: WEAR GOGGLES.
Sterilize items that may be contaminated
–make sure that proper protocol is
followed
Practice good personal hygiene
The need for a dress code…
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To protect you and your patients
Short nails harbour fewer
pathogens…concerns specifically with
artificial nails
Jewelry is also a reservoir for pathogens
It is alarmingly easy to transfer from
patient to patient and from you to your
family
Handwashing
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Perform it to remove transient and resident
bacteria
Soaps: make sure you are using an
appropriate cleansing agent
Perform a 10-15 second scrub with jewelry
off...unless you had it on when performing care
Wash with the hands lower than the wrists,
scrub 1” above the wrist
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Use an orange stick to clean under the
fingernails
Rinse hands thoroughly
Dry hands beginning with the fingers and
moving up
Use a clean paper towel to turn off taps
Use lotion, make sure to check skin
integrity
When to wash your hands
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Start of shift, end of shift,
between patients,
before and after breaks/meals,
after you sneeze or use the washroom,
when you remove gloves
You can never do this too often
Good hand washing should become a habit
How to wash your hands
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Wet hands and wrist area. Keep hands
lower than elbows to allow water to flow
toward fingertips.
Cover all areas of the hands with soap.
Use firm rubbing and circular motions,
wash the palms and backs of the hands,
each finger, area between the fingers,
knuckles, wrists, & forearms.
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Wash at least one inch above area of
contamination. If hands are not visibly
soiled, wash to one inch above the
wrists.
Continue this motion for 10-15 seconds
Dry hands beginning with fingers &
moving upward toward forearms
Routine Practices
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May also be known as Universal Precautions
Precautions taken with all patients, especially
when there is potential exposure to body fluids,
especially blood, excretions, non-intact skin
Designed to protect all from risk of infection
through transfer of infectious material from
patient - patient or from patient -staff
Routine Practices include:
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Gloves, gowns, masks, goggles worn
whenever risk of exposure to body fluids
is present (emptying a urinal, suctioning
a patient)
Sharps disposal in puncture resistant
containers
Elimination of needle recapping
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Immunization of personnel, e.g flu shot
Garbage- use of bags as indicated by
policy
Disease specific precautions
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Always read the sign on the door before
entering the room
Airborne precautions – for patients with
infections that spread through the air i.e.
TB, chicken pox, measles
Droplet precautions – infections that
spread through large particle droplets,
i.e. mumps, rubella, diptheria
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Contact precautions – for patients with
infections that spread through contact,
i.e. MRSA,VRE, C. Diff.
Each type of precaution has different
guidelines related to type of room,
protective clothing required, patient
transport, sharing of equipment etc.
Protective Clothing
Gloves: use once only and then discard
 Not a substitute for hand washing
 Latex allergies are a growing problem
 Not needed for routine tasks that will not
bring you into contact with bodily fluids
Gowns
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Used to prevent soiling of your clothing
More common to use paper gowns
Put on immediately prior to entering
room and take off when leaving the
room!
Use once and discard
Masks
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Prevent from inhaling large particle
aerosols and small particle droplets
Also discourages you from touching your
face thus limiting contact
Sometimes the patient also needs to
wear a mask
Need to be aware of various types of
masks
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Debate about how long a mask is
effective
Special masks are available, e.g. HEPA
masks, N95
Eye Wear
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Goggles and face shields should be
worn when any risk of eye contamination
is present
Simply wearing eye glasses is not
enough!
Now seeing more face shields and other
devices
Protective Clothing
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Putting on:, gown, glove, mask, eyewear.
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Taking off: remove gloves, wash hands, untie
front waist string, gown (if soiled slide out),
wash hands, masks & eye wear last.
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Wash hands!!