Transcript Infection Control Measures

Chapter 22
Infection Control
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
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 Infectious diseases (diseases spread from one
person to another) are also called contagious
or communicable diseases .
 They were once the leading cause of death,
but that is no longer true because of vaccines,
aggressive public health measures, and
advances in drug therapy.
 Nevertheless, infectious diseases have not
disappeared.
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Fundamental of Nursing - B
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Infection
 Infection:
is a condition that results when
microorganisms cause injury to a host
 Colonization: a condition in which microorganisms
are present but host is without signs or symptoms of
infection
 The host can transmit pathogens and infectious
diseases to others.
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 Infections progress through distinct stages
Incubation stage
2. Prodromal stage
3. Acute stage
4. Convalescent stage and ,
5. Resolution stage (Table 22-1).
The characteristics and length of each stage may differ
depending on the infectious agent.
For example, the incubation period for the common cold is
approximately 2 to 4 days before symptoms appear, but it may
take months or years before a person infected with HIV
demonstrates symptoms of AIDS.
1.
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2014 - 10 - 13
Bader A. EL Safadi
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BSN , MSc
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Infection Control Precautions
 Infection control precautions :
 Are physical measures designed to curtail(minimize)
the spread of infectious diseases.
 They are essential when caring for clients.
 Require knowledge of the mechanisms by which an
infectious disease is transmitted and the methods that
will interfere with the chain of infection.
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 The Centers for Disease Control and Prevention( CDC)
(2007) has established guidelines for two major
categories of infection control precautions:
1. Standard precautions
2. Transmission-based precautions.
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Fundamental of Nursing - B
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Standard Precautions
 Standard precautions are measures for reducing
the risk for microorganism transmission from
both recognized and unrecognized sources of
infection.
 Health care personnel Followed when potential
exists for contact with (Box 22-2).

Blood.
 All body fluids except sweat.
 Non intact skin.
 Mucous membranes
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
Infection Control
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Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
Infection Control
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Box 22-2 Standard Precautions
Hand washing
 Wash hands after touching blood, body fluids,
secretions, excretions, and contaminated items,
whether or not gloves are worn.
 Wash hands immediately after gloves are
removed, between patient contacts, and when
otherwise indicated; wash between tasks and
procedures on the same patient to prevent crosscontamination of different body sites.
 Use plain (non-antimicrobial) soap for routine
hand washing.
 Use an antimicrobial agent or a waterless
antiseptic agent to control outbreaks or
hyperendemic infections (highly infectious in
all age groups)
Gloves
 Wear clean, non sterile gloves when touching
blood, body fluids, secretions, excretions, and
contaminated items.
 Change gloves between tasks on the same
patient after contact with material that may
contain a high concentration of microorganisms.
 Remove gloves and wash hands immediately
before caring for another patient.
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Mask, Eye Protection, Face Shield
 Wear a mask and eye protection, or face
shield to protect the eyes, nose, and
mouth when there is a likelihood that
splashes or sprays of blood, body fluids,
secretions, or excretions will occur.
Gown
 Wear a clean, non sterile gown when
there is a likelihood that splashes or
sprays of blood, body fluids, secretions,
or excretions will occur.
 Remove a soiled gown promptly and
wash hands.
Patient-Care Equipment
 Handle equipment soiled with blood,
body fluids, secretions, and excretions
so as to prevent the transfer of
microorganisms to oneself, others, or the
environment.
 Ensure that soiled reusable equipment is
cleaned before another subsequent use.
 Discard soiled single-use equipment
properly.
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Environmental Control
 Ensure that procedures for routine
cleaning and disinfection of
environmental surfaces, beds, bedrails,
bedside equipment, and other
frequently touched surfaces are carried
out.
Linen
 Handle, transport, and process soiled
linen in such a way as to prevent
exposure to oneself, others, and the
environment.
Occupational Health and Blood-borne
Pathogens
 Prevent injuries when using needles,
scalpels, and other sharp devices
◦ Never recap used needles
◦ Use either a one-handed “scoop”
method or mechanical device for
covering a needle.
◦ Place all disposable sharp items in a
puncture-resistant container as
close to the location of use as
possible; transport reusable
syringes and needles in a punctureresistant container for reprocessing.
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 Use mouthpieces, resuscitation
bags, or other ventilation devices as
an alternative to mouth-to-mouth
resuscitation methods in areas
where the need for resuscitation is
predictable.
Patient Placement
 Place a patient who contaminates
the environment, who does not—or
cannot be expected to—assist in
maintaining appropriate hygiene or
environmental control in a private
room.
 Consult with an infection control
professional concerning alternatives
if a private room is not available.
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Transmission-Based Precautions
 Transmission-based precautions are measures for
controlling the spread of infectious agents from
clients known to be or suspected of being infected
with highly transmissible or epidemiologically
important pathogens. They are also called isolation
precautions
 The three types of transmission-based precautions
are
Airborne precautions,
2. Droplet precautions, and
3. Contact precautions (Table 22-2).
1.
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Fundamental of Nursing - B
Infection Control
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Second semester 15 - 16 Bader A. EL Safadi
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Fundamental of Nursing - B
Infection Control
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Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
Infection Control
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Airborne Precautions
Airborne precautions are measures that reduce the risk
for transmitting airborne infectious agents.
They block pathogens 0.3 microns or smaller that are
present in the residue of evaporated droplets that remain
suspended in the air, as well as those attached to dust
particles.
Examples :
1. Tuberculosis (TB), measles, chickenpox
are diseases transmitted in the air.
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Fundamental of Nursing - B
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Droplet Precautions
Droplet precautions are measures that block pathogens
within moist droplets larger than 5 microns.
They are used to reduce pathogen transmission from close
contact (usually 3 feet or less) between an infected person
or a person who is a carrier of a droplet-spread
microorganism and others.
Microorganisms carried on droplets commonly exit the
body during coughing, sneezing, talking, and procedures
such as airway suctioning and bronchoscopy.
Airborne precautions are not used because droplets do not remain
suspended in the air.
Meningitis, influenza common cold are examples of
diseases transmitted by droplets.
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Contact Precautions
 Contact precautions are measures used to block
the transmission of pathogens by direct or indirect
contact. (chickenpox, smallpox, SARS )
 This is the final category of transmission-based
precautions.
1. Direct contact involves skin-to-skin contact with an
infected or colonized person.
2. Indirect contact occurs by touching a contaminated
intermediate object in the client's environment.
Additional precautions are necessary if the
microorganism is antibiotic resistant
Second semester 15 - 16 Bader A. EL Safadi
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Fundamental of Nursing - B
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Contact Precautions
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Fundamental of Nursing - B
Infection Control
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Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
Infection Control
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Infection Control Measures
 Infection control measures involve the use of personal
protective equipment (garments that block the transfer
of pathogens from one person, place, or object to
oneself or others) and techniques that serve as barriers
to transmission (Fig. 22-3).
 Disposing of contaminated linen, equipment, and
supplies in such a way that nurses do not transfer
pathogens to others
 Using infection control measures to prevent pathogens
from spreading when transporting laboratory
specimens or clients
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
Infection Control
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Infection Control Measures
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
Infection Control
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Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
Infection Control
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Depending on the type of precautions used, nurses
implement all or some of the following measures:
 Locating a client and equipping a room so as to confine
pathogens to one area
 Using personal protective equipment such as cover
gowns, face shields or goggles, cloth or paper masks or
respirators and gloves to prevent spreading
microorganisms through direct and indirect contact
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
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Client Environment
 The client environment includes the room designated for
the care of a client with an infectious disease and the
equipment and supplies essential to controlling
transmission of the pathogens
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
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Infection Control Room
 Most health care agencies assign infectious or potentially
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infectious clients to private rooms.
They keep the door to the room closed to control air
currents and the circulation of dust particles.
The room has a private bathroom so that personnel can
flush contaminated liquids and biodegradable solids. A sink
is also located in the room for hand washing.
Staff members post an instruction card stating that isolation
precautions are required on the door or nearby at eye level
(Fig. 22-4).
Nurses are responsible for teaching visitors how to comply
with the infection control measures.
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
Infection Control
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Equipment and Supplies
 The infection control room contains the same equipment
and supplies as any other hospital room, with a few
modifications. Equipment that personnel would ordinarily
use for several non infected clients, such as a stethoscope
and sphygmomanometer, remains in the client's room
whenever possible. This prevents the need to clean and
disinfect the items each time they are removed.
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
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 For the same reason, disposable
thermometers are preferred. Personnel
disinfect electronic or tympanic
thermometers to make them safe for the
next client.
 Items such as a container for soiled
laundry (Fig. 22-5), lined waste
containers, and liquid soap dispensers are
also placed in the room
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
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Personal Protective Equipment
 Infection control measures involve the use of one or
more items for personal protection. Personal protective
equipment, also called barrier garments (Fig. 22-7),
includes gowns, masks, respirators, goggles or face
shields, and gloves.
 These items are located just outside the client's room or
in an anteroom (Fig. 22-8).
 The procedure involves making contact between two
contaminated surfaces or two clean surfaces. Nurses
remove the garments that are most contaminated first,
preserving the clean uniform underneath
Second semester 15 - 16 Bader A. EL Safadi
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Personal Protective Equipment
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
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 Double-bagging is an infection
 Disposing of
Contaminated Linen,
Equipment, and Supplies
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control measure in which one
bag of contaminated items, such
as trash or laundry, is placed
within another
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 Removing Reusable Items
 They are cleaned with an antimicrobial disinfectant,
bagged, and sterilized using heat or chemicals .
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Fundamental of Nursing - B
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 Removing Reusable Items
 They are cleaned with an antimicrobial disinfectant,
bagged, and sterilized using heat or chemicals .
 Transporting Clients
 During transport, nurses use methods to prevent the spread
of pathogens either directly or indirectly from the client.
 The client wears a mask or particulate air filter respirator
if the pathogen is transmitted by the airborne or droplet
route. Any hospital personnel having direct contact with
the client use personal protective equipment similar to that
used in client care.
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BSN , MSc
Fundamental of Nursing - B
Infection Control
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 Psychological Implications
 Although infection control measures are necessary,
they often leave clients feeling shunned or
abandoned. Clients with infectious diseases
continue to need human contact and interaction.
 Promoting Social Interaction
 Nurses encourage visitors to come as often as the
agency's policies and the client's condition permit.
They use every opportunity to emphasize that as
long as visitors follow the infection control
precautions, they are not likely to acquire the
disease.
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
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Nursing Implications
 Risk for Infection
 Ineffective Protection
 Risk for Infection Transmission
 Impaired Social Interaction
 Social Isolation
 Risk for Loneliness
 Deficient Diversional Activity
 Powerlessness
 Fear
Second semester 15 - 16 Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing - B
Infection Control
34