Transcript Infection Control UNIT-F

Infection Control
UNIT-F
2H06. Apply infection control
measures in a clinical setting.
• Specific Objectives:
• 2H06.01Analyze principles of infection
control.
• 2H06.02 Maintain sterile technique and
isolation.
Basic Principles
(disease transmission)
Microbe Classifications
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Bacteria
Protozoa
Fungi
Rickettsiae
Viruses
Bacteria
Rickettsiae
Protozoa
Viruses
Fungi
Microorganisms or
Microbes
• Small living organisms
• Not visible to the naked eye
• Microscope must be used to
see them
• Found everywhere in the
environment
• Found on and in the human
body
• Many are part of normal flora of
body
• May be beneficial
Microorganisms
• This consist of any organism that can be
seen with the aid of a microscope
• Also known as microbe
Pathogens
• Also known as germs
• Disease producing organism
• At times, non-pathogens can become
pathogenic when it is present in another
body system.
– Ex. E. Coli
Non-Pathogens
• Microorganisms that
are part of the normal
flora and are beneficial
in maintaining certain
body processes.
Bacteria
• Simple, one-celled
organisms that multiply
rapidly
• Some are beneficial
and some cause
disease
• Classified by shape and
arrangement
– Cocci- round or spherical
in shape
– Bacilli- rod-shaped
– Spirilla- spiral or
corkscrew in shape
Flesh Eating Bacteria
• Necrotizing fasciitis (NF)
• NF is a bacterial infection
that attacks the soft tissue
and the fascia which
covers the muscles. NF
can occur from minor
trauma but is usually
related to surgery.
• The NF Bacteria is
commonly called strep
type A.
Protozoa
• One-celled animals often
found in decayed
materials and
contaminated water
• May contain flagella,
which allows better
movement
• Some are pathogenic &
cause disease
• Ex. Malaria, amebic
dysentery trichomonas,
and African sleeping
disease
Fungi
• Simple, plantlike organisms
that live on dead organic
matter.
• Yeast and molds are two
common forms that can be
pathogenic.
• Cause diseases
Ring Worm
– Ex. Ring worm, athlete’s foot,
thrush, histopasmosis, and
yeast vaginitis
Thrush
• Cannot be killed by
antibiotics
• Antifungal medications are
available for pathogenic
fungi.
– Must be taken internally for
long periods of time and may
cause liver damage.
Athlete’s Foot
Rickettsiae
• Micro parasite that lives within
an organism.
• Commonly found in fleas, lice,
ticks, & mites.
• Transmitted to humans by the
bites of these insects. Causes
diseases
– Ex. Typhus fever and Rocky
Mountain spotted fever.
• Antibiotics are effective against
many different rickettsiae.
Viruses
• Lives on living cells
• Smallest
microorganisms
• Cannot reproduce
unless they are inside
another living cell.
Viruses
• Spread human to
human by blood & other
body secretions.
• Difficult to kill because
they are resistant to
many disinfectants and
are not affected by
antibiotics.
• Visible only through
electron microscope.
• Causes diseases
Hepatitis B
Hepatitis B
• Also known as Serum
hepatitis
• Caused by HBV virus and
is transmitted by blood,
serum, and other body
secretions.
• Affects the liver, leads to
scarring or destruction of
liver cells.
• Life long infection
• Cirrhosis of liver
Hepatitis C
• Caused by HCV virus
• Transmitted by blood
and blood containing
fluids.
• Referred to as ‘silent
epidemic’.
• Sometimes don’t
experience symptoms
for decades after
infection.
• No vaccination, unlike
Hep B
Opportunistic
Infections
• Infections that occur
when bodies immune
systems are weak
• Do not usually occur
within individuals with
good immune systems
– Ex. Kaposi’s sarcoma or
neumocystis carinii
Mouth yeast infection
Kaposi’s sarcoma
Aerobic
• Organisms that need oxygen to live.
Escherichia coli
Anaerobic
• Lives without oxygen
• Facultative Bacteria
Endogenous
• Infection or disease
originating within the
body.
• Include metabolic
disorders, congenital
abnormalities, tumors,
and infections caused by
microorganisms.
Exogenous
• Infection or disease
originating outside of
the body.
• Include pathogenic
organisms that invade
body, radiation,
chemical agents,
trauma, electric shock,
& temperature
extremes.
Noscomial
• Pertaining to or
originating in a health
care facility such as a
hospital.
• Usually transmitted from
health care worker to the
patient.
• Antibiotic-resistant
• Staphylococcus,
pseudomonas, and
enterococci.
Stop Infection - Break the Chain
• Must be present for
disease to occur &
spread from one
individual to another.
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Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Asepsis
• Being free from infection
• Any object or area that may
contain pathogens is
considered to be contaminated.
• Aseptic techniques are
directed toward maintaining
cleanliness and eliminating or
preventing contamination.
• 10% bleach solutions are
used around a house to
control pathogens on counter
surfaces.
• Sterilized instruments expire
in 30 days.
• The drop technique is use to
add sterile items to a sterile
field.
• During a procedure that
produces blood and body
floods your mask and
eyewear should be worn.
HANDWASHING
1. Standard precautions are used for
all patients.
2. 2.Use continuously running H2O
3. Use generous amt. of soap
4. Apply vigorous contact/scrubbing
5. Wash for 15-30 seconds
6. When washing hands keep
fingertips pointed down.
7. After washing your hands turn
faucet off with a dry paper towel.
8. Health care workers can prevent
the spread of microorganisms from
one patient to another by proper
hand washing.
9. A health care worker should
change gloves between patients.
Standard Precautions
Standard precautions refer to
Safeguards taken that help to
Keep employees & consumers
protected and healthy when there
may be the potential to come into
contact with blood or other body
fluids. The Occupational Safety
& Health Administration (OSHA)
sets many standards for
employers & workplaces.
Standard Precautions
• Used for all patients.
• •Must wear gloves when
touching:
• •Blood
• •All body fluids
• •Non-intact skin
• •Mucous membranes
• •Wash hands
immediately after glove
removal and between
patients
Standard Precautions
•Masks, eye protection, face shield:
• •Wear during activities likely to
generate splashes or sprays
• •Gowns
• •Protect skin and soiling of
clothing
• •Wear during activities likely to
generate splashes or sprays
• •Sharps
• •Avoid recapping of needles
• •Avoid removing needles from
syringes by hand
• •Place used sharps in puncture
–resistant containers
HBV/HIV
Assume that every person’s blood
& body fluids are infectious.
Top 4 ways to prevent
the spread of disease.
1. Wash your hands
often.
2. Get immunized
3. Practice standard
precautions.
4. Disinfect regularly
Body fluids known to be infectious
for HBV, HIV .
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Semen
Vaginal secretions
Cerebrospinal fluid
Synovial fluid
Pleural fluid
Pericardial fluid
Peritoneal fluid
Amniotic fluid
Saliva
2H06.02 Maintain sterile
technique & isolation.
Sterilization - autoclave
pressure & steam
sterilization.
Disinfection Methods
1. Chemical disinfectionto disinfect using a
chemical to kill the germs.
2. Boiling water-hot water
to kill germs.
3. Ultrasonic unit-sound
waves terms.
Autoclave
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Before wrapping instruments to be
autoclaved make sure to clean them
first.
Ultrasonic units uses the process of
Cavitations to disinfect instruments.
Cavitations uses millions of
microscopic bubbles produced by
sound waves.
In a medical office they buy a
autoclave to sterilize instruments
Disinfections are use on hospital
beds.
Sterilized Article
• Used instruments
should be put in a
puncture resistant
container
Wrapping Instruments for
Autoclave
• Before using a sterile package
check expiration date &
indicators.
• When the indicators has
changed colors you know the
article is sterile.
Using Sterile Technique
Principles of Sterile Technique
1.
Only Sterile Items Are Used Within
the Sterile Field.
2. Gowns Are Considered Sterile Only
from the Waist to Shoulder Level in
Front and the Sleeves.
3. Tables Are Sterile Only at Table
Level.
4. Persons Who Are Sterile Touch
Only Sterile Items or Areas;
5. Persons Who Are Not Sterile Touch
Only Unsterile Items or Areas.
6. Edges of Anything That Encloses
Sterile Contents Are Considered
Unsterile.
7. Sterile Field Is Created as Close as
Possible to Time of Use.
8. Sterile Areas Are Continuously
Kept in View.
9. Sterile Persons keep Well within
the Sterile Area.
10. Sterile Persons Keep Contact with
Sterile Areas to a Minimum.
11. When working in a sterile field
never turn your back on the field.
Opening Sterile Packages
1. Place in center of work area
2. Reaching around (not over it!), pinch 1st flap on
outside of wrapper.
3. Repeat for side flaps
4. Pull the 4th flap toward you grasping the turned
down corner.
5. Establish a sterile field using a drape- pluck the back
of the drape & allow it to open freely without
touching anything.
7. Lay drape across a clean, dry surface without
reaching over it.
8. Use sterile forceps to handle sterile supplies.
Drop Method
Putting on Sterile Surgical
Gloves
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Preparation for putting on surgical gloves
Gloves are cuffed to make it easier to put them on without contaminating them.
When putting on sterile gloves, remember that the first glove should be picked
up by the cuff only. The second glove should then be touched only by the other
sterile glove.
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Step 1
Prepare a large, clean, dry area for opening the package of gloves. Either open
the outer glove package and then perform a surgical scrub or perform a
surgical scrub and ask someone else to open the package of gloves for you.
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Step 2
Open the inner glove wrapper, exposing the cuffed gloves with the palms up.
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Step 3
Pick up the first glove by the cuff, touching only the inside portion of the cuff
(the inside is the side that will be touching your skin when the glove is on).
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Step 4
While holding the cuff in one hand, slip your other hand into the glove.
(Pointing the fingers of the glove toward the floor will keep the fingers open.)
Be careful not to touch anything, and hold the gloves above your waist level.
• NOTE: If the first glove is not fitted correctly, wait to
make any adjustment until the second glove is on.
Then use the sterile fingers of one glove to adjust the
sterile portion of the other glove.
• Step 5
Pick up the second glove by sliding the fingers of the
gloved hand under the cuff of the second glove. Be
careful not to contaminate the gloved hand with the
ungloved hand as the second glove is being put on.
• Step 6
Put the second glove on the ungloved hand by
maintaining a steady pull through the cuff.
• Step 7
Adjust the glove fingers until the gloves fit comfortably.
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Donning & removing isolation garments *
Applying the sterile dressing
1. Loosen the tape on the patient's
existing dressing.
2. Put on sterile gloves.
3. Remove the dressing, using forceps, if
required.
4. Place the used dressing and forceps in
a plastic bag.
5. Does the wound require cleaning?
6. Clean the wound with a sterile
applicator using a circular motion
beginning at the center of the wound
and extending outward.
7. Place the used applicator's) in a plastic
bag.
• Caution: Do not touch the wound site
with a used applicator's).
8. Observe the wound for complications.
• Examples: Discoloration, edema,
purulent drainage
Sterile Dressing Change
1. Gather the following:
PPE
Dressing Supplies
Equipment
2. Make the necessary arrangements to maintain privacy during the
procedure.
Note: Dressing changes should take place in the examination room.
3. Explain the procedure to the patient.
4. Position the dressing set on the table.
5. Wash your hands with antiseptic solution.
6. Open the dressing set without touching the contents.
7. Leave the dressing set on the open wrapper.
Reason: The wrapper provides a sterile environment for the dressing set.
8. Open the sterile supplies and pour the necessary solutions
Applying the sterile dressing
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Apply the sterile dressing.
Remove your gloves and place them in a
plastic bag.
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Tape the new dressing in place.
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Double-bag the contaminated articles
closing each bag securely.
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Place these bags inside a red plastic bag
outside of the room.
6.
Wash your hands using the proper
technique.
7.
Clean up the treatment room and complete
the charge tickets for materials used.
8.
Document the following in the patient's
record:
Name of person performing the procedure
Time of procedure
Description of the wound
Example: Absence or presence of edema,
discoloration, and/or drainage
Patient's reaction to dressing change.
9. Report any unusual findings to the physician.
Isolation
• Goal: Prevent
transmission of
microorganisms
from infected or
colonized patients
to other patients,
hospital visitors,
and healthcare
workers.
Types of Isolation
• Airborne
• Droplet
• Contact Transmission
Airborne Precautions
•Designed to prevent airborne
transmission of droplet nuclei
or dust particles containing
infectious agents
• •For patient with documented
or suspected:
• •Measles
• •Tuberculosis (primary
orlanryngeal)
• •Varicella(airborne + contact)
• •Zoster (disseminated
orimmunocompromisedpatient;
(airborne and contact)
• •SARS (Contact+airborne)
Airborne Precautions
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Room:
•Negative pressure
•Private
•Door kept closed
•Mask
•Orange ‘duckbill’
mask required to
enter room
Droplet Precautions
•Designed to prevent droplet (larger
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particle) transmission of infectious
agents when the patient talks,
coughs, or sneezes
•For documented or suspected:
•Adenovirus (droplet+contact)
•Group A steppharyngitis,
neumonia, scarlerfever (in infants,
young children)
•H. Influenzameningitis, epiglottitis
•Infleunza, Mumps, Rubella
•Meningococcal infections
•Used to prevent transmission of
epidemiologically important
organisms from an infected or
colonized patient through
direct (touching patient) or indirect
(touching surfaces or objects in
the patient’s environment) contact.
For suspected or documented:
• Adenovirus (contact + droplet)
• Infectious diarrhea in
diapered/incontinent patients
• Group A strep wound infections
• MDR bacteria (MRSA,VRE)
• Viral conjunctivitis
• Lice, scabies
• RSV infection
• Varicella (Contact + airborne)
• Zoster (disseminated or
immunocompromised; contact +
airbrone
• SARS (Contact + airborne)
Contact
Precautions