© 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-1 Infection Control Techniques PowerPoint® presentation to accompany: Medical Assisting.
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20-1
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
Infection Control TechniquesInfection Control Techniques
PowerPoint® presentation to accompany:
Medical AssistingThird Edition
Booth, Whicker, Wyman, Pugh, Thompson
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-2
Learning Outcomes
20.1 Describe the medical assistant’s role in infection control.
20.2 Describe methods of infection control.
20.3 Compare and contrast medical and surgical asepsis.
20.4 Describe how to perform aseptic hand washing.
20.5 Compare and contrast the procedures for sanitization, disinfection, and sterilization.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-3
Learning Outcomes (cont.)
20.6 Describe measures used in sanitization.
20.7 List various methods used in disinfection and the advantages and disadvantages of each.
20.8 Discuss the goal of surgical asepsis.
20.9 Explain what an autoclave is and how it operates.
20.10 List the steps in the general autoclave procedures.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-4
Learning Outcomes (cont.)
20.11 Explain how to wrap and label items for sterilization in an autoclave.
20.12 Describe how to complete the sterilization procedure using an autoclave.
20.13 Define the Blood-Borne Pathogens Standard and Universal Precautions as described in the rules and regulations of the Occupational Safety and Health Administration (OSHA).
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-5
Learning Outcomes (cont.)
20.14 Explain the role of Universal Precautions in the duties of a medical assistant.
20.15 List the procedures and legal requirements for disposing of hazardous waste.
20.16 Describe Centers for Disease Control and Prevention (CDC) requirements for reporting cases of infectious disease.
20.17 Discuss the need for specific guidelines for isolating patients in health-care settings.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-6
Learning Outcomes (cont.)
20.18 Describe the appropriate use of personal protective equipment in various situations.
20.29 Explain the purpose of immunization.
20.20 Describe your role in educating patients about immunizations.
20.21 Explain how to educate patients in preventing disease transmission.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-7
Introduction
Patients coming to the office for treatment may be more susceptible to infections
Immunizations and patient education are important methods of infection control
You will be introduced to OSHA guidelines, the Blood-Borne Pathogen Standard, reporting
guidelines, and isolation procedures.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-8
MA’s Role in Infection Control
To control infectious diseases, the cycle of infection must be broken
Apply principles of infection control in office setting
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-9
MA’s Role in Infection Control (cont.)
Follow correct sanitization, disinfection, and sterilization procedures
Help patients understand basic disease prevention
Educate patients about immunizations
Administer immunizations
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-10
Apply Your Knowledge
What is your role as a medical assistant in control of infection in the medical office?
ANSWER: To apply principles of infection control by following correct sanitization, disinfection, and sterilization procedures.
Correct!
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-11
Infection Control Measures
Eliminate elements needed for disease to occur
Knowledge of Medical asepsis
Based on cleanliness As few microorganisms as possible
Surgical asepsis Sterile environment No microorganisms
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-12
Medical Asepsis
Keep office clean: Reception area: sick vs. well patients Reception room clean, well lit, and
ventilated Keep furniture in good repair Strict “no food or drink” policy Empty trash as necessary
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-13
Medical Asepsis (cont.)
During medical assistant procedures Prevent cross-contamination
Hand washing Beginning of day After breaks Before and after each patient Before and after handling equipment or specimens After blowing your nose or coughing
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-14
Medical Asepsis (cont.)
Other precautions Avoid leaning against sinks, supplies, equipment Avoid touching your face and mouth Use tissues when you cough or sneeze, and
always wash your hands afterward Avoid working directly with patients when you
have a cold; wear gloves and mask if you must Stay home if you have a fever
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-15
Apply Your Knowledge
Describe the difference between medical and surgical asepsis.
ANSWER: Medical asepsis is based on cleanliness and reducing the number of microorganisms as much as possible. Surgical asepsis is maintaining a sterile environment by eliminating all microorganisms.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-16
Sanitization
Scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow
For cleaning items that touch only healthy, intact skin
OR First step in disinfection and
sterilization for other equipment
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-17
Sanitization (cont.)
Collect items for sanitization Place in water and special
detergent solution Use utility gloves Separate sharps from other
equipment
Scrub items Follow manufacturers’ guidelines Dry thoroughly Examine carefully
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-18
Sanitization (cont.)
Rubber and plastic items Syringes and needles
Use disposable whenever possible Ultrasonic cleaning
For delicate instruments and those with moving parts
Sound waves generated through a cleaning solution to loosen contaminants
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-19
Apply Your Knowledge
What is sanitation, and what types of items is it adequate for cleaning?
ANSWER: Sanitation is scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow. It is adequate for cleaning items that touch only healthy, intact skin.
Nice Job!
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-20
Disinfection
Adequate for instruments that do not penetrate skin or mucus membranes and surfaces not considered sterile
OR Second step in infection control prior to
sterilization Will not kill spores, certain viruses
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-21
Disinfection (cont.)
Using disinfectants Cleaning products applied to
inanimate materials to reduce or eliminate infectious organisms
Antiseptics are anti-infective cleaning agents used on human tissue
Follow manufacturers’ guidelines
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-22
Disinfection (cont.)
Factors impacting effectiveness of disinfectants
Number of times solution is used Wet items – surface moisture may
dilute solution Traces of soap left from sanitization
– alters chemical composition Evaporation
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-23
Disinfection (cont.)
Choose the correct disinfectant Germicidal soap products Alcohol Acid products Formaldehyde Glutaraldehyde – “cold disinfection” Bleach Iodine and iodine compounds
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-24
Disinfection (cont.)
Handling disinfected supplies Prevent contamination with other
surfaces
Use sterile transfer forceps
Wear gloves
Store in clean, moisture-free environment
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-25
Apply Your Knowledge
What is the difference between a disinfectant and an antiseptic?
ANTISEPTIC: Disinfectants are cleaning products applied to inanimate materials to reduce or eliminate infectious organisms. Antiseptics are anti-infective cleaning agents used on human tissue.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-26
Surgical Asepsis
Goal is to keep the surgical environment completely free of all microorganisms
Used for even minor operations and injections
The more extensive the procedure, the greater the risk of infection
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-27
Sterilization
Required for all instruments or supplies that Penetrate the skin Contact normally sterile areas of the body
Object is either sterile or not sterile If unsure of sterility, consider it not sterile
Prior to sterilization Sanitize Disinfect
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-28
Sterilization: The Autoclave
Primary method of sterilization Pressurized steam
Operates at lower temperatures than dry heat sterilization
Moisture causes coagulation of proteins in microorganisms at lower temperatures
Cell walls burst when cell cools, killing the microorganism
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20-29
Sterilization: The Autoclave (cont.)
Wrap sanitized and disinfected items Special porous fabric, paper, or
plastic Items should not touch Label
Check water level – distilled water only
Preheat, but do not overheat
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20-30
Sterilization: The Autoclave (cont.)
Load, choose correct setting, run cycle Temperature 250° to 270° F
Pressure 15 to 30 pounds
Unload
Store items properly Clean, dry location
Shelf life based on packaging, but generally 30 days
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-31
Sterilization: The Autoclave (cont.)
Clean autoclave and area Quality control checks
Sterilization indicators – confirm that items have been exposed to correct volume of steam at the correct temperature for the correct length of time
Biological indicators – contain bacterial spores and confirm that sterilization occurs
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-32
Sterilization: The Autoclave (cont.)
Prevent incomplete sterilization Correct timing Adequate temperature Properly wrapped packs Adequate steam levels
Timing Preset for load types Use sterilization indicators
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-33
Sterilization: The Autoclave (cont.)
Temperature Too high – steam too little moisture Too low – steam too much moisture
Do not overcrowd autoclave
Steam level If incorrect, items will not be sterile at end of
cycle
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-34
Sterilization: Sterile Technique
Surgical scrub
During surgical procedures Do not touch sterile items without
sterile gloves or transfer forceps Aseptic technique
Throughout surgical procedures Caring for surgical wounds
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-35
Sterilization: Surgical Asepsis
After procedures Sanitize, disinfect, and sterilize reusable items Disinfect surfaces
Waste disposal Biohazard waste containers
Leak-proof containers either color-coded red or labeled with biohazard symbol
Biohazardous waste Biological agents that can spread disease
to living things
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-36
Apply Your Knowledge
ANSWER: Sterilization is required for all instruments or supplies that penetrate the skin or come in contact with normally sterile areas of the body.
What items need to be sterilized?
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-37
Apply Your Knowledge
ANSWER: Use medical asepsis while preparing the patient, and then use surgical asepsis during the procedure.
The physician is going to remove a small growth from your patient’s back. In order to prepare for this procedure, what steps would you take to prevent the spread of infection?
Right!
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-38
OSHA Guidelines
Blood-Borne Pathogen Standards Protect health-care workers from health hazards
on the job Also protect patients and others who come to
medical facilities Dictate how to handle infectious or potentially
infectious wastes Discarded Held for processing
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-39
OSHA Guidelines (cont.)
Blood-Borne Pathogen Standards Measures to prevent the spread of
infection Provide a margin of safety by
ensuring that medical facilities meet minimal standards for asepsis
Requirements for training, keeping records, housekeeping, and personal protective gear
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-40
OSHA Guidelines (cont.)
Universal Precautions Prevent health-care workers from exposure to
infections Assume that all blood and blood and body
fluids are infected with blood-borne pathogens Standard Precautions
Combination of Universal Precautions and Body Substance Isolation guidelines
Used in hospitals to prevent transmission of disease
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-41
OSHA Guidelines (cont.)
Categories of tasksI. Tasks that expose a worker to blood, body
fluids, or tissues and require specific protective measures
II. Tasks that usually do not involve risk of exposure but require precautions in certain situations
III. Tasks that have no risk of exposure, so no special protection is required
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-42
OSHA Guidelines (cont.)
Personal Protective Equipment Protective gear worn to protect
against physical hazards Employers must provide PPE at no
charge to the employee Disposable, sterile exam and utility
gloves Masks and protective eyewear or face
shields Protective clothing
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-43
OSHA Guidelines (cont.)
Postprocedure Cleanup Decontaminate all
exposed surfaces
Replace protective coverings on surfaces or equipment
Decontaminate receptacles
Pick up any broken glass with tongs
Discard all potentially infectious waste materials
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-44
OSHA Guidelines (cont.)
Apply guidelines daily on the job
Exposure incidents Contact with infectious substance Rules apply to all serious infections – HIV, HBV HBV vaccine
Transmission to patients Nosocomial infection – an infection acquired by a
patient in a health-care facility
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-45
Apply Your Knowledge
ANSWER: There are three categories of risk:Category 1: Expose a worker to blood, body fluids, or tissues and
require specific protective measuresCategory 2: Usually do not involve risk of exposure, but
precautions are required in certain situationsCategory 3: No risk of exposure, so no special protection is
required
OSHA divides medical tasks by level of risk. What are these risk categories?
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-46
Reporting Guidelines
Certain diseases must be reported to state or county health department
Information is forwarded to the CDC – control of the spread of infection
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-47
Reporting Guidelines (cont.)
National Notifiable Disease Surveillance System (Table 20-2)
Examples HIV/AIDS Cholera Rubella Hepatitis Legionellosis Lyme disease Mumps Smallpox Tetanus Tuberculosis
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-48
Apply Your Knowledge
How is the information on reportable diseases used by the CDC?
ANSWER: The CDC uses the information reported to them to help control the spread of infection.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-49
Isolation Guidelines
CDC guidelines Types of precautions needed Patients requiring precautions
Create an environment that protects against pathogens
Standard Precautions
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20-50
Isolation Guidelines (cont.)
PPE Select appropriate PPE for mode of
transmission Gloves Masks, face shields,
respirators Gowns
Table 20-3
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-51
Apply Your Knowledge
Mrs. Findley brings her child with chickenpox into the medical office. What type of personal protective equipment should you use when caring for this child?
ANSWER: Chickenpox requires airborne and contact precautions, so you should use gloves and a mask and goggles or a respirator.
Nice!
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-52
Immunizations
Immunization Administration of a vaccine or
toxoid to protect susceptible individuals from infectious diseases
Reduces risk of infection spread Decreases the susceptibility of
the host
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20-53
Immunizations: Recommendations
Immunization schedules for children Advisory Committee on Immunization Practices American Academy of Pediatrics American Academy of Family Physicians
Immunization schedules for adults The National Coalition of Adult Immunization
(NCAI)
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-54
Immunizations (cont.)
When administering. you must explain The need for immunization Side effects
Soreness at site Low-grade fever General malaise
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20-55
Immunizations (cont.)
Concerns Pediatric patients
Do not give if child has fever
Informed consent Explain benefits and risks
Contraindications Symptoms that render the use of a remedy or
procedure inadvisable because of the risk
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-56
Immunization records National Childhood Vaccine Injury Act of 1988 Instruct parents keep record as proof of
immunization
Pregnant patients Avoid live virus vaccines FDA categories A, B, C, D, and X
Elderly More likely to develop side effects
Immunizations (cont.)
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-57
Immunizations (cont.)
Immunocompromised patients May experience minimal to dangerous effects Adjust dosage or delay administration Must also consider immunization status of family
and caregivers
Health-care workers Hepatitis B vaccination
offered by employer at nocost to employee
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-58
Apply Your Knowledge
What is an immunization?
ANSWER: An immunization is the administration of a vaccine or toxoid to protect susceptible individuals from infectious diseases.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-59
Preventing Disease Transmission
Patient education Health promotion Disease prevention Disease treatment
Medical Assistant role in patient education Share responsibility Reinforce and explain instructions
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20-60
Preventing Disease Transmission (cont.)
Educate patient on Nutrition and diet Exercise and weight control Prevention of STDs Smoking cessation Alcohol and drug abuse prevention and treatment Proper use of medications and prescribed
treatments Stress-reduction techniques
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-61
Goal of patient education Help patients take care of
themselves
Encourage patients to participate actively in their own health care
Preventing Disease Transmission (cont.)
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-62
Apply Your Knowledge
What three areas should patient education focus on? What is the medical assistant’s role in patient education?
ANSWER: Patient education should focus on health promotion, disease prevention, and disease treatment.
The medical assistant shares responsibility with the physician and other staff members and should reinforce and explain instructions given by others.
Bravo!
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-63
In Summary
Medical Assistant Sanitization, disinfection, and sterilization break the cycle of infection by ridding instruments and equipment of pathogens.
The medical assistant plays a vital role in reducing patient vulnerability by encouraging patients to maintain a correct
immunization status and by being aware of special immunization concerns of certain patients.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
20-64
Soap and education are not as sudden as a massacre, but they are more deadly in the long run.
~ Mark Twain
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