Lancaster High SchoolShelly Carpenter

Chapter 14 Preventing Infection

Objectives

□ Define the key terms listed in this chapter □ Identify what microbes need to live and grow □ List the signs and symptoms of infection □ Explain the chain of infection □ Describe nosocomial infection and the persons at

risk □ Describe the practices of medical asepsis □ Describe disinfection and sterilization methods □ Explain how to care for equipment and supplies □ Explain Standard and Transmission-Based

Precautions and the Bloodborne Pathogen Standard

□ Explain the principles and practices of surgical asepsis

□ Perform the procedures described in this chapter

APPLICATION Defining Infection

INTRODUCTION

□Infection is a major safety and health hazard.

□Infants, older persons, and disabled persons are at great risk.

□The health team protects patients, residents, visitors, and themselves from infection.

MICROORGANISMS

□A microorganism (microbe) □microscopic plant or animal □Microbes are everywhere.

□pathogens. =harmful and cause infections

□non-pathogens =do not usually cause infection

Microbes □TYPES

□Bacteria □a form of plant life that multiplies rapidly

(often called germs).

□Fungi □plants that live on other plants or animals□mushrooms, yeasts, and molds

□Protozoa □one-celled animals.

□Rickettsiae □found in fleas, lice, ticks, and other insects. □spread to humans by insect bites.

□Viruses □Grow in living cells. □Cause many diseases.

MICROBES

□Requirements □reservoir (host) to live and grow.

□People□Plants□Animals□Soil□food and water

□oxygen □warm and dark environment

□grow best at body temperature.

□destroyed by heat and light.

MICROBES

□Normal flora □microbes that live and grow in a

certain area. □in or on a natural

reservoir=nonpathogens. □transmitted from its natural site to

another site or host=pathogen.

MultiDrug-Resistant Organisms

□Resist the effects of anitibiotics□Microbes Change in structure thus

harder to kill□Caused by

□prescribing antibiotics when they aren’t necessary.

□Improper use of antibiotics-not taking the complete dose prescribed.

Common types of MDRO

□Methicillin-resistant Staphylococcus aureus (MRSA)□Commonly called “staph”□Normally found in the nose and on

skin□Causes wound and bloodstream

infections and pneumonia

Common types of MDRO

□Vancomycin rsistant Enterococcus (VRE)□Normally in intestines and feces□Transmitted by

□contaminated hands□toilet seats□care equipment□other contaminated items

□Causes □urinary tract □wound □pelvic

INFECTION

□ a disease resulting from invasion and growth of microbes in the body. □local infection

□occurs in a body part.

□systemic infection□involves the whole body.

Focus on older persons: infection

□ The immune system protects the body from disease and infection.

□ Changes occur in the immune system with aging.

□ When an older person has an infection: □ may not show the signs and symptoms in chapter □ Confusion and delirium may occur (Chapter 35). □ can become life threatening before

signs/symptoms appear. □ be alert to minor changes in behavior or

condition. □ Report concerns to the nurse at once.

APPLICATIONOn the paper given, recall aseptic practices used in your daily activities to

help prevent infection and the spread of microbes.

CHAIN OF INFECTIONCHAIN OF INFECTION

Source

Portal of entry

Transmission

Portal of exit

Reservoir

The Chain of Infection

□Process needing- □Source

□A pathogen

□Reservoir □where the pathogen can grow and

multiply □Humans□animals

□no signs and symptoms of infection indicates carriers.

The chain of infection

□Portal of exit □the pathogen must leave the

reservoir□respiratory □GI □urinary and reproductive tracts □breaks in the skin

□blood

The chain of infection

□Method of transmission □Direct contact

□=contact with infectious substance□ex. Hepatitis B

□Airborne=through air to the host who inhales it

□ex. tB

□Droplet=from infected person into mouth, nose, eyes

□doesn’t remain in the air□fall to an object either inanimate or animate

The Chain of Infection Method of transmission

□Common vehicle-food, fluid, equipment, medication contaminated with pathogen□ex. Salmonella

□Animal transmission-bite from infected animal□can harbor pathogen that only harms

human not the animal□Mosquitoes=malaria□deer ticks=lyme diease□mosquitoes=west nile virus

The chain of infection

□Portal of entry□how the pathogen enters the body □Portals of entry and exit are the

same. □needs Susceptible host (a person at

risk for infection)

The chain of infection

□factors influencing how a host receives an infection□age□gender□another disease that decreases the

immune system□heredity□nutrition□lifestyle□vaccinations

Nosocomial infection

□ an infection acquired during a stay in a health agency.

□ caused by normal flora or microbes transmitted to the person from another source.

□ can enter through equipment used □ Staff can transfer microbes □ Common sites

□ The urinary system □ The respiratory system □ Wounds □ The bloodstream

Hospital Aquired infection

□most common to occur=bacterial□staphylococcus aureus□pseudomonas aerginasa ( is

resistant to antibiotic therapy)□vancomycin resistant enterococci

Hospital Aquired infection

□prevented by: □Medical asepsis □Surgical asepsis □Isolation Precautions

□Bloodborne Pathogen Standard

How do we prevent the spread of Infection?

MEDICAL ASEPSIS

□Asepsis □free of disease-producing microbes. □Medical asepsis (clean technique) is

the practices used to: □Remove or destroy pathogens □Prevent their spread from one person

or place to another person or place

Common Aseptic Practices

□ Washing hands □ After urinating or after a bowel movement □ After changing tampons or sanitary pads □ After contact with your own or another person’s

blood, body fluids, secretions, or excretions □ After coughing, sneezing, or blowing your nose □ Before and after handling, preparing, or eating food

□ Cover your nose and mouth when coughing, sneezing, or blowing your nose.

□ Bathe, wash hair, and brush your teeth regularly.

□ Wash fruits and raw vegetables before eating or serving them.

□ Wash cooking and eating utensils with soap and water after use.

Hand HygieneHand Hygiene

□Hand hygiene □easiest and the most important way

to prevent the spread of infection.

□DONE before and after giving care.

□rules of hand hygiene□SEE TEXT

Hand Washing Hand Washing

□See procedure in the book.□Demonstrate and practice

Surgical Asepsis

□Surgical asepsis□keeps equipment and supplies free of

microbes. □Also called sterile technique

□Sterile means the absence of all microbes (pathogens and non-pathogens).

□Sterilization is the process that destroys all microbes (pathogens and non-pathogens).

□Contamination is the process of becoming unclean.

□A sterile item or area is contaminated when pathogens or non-pathogens are present.

ISOLATION PRECAUTIONS

□Blood, body fluids, secretions, and excretions can transmit pathogens

□Barriers to prevent spread □Isolation Precautions

□prevent the spread of communicable or contagious diseases.

□based on clean and dirty □Clean areas or objects are free of pathogens. □Dirty areas or objects are contaminated with

pathogens. □also depend on how the pathogen is spread.

ISOLATION PRECAUTIONS

□CDC guidelines for two types of Isolation Precautions □Standard Precautions □Transmission-Based Precautions

ISOLATION PRECAUTIONS: standard precautions

□reduce the risk of spreading pathogens and known and unknown infections.

□used in the care of all persons. □prevent the spread of infection from:

□Blood □All body fluids, secretions, and excretions

(except sweat), even if blood is not visible □Non-intact skin □Mucous membranes

ISOLATION PRECAUTIONSTransmission-Based

Precautions □must understand how certain

infections are spread to apply□Airborne, Droplet, Direct contact□Airborne

□Closed door□Private room□Respiratory mask□Pt to wear mask if moved from the

room□Standard precautions

ISOLATION PRECAUTIONS Transmission-Based

Precautions □Droplet

□Private room□Standard precautions□Mask if within three feet of the pt□Pt to wear a mask if transported

ISOLATION PRECAUTIONS Transmission-Based

Precautions□Direct contact

□Microbes from indirect and direct□Private room□Standard precautions□Use of mask, gloves and gown□Removal of equipment before leaving

the room

Protective measures

□Agency policies may differ from those in this text.

□wearing gloves, a gown, a mask, or protective eyewear.

□Removing items from the room may require double-bagging.

□Special measures are needed to collect specimens and to transport persons.

PURPOSE OF GLOVES

□Protect you from pathogens in the person’s blood, body fluids, secretions, and excretions

□Protect the person from microbes on your hands

PROTECTIVE MEASURESRULES FOR USING GLOVES

□ easier to put on when your hands are dry□ a new pair for every person. □ Remove and discard torn, cut, or punctured gloves at

once. □ Practice hand hygiene, and put on a new pair.

□ Wear gloves once; discard them after use. □ Put on clean gloves before touching mucous

membranes or non-intact skin. □ Put on new gloves when become contaminated

□ Change gloves when moving from a contaminated body site to a clean body site.

□ cover your wrists. □ cover the cuffs of a gown □ Remove so the inside part is on the outside. □ Decontaminate hands after removing gloves.

Removing Gloves

□ Demonstrate the procedure for removing gloves.

□Have each student practice and perform a return demonstration of the procedure.

Masks and respiratory protection

**prevent the spread of microbes from the respiratory tract.

□used for Airborne and Droplet Precautions.

□disposable. □A wet or moist mask is contaminated. □fits snuggly over your nose and mouth. □hand hygiene before putting on a mask. □To remove touch only the ties.

Protective apparel Wearing a Gown

□ Gowns, plastic aprons, shoe covers, boots, and leg coverings □ prevent the spread of microbes. □ also protect against splashes and sprays.

□ must completely cover clothing. □ opens at the back. □ tied at the neck and waist. □ inside and neck are clean. □ outside and waist strings are contaminated. □ used once. □ Disposable gowns are discarded after use.

APPLICATION

□Donning and Removing a Gown, mask, and gloves

□Demonstrate the procedure for donning and removing a gown.

Protective apparelEYE PROTECTION

□Eyewear and face shields □Goggles and face shields protect

your eyes, mouth, and nose from splashing or spraying of blood, body fluids, secretions, or excretions.

Protective apparelEYE PROTECTION

□protect your eyes, mouth, and nose from splashing or spraying of blood, body fluids, secretions, or excretions.

□Discard disposable eyewear after use.

□Reusable eyewear is cleaned before reuse.

Bagging items

□Contaminated items are bagged to remove them from the person’s room. □Leak-proof □labeled with the “BIOHAZARD”

symbol. □Melt-away bags are common. □Tie the bag securely. □Double-bagging is not needed unless

the outside of the bag is soiled.

Bagging items Double Bagging

□See text for procedure

Meeting basic needs

□Patient Rights □How do you promote these rights

for persons on Isolation Precautions ?

□How do you meet the person’s love, belonging, and self-esteem needs ?

□How do you meet the special needs of children and older persons?

Meeting basic needs

the pathogen is undesirable, not the person.

□respect, kindness, and dignity for all patients

□Provide reading matter. □Provide hobby materials if possible. □Place a clock in the room. □Encourage to phone family and friends. □Provide a current TV program guide. □Organize your work so you can visit□Say “hello” from the doorway often.

Meeting basic needs

□Focus on children: Isolation Precautions □Infants and children do not understand

isolation. □Eyewear, masks, and gowns may scare them. □Parents and staff look different. □toys and comfort items may be kept from

the child. □prepares the child and family for isolation. □Simple explanations □the child is given PPE to play □Show your face before putting on a mask

and eyewear. □Say “Hello” to the child, and state your

name.

Meeting basic needs

□Focus on older persons: Isolation Precautions □Let persons see your face. □State your name and tell what you

are doing

BLOODBORNE PATHOGEN STANDARD

□a regulation of OSHA □intended to protect the health

team from exposure to blood borne pathogens

□Blood borne pathogens□Those found or spread through

blood□human immunodeficiency virus (HIV) □hepatitis B virus (HBV)

□See Box 14-7

BLOODBORNE PATHOGEN STANDARD: Exposure control

plan□must have an exposure control plan.

□identifies staff at risk for occupational exposure to blood or OPIM.

□actions to take for an exposure incident. □receive free training:

□At the beginning of employment and yearly □For new or changed procedures and tasks

involving exposure to blood-borne pathogens

BLOODBORNE PATHOGEN STANDARD

□ Training□ An explanation of the standard and where to get a

copy □ The causes, signs, and symptoms of blood-borne

diseases □ How blood-borne pathogens are spread □ explanation of the exposure control plan and

where to get a copy □ How to know which tasks might cause exposure □ use and limits of safe work practices, engineering

controls, and personal protective equipment □ Information on the hepatitis B vaccination □ Who to contact and what to do in an emergency □ reporting an exposure incident, post-exposure

evaluation, and follow-up □ warning labels and color-coding

Preventive Measures

□reduce the risk of exposure. □Hepatitis B vaccination

□vaccination involves three injections □receive within 10 working days of hire □The agency pays for the vaccination. □You can refuse the vaccination

Preventive Measures

□Engineering and work practice controls □reduce exposure risk in the workplace.

□Work Practice controls□Tasks or procedures to prevent spread of or

exposure to BBP□PPE□handwashing

□Engineering controls□Equipment used to reduce the risk of exposure

□Sharps containers□Special needles

Surgical Asepsis

Sterile Gloving

□See procedure in book