Download - Lancaster High School Shelly Carpenter
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Lancaster High SchoolShelly Carpenter
Chapter 14 Preventing Infection
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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
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APPLICATION Defining Infection
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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.
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MICROORGANISMS
□A microorganism (microbe) □microscopic plant or animal □Microbes are everywhere.
□pathogens. =harmful and cause infections
□non-pathogens =do not usually cause infection
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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.
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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.
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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.
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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.
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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
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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
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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.
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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.
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APPLICATIONOn the paper given, recall aseptic practices used in your daily activities to
help prevent infection and the spread of microbes.
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CHAIN OF INFECTIONCHAIN OF INFECTION
Source
Portal of entry
Transmission
Portal of exit
Reservoir
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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.
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The chain of infection
□Portal of exit □the pathogen must leave the
reservoir□respiratory □GI □urinary and reproductive tracts □breaks in the skin
□blood
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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
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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
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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)
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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
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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
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Hospital Aquired infection
□most common to occur=bacterial□staphylococcus aureus□pseudomonas aerginasa ( is
resistant to antibiotic therapy)□vancomycin resistant enterococci
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Hospital Aquired infection
□prevented by: □Medical asepsis □Surgical asepsis □Isolation Precautions
□Bloodborne Pathogen Standard
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How do we prevent the spread of Infection?
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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
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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.
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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
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Hand Washing Hand Washing
□See procedure in the book.□Demonstrate and practice
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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.
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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.
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ISOLATION PRECAUTIONS
□CDC guidelines for two types of Isolation Precautions □Standard Precautions □Transmission-Based Precautions
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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
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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
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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
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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
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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.
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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
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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.
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Removing Gloves
□ Demonstrate the procedure for removing gloves.
□Have each student practice and perform a return demonstration of the procedure.
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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.
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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.
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APPLICATION
□Donning and Removing a Gown, mask, and gloves
□Demonstrate the procedure for donning and removing a gown.
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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.
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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.
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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.
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Bagging items Double Bagging
□See text for procedure
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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?
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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.
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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.
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Meeting basic needs
□Focus on older persons: Isolation Precautions □Let persons see your face. □State your name and tell what you
are doing
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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
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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
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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
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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
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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
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Surgical Asepsis
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Sterile Gloving
□See procedure in book
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