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Infection Control






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Unit 3. Infection Control. Nurse Aide I Course. Introduction to Infection Control. Infection control is one of the most important aspects of environmental safety. Nurse aides have the responsibility to understand and follow the facility’s infection control policies and procedures.
Infection Control

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Slide 1

Unit 3

Infection Control

Nurse Aide I Course

DHSR Approved Curriculum-Unit 3

Slide 2

Introduction to Infection Control

Infection control is one of the most important aspects of environmental safety. Nurse aides have the responsibility to understand and follow the facility’s infection control policies and procedures.

This unit introduces medical asepsis, Standard Precautions and care of the resident on Transmission-Based Precautions.

DHSR Approved Curriculum-Unit 3

Slide 3

Infection

Transmission

DHSR Approved Curriculum-Unit 3

Slide 4

Objective

3.0 Apply the basic principles of infection control.

DHSR Approved Curriculum-Unit 3

Slide 5

Microorganisms (Germs)

  • Can only be seen by using a microscope

  • Surround us

    • in air

    • on our skin and in our bodies

    • in the food that we eat

    • on every surface we touch

DHSR Approved Curriculum-Unit 3

Slide 6

Microorganisms (Germs)(continued)

  • May cause

    • illness

    • infection

    • disease

  • Benefit us by maintaining a balance in our environment and in our body

DHSR Approved Curriculum-Unit 3

Slide 7

Microorganisms (Germs)(continued)

  • Require certain elements to survive:

    • oxygen – aerobic

    • no oxygen – anaerobic

    • warm temperatures

    • moisture

    • dark area to grow

DHSR Approved Curriculum-Unit 3

Slide 8

Microorganisms (Germs)(continued)

  • Require certain elements to survive (continued):

    • food

      • dead tissue – saprophytes

      • living tissue – parasites

DHSR Approved Curriculum-Unit 3

Slide 9

Body Defenses Against Microorganisms/Germs

  • External natural defenses

    • skin as mechanical barrier

    • mucous membrane

    • cilia – fine microscopic hairs in nose

    • coughing and sneezing

    • hydrochloric acid in stomach

    • tears

DHSR Approved Curriculum-Unit 3

Slide 10

Body Defenses Against Microorganisms/Germs(continued)

  • Internal natural defenses

    • phagocytes

    • inflammation

    • fever

    • immune response

DHSR Approved Curriculum-Unit 3

Slide 11

Objectives

3.1 Identify how diseases are transmitted.

3.1.1 List the six components in the chain of infection.

DHSR Approved Curriculum-Unit 3

Slide 12

Chain of Infection Causative Agent – Pathogen

  • Bacteria

  • Viruses

  • Fungi

  • Protozoa

DHSR Approved Curriculum-Unit 3

Slide 13

Chain of InfectionReservoir of the Causative Agent

  • Human with active cases of disease or those that carry disease without having symptoms

  • Animals/insects

  • Fomites

  • Environment

DHSR Approved Curriculum-Unit 3

Slide 14

Chain of InfectionPortals of Entry of Causative Agent

  • Cuts/break in skin

  • Openings in the mucous membranes

  • Respiratory system

  • Gastrointestinal system

  • Urinary system

  • Reproductive system

  • Mother to fetus

DHSR Approved Curriculum-Unit 3

Slide 15

Chain of Infection Portals of Exit of Causative Agent

  • Tears (slight risk)

  • Saliva/respiratory tract

    secretions

  • Urine

  • Feces

  • Wound drainage

  • Reproductive tract secretions

DHSR Approved Curriculum-Unit 3

Slide 16

Chain of Infection Mode of Transmission

  • Contact

    • direct – person to person

    • indirect – fomite to person

    • droplet – common cold

  • Common vehicle

    • salmonella in food

DHSR Approved Curriculum-Unit 3

Slide 17

Chain of Infection Mode of Transmission(continued)

  • Airborne

    • tuberculosis

  • Vectorborne

    • mosquito harbors malaria parasite

DHSR Approved Curriculum-Unit 3

Slide 18

Chain of Infection Host

  • The host is the individual who harbors the infectious organisms

DHSR Approved Curriculum-Unit 3

Slide 19

Medical

Asepsis

DHSR Approved Curriculum-Unit 3

Slide 20

Objectives

3.2 Define medical asepsis.

3.2.1 Identify practices the nurse aide can use to promote medical asepsis in personal life and in work setting.

DHSR Approved Curriculum-Unit 3

Slide 21

Medical Asepsis

Definition: The practice used to remove or destroy pathogens and to prevent their spread from one person or place to another person or place; clean technique

DHSR Approved Curriculum-Unit 3

Slide 22

Practices To Promote Medical Asepsis In Personal Life And Work Setting

  • Washing hands after use of bathroom

  • Washing hands prior to handling food

  • Washing fruits and vegetables before serving or consuming

DHSR Approved Curriculum-Unit 3

Slide 23

Practices To Promote Medical Asepsis In Personal Life And Work Setting(continued)

  • Covering nose and mouth prior to coughing, sneezing or blowing nose and then washing hands

DHSR Approved Curriculum-Unit 3

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Practices To Promote Medical Asepsis In Personal Life And Work Setting(continued)

  • Bathing, washing hair and brushing teeth on a regular basis

  • Washing cooking and eating utensils with soap and water after each use

DHSR Approved Curriculum-Unit 3

Slide 25

Practices To Promote Medical Asepsis In Personal Life And Work Setting(continued)

  • Following sanitation practices

    • Proper disposal of garbage

    • Proper disposal of waste materials

DHSR Approved Curriculum-Unit 3

Slide 26

Practices To Promote Medical Asepsis In Personal Life And Work Setting(continued)

  • Washing hands before and after caring for each resident

  • Using approved waterless hand cleaner

  • Washing resident’s hands before meals

DHSR Approved Curriculum-Unit 3

Slide 27

Practices To Promote Medical Asepsis In Personal Life And Work Setting(continued)

  • Cleaning resident’s unit

  • Cleaning all reusable equipment after use

DHSR Approved Curriculum-Unit 3

Slide 28

Objectives

3.2.2 Discuss the methods used to kill or control microorganisms.

3.2.3 Observe basic cleaning, disinfecting and sterilizing tasks.

DHSR Approved Curriculum-Unit 3

Slide 29

Methods To Kill Or Control Microorganisms

  • boil small items in water for 15 minutes

  • use chemical disinfectants for cleaning supplies and equipment

  • Disinfection (kills most microorganisms but not spores)

DHSR Approved Curriculum-Unit 3

Slide 30

Methods To Kill Or Control Microorganisms(continued)

  • Sterilization

    • kills all microorganisms, including spores

    • autoclave – steam under pressure

    • other methods

DHSR Approved Curriculum-Unit 3

Slide 31

Methods To Kill Or Control Microorganisms(continued)

  • Care of supplies and equipment

    • Central supply

    • Disposable equipment used once and discarded in proper manner

DHSR Approved Curriculum-Unit 3

Slide 32

Methods To Kill Or Control Microorganisms(continued)Care of supplies and equipment

  • Cleaning non-disposable equipment

    • Rinse in cold water to remove organic material

    • Wash with soap and hot water

    • Scrub with a brush if necessary

    • Rinse and dry equipment

    • Sterilize or disinfect equipment

DHSR Approved Curriculum-Unit 3

Slide 33

Objective

3.2.4 Discuss other aseptic measures to prevent the spread of infection.

DHSR Approved Curriculum-Unit 3

Slide 34

Methods To Kill Or Control Microorganisms(continued)

  • Other aseptic measures

    • Hold equipment and supplies away from uniform

    • Avoid shaking linen

    • Damp dust furniture

    • Clean from cleanest area to the most soiled area

DHSR Approved Curriculum-Unit 3

Slide 35

Direct cleaning away from your body and uniform

Pour contaminated liquids into sinks or toilets; do not splash

Other aseptic measures (continued)

Methods To Kill Or Control Microorganisms(continued)

DHSR Approved Curriculum-Unit 3

Slide 36

Methods To Kill Or Control Microorganisms(continued)

  • Do not sit on resident’s bed

  • Do not transport equipment from one resident’s room to another without cleaning

  • Other aseptic measures (continued)

DHSR Approved Curriculum-Unit 3

Slide 37

Bloodborne

Pathogens

DHSR Approved Curriculum-Unit 3

Slide 38

Objective

3.3 Describe HIV and HBV as two examples of blood borne diseases.

DHSR Approved Curriculum-Unit 3

Slide 39

Human Immunodeficiency Virus (HIV)

  • Persons infected with HIV may carry virus without developing symptoms for several years

  • HIV infected persons will eventually develop AIDS (Acquired Immune Deficiency Syndrome)

DHSR Approved Curriculum-Unit 3

Slide 40

Human Immunodeficiency Virus (HIV)(continued)

  • Persons infected with HIV may develop AIDS-related illnesses including neurological problems, cancer, and other opportunistic infections

  • Persons infected with HIV may suffer flu-like symptoms, fever, diarrhea, weight loss and fatigue

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Slide 41

Brain of persons infected with HIV may be affected, causing confusion, memory loss, depression or motor dysfunction

Although drugs may delay symptoms, there is no known cure for AIDS

Human Immunodeficiency Virus (HIV)(continued)

DHSR Approved Curriculum-Unit 3

Slide 42

Hepatitis B Virus (HBV)

  • About one third of persons infected do not show symptoms

  • Another one third have mild flu-like symptoms which go away

  • The last one third experience abdominal pain, nausea and fatigue; skin and eyes jaundiced and urine dark

DHSR Approved Curriculum-Unit 3

Slide 43

HBV preventable with use of HBV vaccine

Six to ten percent of HBV infected persons become chronic carriers (may or may not have active infection, few or no symptoms, but can transmit disease)

Hepatitis B Virus (HBV)(continued)

DHSR Approved Curriculum-Unit 3

Slide 44

Objective

3.3.1 Describe the modes of transmission of HIV and HBV.

DHSR Approved Curriculum-Unit 3

Slide 45

Bloodborne PathogensModes of Transmission

  • Sexual contact

  • Sharing contaminated needles

  • Receiving blood transfusions

  • Pregnant mother to unborn baby

  • Nursing mother to baby through breast milk (for HIV, not HBV)

DHSR Approved Curriculum-Unit 3

Slide 46

Bloodborne PathogensModes of Transmission(continued)

  • Puncture wounds from sharps

  • Mucous membrane contact

  • Contact of infectious substances (urine, feces, saliva) with non-intact skin

  • Contaminated surfaces (for HBV, not HIV)

DHSR Approved Curriculum-Unit 3

Slide 47

Objective

3.3.2 Identify the critical elements in the Exposure Control Plan.

DHSR Approved Curriculum-Unit 3

Slide 48

Exposure

Control

Plan

Bloodborne PathogensExposure Control Plan

  • Copy must be available at workplace

  • Mandated by OSHA

  • Identifies employees at risk of exposure by tasks performed

DHSR Approved Curriculum-Unit 3

Slide 49

Exposure

Control

Plan

Bloodborne PathogensExposure Control Plan(continued)

  • Specific measures to decrease risk to exposure

    • Administrative controls

    • Work practice controls

    • Engineering controls

    • Housekeeping

    • HBV vaccine

DHSR Approved Curriculum-Unit 3

Slide 50

Exposure

Control

Plan

Bloodborne PathogensExposure Control Plan(continued)

  • Post-exposure evaluation and follow-up

    • Wash the area immediately

    • Complete a facility incident report

    • Follow procedures for testing and treatment

DHSR Approved Curriculum-Unit 3

Slide 51

Standard

Precautions

DHSR Approved Curriculum-Unit 3

Slide 52

Objective

3.4 Demonstrate an understanding of the principles of Standard Precautions.

DHSR Approved Curriculum-Unit 3

Slide 53

Standard Precautions

  • Standard Precautions – CDC procedures to control and prevent infections.

  • Contains two tiers of precautions:

    • Standard

    • Transmission-Based

  • Standard precautions are used for the care of all residents

DHSR Approved Curriculum-Unit 3

Slide 54

Standard PrecautionsHANDWASHING

  • Handwashing

    • After touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn

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Standard PrecautionsHANDWASHING(continued)

  • Handwashing (continued)

    • Immediately after gloves are removed, between resident contacts, and when otherwise indicated to prevent transfer of microorganisms to other residents or environments

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Slide 56

Standard PrecautionsHANDWASHING(continued)

  • Handwashing (continued)

    • Between tasks and procedures on the same resident to prevent cross-contamination of different body sites

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Slide 57

Standard PrecautionsGLOVES

  • Wear gloves (clean, nonsterile gloves) when:

    • touching blood, body fluids, secretions, excretions, and contaminated items

    • before touching mucous membranes and non-intact skin

DHSR Approved Curriculum-Unit 3

Slide 58

Standard PrecautionsGLOVES(continued)

  • Wear gloves (clean, nonsterile gloves) when (continued):

    • change gloves between tasks and procedures on the same resident after contact with material that may contain a high concentration of microorganisms

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Slide 59

Standard PrecautionsMASK, EYE PROTECTION, FACE SHIELD

  • Wear a mask and eye protection or a face shield:

    • to protect mucous membranes of the eyes, nose, and mouth

DHSR Approved Curriculum-Unit 3

Slide 60

Standard PrecautionsMASK, EYE PROTECTION, FACE SHIELD(continued)

  • Wear a mask and eye protection or a face shield (continued):

    • during procedures and resident care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, and excretions.

DHSR Approved Curriculum-Unit 3

Slide 61

Standard PrecautionsGOWN

  • Wear a gown:

    • during procedures and resident care activities that are likely to generate splashes of blood, body fluids, secretions or excretions

    • remove soiled gown as soon as possible and wash hands

DHSR Approved Curriculum-Unit 3

Slide 62

Standard PrecautionsMULTIPLE-USE RESIDENT CARE EQUIPMENT

  • Commonly used equipment or supplies (stethoscope, etc.) must be cleaned and disinfected after use or when soiled

  • Single-use equipment is preferred and must be discarded properly

DHSR Approved Curriculum-Unit 3

Slide 63

Standard PrecautionsLINEN

  • Handle, transport, and process used linen soiled with blood, body fluids, secretions, and excretion

    • in a manner that prevents skin and mucous membrane exposures and contamination of clothing

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Slide 64

Standard PrecautionsLINEN(continued)

  • Handle, transport, and process used linen soiled with blood, body fluids, secretions, and excretion (continued):

    • in a manner that prevents transfer of microorganisms to other residents and environments

DHSR Approved Curriculum-Unit 3

Slide 65

Standard PrecautionsRESIDENT PLACEMENT

  • Place resident who contaminates environment or who does not, or cannot be expected to assist in maintaining appropriate hygiene or environmental control, in private room

DHSR Approved Curriculum-Unit 3

Slide 66

Standard PrecautionsRESIDENT PLACEMENT(continued)

  • If a private room is not available, consult with infection control professionals regarding resident placement or other alternatives

DHSR Approved Curriculum-Unit 3

Slide 67

Standard PrecautionsTRANSPORT OF INFECTED RESIDENTS

  • Appropriate barriers (masks, impervious dressings) are worn

  • Personnel in area to which resident is taken are notified of arrival and precautions to take

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Slide 68

Standard PrecautionsTRANSPORT OF INFECTED RESIDENTS(continued)

  • Inform residents in ways they can assist in prevention of transmission

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Slide 69

Transmission

Based

Precautions

DHSR Approved Curriculum-Unit 3

Slide 70

Transmission Based PrecautionsAIRBORNE PRECAUTIONS

In addition to Standard Precautions, use Airborne Precautions, or the equivalent, for resident known or suspected to be infected with microorganisms transmitted by airborne droplets that remain suspended in the air and can be widely dispersed by air currents.

DHSR Approved Curriculum-Unit 3

Slide 71

Transmission Based PrecautionsAIRBORNE PRECAUTIONS(continued)

  • RESIDENT PLACEMENT: Private room. Negative air pressure in relation to the surrounding areas. Keep doors closed at all times and resident in room.

DHSR Approved Curriculum-Unit 3

Slide 72

Transmission Based PrecautionsAIRBORNE PRECAUTIONS(continued)

  • GLOVES: Same as Standard Precautions

  • GOWN OR APRON: Same as Standard Precautions

DHSR Approved Curriculum-Unit 3

Slide 73

Transmission Based PrecautionsAIRBORNE PRECAUTIONSMask and Eyewear

  • For known or suspected pulmonary tuberculosis:

    • Mask N-95 (respirator) must be worn by all individuals prior to entering room

DHSR Approved Curriculum-Unit 3

Slide 74

Transmission Based PrecautionsAIRBORNE PRECAUTIONSMask and Eyewear(continued)

  • For known or suspected airborne viral disease (e.g., chickenpox, or measles)

    • Standard mask should be worn by any person entering the room unless the person is not susceptible to the disease

    • When possible, persons who are susceptible should not enter room

DHSR Approved Curriculum-Unit 3

Slide 75

Transmission Based PrecautionsAIRBORNE PRECAUTIONSHandwashing

  • Hands must be washed before gloving and after gloves are removed

  • Skin surfaces must be washed immediately and thoroughly when contaminated with body fluids or blood

DHSR Approved Curriculum-Unit 3

Slide 76

Transmission Based PrecautionsAIRBORNE PRECAUTIONSResident Transport

  • Limit transport of the resident for essential purposes only

  • Place a mask on the resident, if possible

DHSR Approved Curriculum-Unit 3

Slide 77

Transmission Based PrecautionsAIRBORNE PRECAUTIONSResident Care Equipment

  • When using equipment or items (stethoscope, thermometer), the equipment and items must be adequately cleaned and disinfected before use with another resident

DHSR Approved Curriculum-Unit 3

Slide 78

Transmission Based PrecautionsDROPLET PRECAUTIONS

In addition to Standard Precautions, use Droplet Precautions, or the equivalent, for a resident known or suspected to be infected with microorganisms transmitted by droplets that can be generated by the resident during coughing, sneezing, talking, or the performance of procedures that induce coughing.

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Slide 79

Transmission Based PrecautionsDROPLET PRECAUTIONS(continued)

  • RESIDENT PLACEMENT: Private room or with resident with same disease.

  • GLOVES: Must be worn when in contact with blood and body fluids.

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Slide 80

Transmission Based PrecautionsDROPLET PRECAUTIONS(continued)

  • GOWNS: Must be worn during procedures or situations where there will be exposure to body fluids, blood, draining wounds, or mucous membranes.

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Slide 81

Transmission Based PrecautionsDROPLET PRECAUTIONS(continued)

  • MASKS AND EYEWEAR:

    In addition to Standard Precautions, wear mask when working within three feet of resident (or when entering resident’s room).

DHSR Approved Curriculum-Unit 3

Slide 82

Transmission Based PrecautionsDROPLET PRECAUTIONS(continued)

  • HANDWASHING: Hands must be washed before gloving and after gloves are removed.

DHSR Approved Curriculum-Unit 3

Slide 83

Transmission Based PrecautionsDROPLET PRECAUTIONS(continued)

  • TRANSPORTING: Limit the movement and transporting of the resident from the room for essential purposes only. If necessary to move the resident, minimize resident dispersal of droplets by masking the resident, if possible.

DHSR Approved Curriculum-Unit 3

Slide 84

Transmission Based PrecautionsDROPLET PRECAUTIONS(continued)

  • RESIDENT-CARE EQUIPMENT: When using common equipment or items, they must be adequately cleaned and disinfected.

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Slide 85

Transmission Based PrecautionsCONTACT PRECAUTIONS

In addition to Standard Precautions, use Contact Precautions, or the equivalent, for specified residents known or suspected to be infected or colonized with important microorganisms.

DHSR Approved Curriculum-Unit 3

Slide 86

Transmission Based PrecautionsCONTACT PRECAUTIONS(continued)

These microorganisms can be transmitted by direct contact with the resident (hand or skin-to-skin contact that occurs when performing resident-care activities that require touching the resident’s dry skin) or indirect contact (touching) with environmental surfaces or resident-care items in the resident’s environment.

DHSR Approved Curriculum-Unit 3

Slide 87

Transmission Based PrecautionsCONTACT PRECAUTIONS(continued)

  • RESIDENT PLACEMENT: Private room (if not available, with resident with same disease).

  • GLOVES: Wear gloves when entering the room and for all contact of resident and resident items, equipment, and body fluids.

DHSR Approved Curriculum-Unit 3

Slide 88

Transmission Based PrecautionsCONTACT PRECAUTIONS(continued)

  • GOWN: Wear a gown when entering the room if it is anticipated that your clothing will have substantial contact with the resident, environmental surfaces, or items in the resident’s room.

DHSR Approved Curriculum-Unit 3

Slide 89

Transmission Based PrecautionsCONTACT PRECAUTIONS(continued)

  • MASKS AND EYEWEAR: Indicated if potential for exposure to infectious body material exists.

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Transmission Based PrecautionsCONTACT PRECAUTIONS(continued)

  • HANDWASHING: After glove removal while ensuring that hands do not touch potentially contaminated environmental surfaces or items in the resident’s room.

  • TRANSPORTING: Limit the movement and transporting of the resident.

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Slide 91

Transmission Based PrecautionsCONTACT PRECAUTIONS(continued)

  • RESIDENT-CARE EQUIPMENT: When possible, dedicate the use of non-critical resident care equipment to a single resident.

DHSR Approved Curriculum-Unit 3

Slide 92

Handwashing

DHSR Approved Curriculum-Unit 3

Slide 93

Objective

3.5 Identify the reasons for washing hands.

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Slide 94

HANDWASHING

  • REASONS FOR WASHING HANDS

    • Everything you touch contains germs

    • Prevents cross contamination

    • Washes away many germs on skin

    • Protects residents from infection when hands are washed before and after care and during care, as needed

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Slide 95

Washing hands is

one of the

the most effective ways

to control infection.

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Slide 96

Demonstration

and

Return

Demonstration

DHSR Approved Curriculum-Unit 3

Slide 97

Objective

3.6 Demonstrate proper technique for washing hands.

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Slide 98

Objective

3.7 Demonstrate proper procedure for putting on and taking off a face mask and protective eyewear.

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Objective

3.8 Demonstrate procedure for putting on and taking off gown and gloves.

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Objective

3.9 Demonstrate procedure for putting on and taking off gloves.

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Slide 101

Objective

3.10 Demonstrate procedure for disposing of equipment from unit with Transmission-Based Precautions.

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Slide 102

Specimen

Objective

3.11 Demonstrate procedure of collecting specimen under Transmission-Based Precautions.

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Slide 103

Infection Control

Programs

DHSR Approved Curriculum-Unit 3

Slide 104

Objective

3.12 List three purposes of Quality Assurance Programs as related to Infection Control.

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Slide 105

Quality Assurance andInfection Control

  • Purpose of Infection Control Programs

    • Prevent cross infection

    • Prevent re-infection

    • Environmental control

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Slide 106

Quality Assurance andInfection Control(continued)

  • Role of the Quality Assurance Committee

    • Reviews infections

    • Recommends policies and procedures to prevent infections

    • Made up of members from all disciplines

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Slide 107

Infection Control

Program

Quality Assurance andInfection Control(continued)

  • Role of the Quality Assurance Committee

    • Monitors infection control program

    • All facilities required to have Infection Control Program as part of Quality Assurance Committee

DHSR Approved Curriculum-Unit 3

Slide 108

The

End

DHSR Approved Curriculum-Unit 3


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