Introduction to Infection Control

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DHSR Approved Curriculum-Unit 3. 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. .
Introduction to Infection Control

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1. DHSR Approved Curriculum-Unit 3 1

2. DHSR Approved Curriculum-Unit 3 2

3. DHSR Approved Curriculum-Unit 3 3

4. DHSR Approved Curriculum-Unit 3 4 3.0 Apply the basic principles of infection control.

5. DHSR Approved Curriculum-Unit 3 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

6. DHSR Approved Curriculum-Unit 3 6 Microorganisms (Germs) (continued) May cause illness infection disease Benefit us by maintaining a balance in our environment and in our body

7. DHSR Approved Curriculum-Unit 3 7 Microorganisms (Germs) (continued) Require certain elements to survive: oxygen ? aerobic no oxygen ? anaerobic warm temperatures moisture dark area to grow

8. DHSR Approved Curriculum-Unit 3 8 Microorganisms (Germs) (continued) Require certain elements to survive (continued): food dead tissue ? saprophytes living tissue ? parasites

9. DHSR Approved Curriculum-Unit 3 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

10. DHSR Approved Curriculum-Unit 3 10 Body Defenses Against Microorganisms/Germs (continued) Internal natural defenses phagocytes inflammation fever immune response

11. DHSR Approved Curriculum-Unit 3 11 3.1 Identify how diseases are transmitted. 3.1.1 List the six components in the chain of infection.

12. DHSR Approved Curriculum-Unit 3 12 Chain of Infection Causative Agent ? Pathogen Bacteria Viruses Fungi Protozoa

13. DHSR Approved Curriculum-Unit 3 13 Chain of Infection Reservoir of the Causative Agent Human with active cases of disease or those that carry disease without having symptoms Animals/insects Fomites Environment

14. DHSR Approved Curriculum-Unit 3 14 Chain of Infection Portals 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

15. DHSR Approved Curriculum-Unit 3 15 Chain of Infection Portals of Exit of Causative Agent Tears (slight risk) Saliva/respiratory tract secretions Urine Feces Wound drainage Reproductive tract secretions

16. DHSR Approved Curriculum-Unit 3 16 Chain of Infection Mode of Transmission Contact direct ? person to person indirect ? fomite to person droplet ? common cold Common vehicle salmonella in food

17. DHSR Approved Curriculum-Unit 3 17 Chain of Infection Mode of Transmission (continued) Airborne tuberculosis Vectorborne mosquito harbors malaria parasite

18. DHSR Approved Curriculum-Unit 3 18 Chain of Infection Host The host is the individual who harbors the infectious organisms

19. DHSR Approved Curriculum-Unit 3 19

20. DHSR Approved Curriculum-Unit 3 20 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.

21. DHSR Approved Curriculum-Unit 3 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

22. DHSR Approved Curriculum-Unit 3 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

23. DHSR Approved Curriculum-Unit 3 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

24. DHSR Approved Curriculum-Unit 3 24 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

25. DHSR Approved Curriculum-Unit 3 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

26. DHSR Approved Curriculum-Unit 3 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

27. DHSR Approved Curriculum-Unit 3 27 Practices To Promote Medical Asepsis In Personal Life And Work Setting (continued) Cleaning resident?s unit Cleaning all reusable equipment after use

28. DHSR Approved Curriculum-Unit 3 28 3.2.2 Discuss the methods used to kill or control microorganisms. 3.2.3 Observe basic cleaning, disinfecting and sterilizing tasks.

29. DHSR Approved Curriculum-Unit 3 29 Methods To Kill Or Control Microorganisms boil small items in water for 15 minutes use chemical disinfectants for cleaning supplies and equipment

30. DHSR Approved Curriculum-Unit 3 30 Methods To Kill Or Control Microorganisms (continued) Sterilization kills all microorganisms, including spores autoclave ? steam under pressure other methods

31. DHSR Approved Curriculum-Unit 3 31 Methods To Kill Or Control Microorganisms (continued) Care of supplies and equipment Central supply Disposable equipment used once and discarded in proper manner

32. DHSR Approved Curriculum-Unit 3 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

33. DHSR Approved Curriculum-Unit 3 33 3.2.4 Discuss other aseptic measures to prevent the spread of infection.

34. DHSR Approved Curriculum-Unit 3 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

35. DHSR Approved Curriculum-Unit 3 35 Methods To Kill Or Control Microorganisms (continued) Direct cleaning away from your body and uniform Pour contaminated liquids into sinks or toilets; do not splash Other aseptic measures (continued)

36. DHSR Approved Curriculum-Unit 3 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

37. DHSR Approved Curriculum-Unit 3 37

38. DHSR Approved Curriculum-Unit 3 38 3.3 Describe HIV and HBV as two examples of blood borne diseases.

39. DHSR Approved Curriculum-Unit 3 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)

40. DHSR Approved Curriculum-Unit 3 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

41. DHSR Approved Curriculum-Unit 3 41 Human Immunodeficiency Virus (HIV) (continued) 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

42. DHSR Approved Curriculum-Unit 3 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

43. DHSR Approved Curriculum-Unit 3 43 Hepatitis B Virus (HBV) (continued) 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)

44. DHSR Approved Curriculum-Unit 3 44 3.3.1 Describe the modes of transmission of HIV and HBV.

45. DHSR Approved Curriculum-Unit 3 45 Bloodborne Pathogens Modes 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)

46. DHSR Approved Curriculum-Unit 3 46 Bloodborne Pathogens Modes 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)

47. DHSR Approved Curriculum-Unit 3 47 3.3.2 Identify the critical elements in the Exposure Control Plan.

48. DHSR Approved Curriculum-Unit 3 48 Bloodborne Pathogens Exposure Control Plan Copy must be available at workplace Mandated by OSHA Identifies employees at risk of exposure by tasks performed

49. DHSR Approved Curriculum-Unit 3 49 Bloodborne Pathogens Exposure Control Plan (continued) Specific measures to decrease risk to exposure Administrative controls Work practice controls Engineering controls Housekeeping HBV vaccine

50. DHSR Approved Curriculum-Unit 3 50 Bloodborne Pathogens Exposure Control Plan (continued) Post-exposure evaluation and follow-up Wash the area immediately Complete a facility incident report Follow procedures for testing and treatment

51. DHSR Approved Curriculum-Unit 3 51

52. DHSR Approved Curriculum-Unit 3 52 3.4 Demonstrate an understanding of the principles of Standard Precautions.

53. DHSR Approved Curriculum-Unit 3 53 Standard Precautions Standard Precautions ? CDC procedures to control and prevent infections. Contains two tiers of precautions: Standard Transmission-Based

54. DHSR Approved Curriculum-Unit 3 54 Standard Precautions HANDWASHING Handwashing After touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn

55. DHSR Approved Curriculum-Unit 3 55 Standard Precautions HANDWASHING (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

56. DHSR Approved Curriculum-Unit 3 56 Standard Precautions HANDWASHING (continued) Handwashing (continued) Between tasks and procedures on the same resident to prevent cross-contamination of different body sites

57. DHSR Approved Curriculum-Unit 3 57 Standard Precautions GLOVES Wear gloves (clean, nonsterile gloves) when: touching blood, body fluids, secretions, excretions, and contaminated items before touching mucous membranes and non-intact skin

58. DHSR Approved Curriculum-Unit 3 58 Standard Precautions GLOVES (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

59. DHSR Approved Curriculum-Unit 3 59 Standard Precautions MASK, EYE PROTECTION, FACE SHIELD Wear a mask and eye protection or a face shield: to protect mucous membranes of the eyes, nose, and mouth

60. DHSR Approved Curriculum-Unit 3 60 Standard Precautions MASK, 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.

61. DHSR Approved Curriculum-Unit 3 61 Standard Precautions GOWN 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

62. DHSR Approved Curriculum-Unit 3 62 Standard Precautions MULTIPLE-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

63. DHSR Approved Curriculum-Unit 3 63 Standard Precautions LINEN 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

64. DHSR Approved Curriculum-Unit 3 64 Standard Precautions LINEN (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

65. DHSR Approved Curriculum-Unit 3 65 Standard Precautions RESIDENT 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

66. DHSR Approved Curriculum-Unit 3 66 Standard Precautions RESIDENT PLACEMENT (continued)

67. DHSR Approved Curriculum-Unit 3 67 Standard Precautions TRANSPORT 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

68. DHSR Approved Curriculum-Unit 3 68 Standard Precautions TRANSPORT OF INFECTED RESIDENTS (continued) Inform residents in ways they can assist in prevention of transmission

69. DHSR Approved Curriculum-Unit 3 69

70. DHSR Approved Curriculum-Unit 3 70 Transmission Based Precautions AIRBORNE 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.

71. DHSR Approved Curriculum-Unit 3 71 Transmission Based Precautions AIRBORNE 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.

72. DHSR Approved Curriculum-Unit 3 72 Transmission Based Precautions AIRBORNE PRECAUTIONS (continued) GLOVES: Same as Standard Precautions GOWN OR APRON: Same as Standard Precautions

73. DHSR Approved Curriculum-Unit 3 73 Transmission Based Precautions AIRBORNE PRECAUTIONS Mask and Eyewear For known or suspected pulmonary tuberculosis: Mask N-95 (respirator) must be worn by all individuals prior to entering room

74. DHSR Approved Curriculum-Unit 3 74 Transmission Based Precautions AIRBORNE PRECAUTIONS Mask 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

75. DHSR Approved Curriculum-Unit 3 75 Transmission Based Precautions AIRBORNE PRECAUTIONS Handwashing 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

76. DHSR Approved Curriculum-Unit 3 76 Transmission Based Precautions AIRBORNE PRECAUTIONS Resident Transport Limit transport of the resident for essential purposes only Place a mask on the resident, if possible

77. DHSR Approved Curriculum-Unit 3 77 Transmission Based Precautions AIRBORNE PRECAUTIONS Resident Care Equipment When using equipment or items (stethoscope, thermometer), the equipment and items must be adequately cleaned and disinfected before use with another resident

78. DHSR Approved Curriculum-Unit 3 78 Transmission Based Precautions DROPLET 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.

79. DHSR Approved Curriculum-Unit 3 79 Transmission Based Precautions DROPLET PRECAUTIONS (continued) RESIDENT PLACEMENT: Private room or with resident with same disease. GLOVES: Must be worn when in contact with blood and body fluids.

80. DHSR Approved Curriculum-Unit 3 80 Transmission Based Precautions DROPLET PRECAUTIONS (continued) GOWNS: Must be worn during procedures or situations where there will be exposure to body fluids, blood, draining wounds, or mucous membranes.

81. DHSR Approved Curriculum-Unit 3 81 Transmission Based Precautions DROPLET 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).

82. DHSR Approved Curriculum-Unit 3 82 Transmission Based Precautions DROPLET PRECAUTIONS (continued) HANDWASHING: Hands must be washed before gloving and after gloves are removed.

83. DHSR Approved Curriculum-Unit 3 83 Transmission Based Precautions DROPLET 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.

84. DHSR Approved Curriculum-Unit 3 84 Transmission Based Precautions DROPLET PRECAUTIONS (continued) RESIDENT-CARE EQUIPMENT: When using common equipment or items, they must be adequately cleaned and disinfected.

85. DHSR Approved Curriculum-Unit 3 85 Transmission Based Precautions CONTACT 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.

86. DHSR Approved Curriculum-Unit 3 86 Transmission Based Precautions CONTACT 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.

87. DHSR Approved Curriculum-Unit 3 87 Transmission Based Precautions CONTACT 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.

88. DHSR Approved Curriculum-Unit 3 88 Transmission Based Precautions CONTACT 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.

89. DHSR Approved Curriculum-Unit 3 89 Transmission Based Precautions CONTACT PRECAUTIONS (continued) MASKS AND EYEWEAR: Indicated if potential for exposure to infectious body material exists.

90. DHSR Approved Curriculum-Unit 3 90 Transmission Based Precautions CONTACT 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.

91. DHSR Approved Curriculum-Unit 3 91 Transmission Based Precautions CONTACT PRECAUTIONS (continued) RESIDENT-CARE EQUIPMENT: When possible, dedicate the use of non-critical resident care equipment to a single resident.

92. DHSR Approved Curriculum-Unit 3 92

93. DHSR Approved Curriculum-Unit 3 93 3.5 Identify the reasons for washing hands.

94. DHSR Approved Curriculum-Unit 3 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

95. DHSR Approved Curriculum-Unit 3 95

96. DHSR Approved Curriculum-Unit 3 96

97. DHSR Approved Curriculum-Unit 3 97 3.6 Demonstrate proper technique for washing hands.

98. DHSR Approved Curriculum-Unit 3 98 3.7 Demonstrate proper procedure for putting on and taking off a face mask and protective eyewear.

99. DHSR Approved Curriculum-Unit 3 99 3.8 Demonstrate procedure for putting on and taking off gown and gloves.

100. DHSR Approved Curriculum-Unit 3 100 3.9 Demonstrate procedure for putting on and taking off gloves.

101. DHSR Approved Curriculum-Unit 3 101 3.10 Demonstrate procedure for disposing of equipment from unit with Transmission-Based Precautions.

102. DHSR Approved Curriculum-Unit 3 102 3.11 Demonstrate procedure of collecting specimen under Transmission-Based Precautions.

103. DHSR Approved Curriculum-Unit 3 103

104. DHSR Approved Curriculum-Unit 3 104 3.12 List three purposes of Quality Assurance Programs as related to Infection Control.

105. DHSR Approved Curriculum-Unit 3 105 Quality Assurance and Infection Control Purpose of Infection Control Programs Prevent cross infection Prevent re-infection Environmental control

106. DHSR Approved Curriculum-Unit 3 106 Quality Assurance and Infection Control (continued) Role of the Quality Assurance Committee Reviews infections Recommends policies and procedures to prevent infections Made up of members from all disciplines

107. DHSR Approved Curriculum-Unit 3 107 Quality Assurance and Infection 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

108. DHSR Approved Curriculum-Unit 3 108


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