Lancaster High School Shelly Carpenter

1. Lancaster High SchoolShelly Carpenter Chapter 14 Preventing Infection

2. 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

3. APPLICATION Defining Infection

4. 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.

5. MICROORGANISMS • A microorganism (microbe) • microscopic plant or animal • Microbes are everywhere. • pathogens. =harmful and cause infections • non-pathogens =do not usually cause infection

6. 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.

7. 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.

8. 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.

9. 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.

10. 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

11. 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

12. 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.

13. 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.

14. APPLICATIONOn the paper given, recall aseptic practices used in your daily activities to help prevent infection and the spread of microbes.

15. CHAIN OF INFECTION

16. 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.

17. The chain of infection • Portal of exit • the pathogen must leave the reservoir • respiratory • GI • urinary and reproductive tracts • breaks in the skin • blood

18. 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

19. 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

20. 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)

21. 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

22. 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

23. Hospital Aquired infection • most common to occur=bacterial • staphylococcus aureus • pseudomonas aerginasa ( is resistant to antibiotic therapy) • vancomycin resistant enterococci

24. Hospital Aquired infection • prevented by: • Medical asepsis • Surgical asepsis • Isolation Precautions • Bloodborne Pathogen Standard

25. How do we prevent the spread of Infection?

26. 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

27. 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.

28. Hand 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

29. Hand Washing • See procedure in the book. • Demonstrate and practice

30. 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.

31. 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.

32. ISOLATION PRECAUTIONS • CDC guidelines for two types of Isolation Precautions • Standard Precautions • Transmission-Based Precautions

33. 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

34. 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

35. 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

36. 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

37. 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.

38. 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

39. 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.

40. Removing Gloves • Demonstrate the procedure for removing gloves. • Have each student practice and perform a return demonstration of the procedure.

41. 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.

42. 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.

43. APPLICATION • Donning and Removing a Gown, mask, and gloves • Demonstrate the procedure for donning and removing a gown.

44. 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.

45. 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.

46. 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.

47. Bagging items Double Bagging • See text for procedure

48. 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?

49. 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.

50. 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.