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Isolation Class 10 . Last Class. Preventing the spread of infection. What do we do when a client has a highly infectious disease?. Specific Infection Control Policies. Isolation – the principle is to create a physical barrier that prevents the transfer of microorganisms.

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Presentation Transcript
preventing the spread of infection
Preventing the spread of infection
  • What do we do when a client has a highly infectious disease?
specific infection control policies
Specific Infection Control Policies
  • Isolation – the principle is to create a physical barrier that prevents the transfer of microorganisms.
what are appropriate barriers depending on
What are appropriate barriers? Depending on -
  • Organism Transmission
    • Airborne
    • Vehicle
    • Contact
      • Direct
      • Indirect
      • Droplet
types of barriers
Types of Barriers
  • PPE (personal protective equipment)
    • Gowns
    • Gloves
    • Masks
    • Eyewear
what about when we don t know
What about when we don’t know?
  • 3 systems
    • Universal precautions
    • Body substance precautions
    • Standard precautions
precautions to guard against the unknown
Precautions to guard against the unknown
  • Apply to everyone
  • General public
  • May or may not carry an infection
history lesson
History Lesson
  • Initially concerned with patient to patient
  • Followed by concern for health care professionals
  • 1970 – Hepatitis B
  • 1987 – HIV
    • Universal precautions by Center for Disease Control (CDC)
universal precautions
Universal precautions

Stated :

All blood & body flds should be treated as potentially infectious.

body substance isolation bsi
Body Substance Isolation (BSI)
  • Infection control practitioners in Seattle and SanDiego
  • Canada adopted policy but renamed it Body Substance Precautions (BSP)
standard precautions
Standard Precautions
  • 1996- newest guidelines by CDC combined the major features of universal precautions & BSP
2 tier system
2 Tier System
  • 1996 CDC new guidelines
1 st tier standard precautions
1st Tier – Standard Precautions
  • Most important
  • Universal precautions + BSP
  • Applies to everyone
  • Primary strategies for prevention of infection
  • Standard precautions
    • Blood, body flds., nonintact skin, mucus membranes
2 nd tier
2nd Tier
  • Specific infections/diagnosis
  • Droplet, airborne, contact with contaminated surface
3 types transmission based precautions
3 Types Transmission Based Precautions
  • Airborne, droplet, contact
  • Some infections combination (chicken pox)
  • These extra precautions are in addition to Standard Precautions
airborne
Airborne
  • Travels on small particles
  • Air currents
  • Portal of entry – nose, mouth, mucus membranes
    • Measles, chicken pox, TB
requirements for airborne
Requirements for Airborne
  • Negative pressure room – door closed
  • TB = HEPA filter
  • Do not enter if not immune to measles/chickenpox
  • Client wears mask when required to leave room
droplet
Droplet
  • Large droplets of moisture
  • Coughing, sneezing, talking
    • Travels 3 ft. or less
    • Enters nose / mouth
    • Mumps, pertusis, influenza
  • Private room
  • Staff regular mask for 3 ft.
  • Client mask for transport
contact
Contact
  • Dry skin to dry skin = Direct
  • Dry skin to object = Indirect
  • Impetigo, herpes zoster, scabies
  • Gloves – for direct care or touching anything in the room
  • Private room or semi if cohort has same diagnosis
slide21
Remove gloves prior to exiting and wash hands
  • Gown for
    • patient contact
    • Changing linen
    • Handling objects in the room
slide22
Remove gown prior to exiting
  • Wash hands
  • Careful clothing does not touch room surfaces
protective isolation reverse isolation
Protective Isolation / Reverse isolation
  • Compromised or suppressed immune system
  • Highly susceptible to infections
  • Protection from environmental pathogens
protective isolation reverse isolation24
Protective Isolation / Reverse isolation

What do you need ?

  • Private room – door closed
  • Gown, mask, gloves if direct contact
  • Wash hands
  • No plants / flowers
procedure
Procedure
  • Before instituting
    • EXPLAIN to client & family
      • Disease
      • Purpose of isolation
      • Steps to follow
      • Time frame
room preparation
Room Preparation
  • Private with BR facilities
  • Sign on door
  • Isolation cart outside door
  • Laundry hamper in room
  • Waste basket with plastic bag
  • Thermometer, B/P cuff, stethoscope in room
  • Sharps receptacle
slide27
Be organized
  • Gather equipment prior to entering room
  • Remove rings and wash hands
  • Don PPE
  • Gown usually disposable
  • Gloves up over cuff of gown
slide28
Put your watch in a plastic bag if no clock in room
  • Linen is placed in a water soluble bag & then cream/yellow bag
  • No special treatment for dishes / trays
exiting room
Exiting Room
  • Untie gown at waist
  • Remove gloves properly
  • Remove mask
  • Untie gown at neck, drop over shoulders, don’t touch outside, fold inwards, and discard
exiting room30
Exiting Room
  • Wash hands
  • Use paper towel on door handle
  • Wash hands again outside room

Important to do as much client care as you can while you are in the room….CLUSTER ACTIVITY.

basic principles
Basic Principles
  • Wash hands prior to entering & exiting room
  • Careful disposal of contaminated materials
  • Knowledge of disease and mode of transmission
  • Protection of client and public during transport
client consideration
Client Consideration
  • Isolation
  • Loneliness
  • Self – esteem, body image
  • Boredom
sterile technique surgical asepsis
Sterile Technique / Surgical Asepsis

Purpose – to eliminate all microorganisms from objects that come into contact with the tissues of the body that are normally sterile.

practice areas
Practice Areas
  • Operating room
  • Labor and delivery
  • Major diagnostic area
  • At the bedside in 3 main situations
    • Procedures requiring intentional perforation of the skin
slide35
When the skin’s integrity is broken due to surgery or burns
  • During procedures involving insertion of devices into normally sterile body cavities
slide36
Any break in technique could result in contamination increasing clients risk for infection.
methods of sterilization
Methods of Sterilization
  • Steam – most common
  • Dry heat
  • Ethylene oxide gas
  • Chemicals
  • Indicator of sterility –
    • tape on pkg. turns color or forms lines
    • Expiration Date
examples of sterilization processes
Moist heat /steam

Radiation

Autoclave- instruments, parental solutions, dressings

Drugs, foods, heat sensitive items

Examples of sterilization processes
examples of sterilization processes39
Chemicals

All types microorganisms

Rapid action

Work with water

Stable in heat & light

Inexpensive

Not harmful to body tissue

Instruments

Glass thermometers

Ex. Chlorine – used to disinfect water & for housekeeping purposes

Examples of sterilization processes
examples of sterilization processes40
Ethylene oxide gas

Destroys microorganisms by altering cells’ metabolic processes.

Rubber

Plastic

Examples of sterilization processes
examples of sterilization processes41
Boiling water

Cheap

Imp. – bacterial spores andsome viruses resist boiling. Not used in hospitals!

Items should be boiled for at least 15 min.

Examples of sterilization processes
practical exam
Practical Exam
  • Prepare a sterile field
  • Add an item
  • Add a liquid
  • Don sterile gloves
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