Unit 13

1. Unit 13 Infection Control

2. Objectives • Spell and define terms. • Explain the principles of medical asepsis. • Explain the components of standard precautions.

3. Objectives • List the types of personal protective equipment. • Describe nursing assistant actions related to standard precautions.

4. Objectives • Describe airborne precautions. • Describe droplet precautions. • Describe contact precautions.

5. Disease Prevention • In the last unit, you learned what infections are and some of their causes • In this unit • You will learn actions and procedures that can help prevent the transmission of infection to protect yourself, your coworkers, and those in your care

6. Medical Asepsis • Asepsis • Absence of disease-producing microorganisms

7. Medical Asepsis • Medical asepsis • Reducing the numbers of disease-producing microorganisms • Or interrupting transmission from one person to another person or from a person to a place or an object

8. Handwashing • Single most important health procedure any individual can perform to prevent the spread of microbes

9. Handwashing • Vigorous, short rubbing together of all the surfaces of soap-lathered hands • Followed by rinsing under a stream of running warm water • Handwashing should take at least 15 seconds

10. Waterless Hand Cleaners • Many facilities provide dispensers containing waterless hand cleaners in various locations

11. Waterless Hand Cleaners • Hand cleaners • Alcohol-based gel, lotion, or foam that is dispensed in small dime- to quarter-sized portions • Alcohol products may be used to clean your hands for most routine care

12. Using Alcohol Hand Cleaner • Wash at the sink if: • Hands are soiled with a protein substance • Patient is known or suspected of having a disease caused by spores

13. Hand Lotion and Cream • Maintaining the integrity of the skin on your hands • Very important to prevent injury and exposure to microbes

14. Hand Lotion and Cream • Hand care products • Use products from individual, personal size packages, or from a pump dispenser or squeeze bottle, but don’t touch the spout • Avoid products in a jar

15. Protecting Yourself • As you perform your duties, you may contact potentially infectious material • Blood or other body fluids, that may contain pathogens

16. Standard Precautions • Infection control actions used for all people receiving care • Regardless of their condition or diagnosis

17. Standard Precautions • Previously called Universal Precautions • Assumes blood and body fluid of any patient could be infectious

18. Standard Precautions • Recommends PPE and other infection control practices to prevent transmission in any healthcare setting • Decisions about PPE use determined by type of clinical interaction with patient

19. PPE for Standard Precautions (1) • Gloves • Use when touching blood, body fluids, secretions, excretions, contaminated items • For touching mucus membranes and nonintact skin

20. PPE for Standard Precautions (1) • Gowns • Use when in contact with clothing, exposed skin with blood/body fluids, secretions, or excretions

21. PPE for Standard Precautions (2) • Mask and goggles or a face shield • Used during patient care activities likely to generate splashes or sprays of blood, body fluids, secretions, or excretions

22. Transmission-Based Precautions • Standard precautions do not eliminate the need for other isolation precautions • A second set of precautions is used with certain highly transmissible diseases • Second tier of precautions is called transmission-based precautions

23. Four Isolation Techniques • Isolation techniqueis the name given to the method of caring for patients with easily transmitted diseases • Essential that every person take responsibility and use the proper isolation techniques to prevent the spread of disease to others

24. Four Isolation Techniques 3. All items that come into contact with a patient’s excretions, secretions, blood, body fluids, mucous membranes, or nonintact skin are considered contaminated. Infectious material must be treated in a special way.

25. Isolation Technique 4. Standard precautions are always used in addition to transmission-based precautions

26. Isolation Unit • May be an area or a private room • Patients with the same disease may share a room • A room with handwashing facilities and an adjoining room with bathing and toilet facilities is best

27. AII (A2) Rooms • Rooms with a special air handling system may be called A2 rooms • These rooms have negative pressure • Air flow in which air from the room is vented directly to the outside • Or filtered so pathogens cannot escape

28. AII (A2) Rooms • Ventilation is needed for airborne precautions • A HEPA respirator or NIOSH-approved mask • Must always be worn when entering an airborne precautions room

29. Ultraviolet Germicidal Irradiation (UVGI) • Ultraviolet Germicidal Irradiation (UVGI) lights • Used to eliminate pathogens in some isolation rooms

30. Ultraviolet Germicidal Irradiation (UVGI) • UVGI lights • Used intermittently as a secondary measure to kill or inactivate the pathogens in the upper portion of the room or passing through the air duct

31. Ultraviolet Germicidal Irradiation (UVGI) • Lights are not on all the time • Not a threat to the patient or health care workers

32. The Anteroom • Used to enter some isolation rooms • Is a small room inside the entrance to the patient room • It contains a sink and containers for trash disposal

33. The Anteroom • Reduces escape of infectious organisms when the door is opened and closed • It serves as a buffer between the changes in air pressure in the patient room and the hallway • Refer to Figure 13-11

34. The Anteroom

35. Additional Respiratory Precautions • CDC recommends: • Teaching new admissions and those who accompany them to use respiratory precautions • Notifying staff if symptoms of a respiratory infection are present when they first register for care

36. Additional Respiratory Precautions • Other respiratory precautions are: • Practicing respiratory hygiene/cough etiquette • Containing secretions • Covering the nose and mouth when coughing or sneezing

37. Additional Respiratory Precautions • Other respiratory precautions are: • Using tissues to contain respiratory secretions • Discarding the tissues in the nearest trash can after use

38. Additional Respiratory Precautions • Other respiratory precautions are: • Performing hand hygiene after contact with respiratory secretions and/or contaminated objects and/or materials • Using alcohol hand cleaner from dispensers mounted in public areas

39. Preparing for Isolation • To prepare a patient room for isolation, do the following: • Indicate type of isolation precautions on the door to the patient’s room • Place an isolation cart next to the door • Provide PPE (personal protective equipment) as needed

40. Preparing for Isolation • To prepare a patient room for isolation, do the following: • Line wastepaper basket inside the room with a plastic bag labeled or color-coded for infectious waste • Place a laundry hamper in the room • Line it with a yellow biohazard laundry bag

41. Preparing for Isolation • To prepare a patient room for isolation, do the following: • At the sink, check the supply of paper towels and soap • Soap should be in a wall dispenser or foot-operated dispenser

42. Personal Protective Equipment • Personal protective equipment includes: • Gloves, gown, mask, and goggles or face shield • Regular eyeglasses do not provide adequate protection

43. Personal Protective Equipment • Eye protection must also protect the sides of the eyes • A mask may be worn without eye protection • But eye protection should never be worn without a mask

44. Selecting PPE • For maximum protection, select the appropriate PPE based upon: • Type of anticipated exposure • Whether you expect only touch, or if splashes, sprays, or large volumes of blood or body fluid, secretions, or excretions may be present

45. Selecting PPE • For maximum protection, select the appropriate PPE based upon: • Durability and appropriateness of the PPE for the task • How well the PPE fits you

46. Key Points About PPE • Don before contact with the patient, generally before entering the room • Use carefully • Don’t spread contamination

47. Key Points About PPE • Remove and discard carefully • Either at the doorway or immediately outside patient room • Remove respirator outside room • Immediately perform hand hygiene

48. Sequence for Applying Personal Protective Equipment • Wash hands • Gown • Mask or respirator • Goggles or face shield • Gloves

49. How to Don a Gown • Select appropriate type and size • Opening is in the back • Secure at neck and waist • If gown is too small, use two gowns • Gown #1 ties in front • Gown #2 ties in back

50. How to Don a Mask • Place over nose, mouth, and chin • Fit flexible nose piece over nose bridge • Secure on head with ties or elastic • Adjust to fit