Infection Control

1. Infection Control Unit 13

2. Disease Prevention • Asepsis: absence of disease-producing microorganisms • Medical Asepsis: medical practice that reduces the numbers of microorganisms or interrupts transmission from one person to another person or from person to place or object. • Handwashing • Using nonsterile gloves when in contact with blood, moist body fluid (except sweat), secretions, excretions, mucous membranes or non-intact skin • Cleaning and/or disinfecting equipment

3. Disease Prevention • Guidelines for maintaining asepsis: • Wash and dry hands well • Wash breaks in skin immediately, clean with antiseptic & report injury to supervisor • Use gloves when necessary • Bath or shower daily • Wear clean clothing • Keep your hair clean and away from your face • Keep fingernails short and neat • Other than plain wedding band, avoid wearing rings • Assist patients with personal hygiene

4. Disease Prevention • Guidelines for maintaining asepsis: • Cover bedpans and urinals during transfers and avoid “splashes” during this time. • Avoid contaminating environmental surfaces when wearing used gloves • Use the overbed table only for clean items, such as food trays, water pitcher, and clean supplies • Keep the water pitcher covered at the bedside • Keep food and water supplies clean • Carry soiled linen away from your uniform • Dispose of soiled linen according to policy • Do not store items on floor

5. Disease Prevention • Guidelines for maintaining asepsis: • Avoid items that have been on the floor until they have been disinfected • Avoid activities that raise dust into the air • Avoid shaking linen! • Fold soiled linen inward and dispose of properly • Keep soiled linen hamper, housekeeping cart from clean linen cart and food cart by at least one room’s width • Clean from least soiled area to most soiled area • Keep work areas clean

6. Disease Prevention • Handwashing: most important measure the nursing assistant can take to prevent the spread of disease • Vigorous rubbing together of soap-lathered hands, followed by rinse in running water • Most important aspect of handwashing is friction created when the hands are rubbed together, thereby removing germs • Prevents cross-contamination between one patient and another, the equipment, and the nursing assistant • Most important measure to break the chain of infection

7. Disease Prevention • Handwashing: most important measure the nursing assistant can take to prevent the spread of disease • Should always occur before and after: • Direct patient care • Handling food • Touching a wound • Using the bathroom • Should last a minimum of 30 seconds, or longer if visibly soiled • Use soap from dispenser instead of bar soap • Alcohol-based cleaners can be used for routine handwashing, unless hands are visibly soiled

8. Protecting Yourself • Occupational Exposure Incident: contact with potentially infectious material, such as blood or body fluids containing pathogens • Occurs when eyes, mouth or non-intact skin comes in contact with potentially infectious material • If this occurs: • Rinse immediately and report the incident to your supervisor

9. Standard Precautions • Standard precautions: used in the care of ALL patients without regard for disease or diagnosis • Apply in all situations in which the nursing assistant may have contact with blood, body fluids (except sweat), secretions, excretions, mucus membranes, and non-intact skin • Involve the use of Personal Protective Equipment (PPE)

10. Standard Precautions • Guidelines: • Proper handwashing or use of alcohol-based product • Wear gloves when potential contact with blood or body fluids exist OR when the health care workers skin (on their hands) is not intact • NOTE: gloves are provided in patient care areas, but the nursing assistant should carry a pair, so they are available quickly, if needed • Get new pair of gloves for every patient, every situation • Replace gloves you keep at beginning of shift

11. Standard Precautions • Guidelines: • If sensitivity to latex exists (patient or health care worker) use non-latex gloves. • Properly dispose of gloves, according to facility policy • Waterproof gowns, or plastic aprons; goggles, masks or face shields are to be worn if possibility of splashing exists • Mask to mouth resuscitation devices should be used during CPR • Sharp objects should be carefully handled & should be disposed of in puncture-resistant container

12. Standard Precautions • Guidelines: • Blood spills should be cleaned up immediately with a disinfectant or bleach solution • Do not eat, drink, smoke, apply cosmetics or contact lenses in work areas • Do not store food/drinks in refrigerators where they may be exposed to blood or other body fluids • Do not pick up broken glass with hands – even if wearing gloves – use brush, tongs or forceps and a dust pan • All specimens are considered to be infectious

13. Transmission-Based Precautions • Transmission-based precautions: used to interrupt the mode of transmission of the causative agent • Three major categories: • Airborne precautions: negative pressure ventilation system; door to room is kept closed and caregivers must wear special N95 mask when entering room • Droplet precautions: surgical mask if working within 3 feet of patient; patient wears mask if leaving room • Contact precautions: gloves and gown are required (gloves/gowns/masks are for SINGLE USE ONLY!)

14. Transmission-Based Precautions • Isolation Techniques: methods of caring for patient with easily transmittable disease • Each person working in isolation room must take responsibility to using proper techniques to prevent the spread of infection • Isolation Unit: an area or private room used for patients who: • Are highly infectious • Have poor personal hygiene • Require special air control procedures within the room

15. Transmission-Based Precautions • Containment of contaminated articles: • Should be handled as little as possible • Fold dirtiest side inward • Do not shake linen • Bag linen before leaving the room • Keep contaminated linen separate from regular linen • Transport soiled, wet linen in leak-proof bag

16. Transmission-Based Precautions • Transporting the patient in isolation: • Notify receiving agency staff of type of precaution being used to ensure they are prepared to receive patient • If airborne or droplet precautions exists, patient is to wear a mask when out of the room • If patient is on contact precautions, infected areas should be covered • NOTE: The nursing assistant wears protective equipment in the room only – not in the hallway!

17. Disinfection & Sterilization • Disinfection: process by which chemicals are used to eliminate harmful pathogens; the nursing assistant may be required to disinfect reusable patient equipment • Sterilization: Elimination of all microorganisms from an item • Autoclave used to accomplish this process (uses steam and pressure)

18. Disinfection & Sterilization • Sterilization of equipment: is specially wrapped; indicator strips change color when the contents of the package are sterile • Sterile procedures: surgical asepsis is used when the patient care environment must be free of all microorganisms; all equipment and supplies are sterile • Sterile field: area of sterile equipment and materials; special procedures are used when working with a sterile field • 1” border • NEVER reach over sterile field • If moist or wet = contaminated

19. The End