Infection Control Techniques 2011 The McGraw-Hill Companies, Inc. All rights reserved. Learning Outcomes 10) Demonstrate mastery of concepts and skills related to asepsis, Universal Precautions, sanitation, disinfection, and sterilization for patient/client care settings in adherence to standards and guidelines from the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) in a lab/clinical setting. (TN Reading 3)
At the conclusion of todays class I CAN: Define key terms related to infection control Compare and contrast sanitation disinfection and sterilization Describe the significance of the CDC and OSHA related to workplace safety in healthcare 33 -2 Introduction Patients coming to the office for treatment may be more susceptible to infections
Immunizations and patient education are important methods of infection control You will be introduced to Occupational Safety and Health Administration (OSHA) guidelines, the Blood-Borne Pathogen Standard, reporting guidelines, and isolation procedures. 33 -3 Employees Role in Infection
Control To control infectious diseases, the cycle of infection must be broken Apply principles of infection control in workplace setting 33 -4
Employees Role in Infection Control (cont.) Follow correct sanitization, disinfection, and sterilization procedures Help patients understand basic disease prevention Educate patients about immunizations Administer immunizations 33 -5
Apply Your Knowledge What is the role of the healthcare professional in controlling infection in the medical office? ANSWER: To apply principles of infection control by following correct sanitization, disinfection, and sterilization procedures. Correct! 33 -6 Infection Control Methods Eliminate elements needed for disease to occur Knowledge of Medical asepsis
Based on cleanliness As few microorganisms as possible Surgical asepsis Sterile environment No microorganisms 33 -7 Medical Asepsis Keep work area clean: Reception area: sick vs. well patients Reception room clean, well lit, and ventilated
No sick visitors in hospital Limit visitors during cold and flu season Keep furniture in good repair Strict no food or drink policy Empty trash as necessary 33 -8 Medical Asepsis (cont.) Hand washing Beginning of day
After breaks Before and after each patient Before and after handling equipment or specimens After blowing your nose or coughing Before and after eating 33 -9 Medical Asepsis (cont.) Other precautions
Avoid leaning against sinks, supplies, equipment Avoid touching your face and mouth Use tissues when you cough or sneeze, and always wash your hands afterward Avoid working directly with patients when you have a cold; wear gloves and mask if you must Stay home if you have a fever 33 10 Apply Your Knowledge Describe the difference between medical and surgical asepsis. ANSWER: Medical asepsis is based on cleanliness and reducing the number of microorganisms as much as possible. Surgical asepsis is maintaining a sterile environment by eliminating all microorganisms.
Good Answer! 33 11 Sanitation Used to promote health and prevent disease. the process of keeping places free from dirt, infection, disease, etc., by removing waste, trash and garbage, by cleaning streets, etc. 33 12 Sanitization
Scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow For cleaning items that touch only healthy, intact skin OR First step in disinfection and sterilization for other equipment
33 13 Sanitization (cont.) Collect items for sanitization Place in water and special detergent solution Use utility gloves Separate sharps from other equipment
Scrub items Follow manufacturers guidelines Dry thoroughly Examine carefully Rubber and plastic items Syringes and needles use disposable whenever possible 33 14 Apply Your Knowledge
What is sanitation, and what types of items is it adequate for cleaning? ANSWER: Sanitation is scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow. It is adequate for cleaning items that touch only healthy, intact skin. Can also include removing trash. Nice Job! 33 15 Disinfection Adequate for instruments that do not penetrate skin or mucous membranes and
surfaces not considered sterile OR Second step in infection control prior to sterilization Will not kill spores, certain viruses 33 16 Disinfection (cont.) Using disinfectants Cleaning products
applied to inanimate materials to reduce or eliminate infectious organisms Antiseptics are antiinfective cleaning agents used on human tissue Follow manufacturers guidelines 33 17 Disinfection (cont.) Factors impacting effectiveness of
disinfectants Number of times solution is used Wet items surface moisture may dilute solution Traces of soap left from sanitization alters chemical composition Evaporation 33 18 Disinfection (cont.) Choose the correct disinfectant Germicidal soap products
other surfaces Use sterile transfer forceps Wear gloves Store in clean, moisture-free environment 33 20 Apply Your Knowledge What is the difference between a disinfectant and an antiseptic? ANSWER: Disinfectants are cleaning products applied to inanimate materials to reduce or eliminate infectious organisms. Antiseptics are anti-infective cleaning agents used on human tissue. Excellent!
33 21 Surgical Asepsis Goal is to keep the surgical environment completely free of all microorganisms Used for even minor operations and injections
Surgical includes ANYTHING that penetrates the skin The more extensive the procedure, the greater the risk of infection 33 22 Sterilization Required for all instruments or supplies that Penetrate the skin
Contact normally sterile areas of the body Object is either sterile or not sterile If unsure of sterility, consider it not sterile Prior to sterilization Sanitize Disinfect 33 23 The Autoclave
Primary method of sterilization Pressurized steam Operates at lower temperatures than dry heat sterilization Moisture causes coagulation of proteins in microorganisms at lower temperatures Cell walls burst when cell cools, killing the microorganism 33 24 The Autoclave
(cont.) Prevent incomplete sterilization Correct timing Adequate temperature Properly wrapped packs Adequate steam levels Timing Preset for load types Use sterilization indicators 33 25
The Autoclave (cont.) Temperature Too high steam too little moisture Too low steam too much moisture Do not overcrowd autoclave Steam level If incorrect, items will not be sterile at end of cycle
33 26 Sterile Technique Strict adherence to set order of procedures Sterile against sterile Clean against clean Unclean against unclean
Surgical scrub Never skimp on a surgical scrub! 33 27 Surgical Asepsis During surgical procedures Do not touch sterile items without sterile gloves or transfer forceps Aseptic technique Throughout surgical procedures
Caring for surgical wounds 33 28 Surgical Asepsis (cont.) After procedures Sanitize, disinfect, and sterilize reusable items Disinfect surfaces Waste disposal
Biohazard waste containers Leak-proof containers either color-coded red or labeled with biohazard symbol Biohazardous materials Biological agents that can spread disease to living things 33 29 Apply Your Knowledge 1. What items need to be sterilized? ANSWER: Sterilization is required for all instruments or supplies that penetrate the skin or come in contact with normally sterile areas of the body. 33 30
Apply Your Knowledge 2. The physician is going to remove a small growth from your patients back. In order to prepare for this procedure, what steps would you take to prevent the spread of infection? ANSWER: Use medical asepsis while preparing the patient, and then use surgical asepsis during the procedure. Right! 33 31 OSHA Guidelines Blood-Borne Pathogen Standards Protect health-care workers from health hazards on
the job Also protect patients and others who come to medical facilities Dictate how to handle infectious or potentially infectious wastes Discarded Held for processing Blood-borne pathogens can enter the skin through any opening, break in skin, or mucous membranes 33 32 OSHA Guidelines
(cont.) Blood-Borne Pathogen Standards Measures to prevent the spread of infection Provide a margin of safety by ensuring that medical facilities meet minimal standards for asepsis Requirements for training, keeping records, housekeeping, and personal protective gear
33 33 OSHA Guidelines (cont.) Universal Precautions Prevent health-care workers from exposure to infections Assume that all blood and body fluids are infected with blood-borne pathogens
33 34 OSHA Guidelines (cont.) Standard Precautions Combination of Universal Precautions and Body Substance Isolation guidelines Used in health-care facilities to prevent transmission of disease
33 35 OSHA Guidelines (cont.) Categories of tasks I. Tasks that expose a worker to blood, body fluids, or tissues and require specific protective measures
II. Tasks that usually do not involve risk of exposure but require precautions in certain situations III. Tasks that have no risk of exposure, so no special protection is required 33 36 Respiratory Hygiene/Cough Etiquette
Guidelines established by CDC Education Posting signs Controlling source or transmission Proper hand hygiene Separating patients with respiratory infections from other patients 33 37 BBP Safety Flush your eyes for 10 minute if blood or potentially infectious materials are splashed into your eye Always dispose of sharps in approved container
NEVER EVER RECAP Use cup bleach:1 gal water to effectively decontaminate most surfaces. Leave for 10 minutes 33 38 Personal Protective Equipment Protective gear worn to protect against physical hazards Employers must provide
PPE at no charge to the employee Disposable, sterile exam and utility gloves Masks and protective eyewear or face shields Protective clothing 33 39 Postprocedure Cleanup Decontaminate all exposed surfaces
Replace protective coverings on surfaces or equipment Decontaminate receptacles Pick up any broken glass with tongs
Discard all potentially infectious waste materials 33 40 OSHA Guidelines (cont.) Apply guidelines daily on the job
Exposure incidents Contact with infectious substance Rules apply to all serious infections HIV, HBV HBV vaccine Transmission to patients Nosocomial infection an infection acquired by a patient in a health-care facility 33 41 Apply Your Knowledge OSHA divides medical tasks by level of risk. What are these risk categories? ANSWER: There are three categories of risk:
Category 1: Expose a worker to blood, body fluids, or tissues and require specific protective measures Category 2: Usually do not involve risk of exposure, but precautions are required in certain situations Category 3: No risk of exposure, so no special protection is required 33 42 Apply your knowledge Mary was a patient in the hospital after suffering from a broken hip. Two days after admission she began running a fever. She was diagnosed with a Urinary Tract Infection. What type of infection is this? Nosocomial Infection
33 43 Reporting Guidelines Certain diseases must be reported to state or county health department Information is forwarded to the CDC control of the spread of infection 33
44 Reporting Guidelines (cont.) National Notifiable Disease Surveillance System (Table 33-2) Examples HIV/AIDS Rubella Legionellosis Mumps Tetanus
Cholera Hepatitis Lyme disease Smallpox Tuberculosis 33 45 Apply Your Knowledge How is the information on reportable diseases used by the CDC? ANSWER: The CDC uses the information reported to them to help control the spread of infection. Good Answer!
33 46 Isolation Guidelines CDC guidelines Types of precautions needed Patients requiring precautions Create an environment that protects against pathogens Standard Precautions
33 47 Isolation Guidelines (cont.) Select appropriate PPE Gloves Masks, face shields, respirators Gowns 33 48
33 49 Apply Your Knowledge Mrs. Findley brings her child with chickenpox into the medical office. What type of personal protective equipment should you use when caring for this child? ANSWER: Chickenpox requires airborne and contact precautions, so you should use gloves and a mask and goggles or a respirator. Nice! 33 50 Immunizations
Immunization Administration of a vaccine or toxoid to protect susceptible individuals from infectious diseases Reduces risk of infection spread Decreases the susceptibility of the host 33 51 Immunizations
(cont.) When administering, you must explain The need for immunization Side effects Soreness at site Low-grade fever General malaise 33 52 Immunizations (cont.)
Concerns Pediatric patients Do not give if child has a high grade fever Informed consent explain benefits and risks Contraindications symptoms that render the use of a remedy or procedure inadvisable because of the risk What would be contraindications for vaccines? Immunization records National Childhood Vaccine Injury Act of 1988 Instruct parents keep record as proof of immunization 33 53 Immunizations
(cont.) Pregnant patients Avoid live virus vaccines FDA categories A, B, C, D, and X Elderly Dispel common misconception and cost concerns More likely to develop side effects 33 54 Immunizations (cont.)
Immunocompromised patients May experience minimal to dangerous effects Adjust dosage or delay administration Must also consider immunization status of family and caregivers Health-care workers Hepatitis B vaccination offered by employer at no cost to employee 33 55 Apply Your Knowledge What is an immunization? ANSWER: An immunization is the administration of a
vaccine or toxoid to protect susceptible individuals from infectious diseases. Great! 33 56 Preventing Disease Transmission Educate patient on Nutrition and diet Exercise and weight control Prevention of STDs Smoking cessation Alcohol and drug abuse prevention and treatment
Proper use of medications and prescribed treatments Stress-reduction techniques 33 57 Preventing Disease Transmission (cont.) Goal of patient education Help patients take care of themselves
Encourage patients to participate actively in their own health care 33 58 Apply Your Knowledge What is the goal of patient education? ANSWER: Help patients take care of themselves. Empowering the patient! Bravo! 33 59
Apply your knowledge How is the spread of infectious diseases stopped? Answer: Break any chain in the chain of infection 33 60 Think.Pair.Share. Compare and contrast medical and surgical
asepsis. 33 61 Apply your knowledge Annie works as a nursing tech in the hospital. She is cleaning the over-the-bed tray with cleaning wipes before placing the patients food tray on it. Is Annie using sterilization, disinfection or sanitation? Answer: disinfection
Before Annie leaves the room she notices the trash can is full and removes the bag. What practice is in place? Answer: Sanitation 33 62 Apply your knowledge Which of the following would not require surgical asepsis? Caring for a wound two days post op Starting a new IV
Removing head lice from a patient Removing a mole from a patient Answer: Removing head lice from a patient 33 63 Apply your knowledge What type of PPE would be required to care for a patient with TB, an airborne disease?
Mask (respirator), gloves 33 64 Apply your knowledge What vaccine must be offered to you free of charge in any healthcare facility? Answer: Hepatitis B 33 65
Apply your knowledge Which disease is NOT required to be reported to the CDC? HIV Small Pox Influenza Tetanus Answer: Influenza 33 66 Soap and education are
not as sudden as a massacre, but they are more deadly in the long run. ~ Mark Twain 33 67
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