Infection Control - Rehabilitation I Flashcards
Objectives
Define MSDS and state the contents and purpose of this manual (chapter 1, p18)
Describe Standard and Transmission-Based Precautions
Demonstrate principles of aseptic techniques, infection control and standard precautions.
fyi
A tiny plant or animal that can cause disease
- Move from place to place in a cyclical manner
- Move in a variety of ways
- Likes to have a host where there is an environment where they like to grow
Microorganisms
Hosts
Human
Animal
Organism wants a new residence . where are some examples?
Has to find a place that opens to the outside
- Mouth, nose, throat, ear, eye, intestinal tract, urinary tract
- Body fluids, wounds
Transmission to spread infection
- Air
- Droplets of water
- Direct contact with skin, equipment, mat, instruments, eating utensils, clothes, body fluids (vaginal secretions, semen, saliva, blood)
Transmission to spread infection
How does it enter another person?
Break in skin, mouth, nose, ear, genitourinary tract
Will all people get sick.
who might?
NO!
- Need to be susceptible
- Low immune system
- Cannot destroy or remove or get rid of pathogen
What if a bug is hard to kill
some drugs work, but are limited
Methicillin-resistant Staphylococcus aureus (MRSA) are a type of staphylococcus or “staph” bacteria
resistant to many antibiotics.
MRSA
What if a bug is hard to kill
Tuberculosis:
HIV:
Tuberculosis: drug resistance
HIV: we can slow progress but so far nothing is killing it
Microorganisms proliferate where?
Proliferate in a dark, moist environment
How do we kill them? microorganisims
With light, extreme heat, cool or dry environment
Hard protective shells
Difficult to destroy them
Be careful with wounds as spores can be deep in wound
Spores are produced by bacteria
- Are very resistant to drying, UV light and chemicals (anthrax)
- Can resist temperatures up to 1oo C
- Can live up to 100 years
Spores
Who are you protecting from microorganisms?
- Patient
- Other people around the environment/family members
- Yourself
how Protect yourself from the patient?
- Remove protective clothing so you don’t cross contaminate
- Clean vs Sterile approach
- Clean- regular cleaning, hand washing, etc.
- Sterilizing- attempting to kill microorganisms and spores with extreme heat, light or other destroying agent
How are microorganisms/pathogens transmitted again?
- Cough
- Sneeze
- Body Fluids
1-What barriers are present to pathogens
2-If person has infection or low immune system, must do what you can to avoid transmission
1-Skin; must be intact
Cilia (hair like structures that trap ): in respiratory tract
2-Glove, mask, gown-washing hands, watch what we do (if we have to sneeze), pull hair back and up. clean equipment. keep pt masked if needed, clean plinths.
What barriers are present to pathogens
Keep treatment area clean
- Keep equipment clean
- Floors
- Bathrooms
- Dispose of soiled linen and gowns
- Dispose protective garments
- Dispose of dressing materials
- Follow medical asepsis
Treat each patient as if…
- They have an infection or communicable disease
- AIDS Hepatitis B
Both can be life threatening
Consider Universal and Standard precautions
Healthcare associated infection
Spread patient to patient or caregiver to patient
Nosocomial Infection
Nosocomial Infection-Prevention
- Washing hands
- Proper hand hygiene
- Proper protective clothes
Universal Precautions
- Protect Healthcare worker
- Reduce transmission of disease
- Hand washing, wearing gloves, keeping treatment area clean
Universal vs Standard precautions
Universal
- Precautions designed to prevent transmission of HIV, HBV and other blood borne pathogens
- Considers blood and certain body fluids potentially infectious
- *Universal precautions do not cover feces, nasal secretions, sputum, urine, sweat, vomit, etc
Universal vs Standard precautions
Standard
Used for isolation and precautions in hospitals
- Uses universal and Body Substance Isolation
- Considered the best way to control nosocomial infections
- Standard precautions pertain to ALL bodily fluids, secretions and excretions
- Box 2-3, p36
- Several organizations are involved with these: CDC, OSHA,EPA, State Health Department
- Each hospital/medical setting will have policies in place that must be followed
Transmission-Based Precautions
“Protection from patients with highly transmissible pathogens”
- Infection control procedures could include hand washing, glove use, gown and mask use, eye protection and splash shields
- Use of gloves and protective equipment when in contact with all patient related items (linen, personal items, etc.)
Isolation precautions
- Depends on method of transmission
- Patient may be isolated or in room with another patient with same disease
- All people entering room must follow precautions to interrupt the route of transmission
- Usual precautions still in place: use hand hygiene and appropriate personal protective equipment
Hand Hygiene
- Most important activity to prevent infection
- With compromised immune system
What could be a minor inconvenience can make a person quite ill
Common method of transmission of infection
Direct contact: most common
- Other methods: air current, contaminated linen/clothes
- Inadequate cleaning of utensils
- Equipment
- Instruments
- Moisture droplets
Hand rubbing
Alcohol based
- Most effective if don’t need to wash hands
- Should be routine before and after patient treatment
- Requires less time than hand washing
- More effective than soap and water
- Easily accessible
- Decrease bacterial count on hands
- Less damaging to skin
Hand Wipes
Ok to use if necessary
- Not as effective as hand rubbing
how to Hand Rub
- Apply small amount to one palm
- Rub briskly over all surfaces of both hands
- Rub until dry
- Do not dry with towel
- After several hand rubs will need to use soap because hands become sticky
how to Hand Wash
- Preferred method when hands are visibly dirty, soiled or contaminated
- Should take 15-30 seconds
- Usually use a product that is antimicrobial (antiseptic)
- Remove jewelry
- Use warm water
- Wash wrists and hands, direct hands into the sink
how to really Hand Wash
- Wash for up to 30 seconds: longer for body fluids, infectious wounds
- Lather/scrub palms
- Wash fingers and web space
- Scrub dorsum
- finger tips
- Finger creases
- Under fingernails
- thumbs
Hand Washing
how to Rinse Thoroughly
- Start at wrist, work down
- Do not go above area you washed!
- Dry Hands with disposable towel
- Use clean dry towel to turn off faucet
- Bugs can stay alive on bar soap, dispenser, basins, etc
- Avoid artificial nails/chipped nails
- Trim nails
- Be cautious if you have broken skin
fyi
hand wash
Criteria for hand hygiene
See box 2-2
Before and after:
- Patient contact
- Contact with wounds, dressings, linens
- Secretions/excretions
- Toileting
- Eating
- After sneezing, blow nose, cough
- After remove gloves
Isolation Precautions
- Use standard precautions and transmission based precautions
- Airborne: measles, varicella, tuberculosis
- Droplet: meningitis, influenza, strep pharyngitis, pneumonii
- Direct: infection of skin, GI tract, Wounds
- Cart left outside room
- Instructions should be on cart concerning what needs to be done
- Look for color coded card on door or wall
- Make sure that, if for some reason the patient has to be taken to another area to be treated, that the equipment is cleaned appropriately and protective equipment is used protectively
Keep area/clinic clean
Special attention to
MRSA: methylation resistant staph aureus
VISA: vancomycin intermediate S. aureus
VRE: Vancomycin resistant enterococcus
Any equipment touched by a patient must be cleaned with disinfectant wipes or solution
Infection Control
Protective Isolation
Patient is at risk of contacting other things that could make them sick or increase chance of infection
- Open burns/wounds
- Low white blood count
- Sepsis
Who is at risk?
- Patient at risk: how you put on the garments is most important
- Caregiver is at risk: how you take off the garments is most important
Removing protective garments
- Wash hands/perform hand rub after removing garments
- Avoid contact between hands and anything else, especially eyes, ears, nostrils, mouth until hands are clean!
Application of protective garments- Next several slides completed in lab
Wash hands
Don gown
Apply mask: make sure that you fit the band over your nose, fit under chin. Secure behind neck and ears
Apply gloves so they fit with ends overlapping the sleeves of the gown
Removing protective garments
- Remove gown: untie or tear by grasping outer front shoulders, pulling it away from your body
- Pull over your arms so gown ends up inside out
- Avoid touching outside of gown
- As you remove arms of gown grasp cuff of glove with opposite hand and remove it (will end up inside out) repeat on opposite hand
- Roll gown into a ball with gloves inside, dispose of
removal of-Gloves not removed with gown:
- Pinch glove 1 inch from wrist, pull off and hold in gloved hand
- With glove free hand, reach clean index finger into cuff of gloved hand and remove glove inside out, dispose of properly
- Remove mask
- Untie each set of ties, handle by ties only
- Dispose of properly
Application of protective garments
- Open package containing gown and gloves
- Place on table or counter
- Wash hands and dry them
Disinfection/Decontamination
- Careful with needles, scalpel blades, scissors, other sharps
- Place sharps in an appropriate sharps container
- Wash skin and other surfaces if came in contact with blood, wound drainage, other body fluids
- Removing gloves: be careful not to touch outer surface of gloves
- Dispose of gloves in non-porous container
Disinfection/Decontamination
- Soiled Linen
- Infected waste
1
Handle as little as possible
Dispose of and transport in bags or other containers
2
Pour into drain or toilet
Follow regulations of the facility you work in
Disinfection/Decontamination
Disposable gloves
- Do not fit as tightly as individually sized
- Sometimes one size fits all, sometimes sm-med-lg
- Can form protective barrier
- Usually do not need gloves to perform vital signs
Disinfection/Decontamination
Body fluid spills
Clean up immediately!!!
- 10% bleach solution
- Hospital disinfectant
- Dispose of towels/linens used to clean up appropriately
Designed to protect the employee
- Educate employee on HBV, HIV
- Facility needs to provide safe, adequate protective equipment
- See page 48 of Principles & Techniques of Patient Care for all of the responsibilities
OSHA
- Remove, inactivate or destroy blood borne pathogens on surfaces or items
- Should no longer be capable of transmitting infection particle
- Surface should be safe for handling/use/disposal
Decontamination
- Used to destroy all forms of microbial life, including spores
- Use several different methods
Steam under pressure (autoclave)
Ethelyne oxide (a gas)
Dry heat source
EPA approved chemical for 6-10 hours
Use for instruments or equipment that can’t sterilize with heat
Sterilization
- High level:
- Destroys all forms of microbial life except high levels of bacterial sporeshot water for 30 min
EPA approved chemical for 10-45min
use with reusable instruments
Disinfection
Disinfection- Intermediate level
- Destroys most viruses, fungi, vegetative bacteria, TB
- DOES NOT KILL bacterial spores
- Use bleach ¼ per gallon dilution
Disinfection-Low level
- Destroy most bacteria, some viruses, some fungi
- DOES NOT KILL TB, bacterial spores
- These cleaners are hospital approved but do not carry claim for killing TB
- Material Safety Data Sheet
- Provide information about agents used for treatment and equipment cleaning and maintenance
- PTA program manual in cabinet below sink in the lab
MSDS Manual
objectives
Define MSDS and state the contents and purpose of this manual (chapter 1, p18???)
Describe Standard and Transmission-Based Precautions
fyi
