Infection Control, Safety, First Aid and Personal wellness Flashcards by Math Ematics

microorganism invades the body,
multiplies, and causes injury or disease

Infection:

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microorganisms that cause disease

Pathogens

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nonpathogenic microorganisms on our skin
and in other areas (GIT)

Normal flora:

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an infection affecting only one area of
the body

Local Infection

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an infection affecting the entire
body

Systemic infection

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infection from one’s own flora

Autogenous infection

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spread from person to person

Communicable Infection

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acquired in hospitals or other health care
facilities

Nosocomial Infection:

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microorganisms develop
resistance to specific antibiotics

Antibiotic-resistant infections

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pathogenic
microorganisms resistant to several drugs

Multidrug resistant organisms (superbugs) :

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a continuous link in the
transmission of harmful
organisms between a
source and the
susceptible host

CHAIN OF INFECTION

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bacteria, fungus, protozoon, rickettsia, virus

infectious agent

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animal, human, equpiment, foo, soil, water

reservoir

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blood, exudates, excretions, secretions

exit pathway

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airborne, contact, droplet, vector, vehicle

means of transmission

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body orifices, mucous membranes, broken skin

entry pathway

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elderly, newborn, acute?chronically ill, immune suppressed, unvaccinated

susceptible host

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components of the chain of infection

Infectious agents (source)

Reservoir

Exit pathway

Means of transmission

Portal of Entry
( Entry Pathway)

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Causative agent
Pathogenic microbe responsible for causing an
infection
Bacteria, parasites, fungi, viruses

Infectious agents (source)

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Source of an infectious agent
Place where the microbe could grow, survive
and multiply
Humans, animals, insects, food, water, soil,
equipment

Reservoir

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a way an infectious agent can leave a reservoir host
secretions from eyes, nose, mouth
exudates from wounds, mucous membranes, tissue
specimens, blood, feces, urine

Exit pathway

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Contact ( Direct or Indirect)
Droplets
Airborne
Vector
Vehicle

Means of transmission

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physical transfer of
infective material from the source
to the susceptible host through
close or intimate contact

Direct contact-

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– transfer of
infective material via an object
,such as bed linens, instruments,
furniture

Indirect contact

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▪ Transfer of an infectious agent to the mucous membranes of a susceptible individual via infectious droplets

DROPLET TRANSMISSION

▪ Do not remain suspended in the air ▪ Transmitted through coughing , sneezing, talking

DROPLET TRANSMISSION

What size of the droplets transmission

▪ 5 um or larger

What size of the droplets transmission

▪ 5 um or larger

* Dispersal of infectious agents that can remain infective for long periods of time in particles less than 5um and can be inhaled

AIRBORNE TRANSMISSION

* droplet nuclei or dried residue of droplets * Airborne droplet nuclei develop when the fluid of pathogenic droplets evaporates * small and light they may remain suspended in the air for several hours * can be spread via ventilation systems

AIRBORNE TRANSMISSION

Transfer of infective material through contaminated items such as food or water

Vehicle

Transmission by insect or animal vectors Dengue, Malaria ( mosquitoes)

Vector-borne

A way an infectious agent enters a susceptible host * body orifices * mucous membranes * breaks in the skin

Portal of Entry ( Entry Pathway)

Someone who is prone to infection ( elderly, newborn, immune-suppressed, unvaccinated, with acute or chronic illness)

Susceptible Host

*stopping infections at the source *preventing contact with substances from exit pathways *eliminating means of transmission *blocking exposure to entry pathways *reducing or eliminating the susceptibility of potential hosts

Breaking the Chain of Infection

WAYS TO BREAK THE CHAIN OF INFECTION

* Effective hand hygiene procedures * Good nutrition, adequate rest, and reduction of stress * Immunization against common pathogens * Proper decontamination of surfaces and instruments * Proper disposal of sharps and infectious waste * Use of personal protective equipment (PPE) * Use of needle safety devices during blood collection

WAYS HEALTHCARE INSTITUTIONS BREAK THE CHAIN

* Infection control programs * Insect and rodent control * Isolation procedures

1. to protect patients, employees, and visitors from infection

INFECTION CONTROL PROGRAM

2. to screen employees for infectious diseases and to require immunization when needed

INFECTION CONTROL PROGRAM

3. to provide evaluation and treatment to health workers who have been exposed to infections while performing their duty

INFECTION CONTROL PROGRAM

3. to provide evaluation and treatment to health workers who have been exposed to infections while performing their duty

INFECTION CONTROL PROGRAM

4. to monitor employees and patients who are at risk of infection and to collect data from patients and health workers who have been exposed to such danger

INFECTION CONTROL PROGRAM

effective way to prevent the spread of infection

Hand Hygiene

* Use plain soap and water  When hands are visibly dirty  Before eating and after using the restroom

Routine hand washing

* Use antimicrobial soap or alcohol-based sanitizers  Alcohol-based hand sanitizers when hands are not visibly dirty  Put sanitizer on hands, rub hands together for 20 seconds or until it feels dry

Hand antisepsis

How many minutes in scrubbing hand at Hand Hygiene?

. Two-minute scrub

* Before and after each patient contact * Between unrelated procedures on a patient * Before putting on gloves and after taking them off * Before leaving the laboratory * Before going to lunch or on break * Before and after going to the restroom * Whenever hands become visibly or knowingly contaminated

SITUATIONS THAT REQUIRE HAND HYGIENE PROCEDURES

According to WHO guidelines, when performing direct patient care, hand hygiene should be performed:

1. Before touching a patient 2. Before performing a clean or aseptic procedure 3. After a risk of body fluid exposure 4. After touching a patient 5. After touching patient surroundings

ROUTINE HANDWASHING TECHNIQUE

Remove jewelry. 1. Stand a few inches from the sink. 2. Turn on the faucet and place hands under the running water. 3. Use soap and work up lather. 4. Make sure to scrub all surfaces. 5. Apply a little friction and rub hands together for at least 15 seconds ( 20 seconds). 6.Rinse the hands from the wrist to fingertips using downward motion. 7. Dry hands using a clean paper towel. 8. Use the paper towel to close the faucet except when it is foot or motion activated. Entire handwashing procedure: 1 minute (40-60 seconds) * Palm to palm to make a lather * Rub right palm over the back of left hand with interlaced fingers, vice versa * Palm to palm with fingers interlaced * Rub the back of fingers to opposing palm with fingers interlocked, repeat for each hand * Rub rotationally left thumb clasped in right palm, vice versa * To clean the tips of the fingers, rub rotationally with clasped fingers of right hand and left palm and vice versa

*alcohol-based antiseptic hand cleaners that contain a minimum of 60% alcohol *if the hands are not visibly soiled *cover all surfaces of the hands, including between the fingers *allow to evaporate *20 to 30 seconds

USE OF ALCOHOL-BASED ANTISEPTIC HAND CLEANERS

equipment worn to minimize exposure to hazards that cause serious workplace injuries and illnesses

PERSONAL PROTECTIVE EQUIPMENT (PPE)

“specialized clothing or equipment worn by an employee for protection against infectious materials” (OSHA)

PERSONAL PROTECTIVE EQUIPMENT (PPE)

Level 1 PPE

surgical mask

Level 2 PPE

– surgical mask, goggles or face shield, gown, gloves

Level 3 PPE -

N95 mask, goggles or face shield, gloves, surgical cap, scrub suits, gowns (or coveralls), shoe covers

Level 4 PPE –

N95 mask (or PAPR), goggles or face shield, double gloves, surgical cap, scrub suits, coveralls (Hazmat suit), dedicated shoes, shoe covers

What are the PERSONAL PROTECTIVE EQUIPMENT (PPE)?

*Gloves * Laboratory gown * Face mask/respirators * Face shields/ goggles * Wear Long pants and closed-toe shoes

 Wear gloves during blood collection and handling of specimen * should be worn over the cuffs of the lab gown DON’T touch surfaces with contaminated gloves DON’T touch your face or adjust PPE with contaminated gloves DON’T reuse disposable gloves

GLOVES

Purpose – patient care, environmental services, others * Glove material – vinyl, latex, nitrile, others * Sterile or nonsterile * One or two pair * Single use or reusable * Work from “clean to dirty

GLOVES

contain no latex and powder free most puncture resistant have a high level of touch sensitivity good for extended period of time work for for high risk situation resist many chemicals have a long shelf life are blue to help identify if the glove

nitrile gloves

fit like a second skin have a high level of touch sensitive good for waring and extedned amount of time work well for high risk cost effective lighlt powedered for easing donning very elastic and strong

latex gloves

no latex looser fit short terms, low risk most economic option anti static properties use with non hazardous materials lighlty powdered

vinyl gloves

* Wear mask when entering the room of a patient in isolation * Fluid-proof masks – spattering of body fluids * Worn once, then discard * Should cover both the nose and mouth * Never be worn around the neck

MASKS

* Fluid resistant * Disposable * Should be put on first * Make sure that it is fastened, and the belt tied

GOWNS

SEQUENCE FOR WEARING (DONNING) PPE

1. Gown 2. Mask or Respirator 3.Goggles or Face shield 4. Gloves

WEARING OF GOWN

* Fully cover torso from neck to knees, arms to end of wrists, and wrap around the back * Fasten in back of neck and waist * 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

WEARING OF MASK

* Mask * Place over nose, mouth and chin * Fit flexible nose piece over nose bridge * Secure on head with ties or elastic

WEARING OF RESPIRATOR

* Respirator * Secure ties or elastic bands at middle of head and neck * Fit flexible band to nose bridge * Fit snug to face and below chin * Fit-check respirator

WEARING OF GOGGLES

* Place over face and eyes and adjust to fit

Wearing of gloves

Extend to cover wrist of isolation gown

“CONTAMINATED” AREAS OF PPE Areas of PPE that have or are likely to have been in contact with body sites, materials, or environmental surfaces where the infectious organism may reside

– outside front

“CLEAN” AREAS OF PPE Areas of PPE that are not likely to have been in contact with the infectious organism

– inside, outside back, ties on head and back

SEQUENCE FOR REMOVAL (DOFFING) OF PPE

1. Gloves 2. Goggles and Face shield 3. Gown 4. Mask or Respirator

SEQUENCE FOR REMOVAL (DOFFING) OF PPE COVID 19 WAY

1. Gloves 2. Gown Perform Hand Hygiene 3. Goggles and Face shield 4. Mask or Respirator Perform hand Hygiene

REMOVING CONTAMINATED GLOVES

Using a gloved hand, grasp outside edge near wrist * Peel away from hand, turning glove inside-out * Hold in opposite gloved hand * Slide ungloved finger under the wrist of the remaining glove * Peel off from inside * Discard gloves in a waste container

Removing goggles or face shield

Remove goggles or face shield from the back by lifting head band or earpieces * If the item is reusable, place in designated receptacle for reprocessing or discard in a waste container

REMOVING USED GOWNS

* Unfasten gown ties, taking care that sleeves don’t contact your body when reaching for ties * Pull gown away from neck and shoulders, touching inside of gown only * Turn gown inside out * Fold or roll into a bundle and discard in a waste container

Removing used mask

Grasp bottom ties or elastics of the mask/respirator, then the ones at the top, and remove without touching the front * Discard in a waste container

NURSERY AND NEONATAL ICU INFECTION CONTROL TECHNIQUE

* 1. Perform proper hand washing before donning PPE * 2. Bring items necessary for specimen collection * 3. Leave blood collection tray outside the nursery/ICU (anteroom) * 4. Remove gloves, wash hands (use a new pair of gloves between patients)

separate patients with certain transmissible infections from contact with other patients and limit their contact with hospital personnel and visitors

ISOLATION PROCEDURES

is used for patients who are highly susceptible to infections.

Protective (reverse) isolation

microorganisms in the human blood that are infectious and can cause human disease

Blood-borne pathogens

can survive a week on objects

Hepatitis B virus

Common Blood-borne pathogens

1. Hepatitis B virus * 2. Hepatitis C * 3. Hepatitis D 4. Immunodeficiency virus

: flu-like, fatigue, loss of appetite, mild fever,muscle join.abdominal pain, nausea vomiting

Hepatitis S/S

Mode of transmission of hepatitis s/s

needlesticks, sexual contact

vaccine for hepatitis

Hepa B

specifies precautions to use in caring for ALL patients regardless of diagnosis or presumed infection status

STANDARD AND TRANSMISSION-BASED PRECAUTIONS

specifies precautions to use for patients either suspected or known to be infected with certain pathogens transmitted by airborne, droplet, or contact routes

Transmission-based precautions

Standard Precautions include

* Hand hygiene * Use of personal protective equipment * Respiratory hygiene / cough etiquette * Sharps safety (engineering and work practice controls) * Sterile instruments and devices * Clean and disinfected environmental surfaces

for patients diagnosed or suspected of a specific transmissible disease

TRANSMISSION-BASED PRECAUTIONS

Precautions based on whether the disease is transmitted by

Airborne: Pulmonary Tuberculosis, Measles ( Rubeola)Chickenpox (Varicella) * Droplets: Influenza * Contact: Diarrhea, skin or wound infection

Pulmonary Tuberculosis, Measles ( Rubeola)Chickenpox (Varicella)

* Airborne:

Influenza

Droplets:

Diarrhea, skin or wound infection

Contact:

Exposure to blood bornepathogens

1. needle-stick injury 2. blood or body fluid splashes in the eyes, nose or mouth 3. blood or body fluid comes in contact with cut, scratch or abrasion 4. human bite cuts the skin

Caused by needlestick or any sharp objects

1. Remove sharp or foreign object 2. Wash the site with soap and water for at least 30 seconds

Through Mucous Membrane

1. Flush with water or saline for at least 10 minutes 2. Eyes: use eyewash station (remove contact lenses) 3. Report the incident to the immediate supervisor

* Cleaning up spill and decontaminating soiled areas immediately with disinfectant * 1:10 bleach solution(sodium hypochlorite) * Prepared daily * Wear gloves * Use absorbent material * Broken glass: do not pick up with hands * Use brush, dustpan or tongs

* Surface Decontamination

* Never eat, drink, smoke, or chew gum. * Never put pencils or pens in the mouth. * Never place food or beverages in a refrigerator used for storing reagents or specimens. * Never apply cosmetics, handle contact lenses, or rub eyes in the laboratory. * Never wear long chains, large or dangling earrings, or loose bracelets. * Never wear a lab coat to lunch, on break, or when leaving the lab to go home. * Never wear personal protective equipment outside the designated area for its use.

GENERAL LABORATORY SAFETY RULES

* Always wear a fully buttoned lab coat. * Always tie back hair that is longer than shoulder length. * Always keep fingernails short and well manicured. * Do not wear nail polish or artificial nails. * Always wear a face shield when performing specimen processing or any activity that might generate a splash or aerosol of bodily fluids. * Always wear gloves for phlebotomy procedures and when processing specimens.

GENERAL LABORATORY SAFETY RULES

Any material that could be harmful to one’s health

Biohazard

Safe handling of biological substances that pose a risk to health. used to prevent and protect clinical laboratories from harmful incidents caused by laboratory specimens that are potential hazardous

Biosafety

Aerosols and splashes can be created when specimens are centrifuged, when tube stoppers are removed, and when specimen aliquots are being prepared a. observe proper handling practices b. wear PPE properly c. use safety shields and guards

Airborne

Biohazards can be ingested if healthcare workers neglect to sanitize hands before handling food a. Frequent hand sanitization, wash hands frequently b. avoid hand-to-mouth activities c avoid placing items in the mouth

Ingestion

through breaks or cuts in the skin a. cover skin breaks or cuts with non-permeable bandages

non-intact skin:

: through the skin (intact) due to needlesticks and other sharp objects a. use needle safety devices. b. wear heavy duty utility gloves when cleaning broken glass c. never handle broken glass with bare hands

Percutaneous

through mucus membranes ;mouth , nose , eyes a. proper specimen handling B. avoid rubbing, touching eyes, nose and mouth

Permucosal:

* Shut off the source of electricity * Source of electricity cannot be shut off? use nonconducting material to remove the source of electricity from the victim * Call for medical assistance * Start CPR if necessary * Keep the victim warm

* Electric Shock

Avoid the use of extension cords. * Do not attempt to make repairs to equipment if you are not trained to do so. * Do not handle electrical equipment with wet hands or when standing on a wet floor. * Do not overload electrical circuits. * Inspect cords and plugs for breaks and fraying. * Know the location of the circuit breaker box. * Unplug and do not use equipment that is malfunctioning. * Unplug equipment that has had liquid spilled in it. * Unplug equipment when you are servicing it

ELECTRICAL SAFETY

Conduct regular fire drills Be familiar with the location of emergency exits Be familiar with the evacuation plans or routes * Post location of fire extinguishers and heavy blankets * Know how to use the fire extinguisher

* Fire Safety

Ordinary combustible materials(wood, paper) Water, foam, dry chem

Class A

Flammable liquids and vapors ( paint, oil, grease, gasoline) Require blocking oxygen dry chem.,CO2 , foam, halon

Class B

Electrical equipment non-conducting agents dry chem,CO2 , halon (DO NOT USE FOAM)

Class C

combustible chemicals/ reactive metals Na,Mg, K , litiumTitanium Power agents sand or dry powde

Class D

Cooking oil, grease fats

Class K

what class of fire extingusher for cloth wood rubber paper plastics

class A

gasolin grease oil

class b

electrical fires

class c

combustible metals

class d

kitchen fires

class k

Never use a .. on grease fires, electrical fires or class D fires - the flames will spread and make the fire bigger!

water extinguisher

* Class ABC: all-purpose fire extinguisher that works on class A, B, and C fires. The extinguishing agent is a __

dry chemical

extinguishers don't leave a harmful residue - a good choice for an electrical fire

CO2

heat, fuel, oxidizing agent (oxygen), chemical reaction * A fire naturally occurs when the elements are combined in the right mixture * prevented or extinguished by removing any one element

* Fire Tetrahedron

compononents of fire tetragedron

heat fuel oxygen or oxidizing agent

rescue anyone in immediate danger

* RESCUE

activate the institutional fire alarm system

* ALARM -

close all doors

* CONTAIN

attempt to extinguish the fire, if possible

EXTINGUISH

__ exposure depends on distance, shielding, and time * __ effects are cumulative

radiatione xposure

collecting specimens from patients injected with radioactive dyes or from nuclear medicine department delivering specimens to radioimmunoassay sections

radiation hazards:

aware of institutional radiation safety procedures cautious when entering areas with radiation hazard symbol

The phlebotomist should be:

*Use special kits containing absorbent and neutralizer

CHEMICAL SPILL PROCEDURES Spill clean up kit

(abnormal or profuse bleeding)

Hemorrhage

*Firmly applying direct pressure to the wound until bleeding stops or emergency rescuers arrive. *Pressure should be applied using cloth or gauze with additional material added if bleeding continues.

FIRST AID External Hemorrhage

insufficient return of blood flow to the heart, resultingnin an inadequate supply of oxygen to all organs and tissues of the body

Shock

* * Pale, cold, clammy skin * * Rapid, weak pulse * * Increased, shallow breathing rate * * Expressionless face and staring eyes

Common Symptoms of Shock

When providing first aid to a victim of shock, be sure to do the following: * 1. Maintain an open airway for the victim. * 2. Call for assistance. * 3. Keep the patient lying down with the head lower than the rest of the body. * 4. Attempt to control bleeding or other cause of shock if known. * 5. Keep the victim warm until help arrives.

FIRST AID FOR SHOCK

CPR – means

– CARDIOPULMONARY RESUSCITATION

* emergency lifesaving procedure performed when the heart stops beating * aims to keep blood and oxygen flowing through the body when a person’s heart and breathing have stopped * can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm

CPR – CARDIOPULMONARY RESUSCITATION

* Check the scene and the person. * Patient lying on his/her back on a steady surface * Call 911 for assistance * ask a bystander to call 911, or a there is no call 911 and begin administering assistance Check for breathing. If there is no breathing begin CPR

BEFORE GIVING CPR

1. Kneel beside the patient and place your hands in the middle of the patient’s chest. 2. Cover the first hand with the heel of the other hand, interlocking the fingers. The fingers should be raised so they do not touch the ribcage. 3. Lean forward (shoulders directly over the patient’s chest) and press down on the chest for about two inches. Release the pressure to allow the chest to come back up. Do not release your hands. Repeat. Give 30 compressions at a rate of 100 compressions per minute.

HOW TO PERFORM CPR?

how many compressions when doing cpr?

0 compressions at a rate of 100 compressions per minute.

using chest compressions and mouth-to-mouth breathing at a ratio of 30:2 compressions-to-breaths

conventional CPR

In adult victims of cardiac arrest, it is reasonable for rescuers to perform chest compressions at a rate of _ for an average adult

100 to 120/min and to a depth of at least 2 inches (5 cm)

1. Personal Hygiene 2. Proper Nutrition 3. Rest 4. Exercise 5. Proper posture/Back protection 6. Stress management

PERSONAL WELLNESS

* Shower or bathe and use deodorant on a regular basis * Brush teeth after eating * Keep hair clean and neatly combed * Fingernails should be clean, short, and neatly trimmed * Avoid heavily scented lotions or colognes

PERSONAL HYGIENE

Nutritious food * plant-based diet rich in a variety of vegetables, fruits, legumes * minimally processed starchy staple foods * balance of carbohydrates, fat, protein, vitamins, minerals, and fiber

Proper Nutrition

* get the required hours of sleep * take breaks during the day to rest, refresh, and stay fit

Rest

 strengthens the immune system  increases energy  reduces stress by releasing substances called endorphins  reduces symptoms of depression and anxiety

* Exercise:

Use proper techniques and equipment when lifting heavy objects

Proper Posture/Back Protection

Use proper techniques and equipment when lifting heavy objects

Proper Posture/Back Protection

Has damaging effect on personal wellness Affects different organs and systems throughout the body Weakens immune system

Negative Stress

* Identify your problem and talk about it. * Learn to relax throughout the day. * Exercise regularly. * Avoid making too many changes at once. * Planning the time you have. * Set realistic goals—be practical about what you can accomplish. * Avoid procrastination by tackling the most difficult job first.

Ways To Control Stress