Infection, prevention and control 1&2 Flashcards
Micro-organisms
Micro-organisms (bacteria and viruses) live in or on some parts of the body e.g skin, mouth, bowel- are known as the body’s normal or ‘resident’ flora.
Transient micro-organisms
On surface of skin, things we touch- easily transferrable, acquired or deposited on the skin by other people or from the environment and are known as ‘transient’. These do not live permanently on the skin and can be readily removed or destroyed by thorough and frequent hand hygiene.
Resident micro-organisms
Found in the first layer of skin, nasal passages, etc.
SICPs (Standard Infection Control Precautions)
Designed to prevent cross contamination from recognised and unrecognised sources of infection. They should be applied at all times within a healthcare setting or when healthcare is being provided and must underpin all activities.
Key areas covered by the precautions
- Hand hygiene and washing
- Bodily fluid spillages
- Safe disposal of sharps
- Decontamination of equipment
- Handling of bed linen
- Personal protective equipment
Anti-bacterial hand rub
Antibacterial or alcohol hand rub can be used between caring for different people and between care activities for the same person. However, remember that alcohol hand rub fixes dirt the skin (trapping it underneath) so your hands have to be visibly clean.
Soap and water
Hands must be washed with soap and water if clostridium difficile or norovirus is suspected or if there is an outbreak of diarrhoea and vomiting, alcohol hand rubs are ineffective in such situations.
Key moments to wash hands
- Before touching a patient
- Before a procedure
- After a procedure
- After touching a patient
- After touching a patient’s surroundings
How long should you perform the eight stage technique for when using alcohol hand rub?
20-30 seconds. If hand rub becomes dry before 20-30 seconds, apply more.
How long should you perform the eight stage technique for when using soap and water?
30-40 seconds
Eight stage hand washing technique
- Wet hands with water
- Apply soap
- Rub palms
- Right hand over left dorsum with interlaced finger- vice versa
- Palm to palm with fingers interlaced
- Backs of fingers to opposing palms with fingers interlocked
- Rotational thumb rubbing
- Finger tips on palm
- Rinse hands
What is the purpose of hand hygiene?
To reduce healthcare associated infections (HCAI)
Choices of hand agents
- Alcohol-based rub
- Soap and water
- Antiseptic solutions
Why would you use alcohol-based rub?
- To remove transient micro-organisms
- Quick and easy to use
- Better tolerated by the hands
- Effective
When would you NOT use alcohol-based rub?
- When hands are visibly soiled
- When caring for a patient with vomiting or diarrhoea - whether gloves have been used or not
Why would you use soap and water?
- To remove dirty, organic matter or transient micro-organisms
- When hands are visibly soiled with bodily fluids
- When caring for a patient with vomiting or diarrhoea
- When caring for a patient with diagnosed norovirus or clostridium difficile
- After several consecutive applications of alcohol-based hand rub
When would you use antiseptic solutions?
- When required to reduce transient and resident micro-organisms
- Seeking a residual effect
- Before surgery and other invasive procedures
- In other circumstances such as during an outbreak of infection or as advises by the hospitals infection control team
What are the five moments for hand hygiene?
1) Immediately BEFORE each episode of direct patient contact or care, including clean aseptic hygiene
2) Immediately AFTER each episode of direct patient contact or care
3) Immediately AFTER contact with bodily fluids, mucous membranes and non-intact skin
4) Immediately AFTER other activities or contact with objects and equipment in the immediate patient environment that may result in the hands being contaminated
5) Immediately AFTER the removal of gloves
How can you ensure your hands are ready to be decontaminated?
- Remove all wrist and hand jewellery
- Wear short sleeved clothing when delivering patient care
- Making sure fingernails are short, clean and free from false nails and nail polish
- Covering cuts and abrasions with waterproof dressings
What are the 3 Stages of effective hand washing?
1) Preparation
2) Washing
3) Drying
What are the risks/hazards of hand hygiene products?
- Skin irritation
- Accidential eye splashes
- Ingestion
- Fire hazard
What would you do in the event of a urine spillage?
- Clean the area with a general purpose detergent
- Dry the area thoroughly
What would you do in the event of a vomit spillage?
- Wipe up the area with disposable paper towels
- Clean the area using a detergent
- Dry the area thoroughly
What would you do in the event of a blood spillage?
- Cover the area with paper towels
- Allow the towels to soak up the blood before disposing
- Clean the area using a bleach solution
- Dry the area thoroughly
What would you do in the event of a splash in the eye or mouth?
- Stop what you are doing
- Wash out your eyes or mouth with cold water
- Inform your manager, contact occupational health or A&E out of hours
- Complete an incident report
What would you do in the event of a splash on broken skin?
- Stop what you are doing
- Wash the area under running water
- Dry the area and apply a waterproof plaster
- Inform your manager, contact occupational health or A&E out of hours
- Complete an incident report
What would you do in the event of a sharps injury?
- Stop what you are doing
- Dispose of any contaminated sharps appropriately
- Encourage the wound to bleed with gentle pressure (do not suck the wound)
- Dry the wound and apply a waterproof plaster
- Inform your manager, contact occupational health or A&E out of hours
- Complete an incident report
How do you handle bed linen?
- Staff must wear personal protective equipment when handling dirty linen and ensure that their hands are decontaminated prior to handling clean linen
- Infected and heavily soiled linen should be handled carefully in line with local standard operating procedure
- If the patient is at home, any linen should be washed at a temperature of at least 60 degrees
- Staff must wear personal protective equipment when handling dirt linen
How to use PPE
- An apron and gloves must be worn when there is a risk of exposure to blood and body fluids and for close patient contact, even bed making
- The gloves should be applied after the apron but removed before the apron (gloves last on but first off). Both must be single use only and should be discarded after each care activity and before contact with other items e.g door handles, pens, etc.
- Your hands must still be cleansed once the gloves have been removed
What patients are at risk?
- People with dementia
- People of an advanced age
- People with immunological issues
- People underlying chronic diseases e.g diabetes, chest, heart disease, cancer
- People with other existing infections
- People taking drugs e.g steroids, chemotherapy drugs
- People with indwelling medical devices e.g urinary catheters
What is unacceptable practice?
- It is never acceptable to wash gloves rather than change them- single use only
- Touching your pen, a door handle or curtains after care activity before gloves are removed and hands decontaminated is also unacceptable practice
- It is not acceptable to wear the same pair of gloves or apron between patient activity or to not wash yours hands
What is a duty of care?
Duty of care means to ‘cause no harm’ and is imposed through law upon every care worker in the country to stop them being reckless or negligent
What are the six parts of the chain of infection?
- Infectious agent
- Reservoirs
- Portal of exit
- Means of transmission
- Portal of entry
- Susceptible host
What is the infectious agent?
Any micro-organism that can produce infection e.g a pathogenic microorganism, e.g. MRSA, Clostridium difficile.
What is the reservoirs?
The place an organism resides e.g water, food, respiratory tract, bowels, etc.
What is the portal of exit?
Needs to leave the reservoir to establish infection i.e mouth, open wound, rectum through faeces, urine, vomit, skin cells, respiratory tract secretions, etc.
What is the means of transmission?
How out travels, direct or indirect, from inanimate objects of living organisms.
What is the portal of entry?
The place it enters the body e.g wound, broken skin, respiratory, gastrointestinal or genito-urinary tract.
What is the susceptible host?
A person who is at higher risk of infection e.g immunosuppressed individuals, elderly, newborns, terminally ill individuals, etc.
Decontamination: What is sterilisation?
Suitable where there is contact with breaks in the skin/mucous membranes, or for equipment introduced into sterile body areas.
Decontamination: What is cleaning?
Suitable for equipment not in contact with the patient, or in contact with healthy skin.
Decontamination: What is disinfection?
Suitable where there is contact with mucous membranes, or where there is a risk of contamination by transmissible micro-organisms.
What is a killed vaccination?
Contain killed, but previously virulent, micro-organisms that have been destroyed with chemicals, heat, radioactivity or antibiotics, e.g Influenza, cholera, bubonic plague, polio, hep A, rabies.
What is an attenuated vaccination?
Contain live, attenuated microorganisms. Many of these are live viruses that have been cultivated under conditions that disable their virulent properties, or which use closely related but less dangerous organisms to produce a broad immune response. Although most attenuated vaccines are viral, some are bacterial in nature, e.g Viral Diseases(yellow fever, measles, rubella, and mumps) Bacterial Diseases (typhoid, BCG).
What is a toxoid vaccination?
Made from inactivated toxic compounds that cause illness, rather than from the micro-organism. Toxoid vaccines are known for being effective, e.g Tetanus, diphtheria.
What is a protein subunit vaccination?
Microorganism fragment combined with other organic material and used to create an immune response, e.g Hep B, human papillomavirus (HPV).
