pt. safety and infection control Flashcards
medical and surgical asepsis
- medical asepsis refers to use the use of precise practices to reduce the number, growth and spread of micro-organisms (“clean technique”)
- it applies to administering oral medication, managing nasogastric tubes, providing personal hygiene and performing many other common nursing tasks
what should healthcare providers do before beginning any task that requires an aseptic technique?
- check for latex allergies
practices that promote medical asepsis
hand hygiene
protective clothing
physical environment
practices that maintain a sterile field
- prolonged exposure to airborne mircro-organisms can make sterile items non sterile
- only sterile items can be in a sterile field
equipment
- select a clean area above waist level in the client’s environment to set up the sterile field
- check that all sterile packages are dry and intact and have a future expiration date
- any chemical tape must show the appropriate color change
- make sure an appropriate waste receptacle is nearby
sterile field setup
- open the covering of the package per the manufactures directions, slipping the package onto the center of the workspace with the top flap
- grasp the tip of the top flap of the package, and with arm positioned away from the sterile field, unfold the top flap away from the body
- next open the slide flaps, using the right hand for the right flap and the left hand for the left flap
additional sterile packages
- open next to the sterile feild by holding the bottom edge with one hand and pulling back on the top flap with the other hand
- place the packages that will be used last furtherest from the sterile field; open these first
- add them directly to the sterile field. Lift the package from the dry surface, holding it 15cm above the sterile field, pulling the two surfaces apart, and dropping in into the sterile field
pour sterile solutions
- remove bottle cap
- hold the bottle with the label in the plan of the hand so that the solution does not run down the label
- pour the solution onto the dressing or site without touching the bottle to the site
- sterile solutions expire 24 hr after opening and recapping in some facilities
when does infection occur
when the presence of a pathogen leads to a chain of events cause infections
bacteria
staphylococcus aureus
escherichia coli
mycobacterium tuberculosis
viruses
organsims that use the host genetic machinery to reproduce hiv hepatitis herpes zoster herpes simplex virus
fungi
molds and yeasts
candid albicans
aspergillus
parasites
protozoa (malaria, toxoplasmosis)
helminths (worms, flatworms, roundworms, flukes
virulence
is the ability of a pathogen to invade and injure a host
herpes zoster
common viral infection that erupts years after exposure to chickenpox and invades a specific never tract
mode of transmission
contact
droplet
airbone
vector borne
contact
- direct physical contact: person to person
- indirect contact with an inanimate object
- fecal-oral transmission: handling food after using a restroom and failing to wash hands
droplet
sneezing, coughing, talking
airborne
sneezing and coughing
vector borne
animals or insects as intermediaries (ticks transmit lyme disease; mosquitoes transmit west nile and malaria
antigens
- substances the body recognizes as foreign that elicit an immune response
- most are composed of protein
antibodies
immune globulins produced by lympoctes in response to antigens
active immunity
allows the body to make antibodies in response to antigens that go into the body
active natural
antibodies in response to live pathogen
active artifical
antibodies in response to the vaccine
- giving a client a vaccine causes the production of antibodies that prevent illness
- vaccines are made from live or weakened virus
diagnostic procedures
identify pathogenic micro-organisms
the most definitive way to identify microorganism is to examine
blood
body fluids
tissue samples
treament can not begin untill
pathogen is identified
immunizations
- tetanus, diptheria booster
- measles, mumps, and rebulla vaccine
- varicella vaccine
- pneumococcal vaccine
- hepatitis a,b
- influenza vaccine
- meningococcal polysaccharide vaccine (MPSV4) and meningococcal 4- valent conjugate (MenACWY) vaccine
- human papilloma virus HPV2, HPV4, HPV9
- zoster vaccine
isolation precautions
- group of actions that include hand hygiene and the use of barrier precautions
- precautions apply to every client
- clients in isolation are at a higher risk for depression and loneliness
- assist the client and their family to understand the reason for isolation and provide sensory stimulation
standard precaustion
- applies to all body fluids
- nurse should implement standard precuations for all clients
- hand hygiene
- gloves
- mask, eye protection, and face sheilds ar required when care might cause splashing or spraying of body fluids
- properly clean all equipment for client care; dispose of one time use items according to facitly policy
- client does not need a private room unless
contact precautions
protect against environemntal contact infections
contact precautions require
- private room or room with other clients who have the same infection
- gloves and gowns worn by caregivers and visitors
- disposal of infections dressings material into a single, nonporous bag
droplet precautions require
- private room with other clients who have same infectious disease
- ensure that client have their own equipment
- masks, gowns, gloves for providers and visitors
airborne precautions
protects against measles, varicella, pulmonary or tb
require private room:
- masks and respiratory protection devices for caregivers and visitors
- negative pressure airflow
- if splashing or spraying is a possibility, wear full face
- use n95
clinical findings for infection
- fever
- chills
- temp is rising
- diaphoresis
- increase pulse and respiratory rate
- malise
- fatigue
- anorexia, nausea, vomiting
- abdominal cramping and diarrhea
- enlarged lymph nodes
client saftey falls
- use risk assessment
- encourgae client to speak up
- communicate risk factors
- use protocols for responding to dangerous situations
- use correct evidence to promote a culture of safety, while using the national patient and safety goals as a guide
- disaster plan
- identify incidents and responses
- location of safety date sheets and hazadorus chemicals in the environmental
preventing falls
- complete fall risk
- individual plan for each client
- had to use call light
- respond to call lights in a timely manner
- use fall risk alerts
- regular toileting
- provide adequate lighting
- assistive devices
- near nurses stations
- provide hourly rounding
- bed site tables
- bed in low position
seclusion and restraint
- know federal, state, and facility policy for restraints
- seclusion rooms and restraints
- shortest duration
- physical protection of the client or the protection of other clients or staff
- client can voluntarily request temporary seclusion if the environment is disturbing or seems too stimulating
- restraints can be either physical
- restraints can cause complications, including pneumonia incontinence, and pressure injuries
- provider must prescribe seclusion or restaints
- nurses can put it in an emergency situation
innapproprate to use seclusion or restraints
- convenience of the staff
- punishment for the client
- clients who are extremely physically or mentally unstable
- clients who cannot tolerate the decreased stimulation of a seclusion room
restraints should
- never interfere with treatment
- restrict movement as little as is necessary
- fit properly and be as directed as possible
- be easy to remove or change
presciption
- reaosn for the restraints
- type of restraints
- location of the restraints
- how long to use the restraints
- type of behavior
- 4hr restraints
- can not prn
nursing responsibilities
- explain the need for restraints to clients and family
- sign a conset form
- review instructions for correct application
- assess skin integrity
- offer food and fluid
- provide means for hygiene and elimination
- monitor vital signs
- offer range of motion
- pad an bony prominences
- secure restraints to a moveable part of bed
- two finger breaths
- remove frequently for good circulation
- ongoing eval
- determine need for restrants
- never leave cliet alone
- check facilities guidelines
documenting restraints
- time of application and removal
- type of restraints and location
- client behavior
- type and frequency of care
- condition of body
- clients response at removal
- medication admin
