(Guidelines for isolation(2007 CDC 1- standard precautions, which apply to all patients. 2- transmission-based precautions.
TRANSMISSION -BASED precautions. to patients which apply with documented or suspected infection or colonization with certain microorganisms.
Standard Precautions All patients may potentially be colonized or infected with organisms that can transmitted wherever be health care is provided.
STANDARD PRECAUTIONS gloves should be worn to touch any of the following: blood, all body fluids, secretions, and excretions. except sweat, regardless of whether they are visibly bloody, non intact skin, and mucous membranes.
STANDARD PRECAUTIONS Hands should be washed immediately after -gloves are removed, - before and after patient contact. with items in the patient’s and after contact environment that may be contaminated.
Two new elements of standard precautions 1-In Lumbar puncture wear masks to prevent contamination of the spinal needle or the procedure site with the oral flora of the operator, which may occur when the operator is talking.
Two new elements of standard precautions 2 -respiratory hygiene, which includes instructing patients to cover their nose and mouth with a tissue when coughing or sneezing. placing a surgical mask on the coughing patient in commo n areas. and spatially separating patients with respiratory infections from other patients when feasible. - using hand hygiene after contact with respiratory secretions..
STANDARD PRECAUTIONS 1-gloves 2-HAND WASHING. 3-mask with eye protection 4-gown 5-Needles and syringes.
HAND HYGIENE Hand hygiene is the single most important factor in preventing nosocomial infections.
HAND HYGIENE It prevents transmission of pathogens by contact and the fecal-oral route
HAND HYGIENE The principles of hand washing are based on the work of Semmelweis.
HAND HYGIENE hand washing remains the single most important means to prevent transmission of nosocomial pathogens.
HAND HYGIENE It has been estimated that an increase in hand washing compliance by 1.5- to 2.0-fold would result in a 25% to 50% decrease in the incidence of HAIs.
microorganisms on hands 1-transient flora 2-resident flora
Transient flora 1-Are important causes of HAIs. 2-These organisms are acquired primarily by contact. 3- L oosely attachedto the skin 4- Easily washed off.
RESIDENT FLORA 1-organisms of low virulence (e.g., coagulase-negative staphylococci, Micrococcus, Corynebacterium) 2-that are rarely transmitted to patients except when introduced by invasive procedures 3- Not easily removed through hand washing.
Purpose of hand washing Remove the transient flora recently acquired by contact with patients or environmental surfaces.
HANDS OF HCWS HAIs have been attributed to bacterial contamination of artificial fingernails therefore, they should not be worn by health care workers.
Alcohol-based hand rubs the recommended agents for hand hygiene in the health care setting.
washing with soap 1-visibly soiled, washing with soap (antimicrobial or non antimicrobial) and water. 2-Clostridium difficile diarrhea. CDC suggests that soap and water be used because of the poor sporicidal activity of.alcohols
ALCOHOL -BASED HAND RUBS
WHEN 1-before and after contact with patients. 2- immediately after removing gloves.
Wall-mounted dispensers alcohol-based, waterless hand rubs should be installed in all hospital and outpatient rooms. In areas in which this is not feasible, individual health care workers should carry small containers of waterless agents.
GLOVES 1- to prevent contamination of the hands with microorganisms. 2-to prevent exposure of the health care Worker to blood-borne pathogens. 3- to reduce the risk of transmission of microorganisms from the hands of the health care worker to the patient
GLOVES 1-gloves do not replace the need for hand hygiene 2-gloves should be changed during the care of a patient when moving from a contaminated or body site (e.g., wound perineal care) to a clean body site. 3- Gloves have small perforations that may allow to contaminate the hands. - not as a substitute for hand hygiene.
Transmission-Based precautions patients based on a suspected or confirmed clinical syndrome. a specific diagnosis, or colonization or infection with epidemiologically important organisms.
IMPORTANT It is important to note that transmission-based precautions are always implemented in conjunction with standard precautions.
TRANSMISSION-BASED PRECAUTIONS Three types 1-Airborne 2-Droplet borne 3-Contact borne
ISOLATION CATEGORY A few diseases varicella, SARS, MERS-COV require more than one isolation category.