Key Terms Anthrax Antiseptic Asepsis Autoclave Contaminated Disinfectant Local infection OSHA Pathogen Standard precautions Sterile Systemic infection Transmission based precaution
Objectives Upon completion of this lesson, students will be able to: Differentiate between the modes of transmission Determine methods for breaking the chain of infection Select and use PPE in health care settings Assess the appropriate circumstances for when each type of PPE should be used Correctly demonstrate how to don and remove PPE
Engage What is the biggest challenge for healthcare workers when using personal protective equipment (PPE)? Do you think the PPE provides the proper protection for healthcare workers? What type of PPE do you think is used most frequently by healthcare workers? What are the biggest mistakes that you think healthcare workers make when wearing PPE?
The Chain of Infection An interaction of microorganisms that cause disease with the environment and the host. Elements: Disease microbe (agent) Reservoir where the microorganism can live Way of exit or escape from the reservoir Way for transmission or transfer to the host Way of entry into the host Susceptible (vulnerable) host
Methods of Transmission Airborne Diseases that are spread through the air (chickenpox, measles, TB) Droplet Diseases spread by droplets, as in a sneeze or cough (pneumonia, influenza, types of meningitis) Contact Diseases spread by contact with infected skin or objects (herpes, impetigo, scabies, AIDS, MRSA) Reverse or Protective Isolation Direct or indirect through an inanimate object (*protects the patient from the health care worker) Necessary for patients with deficient/suppressed immune systems (AIDS, transplant, cancer chemo patients)
Antibiotic-Resistant Diseases In 2005, the Centers for Disease Control Prevention (CDC) listed eight diseases exhibiting antibiotic resistance. Methicillin-resistant Staphylococcus aureus (MRSA) Most relevant nosocomial pathogen in the United States Main mode of transmission is on hands
Infection Symptomatic Asymptomatic Local infection: limited to a small area of the body Redness Heat Swelling Pain fluid Systemic infection: located throughout the body Fever Chills Pain Ache or tenderness General feeling of tiredness Night sweats
Defense Systems of the Body First line of defense is the skin. Acts as a barrier to prevent microorganisms from entering the body Second line of defense is the action of the phagocytic cells of the immune system. Immune system prevents infection by producing antibodies and antitoxins to combat the action of pathogens that enter the body. Immunity can be inborn or acquired People are born with an innate immunity to some organisms. Acquired immunity results when the body produces cell or antibodies to combat a specific organism Immunity to some microorganisms results from administering a vaccine.
Principles of Asepsis Medical asepsis can be evaluated on three levels: Antiseptics, which inhibit the growth of bacteria Can be used on the skin Disinfectants, which are agents that destroy most bacteria and viruses Agents can be caustic or harmful to the skin. Disinfection can be accomplished by boiling and by using chemical agents. Sterility, also referred to as surgical asepsis, is a state of sterility or the use of sterile technique.
Isolation Precautions Standard Isolation Precautions: Equipment and methods that prevent the transmission of microorganisms from one person to another. Established early in the AIDS epidemic Prior to the diagnosis of AIDS, PPE was used only in identified infectious people. These are applied to all patients/residents at all times because not all diseases are readily observable. Transmission-Based Precautions are applied to patients with known or suspected infections.
Standard Precaution Procedure Gloves should be worn at all times; hands should be washed for a minimum of 20 seconds and gloves changed when moving from one patient to another. Depending on activity performed with patient, nature of patient’s illness, amount of exposure to fluids, other PPE should be worn. Needles should never be capped All sharps should be disposed of immediately in biohazardous puncture proof sharps containers located in each room. Never carry needles or sharps from one location to another. All unknown spills or waste should be treated as potentially hazardous
Personal Protective Equipment (PPE) Used in Universal Precautions Gloves Mask Respirator Goggles Face shields Gowns Cap
Handwashing for HC Workers Hands are washed thoroughly At the beginning of the work period Between each client contact Before and after eating Before and after using the restroom Before leaving the work environment Gloves are worn AT ALL TIMES when contact is made with body fluids, mucous membranes, or wet secretions.
Handwashing Technique FIGURE 3-2 Handwashing technique. A, Keep the hands lower than the arms during the procedure. (From Kinn MF, Woods M: The medical assistant, ed 8, Philadelphia, 1999, Saunders.)
Handwashing Technique FIGURE 3-2 Handwashing technique. B, In addition to soap and water, friction or rubbing also cleans the skin. (From Kinn MF, Woods M: The medical assistant, ed 8, Philadelphia, 1999, Saunders.)
Handwashing Technique FIGURE 3-2 Handwashing technique C, Rinsing hands thoroughly prevents skin irritation from soap. (From Kinn MF, Woods M: The medical assistant, ed 8, Philadelphia, 1999, Saunders.)
Occupational Safety and Health Administration (OSHA) Regulations To establish standards of safety for the workplace and to enforce the standards To research and provide documentation to OSHA regarding the safe level of exposure to hazards in the workplace