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© 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-1 Infection Control Techniques PowerPoint® presentation to accompany: Medical Assisting.

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Presentation on theme: "© 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-1 Infection Control Techniques PowerPoint® presentation to accompany: Medical Assisting."— Presentation transcript:

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2 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-1 Infection Control Techniques PowerPoint® presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson

3 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-2 Learning Outcomes 20.1Describe the medical assistants role in infection control. 20.2Describe methods of infection control. 20.3Compare and contrast medical and surgical asepsis. 20.4 Describe how to perform aseptic hand washing. 20.5Compare and contrast the procedures for sanitization, disinfection, and sterilization.

4 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-3 Learning Outcomes (cont.) 20.6Describe measures used in sanitization. 20.7List various methods used in disinfection and the advantages and disadvantages of each. 20.8Discuss the goal of surgical asepsis. 20.9Explain what an autoclave is and how it operates. 20.10List the steps in the general autoclave procedures.

5 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-4 Learning Outcomes (cont.) 20.11 Explain how to wrap and label items for sterilization in an autoclave. 20.12 Describe how to complete the sterilization procedure using an autoclave. 20.13 Define the Blood-Borne Pathogens Standard and Universal Precautions as described in the rules and regulations of the Occupational Safety and Health Administration (OSHA).

6 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-5 Learning Outcomes (cont.) 20.14Explain the role of Universal Precautions in the duties of a medical assistant. 20.15 List the procedures and legal requirements for disposing of hazardous waste. 20.16 Describe Centers for Disease Control and Prevention (CDC) requirements for reporting cases of infectious disease. 20.17 Discuss the need for specific guidelines for isolating patients in health-care settings.

7 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-6 Learning Outcomes (cont.) 20.18Describe the appropriate use of personal protective equipment in various situations. 20.29 Explain the purpose of immunization. 20.20 Describe your role in educating patients about immunizations. 20.21 Explain how to educate patients in preventing disease transmission.

8 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-7 Introduction Patients coming to the office for treatment may be more susceptible to infections Immunizations and patient education are important methods of infection control You will be introduced to OSHA guidelines, the Blood-Borne Pathogen Standard, reporting guidelines, and isolation procedures.

9 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-8 MAs Role in Infection Control To control infectious diseases, the cycle of infection must be broken Apply principles of infection control in office setting

10 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-9 MAs Role in Infection Control (cont.) Follow correct sanitization, disinfection, and sterilization procedures Help patients understand basic disease prevention Educate patients about immunizations Administer immunizations

11 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-10 Apply Your Knowledge What is your role as a medical assistant in control of infection in the medical office? ANSWER: To apply principles of infection control by following correct sanitization, disinfection, and sterilization procedures. Correct!

12 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-11 Infection Control Measures Eliminate elements needed for disease to occur Knowledge of Medical asepsis Based on cleanliness As few microorganisms as possible Surgical asepsis Sterile environment No microorganisms

13 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-12 Medical Asepsis Keep office clean: Reception area: sick vs. well patients Reception room clean, well lit, and ventilated Keep furniture in good repair Strict no food or drink policy Empty trash as necessary

14 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-13 Medical Asepsis (cont.) During medical assistant procedures Prevent cross-contamination Hand washing Beginning of day After breaks Before and after each patient Before and after handling equipment or specimens After blowing your nose or coughing

15 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-14 Medical Asepsis (cont.) Other precautions Avoid leaning against sinks, supplies, equipment Avoid touching your face and mouth Use tissues when you cough or sneeze, and always wash your hands afterward Avoid working directly with patients when you have a cold; wear gloves and mask if you must Stay home if you have a fever

16 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-15 Apply Your Knowledge Describe the difference between medical and surgical asepsis. ANSWER: Medical asepsis is based on cleanliness and reducing the number of microorganisms as much as possible. Surgical asepsis is maintaining a sterile environment by eliminating all microorganisms.

17 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-16 Sanitization Scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow For cleaning items that touch only healthy, intact skin OR First step in disinfection and sterilization for other equipment

18 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-17 Sanitization (cont.) Collect items for sanitization Place in water and special detergent solution Use utility gloves Separate sharps from other equipment Scrub items Follow manufacturers guidelines Dry thoroughly Examine carefully

19 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-18 Sanitization (cont.) Rubber and plastic items Syringes and needles Use disposable whenever possible Ultrasonic cleaning For delicate instruments and those with moving parts Sound waves generated through a cleaning solution to loosen contaminants

20 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-19 Apply Your Knowledge What is sanitation, and what types of items is it adequate for cleaning? ANSWER: Sanitation is scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow. It is adequate for cleaning items that touch only healthy, intact skin. Nice Job!

21 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-20 Disinfection Adequate for instruments that do not penetrate skin or mucus membranes and surfaces not considered sterile OR Second step in infection control prior to sterilization Will not kill spores, certain viruses

22 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-21 Disinfection (cont.) Using disinfectants Cleaning products applied to inanimate materials to reduce or eliminate infectious organisms Antiseptics are anti-infective cleaning agents used on human tissue Follow manufacturers guidelines

23 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-22 Disinfection (cont.) Factors impacting effectiveness of disinfectants Number of times solution is used Wet items – surface moisture may dilute solution Traces of soap left from sanitization – alters chemical composition Evaporation

24 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-23 Disinfection (cont.) Choose the correct disinfectant Germicidal soap products Alcohol Acid products Formaldehyde Glutaraldehyde – cold disinfection Bleach Iodine and iodine compounds

25 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-24 Disinfection (cont.) Handling disinfected supplies Prevent contamination with other surfaces Use sterile transfer forceps Wear gloves Store in clean, moisture-free environment

26 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-25 Apply Your Knowledge What is the difference between a disinfectant and an antiseptic? ANTISEPTIC: Disinfectants are cleaning products applied to inanimate materials to reduce or eliminate infectious organisms. Antiseptics are anti-infective cleaning agents used on human tissue.

27 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-26 Surgical Asepsis Goal is to keep the surgical environment completely free of all microorganisms Used for even minor operations and injections The more extensive the procedure, the greater the risk of infection

28 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-27 Sterilization Required for all instruments or supplies that Penetrate the skin Contact normally sterile areas of the body Object is either sterile or not sterile If unsure of sterility, consider it not sterile Prior to sterilization Sanitize Disinfect

29 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-28 Sterilization: The Autoclave Primary method of sterilization Pressurized steam Operates at lower temperatures than dry heat sterilization Moisture causes coagulation of proteins in microorganisms at lower temperatures Cell walls burst when cell cools, killing the microorganism

30 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-29 Sterilization: The Autoclave (cont.) Wrap sanitized and disinfected items Special porous fabric, paper, or plastic Items should not touch Label Check water level – distilled water only Preheat, but do not overheat

31 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-30 Sterilization: The Autoclave (cont.) Load, choose correct setting, run cycle Temperature 250° to 270° F Pressure 15 to 30 pounds Unload Store items properly Clean, dry location Shelf life based on packaging, but generally 30 days

32 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-31 Sterilization: The Autoclave (cont.) Clean autoclave and area Quality control checks Sterilization indicators – confirm that items have been exposed to correct volume of steam at the correct temperature for the correct length of time Biological indicators – contain bacterial spores and confirm that sterilization occurs

33 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-32 Sterilization: The Autoclave (cont.) Prevent incomplete sterilization Correct timing Adequate temperature Properly wrapped packs Adequate steam levels Timing Preset for load types Use sterilization indicators

34 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-33 Sterilization: The Autoclave (cont.) Temperature Too high – steam too little moisture Too low – steam too much moisture Do not overcrowd autoclave Steam level If incorrect, items will not be sterile at end of cycle

35 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-34 Sterilization: Sterile Technique Surgical scrub During surgical procedures Do not touch sterile items without sterile gloves or transfer forceps Aseptic technique Throughout surgical procedures Caring for surgical wounds

36 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-35 Sterilization: Surgical Asepsis After procedures Sanitize, disinfect, and sterilize reusable items Disinfect surfaces Waste disposal Biohazard waste containers Leak-proof containers either color-coded red or labeled with biohazard symbol Biohazardous waste Biological agents that can spread disease to living things

37 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-36 Apply Your Knowledge ANSWER: Sterilization is required for all instruments or supplies that penetrate the skin or come in contact with normally sterile areas of the body. What items need to be sterilized?

38 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-37 Apply Your Knowledge ANSWER: Use medical asepsis while preparing the patient, and then use surgical asepsis during the procedure. The physician is going to remove a small growth from your patients back. In order to prepare for this procedure, what steps would you take to prevent the spread of infection? Right!

39 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-38 OSHA Guidelines Blood-Borne Pathogen Standards Protect health-care workers from health hazards on the job Also protect patients and others who come to medical facilities Dictate how to handle infectious or potentially infectious wastes Discarded Held for processing

40 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-39 OSHA Guidelines (cont.) Blood-Borne Pathogen Standards Measures to prevent the spread of infection Provide a margin of safety by ensuring that medical facilities meet minimal standards for asepsis Requirements for training, keeping records, housekeeping, and personal protective gear

41 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-40 OSHA Guidelines (cont.) Universal Precautions Prevent health-care workers from exposure to infections Assume that all blood and blood and body fluids are infected with blood-borne pathogens Standard Precautions Combination of Universal Precautions and Body Substance Isolation guidelines Used in hospitals to prevent transmission of disease

42 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-41 OSHA Guidelines (cont.) Categories of tasks I.Tasks that expose a worker to blood, body fluids, or tissues and require specific protective measures II.Tasks that usually do not involve risk of exposure but require precautions in certain situations III.Tasks that have no risk of exposure, so no special protection is required

43 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-42 OSHA Guidelines (cont.) Personal Protective Equipment Protective gear worn to protect against physical hazards Employers must provide PPE at no charge to the employee Disposable, sterile exam and utility gloves Masks and protective eyewear or face shields Protective clothing

44 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-43 OSHA Guidelines (cont.) Postprocedure Cleanup Decontaminate all exposed surfaces Replace protective coverings on surfaces or equipment Decontaminate receptacles Pick up any broken glass with tongs Discard all potentially infectious waste materials

45 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-44 OSHA Guidelines (cont.) Apply guidelines daily on the job Exposure incidents Contact with infectious substance Rules apply to all serious infections – HIV, HBV HBV vaccine Transmission to patients Nosocomial infection – an infection acquired by a patient in a health-care facility

46 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-45 Apply Your Knowledge ANSWER: There are three categories of risk: Category 1: Expose a worker to blood, body fluids, or tissues and require specific protective measures Category 2: Usually do not involve risk of exposure, but precautions are required in certain situations Category 3: No risk of exposure, so no special protection is required OSHA divides medical tasks by level of risk. What are these risk categories?

47 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-46 Reporting Guidelines Certain diseases must be reported to state or county health department Information is forwarded to the CDC – control of the spread of infection

48 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-47 Reporting Guidelines (cont.) National Notifiable Disease Surveillance System (Table 20-2) Examples HIV/AIDS Cholera Rubella Hepatitis Legionellosis Lyme disease Mumps Smallpox Tetanus Tuberculosis

49 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-48 Apply Your Knowledge How is the information on reportable diseases used by the CDC? ANSWER: The CDC uses the information reported to them to help control the spread of infection.

50 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-49 Isolation Guidelines CDC guidelines Types of precautions needed Patients requiring precautions Create an environment that protects against pathogens Standard Precautions

51 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-50 Isolation Guidelines (cont.) PPE Select appropriate PPE for mode of transmission Gloves Masks, face shields, respirators Gowns Table 20-3

52 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-51 Apply Your Knowledge Mrs. Findley brings her child with chickenpox into the medical office. What type of personal protective equipment should you use when caring for this child? ANSWER: Chickenpox requires airborne and contact precautions, so you should use gloves and a mask and goggles or a respirator. Nice!

53 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-52 Immunizations Immunization Administration of a vaccine or toxoid to protect susceptible individuals from infectious diseases Reduces risk of infection spread Decreases the susceptibility of the host

54 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-53 Immunizations: Recommendations Immunization schedules for children Advisory Committee on Immunization Practices American Academy of Pediatrics American Academy of Family Physicians Immunization schedules for adults The National Coalition of Adult Immunization (NCAI)

55 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-54 Immunizations (cont.) When administering. you must explain The need for immunization Side effects Soreness at site Low-grade fever General malaise

56 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-55 Immunizations (cont.) Concerns Pediatric patients Do not give if child has fever Informed consent Explain benefits and risks Contraindications Symptoms that render the use of a remedy or procedure inadvisable because of the risk

57 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-56 Immunization records National Childhood Vaccine Injury Act of 1988 Instruct parents keep record as proof of immunization Pregnant patients Avoid live virus vaccines FDA categories A, B, C, D, and X Elderly More likely to develop side effects Immunizations (cont.)

58 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-57 Immunizations (cont.) Immunocompromised patients May experience minimal to dangerous effects Adjust dosage or delay administration Must also consider immunization status of family and caregivers Health-care workers Hepatitis B vaccination offered by employer at no cost to employee

59 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-58 Apply Your Knowledge What is an immunization? ANSWER: An immunization is the administration of a vaccine or toxoid to protect susceptible individuals from infectious diseases.

60 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-59 Preventing Disease Transmission Patient education Health promotion Disease prevention Disease treatment Medical Assistant role in patient education Share responsibility Reinforce and explain instructions

61 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-60 Preventing Disease Transmission (cont.) Educate patient on Nutrition and diet Exercise and weight control Prevention of STDs Smoking cessation Alcohol and drug abuse prevention and treatment Proper use of medications and prescribed treatments Stress-reduction techniques

62 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-61 Goal of patient education Help patients take care of themselves Encourage patients to participate actively in their own health care Preventing Disease Transmission (cont.)

63 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-62 Apply Your Knowledge What three areas should patient education focus on? What is the medical assistants role in patient education? ANSWER: Patient education should focus on health promotion, disease prevention, and disease treatment. The medical assistant shares responsibility with the physician and other staff members and should reinforce and explain instructions given by others. Bravo!

64 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-63 In Summary Medical Assistant Sanitization, disinfection, and sterilization break the cycle of infection by ridding instruments and equipment of pathogens. The medical assistant plays a vital role in reducing patient vulnerability by encouraging patients to maintain a correct immunization status and by being aware of special immunization concerns of certain patients.

65 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 20-64 Soap and education are not as sudden as a massacre, but they are more deadly in the long run. ~ Mark Twain


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