Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 1

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 2  Infection requires several elements:  A microbe (agent)  A reservoir  A way of exit or escape from the reservoir  transmission or transfer to the host  A way of entry into the host  A susceptible (vulnerable) host

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 3  Contact  Direct or indirect through an inanimate object  Droplet  Airborne  Common vehicle  Water, food, or contaminated equipment  Through vectors  Mosquitoes, flies, rats, and other vermin  Mythbusters Mythbusters

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 4 FIGURE 3-1 Infectious process

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 5  Symptomatic  Asymptomatic  Nosocomial Infection  Infection acquired while in the hospital  MRSA 70% of infections  Local infection  Limited to a small area of the body  Systemic infection  Located throughout the body  Mythbusters Mythbusters

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 6 GENERAL INFECTION LOCAL INFECTION  Fever  Chills  Pain  Ache or tenderness  General feeling of tiredness  Night sweats  Redness  Heat  Swelling  Pain  Fluid

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 7  Standard Isolation Precautions are applied to all patients.  Transmission-Based Precautions are applied to patients with known or suspected infections.

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Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 9

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 10  Gloves  Gowns  Aprons  Masks  Protective eyewear Signs are placed outside a patient’s room to indicate which type of PPE is needed.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 11  Sterile gloves  May be required to protect the patient during care or procedures  Nonsterile gloves  Worn when contact is made with  Body fluids  Mucous membranes  Wet secretions  Infection video Infection video

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 12  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

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 13

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 14

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 15  Overuse of antibiotic treatment  Incomplete cycles of prescribed antibiotics

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 16  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.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 17  OBRA requires training for nursing assistants:  Completion of a written examination  Demonstration of ability to perform skills correctly  Continuing education  Periodic evaluation of performance  Retraining if the nursing assistant does not work in the field for 2 years or more at one time

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 18  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

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 19

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 20  Body mechanics  Refers to the way the body is moved to prevent injury to oneself and to others  Accomplished by using knowledge of proper body alignment, balance, and movement  Posture is the position of body parts in relation to each other.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 21  Health care workers are responsible for preventing and reacting to fires to protect patients  Be familiar with the policy for fire response.  For a fire to burn, it must have oxygen, fuel, and heat.  Fire may be controlled or extinguished if one of these factors is removed.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 22  R = Rescue  Move patients from the point of origin of the fire.  Horizontal – moving patients through one set of fire doors on the same floor  Vertical – moving patients down stairs to a lower level  A = Alarm  Use emergency call box or pull station.  C = Contain  Confine or contain the fire to one area if possible.  E = Extinguish  Use a fire extinguisher.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 23  Class A  For use on paper, wood, trash, cloth, upholstery, rubber, and similar materials  Class B  For use on fuel oil, gas, paint, solvents, and other flammable liquids  Class C  For use on electrical equipment, fuse boxes, wiring, and appliances  Class D  For use on metals

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 24

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 25  Personnel from all areas of health care are asked to assist the community during a natural disaster, severe weather, or bioterrorism.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 26