INFECTION CONTROL AND ASEPTIC TECHNIQUE

Nosocomial Infections IInfections patients receive while in an acute care hospital or any other healthcare facility. UUrinary tract most common – catheters WWounds after surgery and respiratory tract infections also common

CYCLE OF INFECTION  Source (Infectious Agent)  Reservoirs of Infection  Portal of Exit  Modes of Transmission  Portal of Entry  Host

Infectious Agent  Pathogenicity – ability to cause disease.  Virulence – ability to grow and multiply with speed.  Invasiveness – ability to enter tissues.  Specificity – organism’s attraction to a particular host.

Modes of Transmission  Direct or Indirect contact (fomite)  Droplet  Vehicle  Airborne  Vector

Microorganisms  Algae  Protozoa  Fungi  Bacteria

Pathogens  Parasites –Protozoa, Helminths  Fungi – yeasts and molds  Bacteria – colorless, minute, one- celled organisms with a typical nucleus  Virus

Viruses  Influenza  Common cold  Mumps and measles  Hepatitis A, B, C, D, E  AIDS

HIV and AIDS HHIV enters the body after exposure through contact with blood or body fluids and attacks the immune system. FFive phases (pg 57) PPractice Standard Precautions and be cautious handling needles NNeedle sticks must be reported

Viral Hepatitis  Inflammation of the cells of the liver  Hep A and Hep E are transmitted by the fecal-oral route  Others by blood or body fluids  Hep B, C and D can be chronic  Acute demonstrated as flu-like symptoms then in 1-2 weeks becomes jaundiced, liver enlarges, liver cells die  Can regenerate unless it turns chronic

Tuberculosis  Most commonly affects the lungs, but can affect any part of the body.  It is a communicable (infectious) disease  Pulmonary TB is treatable if caught early

ASEPSIS AA state of being free from germs MMedical Asepsis - clean SSurgical Asepsis – sterile

GOALS OF HANDWASHING  Reduce number of transient and resident bacteria on hands  Prevent transmission of infection to: –Patients and family members –Health care workers –Yourself

UNIVERSAL PRECAUTIONS  Defined as the minimum standard for safety.  Uniforms and Clothing  Laundry

UNIVERSAL PRECAUTIONS  Gloves should be worn whenever contact with blood or other body fluids or tissue is expected.  Gloves should be changed after each patient.  Masks and eye shields worn to protect from droplets of blood or body fluids  Gowns should be worn if blood/body fluids  Hands and other skin washed immediately

UNIVERSAL PRECAUTIONS  Needles never recapped, bent or broken or removed from syringes.  Needles disposed of in puncture resistant container.  Mouthpieces, ambu bags and vent devices used rather than mouth-to-mouth  Workers with oozing or open sores should refrain from direct contact with patients and equipment.

ISOLATION PRECAUTIONS  Protective Isolation  Imaging Considerations  Transporting Patients

CATEGORY-SPECIFIC ISOLATION CATEGORYPROTECT AGAINST NECESSARY ITEMS STRICTDroplet/directGown,glove,mask CONTACTdirectGown,glove,mask RespiratoryDropletsMask ENTERICFecesGown, gloves TUBERCULOSTBMask, gown(?) Drain/SecretionDirectGown, gloves

Inhibiting and destroying Microorganism growth  Sanitization  Disinfection  Sterilization

Sanitization  Clean with detergent and brush  Ultrasonic

Disinfection CChemical germicides or boiling water CCheck dilution ratio of chemical EExposure to chemical may vary from 20 minutes to 3 hours RRinse

Sterilization  Sanitize first then dry  Wrap or disposable packaging  Hinged instruments should be left open (hemostats)  Place in Autoclave (steam under pressure)

Chemical Sterilization Indicators  Special dyes change color with temperature, pressure or time  Autoclave tape – used to tape package, diagonal stripes turn black  Autoclave – 250 degrees F; 15 min to 30 min

Surgery Suite  Surgical Scrubs, booties, hat  Mask when entering the room  Portable in Surgery; if not, clean one before entering  Sterile bags over tube if positioning over a patient

SURGICAL ASEPSIS  Sterile Attire  Preparing A Sterile Field  Sterile Field

MAINTAINING A STERILE FIELD  Area neat and uncluttered  Organize supplies before procedure  Avoid quick movements or rearrangement once opened  Minimize people walking into areas  Drop supplies w/out reaching over  Close doors and windows

MAINTAING A STERILE FIELD  If clean item touches sterile, its contaminated  Sterile objects >2.5cm from edge of field  Avoid touching face or body with sterile gloves  When pouring, pour small amount into trash then fill sterile container.