Infection Control AHS II Unit F

Standard Precautions Sometimes called “Universal” precautions Sometimes called “Universal” precautions Used to break the chain of infection Used to break the chain of infection Pathogens spread by blood and body fluids Pathogens spread by blood and body fluids Hepatitis B (HBV) Hepatitis B (HBV) Human immunodeficiency virus (HIV) Human immunodeficiency virus (HIV)

OSHA passed regulations in 1991 requiring all health care facility employers to: Determine which employees will have exposure to blood and body fluids Determine which employees will have exposure to blood and body fluids Provide Hepatitis B vaccine free to employees with exposure risk (or signed refusal) Provide Hepatitis B vaccine free to employees with exposure risk (or signed refusal)

OSHA passed regulations in 1991 requiring all health care facility employers to: Provide personal protective equipment (PPE) such as gloves, gowns, lab coats, masks, and face shields Provide personal protective equipment (PPE) such as gloves, gowns, lab coats, masks, and face shields Provide adequate handwashing facilities and supplies Provide adequate handwashing facilities and supplies

OSHA passed regulations in 1991 requiring all health care facility employers to: Ensure clean & safe work environment Ensure clean & safe work environment Follow decontamination protocol for contaminated surfaces Follow decontamination protocol for contaminated surfaces

OSHA passed regulations in 1991 requiring all health care facility employers to: Dispose of infectious wastes correctly Dispose of infectious wastes correctly No eating, drinking, smoking, handling contact lenses, applying lip balm, etc. in risk area No eating, drinking, smoking, handling contact lenses, applying lip balm, etc. in risk area

OSHA passed regulations in 1991 requiring all health care facility employers to: Provide color-coded containers labeled for sharps and other infectious wastes Provide color-coded containers labeled for sharps and other infectious wastes Post signs in work areas where this is exposure risk Post signs in work areas where this is exposure risk

OSHA passed regulations in 1991 requiring all health care facility employers to: Provide medical evaluation & follow-up for employees who’ve had an exposure incident Provide medical evaluation & follow-up for employees who’ve had an exposure incident Provide training about the regulations to all employees at no cost during working hours Provide training about the regulations to all employees at no cost during working hours

Standard precautions rules are developed by the CDC and FDA. 1. All body fluids should be considered potentially infectious 2. All patients should be considered potential sources of infection 3. Wash hands before and after any patient

Standard precautions 4. If any surface comes in contact with blood or body fluids, wash immediately and thoroughly 5. Wash hands after removal of gloves 6. Wear gloves whenever contact with blood or body fluids is possible

Standard precautions 7. Change gloves after contact with each patient 8. Gloves should not be reused 9. Gowns should be worn during any procedure with risk of splashing blood or body fluids

Standard precautions 10. Masks and protective eyewear to be worn during procedures that may produce blood or body fluids 11. Extreme care should be taken while handling sharp objects. (Do not bend, break or recap needles. Dispose of them in puncture-resistant containers.)

Standard precautions 12.Spills or splashes of blood or body fluids should be wiped up immediately. Wear gloves, and use a disinfectant solution.

Standard precautions 13. Mouthpieces or resuscitation devices should be used to avoid the need for mouth-to-mouth resuscitation. 14. Know the requirements for disposal of waste materials and dispose of wastes in the proper container.

Standard precautions 15. Report any cut, injury, needle stick, or splashing of blood or body fluids immediately.

Disinfection Chemicals frequently used for aseptic control Chemicals frequently used for aseptic control They do not kill spores & viruses so it’s not sterilization They do not kill spores & viruses so it’s not sterilization

Used to disinfect instruments that don’t penetrate body tissue: dental instruments dental instruments percussion hammers percussion hammers thermometers thermometers

Examples: Examples: 90% isopropyl alcohol 90% isopropyl alcohol formaldehyde-alcohol formaldehyde-alcohol 10% bleach solution 10% bleach solution Lysol Lysol Zephiran Zephiran

Boiling water disinfects but does not sterilize Boiling water disinfects but does not sterilize Satisfactory for home care where instruments/supplies used for one person only Satisfactory for home care where instruments/supplies used for one person only Usually minutes Usually minutes

Ultrasonic unit – used in dental & medical offices to disinfect – used in dental & medical offices to disinfect Uses sound waves to produce millions of microscopic bubbles Uses sound waves to produce millions of microscopic bubbles Cavitation – bubbles hit instrument and explode, driving cleaning solution into article Cavitation – bubbles hit instrument and explode, driving cleaning solution into article

Sterile Technique - Principles Surgical Asepsis – procedures that keep an object or area free from living organisms Surgical Asepsis – procedures that keep an object or area free from living organisms Sterile – free from all organisms, including spores and viruses Sterile – free from all organisms, including spores and viruses

Sterile Technique - Principles Contaminated – organisms/pathogens are present Contaminated – organisms/pathogens are present A clean, uncluttered work area necessary when working with sterile supplies A clean, uncluttered work area necessary when working with sterile supplies

Sterile Technique - Principles Sterile field – sterile area – never reach across a sterile field – reach in from the side Sterile field – sterile area – never reach across a sterile field – reach in from the side Never turn your back on a sterile field Never turn your back on a sterile field 2-inch border of sterile field is considered contaminated 2-inch border of sterile field is considered contaminated

Sterile Technique - Principles Common techniques: Common techniques: Drop technique Drop technique Mitten technique Mitten technique Transfer forceps Transfer forceps

Sterile Technique - Principles Keep sterile field dry (pathogens travel through wet) and be careful when pouring fluids Keep sterile field dry (pathogens travel through wet) and be careful when pouring fluids Be sure sterile field is open and ready before putting on sterile gloves Be sure sterile field is open and ready before putting on sterile gloves

Sterile Technique - Principles Sterile gloves are contaminated on the inside – once on, keep hands away from body and above waist Sterile gloves are contaminated on the inside – once on, keep hands away from body and above waist When in doubt, consider it contaminated When in doubt, consider it contaminated

Opening Sterile Packages Check to be sure the sterile package has not expired Check to be sure the sterile package has not expired Open the distal end and pull it away from you, reaching around the package, not across Open the distal end and pull it away from you, reaching around the package, not across Open the sides without touching the inside wrapper Open the sides without touching the inside wrapper

Opening Sterile Packages Pull the bottom down toward you Pull the bottom down toward you Drop technique Drop technique Mitten technique Mitten technique Transfer forceps Transfer forceps