Nursing Skill Labs 1 Routine Practices and Disease Specific Precautions September 11, 2007

Hand Hygiene Review Why do we do this? Why do you need to keep your uniform from touching the sink? Why warm water? Why do we keep the hands lower than the elbows? What order do you dry your hands? When should we do this?

Why do we Need to Take all of These Precautions??? Antibiotic resistant organisms (ARO’s)….VRE, MRSA, SARS Bacteria may become resistant to antibiotics in different ways Which patients have the highest risk of developing infection?

ARO’s may or may not cause infection If they just live happily on and in the body but don’t cause infection the patient is termed as “colonized” If the patient is infected with an ARO the presenting data is the same as with any infection WHAT MIGHT THIS BE??

Why Should we be Concerned about AROS??? Fewer antibiotic treatment choices available for infected patients Once a patient is colonized with an ARO they can remain colonized acting as a reservoir for further spread Some ARO’s can survive easily in the environment for a long period of time

What can we do??? Screen high risk patients on admission Initiation of prompt standard/routine and additional Transmission Based Precautions Cleaning and disinfecting of equipment and surfaces HAND Hygiene!!!!

Routine Practices…... Also called Universal Precautions Precautions taken with all patients when there is blood, body fluid secretions, excretions or non- intact skin and/or mucous membranes Designed to protect all individuals from risk of infection through transfer of infectious material from patient to patient by staff

Transmission Based Precautions… Used for patients with infections that are spread through droplets, airborne or contact routes Each type of precaution has different guidelines related to type of room, protective clothing required, patient transport, sharing of equipment…………

Protective Clothing…….. Gloves - not a substitute for hand hygiene Gowns - to prevent soiling of your clothing Masks - prevent you from inhaling large particle aerosols and small particle droplets Eyewear – protect eyes from splash back

Dressing and Undressing…… PUTTING ON - wash hands, gown, gloves, mask, eye wear TAKING OFF - untie front waist string, remove gloves, wash hands, remove gown (if soiled, slide out), eye wear and mask last WASH HANDS…………

Additional Modes of Prevention Sharps….. Patient care equipment…… Environmental controls…… Linen……. Patient placement……… Specimen collection…….

What can YOU do to Reduce the Risk? Don’t eat, drink, apply lip balm, handle contact lenses in areas where exposure is likely……… Get Hep B immunization and influenza vaccine Keep immunizations up to date Notify faculty/supervisor immediately if exposure has occurred at work or at home!! Avoid wearing rings, bracelets, watches nail polish, artificial nails…...

Supporting the Patient………. This may be very frightening for the patient and family Provide emotional support and encourage patient to stay as engaged and active as his condition permits Assist visitors with gowning etc. Spend time with patient when you can Cohort patients if possible

Nursing Skills Lab 1 Week 3 – September 18, 2007 Body Mechanics and Positioning Bed Making