1. CHAPTER 3 - SAFETY PRACTICES

2. BOOKLETS
Define:
Antiseptic Ergonomics Sterile
Asepsis Pathogen Nosocomial pathogens
Contaminated Standard Precautions
Disinfectant Transmission Based Precautions
What are the three elements of infection, and write out a scenario, with examples, of how this could occur (first sentence of chpt)
Please list the different types of isolation, what diseases require which level of isolation, & what is worn for each
Medical asepsis can be evaluated in which 5 levels; please write what each level involves (see table 3-1)
What are OBRA & OSHA, & what do they oversee?
What do RACE & PASS stand for
Compare the signs & symptoms of a local vs. general infection

3. Disease Transmission • Infection requires several elements:
Pathogenic agent
A reservoir
Method of escape from the reservoir
Mode of transmission or transferring to the host
A way of entry into the host
A susceptible host

4. The Infection Process
The microbe/agent is anything that can cause communicable disease such as bacteria, virus, fungi, or animals like worms
The source or reservoir may be the patient, other people, or inanimate objects like a doorknob
Modes of transmission are contact (touching contaminated object), droplet (sneeze), airborne (TB, Chicken Pox), and vectors like mosquitoes or ticks
Method of entry could be a mosquitoes bite, an open sore or a mucus membrane
A susceptible host that does not have enough resistance to fight infection, due to illness or poor health

5. Primary Methods of Transmission
Contamination: Soiled, unclean, or infected by pathogens
Contact: Direct or indirect through an inanimate object
Droplet: Spread thru droplets (sneeze/cough; ex: pneumonia)
Airborne: in the air
Common vehicle: Water, food, contaminated equipment
Vectors: mosquitoes, rats, vermin

6. Disease Transmission
The infectious process

7. Signs and Symptoms of a General Infection
Fever
Chills
Pain
An ache or tenderness
General feeling of tiredness
Night sweats

8. Signs and Symptoms of a Local Infection
Redness
Heat
Swelling
Pain
Fluid

9. Standard Precautions
Standard Precautions are applied to ALL patients, ALL body fluids, ALL the time!
Designed to reduce the transmission of microorganisms.
Isolation Precautions are applied to patients with known or suspected infections

11. Table 3-1 Isolation Precautions
Airborne--Measles, varicella, tuberculosis
Droplet--pneumonia

12. Requirements of Isolation Precautions If an employee is contaminated with body fluids from a patient with a known disease, employee must be seen in the ER within 2 hours

13. Box 3-3 Bioterrorism Agents Ex: Anthrax, Plague, Smallpox

14. Antibiotic-Resistant Diseases
In 2005 Centers for Disease Control Prevention listed eight diseases that have been connected to antibiotic resistance
Methicillin-resistant Staphylococcus aureus (MRSA) multi drug resistant
Most relevant nosocomial pathogen in the United States
Main mode of transmission is via hands

15. Box 3-4 Diseases Connected to Antibiotic Resistance

16. Factors Associated with Development of Antibiotic Resistance
Overuse of antibiotic treatment
Incomplete cycles of prescribed antibiotics
Taking another person’s antibiotics

17. Handwashing Technique Primary Protection from Infection
Hands are washed thoroughly at the beginning of the work period
Between each client contact
Before and after eating
Before and after using the restroom
Before leaving the work environment
Gloves are worn when contact is made with body fluids, mucous membranes, or wet secretions

18. Handwashing Technique
Wet hands
Apply soap
Keep hands below arms
Use friction / rubbing
Dry with paper towels
Paper towels are NOT sterile
Turn off faucet with towel

19. Principles of Asepsis freedom from infection/to prevent the spread of microorganisms
Medical asepsis can be evaluated on three levels:
Antiseptics, which deters or inhibits the growth of bacteria; they can be used on the skin
Disinfectants are agents that kills most bacteria. Disinfection can be accomplished by boiling as well as by using chemical agents (do not kill viruses or spores).
Sterile (surgical asepsis), is a state of sterility or the use of sterile technique - Free of any living organism.
An autoclave is used to remove all microorganisms by using steam under pressure to sterilize materials

20. Omnibus Budget Reconciliation Act (OBRA) Regulations
OBRA requires training for nursing assistants. This includes:
Completion of a written competency test.
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

21. Occupational Safety and Health Administration (OSHA) Regulations
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

22. Safe Movement Body mechanics and ergonomics
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
Balance is the ability to maintain a steady position that does not tip
Ergonomics refers to the design of equipment that minimizes fatigue and discomfort

23. Assistive Devices Allow mobility while preventing injury Gait belt
Worn by the patient when transferring or ambulating
Strong cloth belt
Provides a firm grasping area
Protects patient from trauma to the skin
Health care worker may also wear a belt to prevent back injury

25. R.A.C.E.
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 lower level
A = Alarm
Use emergency call box or pull station
C = Confine or contain fire to one area if possible
E = Extinguish
Use fire extinguisher

26. P.A.S.S. Guidelines for Fire Extinguisher Use

27. Fire Extinguisher Types
A B C D

28. Lab Activity: Ecosystems of the Human Body

29. Lab 12a allows students to collect and grow bacteria from the mouth
Lab 12a allows students to collect and grow bacteria from the mouth. They will be using cotton swabs to obtain a buccal sample and place on nutrient agar. The same student who provided the sample will then rinse with mouthwash and a second buccal swab will be taken. In a similar fashion, students will wipe their finger on the nutrient agar, wash their hands and then wipe their finger on the agar again. The samples on the nutrient agar plates will then be allowed to grow and students will observe bacterial growth from the mouth and skin in unwashed and washed conditions. The concept of normal flora and bacteria interactions will be covered in the analysis.

31. Number of Different Organisms
Plate
Area
Number of Different Organisms
Skin Washed (SW)
Skin Unwashed (SU)
Mouth Washed
(MW)
Mouth Unwashed (MU)