1. CHAPTER 3 HEALTH CAREERS TODAY SAFETY PRACTICES – INFECTION CONTROL AND HAND WASHING

2. Objectives
Protect ourselves, patients, peers, family members and others from cross contamination and transmission of disease
Learn to demonstrate proper hand washing according to CDC guidelines
Multiple body fluids
Close physical contact throughout the 2 year Program
Temperature, pulse, respiration, B/P
Occupied bed making
EKG’s
CPR

3. Bacteria, viruses, protozoa, fungi
Bacteria: bacteria can cause trouble, too — ever had a cavity, urinary tract infection, or strep throat? These infections are all caused by bacteria.
Viruses: Most viruses can only live for a very short time outside other living cells.
Stay on surfaces like a countertop or toilet seat in infected bodily fluids for a short period of time, but they quickly die there unless a live host comes along. But some viruses, such as the kind that cause hepatitis (an infection of the liver), can survive on surfaces for a week or longer and still be able to cause infections.
Once viruses move into your body, spread easily and can make you quite sick. Viruses are responsible for not-so-serious diseases like colds as well as extremely serious diseases like smallpox.

4. Fungi: Two common fungal infections include athlete's foot and yeast infections. Like damp, warm environments
Protozoa love moisture, so intestinal infections and other diseases they cause are often spread through contaminated water.
Protozoa draws all their energy from you!
They damage or destroy your own healthy cells.
As they use up your nutrients and energy, most will produce waste products, known as toxins.

5. Disease Transmission Source of microorganisms A susceptible host
• Infection requires three elements:
Source of microorganisms
A susceptible host
A means of transmission to the host

6. Questions Why is hand washing important to you? What are germs?
When should you wash your hands?
When are we at an increased risk of spreading germs to ourselves or another?
Where do germs hide?

7. The Chain of Infection Start #1 Infectious Agent Reservoir Host
Susceptible Host
Portal of Exit
Portal of Entry
Mode of Transmission

8. 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

9. Methods of Transmission
Contact
Direct or indirect through an inanimate object
Droplet
Airborne
Common vehicle
Water, food, contaminated equipment
Through vectors
Mosquitoes, flies, rats, and other such vermin

10. Infection Symptomatic Asymptomatic Local infection Systemic infection
Limited to a small area of the body
Systemic infection
Located throughout the body

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

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

13. Isolation Precautions
Standard Isolation Precautions are applied to ALL patients
Transmission-Based Precautions are applied to patients with known or suspected infections

14. Box 3-1 Evolution of Infection Control Procedures

15. Table 3-1 Isolation Precautions

16. Box 3-2 Requirements Standard Precautions

17. 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)
Most relevant nosocomial pathogen in the United States
Main mode of transmission is via hands

18. Box 3-4 Diseases Connected to Antibiotic Resistance

19. Factors Associated with Development of Antibiotic Resistance
Overuse of antibiotic treatment
Incomplete cycles of prescribed antibiotics

20. Principles of Asepsis
Medical asepsis can be evaluated on three levels:
Antiseptics, which inhibit the growth of bacteria; they can be used on the skin
Disinfectants are agents that destroy most bacteria and viruses. They can be caustic or harmful to the skin. Disinfection can be accomplished by boiling as well as by using chemical agents.
Sterile, also referred to as surgical asepsis, is a state of sterility or the use of sterile technique

21. Definitions Hand hygiene Handwashing Antiseptic handwash
Performing handwashing, antiseptic handwash, alcohol-based handrub, surgical hand hygiene/antisepsis
Handwashing
Washing hands with plain soap and water
Antiseptic handwash
Washing hands with water and soap or other detergents containing an antiseptic agent
Alcohol-based handrub
Rubbing hands with an alcohol-containing preparation
Surgical hand hygiene/antisepsis
Handwashing or using an alcohol-based handrub before operations by surgical personnel
Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.

22. Efficacy of Hand Hygiene Preparations in Killing Bacteria
Good
Better
Best
Plain Soap
Antimicrobial soap
Alcohol-based handrub

23. Indications for Hand Hygiene
When hands are visibly dirty, contaminated, or soiled, wash with non-antimicrobial or antimicrobial soap and water.
If hands are not visibly soiled, use an alcohol-based handrub for routinely decontaminating hands.
Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.

24. Fingernails and Artificial Nails
Natural nail tips should be kept to ¼ inch in length
Artificial nails should not be worn when having direct contact with high-risk patients (e.g., ICU, OR)
Guideline for Hand Hygiene in Health-care Settings. MMWR 2002;
vol. 51, no. RR-16.

25. Time Spent Cleansing Hands: one nurse per 8 hour shift
Hand washing with soap and water: 56 minutes
Based on seven (60 second) handwashing episodes per hour
Alcohol-based handrub: 18 minutes
Based on seven (20 second) handrub episodes per hour
~ Alcohol-based handrubs reduce time needed for hand disinfection ~
Voss A and Widmer AF, Infect Control Hosp Epidemiol 1997:18;

26. ALCOHOL-BASED HANDRUBS: WHAT BENEFITS DO THEY PROVIDE?
Require less time
More effective for standard handwashing than soap
More accessible than sinks
Reduce bacterial counts on hands
Improve skin condition

27. Handwashing Technique
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

28. Hand Rub Poster
CDC How to Wash Hands
Skill Video for Medical Asepsis Handwashing LINK: _global_0001&mode=

29. PREVENTION IS PRIMARY! Protect patients…protect healthcare personnel…
promote quality healthcare!