Chapter 14 Infection Control 2009 Delmar Cengage Learning

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Chapter 14 Infection Control © 2009 Delmar, Cengage Learning

Chapter 14 Infection Control © 2009 Delmar, Cengage Learning

14: 1 Principles of Infection Control • Understanding is essential to all health care

14: 1 Principles of Infection Control • Understanding is essential to all health care workers • Provide a basic knowledge of how disease is transmitted • Main emphasis on prevention of disease transmission © 2009 Delmar, Cengage Learning

Microorganisms or Microbes • • Small living organisms Not visible to the naked eye

Microorganisms or Microbes • • Small living organisms Not visible to the naked eye Microscope must be used to see them Found everywhere in the environment Found on and in the human body Many are part of normal flora of body May be beneficial (continues) © 2009 Delmar, Cengage Learning

Microorganisms or Microbes (continued) • Called nonpathogens when not harmful to the body •

Microorganisms or Microbes (continued) • Called nonpathogens when not harmful to the body • Some cause infections and disease • Called pathogens (germs) when able to harm the body (continues) © 2009 Delmar, Cengage Learning

Microorganisms or Microbes (continued) • • • Most prefer warm environments Most prefer darkness

Microorganisms or Microbes (continued) • • • Most prefer warm environments Most prefer darkness Need source of food and moisture Need for oxygen varies Human body is ideal supplier of all the requirements © 2009 Delmar, Cengage Learning

Microbe Classifications • • • Bacteria Protozoa Fungi Rickettsiae Viruses © 2009 Delmar, Cengage

Microbe Classifications • • • Bacteria Protozoa Fungi Rickettsiae Viruses © 2009 Delmar, Cengage Learning

Bacteria • Simple, one-celled organisms • Multiply rapidly • Classified by shape and arrangement

Bacteria • Simple, one-celled organisms • Multiply rapidly • Classified by shape and arrangement (continues) © 2009 Delmar, Cengage Learning

Bacteria (continued) • Cocci are round or spherical in shape – Diplococci—in pairs –

Bacteria (continued) • Cocci are round or spherical in shape – Diplococci—in pairs – Streptococci—in chains – Staphylococci—clusters or groups • Examples of diseases (continues) © 2009 Delmar, Cengage Learning

Bacteria (continued) • Bacilli are rod shaped – Occur singly, in pairs, or in

Bacteria (continued) • Bacilli are rod shaped – Occur singly, in pairs, or in chains – May have flagella – Ability to form spores • Examples of diseases (continues) © 2009 Delmar, Cengage Learning

Bacteria (continued) • Spirilla are spiral or corkscrew shaped – Includes comma-shaped vibrio and

Bacteria (continued) • Spirilla are spiral or corkscrew shaped – Includes comma-shaped vibrio and corkscrew spirochete • Diseases include syphilis and cholera © 2009 Delmar, Cengage Learning

Antibiotics • Antibiotics are used to kill bacteria • Some strains of bacteria have

Antibiotics • Antibiotics are used to kill bacteria • Some strains of bacteria have become antibiotic-resistant • When antibiotic-resistant, the antibiotic is no longer effective against the bacteria © 2009 Delmar, Cengage Learning

Protozoa • One-celled, animal-like organism • Found in decayed materials and contaminated water •

Protozoa • One-celled, animal-like organism • Found in decayed materials and contaminated water • May have flagella for movement • Some are pathogenic • Examples of diseases © 2009 Delmar, Cengage Learning

Fungi • • Simple, plant-like organisms Live on dead organic matter Yeast and molds

Fungi • • Simple, plant-like organisms Live on dead organic matter Yeast and molds Can be pathogenic Examples of diseases Antibiotics do not kill Antifungal medications © 2009 Delmar, Cengage Learning

Rickettsiae • Parasitic microorganisms • Cannot live outside the cells of another living organism

Rickettsiae • Parasitic microorganisms • Cannot live outside the cells of another living organism • Transmitted to humans by the bites of insects (e. g. , fleas, lice, ticks, mites) • Examples of diseases • Antibiotics are effective against many of them © 2009 Delmar, Cengage Learning

Viruses • Smallest microorganisms • Must use electron microscope to see • Must be

Viruses • Smallest microorganisms • Must use electron microscope to see • Must be inside another living cell to reproduce • Spread by blood and body secretions • Very difficult to kill • Cause many diseases (continues) © 2009 Delmar, Cengage Learning

Viruses (continued) • Viruses infecting animals can mutate to infect humans • Examples include:

Viruses (continued) • Viruses infecting animals can mutate to infect humans • Examples include: – – – Severe acute respiratory syndrome (SARS) West Nile Virus (WNV) Monkeypox Ebola and Marburg H 5 N 1 © 2009 Delmar, Cengage Learning

Virus—Hepatitis B • Also called serum hepatitis • Caused by HBV • Transmitted by

Virus—Hepatitis B • Also called serum hepatitis • Caused by HBV • Transmitted by blood serum and body secretions • Affects the liver • Vaccine available for protection • Vaccine is expensive (continues) © 2009 Delmar, Cengage Learning

Virus—Hepatitis B (continued) • Vaccine given in a series of three injections • By

Virus—Hepatitis B (continued) • Vaccine given in a series of three injections • By law, employers must provide vaccine at no cost to employees with occupational exposure to blood or other body secretions • If employee refuses, written statement must be signed documenting refusal © 2009 Delmar, Cengage Learning

Hepatitis C • Caused by HVC • Transmitted by blood and blood-containing body fluids

Hepatitis C • Caused by HVC • Transmitted by blood and blood-containing body fluids • Many infected individuals are asymptomatic • Others have mild symptoms • Can cause severe liver damage (continues) © 2009 Delmar, Cengage Learning

Hepatitis C (continued) • • Currently, no vaccine ready for use Vaccine is in

Hepatitis C (continued) • • Currently, no vaccine ready for use Vaccine is in development stage Extremely difficult to destroy HVC Can survive and remain active for several days in dried blood • Health care workers must follow precautions to protect against virus © 2009 Delmar, Cengage Learning

Acquired Immune Deficiency Syndrome (AIDS) • Caused by the Human Immunodeficiency Virus (HIV) •

Acquired Immune Deficiency Syndrome (AIDS) • Caused by the Human Immunodeficiency Virus (HIV) • Suppresses the immune system • Individual becomes susceptible to cancers and infections that would not affect a healthy person • No cure presently and no vaccine • Take precautions for prevention © 2009 Delmar, Cengage Learning

Helminths • Multicellular parasites otherwise known as worms or flukes • Are transmitted: –

Helminths • Multicellular parasites otherwise known as worms or flukes • Are transmitted: – By eating contaminated food – Being bitten by infected insects – When worms enter the skin © 2009 Delmar, Cengage Learning

How Pathogens Cause Infection and Disease • Some produce poisons called toxins • Some

How Pathogens Cause Infection and Disease • Some produce poisons called toxins • Some cause an allergic reaction • Others attach and destroy the living cells they invade © 2009 Delmar, Cengage Learning

Classifications of Diseases and Infections • • Endogenous Exogenous Nosocomial Opportunistic © 2009 Delmar,

Classifications of Diseases and Infections • • Endogenous Exogenous Nosocomial Opportunistic © 2009 Delmar, Cengage Learning

Endogenous • Originates within the body • Examples: metabolic disorders, congenital abnormalities, tumors, and

Endogenous • Originates within the body • Examples: metabolic disorders, congenital abnormalities, tumors, and infections caused by microorganisms within the body © 2009 Delmar, Cengage Learning

Exogenous • Originates outside the body • Examples: radiation, chemical agents, trauma, electric shock,

Exogenous • Originates outside the body • Examples: radiation, chemical agents, trauma, electric shock, and temperature extremes © 2009 Delmar, Cengage Learning

Nosocomial • Acquired in a health care facility • Usually present in facilities and

Nosocomial • Acquired in a health care facility • Usually present in facilities and carried by health care workers to the patient • Many are antibiotic-resistant • Can cause serious and even life-threatening infections (continues) © 2009 Delmar, Cengage Learning

Nosocomial (continued) • Examples are staphylococcus, pseudomonas, and enterococci • Infection-control programs are used

Nosocomial (continued) • Examples are staphylococcus, pseudomonas, and enterococci • Infection-control programs are used in facilities to prevent and deal with nosocomial infections © 2009 Delmar, Cengage Learning

Opportunistic • Infections that occur when the body’s defenses are down • Usually do

Opportunistic • Infections that occur when the body’s defenses are down • Usually do not occur in normal immune system • Examples: Kaposi’s sarcoma (rare type of cancer) and Pneumocystis carinii pneumonia in individuals with AIDS © 2009 Delmar, Cengage Learning

Chain of Infection • Present for disease to occur and spread from one individual

Chain of Infection • Present for disease to occur and spread from one individual to another – – – Causative agent Reservoir Portal of exit Mode of transmission Portal of entry Susceptible host © 2009 Delmar, Cengage Learning

Common Body Defenses • • Mucous membranes Cilia Coughing and sneezing HCL in the

Common Body Defenses • • Mucous membranes Cilia Coughing and sneezing HCL in the stomach Tears Fever Inflammation response Immune response © 2009 Delmar, Cengage Learning

Ending the Chain of Infection • Eliminate any step in the chain and infection

Ending the Chain of Infection • Eliminate any step in the chain and infection is stopped • Follow practices to interrupt or break the chain • Remember, pathogens are everywhere • Prevention is a continuous process © 2009 Delmar, Cengage Learning

Aseptic Techniques • Asepsis: absence of disease-producing microorganisms • Contaminated: any object or area

Aseptic Techniques • Asepsis: absence of disease-producing microorganisms • Contaminated: any object or area that may contain pathogens • Major aim: maintaining cleanliness and eliminating or preventing every aspect of contamination © 2009 Delmar, Cengage Learning

Common Aseptic Techniques • • • Thorough handwashing Good personal hygiene Disposable gloves Cleaning

Common Aseptic Techniques • • • Thorough handwashing Good personal hygiene Disposable gloves Cleaning instruments and equipment Proper cleaning of environment © 2009 Delmar, Cengage Learning

Levels of Aseptic Control • Antisepsis—used on the skin • Disinfection—used mainly on objects

Levels of Aseptic Control • Antisepsis—used on the skin • Disinfection—used mainly on objects • Sterilization—use of steam under pressure, gas, radiation, and chemicals on objects © 2009 Delmar, Cengage Learning

Summary • Important for health care workers to know and use proper aseptic techniques

Summary • Important for health care workers to know and use proper aseptic techniques at all times • Prevents spread and transmission of disease © 2009 Delmar, Cengage Learning

14: 2 Bioterrorism • Bioterrorism: use of microorganisms or biologic agents for warfare •

14: 2 Bioterrorism • Bioterrorism: use of microorganisms or biologic agents for warfare • Infecting humans, animals, or plants • Have been used over time by different nations not only in war but also on innocent people © 2009 Delmar, Cengage Learning

Biologic Agents • Microorganisms with characteristics suitable for bioterrorism: – – – Inexpensive, available,

Biologic Agents • Microorganisms with characteristics suitable for bioterrorism: – – – Inexpensive, available, easily produced, spreads quickly Maintains its survival Brings death or disability Travels from person to person Difficult to prevent/treat (continues) © 2009 Delmar, Cengage Learning

Biologic Agents (continued) • High priority agents include: – Smallpox: contagious and infectious disease,

Biologic Agents (continued) • High priority agents include: – Smallpox: contagious and infectious disease, result of the Variola virus – Anthrax: infectious disease caused by Bacillus anthracis – Plague: infectious disease from the bacteria Yersinia pestis (continues) © 2009 Delmar, Cengage Learning

Biologic Agents (continued) – Botulism: paralytic illness resulting from a nerve toxin from the

Biologic Agents (continued) – Botulism: paralytic illness resulting from a nerve toxin from the bacteria Clostridium botulinum – Tularemia: infectious disease from the bacteria Fracisella tularensis – Filoviruses: infectious diseases causing severe hemorrhagic fever known as Ebola virus and Marburg virus © 2009 Delmar, Cengage Learning

Preparing for Bioterrorism • Bioterrorism attack would result in a public health emergency •

Preparing for Bioterrorism • Bioterrorism attack would result in a public health emergency • Would have impact on health care facilities • Social disorder would ensue • Comprehensive plan (continues) © 2009 Delmar, Cengage Learning

Preparing for Bioterrorism (continued) • Bioterrorism Act 2002 passed by Congress and signed into

Preparing for Bioterrorism (continued) • Bioterrorism Act 2002 passed by Congress and signed into law • Involves local, regional, state, and national government and includes: – – Early detection by communities Public to be notified Infection control and education Funding available (continues) © 2009 Delmar, Cengage Learning

Preparing for Bioterrorism (continued) – – – – Guidelines and restrictions Nationwide immunizations Protection

Preparing for Bioterrorism (continued) – – – – Guidelines and restrictions Nationwide immunizations Protection of food/water supplies Trained personnel available Emergency management controls Investigation of potential threats Preparation of health care facilities Efficiency of communication © 2009 Delmar, Cengage Learning

Summary • All health care workers need to be aware of bioterrorism • Attack

Summary • All health care workers need to be aware of bioterrorism • Attack could occur at any time • Being prepared and properly trained will result in saving many lives © 2009 Delmar, Cengage Learning

14: 3 Washing Hands • Major aspect of standard precautions • Most important aseptic

14: 3 Washing Hands • Major aspect of standard precautions • Most important aseptic technique • Hands are perfect media for the spread of pathogens © 2009 Delmar, Cengage Learning

Purpose of Handwashing • Prevent and control spread of pathogens • Protect the health

Purpose of Handwashing • Prevent and control spread of pathogens • Protect the health care worker from disease and illness © 2009 Delmar, Cengage Learning

Recommendations for Handwashing • Regular handwashing with plain soap and water • Antiseptic handwashing

Recommendations for Handwashing • Regular handwashing with plain soap and water • Antiseptic handwashing with antimicrobial soap and water • Antiseptic hand rub with alcohol-based cleaner (waterless) © 2009 Delmar, Cengage Learning

When to Wash Hands • • • On arrival at facility Immediately before leaving

When to Wash Hands • • • On arrival at facility Immediately before leaving facility Before and after every patient contact After contact with patient’s skin Before moving from a contaminated site to a clean site (continues) © 2009 Delmar, Cengage Learning

When to Wash Hands (continued) • Anytime the hands become contaminated during a procedure

When to Wash Hands (continued) • Anytime the hands become contaminated during a procedure • Before applying gloves • Immediately after removing gloves • When gloves are torn or punctured • Before and after handling specimens • After contact with any soiled or contaminated item (continues) © 2009 Delmar, Cengage Learning

When to Wash Hands (continued) • • After picking up any item off the

When to Wash Hands (continued) • • After picking up any item off the floor After personal use of the bathroom Following a cough, sneeze, or using a tissue Before and after any contact with mouth or mucous membranes © 2009 Delmar, Cengage Learning

Principles of Handwashing • • • Use soap as a cleansing agent Use warm

Principles of Handwashing • • • Use soap as a cleansing agent Use warm water Use friction Clean all surfaces Point fingertips down Use dry paper towels to turn faucet on and off • Clean nails © 2009 Delmar, Cengage Learning

Waterless Hand Cleaning • Alcohol-based gel, lotion, or foam • Used if hands are

Waterless Hand Cleaning • Alcohol-based gel, lotion, or foam • Used if hands are not contaminated with blood or body fluids • Apply cleaner to palm of hand • Rub hands together vigorously for at least 15 seconds • After six to ten cleanings hands need to be washed with soap and water © 2009 Delmar, Cengage Learning

14: 4 Observing Standard Precautions • Blood and body fluids are the main ways

14: 4 Observing Standard Precautions • Blood and body fluids are the main ways pathogens are spread • Major pathogens: HBV, HBC, HIV • Extreme care must be taken at all times when there is an area, object, or person contaminated with blood or body fluids © 2009 Delmar, Cengage Learning

Bloodborne Pathogen Standards • Established in 1991 by OSHA • Must be followed by

Bloodborne Pathogen Standards • Established in 1991 by OSHA • Must be followed by all health care workers • Civil penalties if not implemented and followed © 2009 Delmar, Cengage Learning

Regulation Requirements • Written exposure control plan • Identify all employees with occupational exposure

Regulation Requirements • Written exposure control plan • Identify all employees with occupational exposure • Hepatitis B vaccines free of charge • Provide personal protective equipment (continues) © 2009 Delmar, Cengage Learning

Regulation Requirements (continued) • Provide adequate handwashing facilities and supplies • Ensure worksite is

Regulation Requirements (continued) • Provide adequate handwashing facilities and supplies • Ensure worksite is maintained in a clean, sanitary condition • Follow measures for immediate decontamination of surfaces when contaminated (continues) © 2009 Delmar, Cengage Learning

Regulation Requirements (continued) • Dispose of infectious waste correctly • Enforce rules of limited

Regulation Requirements (continued) • Dispose of infectious waste correctly • Enforce rules of limited activities in any potentially contaminated area • Provide appropriate containers for contaminated sharps and other contaminated items (color coded and labeled) (continues) © 2009 Delmar, Cengage Learning

Regulation Requirements (continued) • Post signs at the entrance to work areas with occupational

Regulation Requirements (continued) • Post signs at the entrance to work areas with occupational exposure to biohazardous materials • Red biohazard labels • Provide a confidential medical evaluation and follow-up for any employee with an exposure incident • Provide training to employees © 2009 Delmar, Cengage Learning

Needle Stick Safety Act • Passed by Congress in 2000 • Centers for Disease

Needle Stick Safety Act • Passed by Congress in 2000 • Centers for Disease Control and Prevention (CDC) estimated 600, 000 to 800, 000 needle sticks per year • OSHA revised Bloodborne Pathogen Standard to requirements of this act © 2009 Delmar, Cengage Learning

Employer Requirements • Identify and use effective and safer medical devices • Incorporate changes

Employer Requirements • Identify and use effective and safer medical devices • Incorporate changes in annual update of exposure control plan • Solicit input from nonmanagerial employees who are responsible for direct patient care (continues) © 2009 Delmar, Cengage Learning

Employer Requirements (continued) • Maintain a sharps injury log • Ensure that every employee

Employer Requirements (continued) • Maintain a sharps injury log • Ensure that every employee uses standard precautions at all times © 2009 Delmar, Cengage Learning

Standard Precautions • Rules developed by the CDC • Every body fluid must be

Standard Precautions • Rules developed by the CDC • Every body fluid must be considered potential source of infection • All patients must be considered potential source of infection © 2009 Delmar, Cengage Learning

When to Use Standard Precautions • Any situation where you might come in contact

When to Use Standard Precautions • Any situation where you might come in contact with: – – – Blood or any fluid that contains blood Body fluids, secretions, and excretions Mucous membranes Nonintact skin Tissue or cell specimens © 2009 Delmar, Cengage Learning

Gloves • Gloves must be changed after contact with each patient • When removing

Gloves • Gloves must be changed after contact with each patient • When removing gloves, do not contaminate your skin • Hands must be washed immediately after removal of gloves • Gloves must not be reused © 2009 Delmar, Cengage Learning

When to Wear Gloves • Whenever contact with body fluids, secretions, or excretions •

When to Wear Gloves • Whenever contact with body fluids, secretions, or excretions • When handling or cleaning contaminated items or surfaces • Performing any invasive procedure • Performing venipuncture/blood tests © 2009 Delmar, Cengage Learning

Gowns • Worn during procedures that may cause splashing or spraying • Helps prevent

Gowns • Worn during procedures that may cause splashing or spraying • Helps prevent contamination of clothing or uniforms • Contaminated gowns must be handled per policy • Hands must be washed immediately after removing gown © 2009 Delmar, Cengage Learning

Masks and Eye Protection • Worn during procedures that may cause splashing or spraying

Masks and Eye Protection • Worn during procedures that may cause splashing or spraying • Prevents exposure of mucous membranes of the mouth, nose, and eyes to pathogens • Use masks once then discard—change every 30 minutes if needed (continues) © 2009 Delmar, Cengage Learning

Masks and Eye Protection (continued) • Protective eyewear and face shields protect front, top,

Masks and Eye Protection (continued) • Protective eyewear and face shields protect front, top, bottom, and sides of eyes • If not disposable, must be cleaned and disinfected before reuse © 2009 Delmar, Cengage Learning

Sharp Objects • Use extreme caution to avoid cuts and punctures • When possible,

Sharp Objects • Use extreme caution to avoid cuts and punctures • When possible, use safe needles or needleless system • Follow policies regarding needles • Use sharps containers • Follow laws regarding disposal of sharp objects © 2009 Delmar, Cengage Learning

Spills or Splashes • • Wipe up immediately Wear gloves when wiping up Use

Spills or Splashes • • Wipe up immediately Wear gloves when wiping up Use disposable cleaning clothes Use disinfectant which contains 10% bleach solution • Clean all contaminated surfaces • For large spills, can use absorbent powder to absorb fluid © 2009 Delmar, Cengage Learning

Resuscitation Devices • Use to avoid the need for mouth-to-mouth resuscitation • Place in

Resuscitation Devices • Use to avoid the need for mouth-to-mouth resuscitation • Place in convenient location that is readily accessible © 2009 Delmar, Cengage Learning

Waste and Linen Disposal • Wear gloves • Follow agency policy • Use biohazard

Waste and Linen Disposal • Wear gloves • Follow agency policy • Use biohazard bags appropriately © 2009 Delmar, Cengage Learning

Injuries • Report any cut or injury, needle stick, or splashing of blood or

Injuries • Report any cut or injury, needle stick, or splashing of blood or body fluids immediately • Follow agency policy © 2009 Delmar, Cengage Learning

Summary • Standard precautions need to be followed at all times by every health

Summary • Standard precautions need to be followed at all times by every health care worker • Observing these precautions can help break the chain of infection • Health care workers can protect themselves, their patients, and all other individuals © 2009 Delmar, Cengage Learning

14: 5 Sterilizing with an Autoclave • Equipment that uses steam under pressure or

14: 5 Sterilizing with an Autoclave • Equipment that uses steam under pressure or gas • Most effective method of sterilization • Available in various sizes and types • Preparation of equipment or supplies • Wrapping items for autoclaving (continues) © 2009 Delmar, Cengage Learning

Sterilizing with an Autoclave (continued) • • Autoclave indicators Loading the autoclave Time period

Sterilizing with an Autoclave (continued) • • Autoclave indicators Loading the autoclave Time period for sterilization Care of items after autoclaving Dry heat sterilization Follow directions on specific autoclave Follow agency policy © 2009 Delmar, Cengage Learning

14: 6 Using Chemicals for Disinfection • May not kill spores and viruses •

14: 6 Using Chemicals for Disinfection • May not kill spores and viruses • Disinfect, but do not sterilize • Used to disinfect instruments that do not penetrate body • Preparation of items • Chemical solutions used (continues) © 2009 Delmar, Cengage Learning

Using Chemicals for Disinfection (continued) • • • Read manufacturer’s instructions Antirust tablets or

Using Chemicals for Disinfection (continued) • • • Read manufacturer’s instructions Antirust tablets or solutions added Requirements for disinfection Chemical must completely cover items Care of chemical solutions © 2009 Delmar, Cengage Learning

14: 7 Cleaning with an Ultrasonic Unit • Uses sound waves for cleaning •

14: 7 Cleaning with an Ultrasonic Unit • Uses sound waves for cleaning • Method of aseptic control • Only ultrasonic solutions should be used in unit • Permanent tank of ultrasonic unit • Items cleaned in ultrasonic unit (continues) © 2009 Delmar, Cengage Learning

Cleaning with an Ultrasonic Unit (continued) • Care of glass beakers • Care of

Cleaning with an Ultrasonic Unit (continued) • Care of glass beakers • Care of the permanent tank • Read manufacturer’s instructions before using any ultrasonic unit © 2009 Delmar, Cengage Learning

Summary • Different methods provide different levels of aseptic control • Method used depends

Summary • Different methods provide different levels of aseptic control • Method used depends on equipment and level of aseptic control required • Read manufacturer’s instructions • Clean, rinse, and dry all equipment before processing • Handle all items carefully © 2009 Delmar, Cengage Learning

14: 8 Using Sterile Techniques • Many procedures require use of sterile techniques to

14: 8 Using Sterile Techniques • Many procedures require use of sterile techniques to protect a patient from infection • Surgical asepsis keeps an object or area free from living organisms • Sterile: free from all organisms • Contaminated: organisms and pathogens present (continues) © 2009 Delmar, Cengage Learning

Using Sterile Techniques (continued) • Important to differentiate between sterile and contaminated areas or

Using Sterile Techniques (continued) • Important to differentiate between sterile and contaminated areas or items while using sterile technique • Correct techniques must be strictly followed to maintain sterility and prevent contamination (continues) © 2009 Delmar, Cengage Learning

Using Sterile Techniques (continued) • Clean working area required • Handling of sterile supplies

Using Sterile Techniques (continued) • Clean working area required • Handling of sterile supplies • Sterile field: area used for placement of sterile supplies • All sterile items need to be checked • Observe agency guidelines for date • Necessary to keep sterile field dry © 2009 Delmar, Cengage Learning

Removing Articles from Sterile Wraps • Drop technique—for gauze, pads, dressings, and small items

Removing Articles from Sterile Wraps • Drop technique—for gauze, pads, dressings, and small items • Mitten technique—for bowls, drapes, and linens • Transfer forceps—for cotton balls and small items © 2009 Delmar, Cengage Learning

14: 9 Transmission-Based Isolation Precautions • Some diseases are communicable – Caused by organisms

14: 9 Transmission-Based Isolation Precautions • Some diseases are communicable – Caused by organisms that can be transmitted easily • Epidemic—spreads from person to person and affects large numbers • Pandemic—spreads over a wide geographic area • These precautions are in addition to the Standard Precautions (continues) © 2009 Delmar, Cengage Learning

Transmission-Based Isolation Precautions (continued) • Helps prevent spread of disease • Protects patient, family,

Transmission-Based Isolation Precautions (continued) • Helps prevent spread of disease • Protects patient, family, and health care workers • Type used depends on the causative organism of the disease © 2009 Delmar, Cengage Learning

How Communicable Diseases Spread • Direct contact with a patient • Contact with dirty

How Communicable Diseases Spread • Direct contact with a patient • Contact with dirty linen, equipment, and supplies • Contact with blood, body fluids, secretions, and excretions © 2009 Delmar, Cengage Learning

Terms Defined • Contaminated or dirty: items that contain disease-producing organisms; must not be

Terms Defined • Contaminated or dirty: items that contain disease-producing organisms; must not be touched unless protected • Clean: items that do not contain the organisms; protect these areas from contamination © 2009 Delmar, Cengage Learning

Classifications of Precautions • • Standard precautions Airborne precautions Droplet precautions Contact precautions ©

Classifications of Precautions • • Standard precautions Airborne precautions Droplet precautions Contact precautions © 2009 Delmar, Cengage Learning

Protective or Reverse Isolation • Method used to protect certain patients from organisms present

Protective or Reverse Isolation • Method used to protect certain patients from organisms present in the environment • Used mainly for immunocompromised patients • Precautions vary depending on patient’s condition © 2009 Delmar, Cengage Learning

Summary • Exact procedures for maintaining transmission-based isolation will vary from one facility to

Summary • Exact procedures for maintaining transmission-based isolation will vary from one facility to another • Variations caused by different factors • Basic principles remain the same in any facility and are directed toward preventing the spread of disease © 2009 Delmar, Cengage Learning