Upload
neil-sims
View
216
Download
0
Tags:
Embed Size (px)
Citation preview
Tentative CNA clinical Groups
• Srujal• Nicole• Prachi • Celina• Katie• Jaxmaureen• Taylor M• Shinera
• Sergio• Alexa• Nick
• Sagar• Allison• Dana• Sabrina• Rishi• Jessica• Pierce • James
• Christian• Michal • Kristen
• Ravina• Avani• Juhi• Masaumi• Eduardo
A/B (November)
C Dec/Jan
D Jan/Feb• Edward• Dan• Danielle• Taylor L• Erin• Jessica• Neil • Hubert
• Bailey• Rachel
Preventing Infection
Unit 5
Infection control
• Infection control involves preventing & controlling the spread of disease in a healthcare facility.• All care team members must work to
prevent the spread of disease.• All facilities have infection control
policies.
Microorganisms
• Microorganisms (also called microbes) are tiny living things that can only be viewed through a microscope.
• Pathogens are harmful organisms that invade the body & multiply.
• Pathogens cause infections.
Infections
• Systemic infections• Infection in the bloodstream spread throughout body.• Generalized symptoms: fever, chills, confusion.
• Localized infections• Located in specific part of body.• Causes symptoms at site of infection.
• Healthcare-associated infections (HAIs) are acquired in healthcare settings, as a result of Tx for other conditions. (AKA: nosocomial infections.)
2 kinds of asepsis
• Medical asepsis – process of removing all pathogens.• “Clean” – not contaminated with pathogens• “Dirty” – contaminated with pathogens
• Surgical asepsis – process of removing all micoorganisms, not just pathogens.• Also called “sterile technique”
Matching
1. ____Measures practiced in agencies to prevent & control the spread of infection.
2. ____A harmful microbe.
3. ____Infections that are the result of treatment for other conditions.
4. ____Tiny living things that cannot be seen s a microscope.
5. ____Occurs when pathogens invade the body & multiply.
6. ____Infection that is confined to a specific part of the body.
A. Healthcare-
associated
infection
B. Infection
C. Infection control
D. Localized infection
E. Microorganism or
microbe
F. Pathogen
Matching
7. ____The state of being free of all microbes, not just pathogens.
8. ____The process of removing pathogens, or the state of being free of pathogens.
9. ____When pathogens are in the bloodstream & spread throughout the body.
10. ____In healthcare, objects that have not been contaminated with pathogens.
11. ____In healthcare, objects that have been contaminated with pathogens.
A. Clean
B. Dirty
C. Medical asepsis
D. Surgical asepsis
E. Systemic infection
Chain of infection
Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Chain of infection is a way of describing how disease is transmitted from one living being to another.
Chain of infection
Drag picture to placeholder or click icon to add
Causative agent (pathogen): can be bacteria, fungi, viruses, or protozoa. May be normal flora in one part of body, pathogenic in another.
Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Chain of infection
Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Reservoir is the place where the pathogen lives & grows (usually warm, dark, moist place).
Chain of infection
Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Portal of exit is any opening in the body that allows pathogens to leave (mouth, eyes, wound in skin).
Chain of infection
Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Mode of transmission describes how the pathogen travels from one person to next person (can be by direct contact or indirect contact).
Chain of infection
Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Portal of entry is any body opening that allows a pathogen to enter (mouth, eyes, nose, mucous membrane, or break in skin).
Chain of infection
Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Susceptible host is any uninfected person who could get sick.
Chain of infection
Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Infection prevention practices & vaccinations break links in the chain of infection to stop the transmission of infection.
Matching
1. ____opening on an infected person that lets pathogens leave.
2. ____opening on uninfected person that lets pathogens enter.
3. ____pathogen, microbe that causes disease.
4. ____place were pathogen lives & grows.
5. ____uninfected person who could get sick.
6. ____how pathogens travel from one person to another.
A. Causative agent
B. Reservoir
C. Portal of exit
D. Mode of
transmission
E. Portal of entry
F. Susceptible host
Risk of infection
Elderly are at high risk for infection.• Immune systems are weaker.• Chronic illnesses• Decreased circulation• Slow wound healing• Malnutrition due to difficulties
chewing &/or swallowing, appetite & thirst, weakness, medications
• Limited mobility• Frequent hospitalizations.
Risk of infection
Infection is more dangerous for the elderly.
• Simple illnesses can turn life-threatening
• Recovery takes longer.• Prevention is the key.
Signs & symptoms of infection
S & S of local infection.• Fever• Body aches• Pus• Drainage• Swelling• Heat
Signs & symptoms of infection
S & S of systemic infection.
• Pain• Body aches• Chills• Nausea• Vomiting• Weakness• Headache• Confusion• blood pressure
True or false
1. ____ The elderly have a higher risk for infection than younger people.
2. _____It is normal for a person’s immune system to grow weaker as he or she ages.
3. _____ Blood circulation increases as a person ages.
4. ____ Limited mobility increases the risk of pressure sores as a person ages.
5. _____Nutrition & fluid intake play no part in helping prevent infection.
True or false
6. ____ The elderly are less likely than younger people to have HAIs.
7. _____Infections are less dangerous in the elderly than in young people.
8. _____ CNAs play an important role in protecting elderly residents from infections.
9. ____ Redness & swelling are common symptoms of systemic infections.
10._____Fever, chills, & confusion are symptoms of systemic infection.
Infection control precautions
• The CDC (Centers for Disease Control & Prevention) is a government agency that promotes public health of Americans.• Recommended new infection control
system in 1996 to reduce risk of infectious disease in health care settings.• 2 tiers of precautions• Standard precautions• Transmissions-based (isolation) precautions
Standard precautions
• Standard precautions means to treat all blood, body fluids, & non-intact skin & mucous membranes as if they were infected with an infectious disease.
• For standard precautions, “body fluids” include saliva, sputum (coughed up mucous), urine, feces, semen, vaginal secretions, pus or wound drainage. They do NOT include sweat.
• Remember standard precautions should ALWAYS be practiced with everyone.
• Transmission based precautions are based on how an infection is transmitted & are used in addition to standard precautions.
Standard precautions
• Always practice standard precautions c every person in your care.
• Wash hands a & p gloving.• Do not touch clean objects while wearing gloves.• Wear gloves q time you may come into contact
with blood or body fluids• Includes mouth care, toileting, cleaning up spills
or containers that have held body fluids.
Standard precautions
• Remove gloves immediately when finished c procedure
• Immediately wash all skin surfaces that have been contaminated c blood or body fluids
• Wear gloves & use caution when handling sharps (needles, blades, anything that can cut or pierce skin). Discard these objects in a puncture-resistant biohazard container.
Standard precautions
• Never cap a needle or syringe. Dispose of them in a biohazardous waste container.
• Avoid nicks & cuts when shaving residents.• Carefully bag all contaminated supplies &
dispose of them according to facility policy.• Clearly label body fluids that are saved for a lab
specimen. Keep them in a container with a lid & transport them in a biohazard specimen bag.
• Dispose of contaminated liquid waste in sewer system. Avoid splashing.
True or false
1. ____ Standard precautions means treating all blood, body fluids, non-intact skin, & mucous membranes as if they were infected.
2. _____Standard precautions relate to all body fluids except saliva.
3. _____ You can usually tell if someone is infectious by looking at him.
4. _____ The CDC is a government agency that issues information to protect the health of individuals & communities.
True or false
5. ____You should wash your hands before putting on gloves.
6. _____Syringes should be re-capped p use.
7. _____Giving mouth care will require you to wear gloves.
8. _____It is a good idea to wear a mask & goggles to empty a bedpan.
9. _____When cleaning a urinal, you don’t need to wear gloves.
Multiple choice
10. Standard precautions should be practicedA. Only on people who look like they have a
bloodborne disease.
B. On every single person in your care.
C. Only on people who request that you follow them.
D. Only people who have tuberculosis.
Multiple choice
11. Standard precautions include the following measures
A. Using your used or soiled gloves to gather clean equipment.
B. Wearing gloves if there is a possibility of contact with blood, body fluids, mucous membranes, or broken skin.
C. Touching body fluids with your bare hands.
D. Putting caps on used needles.
Multiple choice
12. Which of the following is true of transmission-based, or isolation precautions?
A. You do not need to practice standard precautions if you practice transmission-based precautions.
B. They are exactly the same as standard precautions.
C. They are practiced in addition to standard precautions.
D. They are never practiced at the same time that standard precautions are used.
Hand hygiene
• CDC definition of hand hygiene includes both:• handwashing with either plain or antimicrobial
soap & water• using alcohol-based hand rubs (gel, rinse, or
foam).
• Alcohol-based hand rubs are not a substitute for handwashing.• Always use soap & water for visibly soiled
hands.
Hand hygiene
• Consider removing rings while working. They may increase the risk of contamination.• Keep fingernails short, smooth, & clean.• Artificial nails harbor bacteria & risk
contamination.• Always wash hands a & p handling food.• A & p applying makeup.• P contact c pets or pet care items.• A you start work & a you leave.
Multiple choice
1. You will come in contact c microbesA. Only in public areas of the facility.
B. Only during direct contact c residents.
C. Only during personal care procedures.
D. Q time you touch something.
Multiple choice
1. You will come in contact c microbesA. Only in public areas of the facility.
B. Only during direct contact with residents.
C. Only during person care procedures.
D. Every time you touch something.
2. Why is it a bad idea to wear artificial nails to work?A. Residents may not like them.
B. They may be lost.
C. They harbor bacteria.
D. They may be damaged by frequent handwashing.
Multiple choice
3. Alcohol-based hand rubs are usedA. With water for maximum effectiveness.
B. When agency runs out of antimicrobial soap.
C. To prevent dry, cracked skin.
D. In addition to washing c soap & water.
4. The CDC defines hand hygiene asA. Handwashing c soap & water & using alcohol-based hand
rubs.
B. Using only alcohol-based hand rubs.
C. Rinsing ands c water.
D. Not washing hands more often than once per day.
Personal protective equipment (PPE)
• Protects employees from contact with workplace hazards.• It is the employers responsibility to
provide appropriate PPE to wear• Includes gloves, gowns, masks, face
shields, & goggles.
Personal protective equipment (PPE)
• GLOVES• Any time you will be in contact with blood or
body fluids• Oral care & shaving• Personal care on non-intact skin• Disposing of soiled bed linens or clothing• Any time you have open sores or cuts on your
hands (1st cover area c bandage or gauze)• Use them only once & discard.
Personal protective equipment (PPE)
• Gowns• Protect clothing & exposed skin• Should fully cover torso• Should fit snugly at wrists• Remove it if wet or soiled, check clothing
& put on a clean gown
Personal protective equipment (PPE)
• Masks & goggles• Masks are worn c residents who have respiratory
illnesses (TB requires special masks)• Must fit snugly over nose & mouth to prevent
fluid penetration• Goggles protect eyes. Glasses are inadequate.• Should fit snugly over & around eyes or glasses
Personal protective equipment (PPE)
• Face Shields• Substitutes for a mask & goggles• Should cover forehead & extend below chin• Wraps around sides of face• Always follow company policy
Handling equipment & linen
• Utility rooms• There are separate utility rooms for “clean” &
“dirty” supplies.• Always wash hands a entering the clean utility
room & a leaving the dirty utility room.
Handling equipment & linen
• Cleaning equipment• General cleaning removes microbes, but doesn’t
kill them. This is adequate for supplies that only touch intact skin (BP cuff)
• Sterilization destroys ALL microbes using steam under pressure, chemicals, or dry heat. Used for items that come in contact c normally sterile areas.
• Disinfection kills all pathogens, but not all microbes, using chemicals or pasteurization.
Handling equipment & linen
• Handling equipment & cleaning• Always avoid contact c portals of entry/exit• Avoid contaminating your clothing• Don’t transfer disease between residents• Dispose of disposable equipment after use• Don’t reuse equipment shared between residents
until it has been cleaned• Clean all environmental surfaces, freq touched
surfaces, beds, rails, & freq touched surfaces
Handling equipment & linen
• Handling linen• Handled soiled linens & clothing to avoid
contact with skin & mucous membranes• Hold linen away from uniform• Don’t shake linens of clothes• Roll dirty linens so soiled area is on inside• Bag soiled linen at point of origin• Sort soiled linen away from patient care areas.• Place wet linen in leak-proof bags
Handling spills
• Always wear gloves• Absorb spill according to policy• Scoop up absorbed spill & dispose according
to policy• Apply disinfectant & wait 10 minutes• Use proper cleaning solution• Do not pick up pieces of broken glass. Use
dustpan & broom or other tools.• Use biohazard containers according to policy.
Matching
1. ____ A measure that destroys all microbes, including pathogens.
2. ____ A process that kills pathogens, but not all microbes.
3. ____ Only to be used once & then discarded.
A. Disinfection
B. Disposable
C. Sterilization
True of false
4. ____You do not need to wear gloves to clean up a small spill.
5. ____Place a disinfectant directly on the spilled fluid a absorbing & removing the fluid
6. ____It’s okay to use your hands to pick up large pieces of glass & use a broom & dustpan for smaller pieces.
7. ____Waste containing body fluids may be disposed of in the trash can in the cafeteria.
8. ____An absorbing powder may be used to absorb a spill before removing it.
Transmission-based (isolation) precautions
• CDC has established 2nd level of precautions (beyond standard precautions )for persons who are infected or suspected of being infected.• Transmission-based precautions will always
be listed on the care plan & assignment sheet.
Transmission-based (isolation) precautions
• 3 categories of transmission-based precautions• Airborne precautions• Droplet precautions• Contact precautions
• Category depends on the disease & how it spreads• May be used in combination for diseases c
multiple routes of transmission
Transmission-based (isolation) precautions
• Multidrug resistant organisms (MDROs) may require additional isolation procedures• MRSA –methacillin-resistant staph aureus• VRE – vancomycin-resistant enterococcus• C-diff – clostridium difficile• Scabies• Lice• Influenza (during outbreak)
Airborne precautions
• Used for diseases transmitted through expelled air• Pathogens are so small they remain floating
for a long time• May require you to wear a special mask (N-
95 or HEPA mask) to avoid infection• Includes: tuberculosis, measles, chickenpox
Droplet precautions
• Used for diseases transmitted by coughing, sneezing, talking, laughing, or suctioning• Pathogens don’t stay suspended in air, usually
don’t travel more than 3 feet• Require face mask during care & restricted
visits from uninfected people• Infected residents must wear masks when out
of their room• Includes: mumps, influenza, scarlet fever
Contact precautions
• Used when there is a risk of transmitting an infection by touching an infected object or person• Includes wearing PPE & resident isolation• Requires washing c antimicrobial soap & not
touching infected surfaces c ungloved hands or uninfected surfaces c contaminated gloves• Examples: hepatitis, VRE, MRSA, lice, scabies
Isolation guidelines
• PPE may be outside room, or inside room• Used PPE should be disposed ofin appropriate
container a leaving resident’s room• Hand sanitizer or handwashing area should be
available where PPE is removed• Don’t share supplies between residents. Use
disposable supplies whenever possible, or dedicated supplies that don’t leave the resident’s room
Isolation guidelines
• Wear PPE when serving food & drink. Do not leave uncovered food in resident’s room. Remove tray to designated area.• Body waste must be disposed of to minimize
splashing & spraying. Gown & goggles may be indicated.• Do not contaminate outside of specimen
containers.• Do not avoid resident or rush through tasks.
Transmission-based precautions
• Indicate “A” for airborne, “D” for droplet, “C” for contact.
1. ___Transmission occurs c skin to skin contact during bathing & transfers.
2. ___Used when there is risk from touching an infected object or person
3. ___Used to guard against tuberculosis & measles.
4. ___Helps prevent the spread of lice & bacterial conjunctivitis (“pink eye”).
Transmission-based precautions
• Indicate “A” for airborne, “D” for droplet, “C” for contact.
5. ___Covering mouth & nose when coughing or sneezing & washing hands afterward.
6. ___Used when microbes don’t stay suspended in air, traveling not more than 3 feet.
7. ___Microbes are transmitted by coughing, sneezing, laughing, talking, or suctioning.
8. ___Helps prevent the spread of illnesses transmitted through air.
Transmission-based precautions
• Indicate “A” for airborne, “D” for droplet, “C” for contact.
9. ___Helps prevent the spread of mumps.
10.___May require the use of a special mask, such as N-95 or HEPA.
Multiple choice
11. Transmission-based precautions are usedA. Every day on the job
B. In addition to standard precautions
C. Instead of standard precautions
D. When treating all residents c terminal illnesses
12. Dedicated equipment isA. Used by multiple residents.
B. Donated to a resident by another resident.
C. Disposable.
D. Only used by one resident.
Multiple choice
13. Which is true of wearing PPE while caring for residents in isolation
A. CNAs will have to decide for themselves which PPE they must wear while caring for residents in isolation.
B. CNAs should remove PPE a exiting a resident’s room.
C. CNAs will always wear the same PPE while caring for all residents in isolation.
D. CNAs should remove PPE p exiting a resident’s room.
Multiple choice
14. When a resident is in isolation,A. The person should be avoided until isolation is
completed.
B. CNAs must perform all tasks requested of them, even if they are outside the scope of practice.
C. The resident still has the same basic human needs.
D. CNAs should leave uneaten food in the room for 24 hours to see if the resident will eat it.
Bloodborne pathogens
• Bloodborne pathogens are microbes found in human blood that cause disease in humans.• The same organisms are found in body fluids,
draining wounds, & mucous membranes.• They are transmitted by infected blood
entering the bloodstream, or infected body fluids coming in contact c mucous membranes.• They are also transmitted by shared needles,
through the placenta, & during birth.
Bloodborne pathogens
• Employers are required by law to help prevent exposure to bloodborne diseases.• They must follow federal standards established
for health agencies by OSHA (Occupational Safety & Health Administration)• They must have a written exposure control
plan that tells employees what to do if exposed to infectious material. • Plan must be accessible to all employees.• Employees must receive training.
Bloodborne pathogens
• Employers must provide needed PPE, free of charge, to all employees, residents, & visitors.• Puncture-resistant, leakproof, & well marked
biohazard containers must be available for disposal of biohazardous waste & sharps.• Free hepatitis B vaccination must be provided
for all employees after hire.• Warning labels must be affixed to waste
containers & refrigerators/freezers that contain potentially infectious material.
HIV
• HIV -Weakens the immune system so that people can’t fight infection, can develop AIDS• Hepatitis – inflammation of the liver caused by
viral infection.• Hepatitis – initially resembles flu-symptoms
(fever, fatigue, nausea, vomiting), then jaundice (yellow skin, mucous membranes, & eyes). Can cause permanent liver damage.
HIV & Hepatitis
• Hepatitis A –Transmitted by fecal-oral contamination.• Hepatitis B (HBV)– bloodborne or needle
transmission. Vaccine is available – TAKE IT!• HBV – short-term illness leads to loss of appetite,
diarrhea, vomiting, jaundice, pain in muscles, joints, & stomach• HBV – long-term illness leads to liver cancer,
cirrhosis, death.• Hepatitis C, D, E – less common, no vaccine
Multiple choice
1. Bloodborne diseases can be transmitted byA. Infected blood entering the bloodstream.
B. Hugging an infected person.
C. Being in the same room c an infected person.
D. Talking to an infected person.
2. Your employer must offer a free vaccine forA. HIV/AIDS
B. Hepatitis B
C. Hepatitis A
D. All bloodborne diseases
Multiple choice
3. How does HIV affect the body?A. It cuts off blood supply to the brain.
B. It causes hearing impairment.
C. It causes diabetes in otherwise healthy people.
D. It weakens the immune system.
4. Which is true of Hepatitis B?A. HBV is caused by fecal oral contamination.
B. There is no vaccine for HBV.
C. HBV is caused by jaundice.
D. HBV can be transmitted in blood.