Standard Precautions And Infection Control For The CNA

Why?  Health-care workers need to use standard precautions to help protect  Patients  Visitors  Employees (Dr’s, Nurses, Volunteers)  And Yourself  In Essence: Everyone

Standard Precautions are…  The infection control actions used for all people receiving care, regardless of their condition or diagnosis.  Treating everyone as though they are potentially contagious.  Using PPE when coming into contact with ANYONE’s  Blood, body fluids, secretions or excretions

Why do Infections Occur?  Many sick people are treated in close quarters  Microorganisms.  Frequent contacts.  Large amounts of contaminated wastes.  Some procedures that save lives may increase risk of infection.  Respiratory therapy: moisture that fosters microorganism growth  Catheterization: open pathway to the bladder  Surgery: opening of the skin  Antibiotics: kills good and bad bacteria

Who Can Get Infections?  Anyone can get infections but some people face higher risk than others.  Newborns  Premature babies  Elderly  Seriously ill patients. (burns, ICU)  Surgical pt  Long-term pt  People on certain types of medications  People with low immune systems (chemo, etc)  Certain Healthcare workers: nurse, doctors, PCT

How Infectious Diseases Spread  All of the following are necessary for a disease to spread:  A germ or pathogen,  A source or reservoir,  A portal of exit,  A method of transmission,  A portal of entry into a person,  A susceptible person.  The goal is to stop germs from traveling from a source into another person. Chain of Infection

Tag-Teaming Infections…  Using Standard Precautions in addition to…  Transmission Based Isolation Precautions  Are for the care of patients who have or may have a contagious disease.  You need to use transmission based precautions in addition to standard precautions for all patients.  There are 3 types that are based on the causative agent and mode of transmission  Useful in preventing the spread of NOSOCOMIAL INFECTIONS!!!

Transmission-Based Precautions: AIRBORNE 1.Prevent the spread of infection dust or small droplets that remain suspended in air 2.They require special air handling and ventilation 3.Wear mask at all times in the room 4.If patient travels out of the room must wear a mask at all times DROPLET 1.Prevent the spread of large droplets that can be created by certain medical procedures, or by coughing, talking or sneezing 2.Must wear a mask if you are within 3 feet of the patient. 3.If patient travels out of the room must wear a mask at all times CONTACT 1.Prevent the spread of infectious disease by skin-to –skin contact or by a contaminated object 2.Must wear gloves with any contact with the patient. 3.Visitors to wear gloves as well 4.During procedures that could cause splashing: wear a gown

Which type of Isolation should you use???  Patient A has tuberculosis? _________________  Patient B has the mumps? __________________  Patient C has the measles? _________________  Patient D has MRSA in a wound? ____________  Patient E has impetigo?____________________  Patient F has the flu? ______________________

Common Nosocomial Infections  Clostridium Difficile is a gastrointestinal infection characterized by watery diarrhea, fever and loss of appetite.  C-diff is found in the feces of infected persons.  Commonly spread from person to person by neglectful hand hygiene.  Which type of isolation?__________________

Common Nosocomial Infections  Methicillin Resistant Staph Aureus is a bacteria that can infect several places in your patients.  Wounds  Urine  Sputum  Nares Many persons are carriers of MRSA in their nares. They do not have active infection but can spread it to others. What type of isolation should you use? ___________________

Take steps to protect patients and yourself from risks  Use your PPE (Demo to follow this slide)  Wash your hands!!  Cover cough and sneezes: wash hands after doing this.  Use a resuscitation device: if you do CPR/rescue breathing  Put a patient in a private room: if you know they have a contagious infection.  Put patient in isolation for transmission-based precautions when needed.

Question…  Have you ever seen this in a movie or TV show?  Why are they all covered up and gloved up?

Asepsis-keeping things clean  Asepsis is the absence of disease- producing microorganisms.  Using aseptic techniques are a major way to break the chain of infection.  Handwashing, good personal hygiene, using disposable gloves, proper cleaning of instruments and the environment are all aseptic techniques

What is “sterile”?  What is “sterile”  Free from all organisms including spores and viruses  What is “contaminated”  Pathogens and organisms are present

Why the hassle of sterility?  Maintaining sterility helps prevent the introduction of infectious organisms into an area free from infectious organisms  Also helps prevent the introduction of additional infectious organisms to an area already infected

Sterile Technique  Using sterile technique keeps an object or area free from living organisms  We must maintain sterility and avoid contamination during certain procedures

Sterile Technique  We must recognize sterile surfaces and contaminated surfaces  If a sterile object touches the skin or any part of your clothing, they are no longer sterile  Keep sterile objects above the waist because areas below the waist are considered contaminated.

Sterile Field  2 inch border around the sterile field is considered contaminated.  Reach in from the side-never the front  Never turn your back on a sterile field  Keep it dry. Why?  If an article gets wet, it is considered contaminated and must be removed or you must start over  Never put on your sterile gloves until you are ready to do your procedure.

Opening Sterile Packages  Check  Open areas and date (>30 days)  Hold away from you  Open:  Distal flap (fold away from you)  Side flaps  Proximal flap (lift up and toward you)  Never touch the inside of the package

Using Sterile Field and Items  Use one of the transfer techniques to add packages to the sterile field  The method depends on the item being transferred  If you ever suspect contamination, it is better to start over. Never take a chance using equipment if there is a possibility of contamination

Your Turn:  Let’s use what you just learned…  There are 6 stations set up around the room  You and a partner are to visit each station and complete the work inside the folder. Replace all items you don’t use. Keep what you have worked on.  This will be picked up at the end of the rotation. You will have 15 minutes per station.