FUNDAMENTALS OF NURSING LESSON 3 MEDICAL ASEPSIS AND INFECTION CONTROL

HISTORY OF ASEPTIC TECHNIQUE ROBERT HOOKE ANTON VON LEUWENHOEK IGNAZ SEMMELWEIS LOUIS PASTEUR JOSEPH LISTER INFECTION—THE INVASION OF MICROBES. MICROBES CAUSE MANY DISEASES. ETIOLOGY—THE STUDY OF THE CAUSE OF DISEASE.

MEDICAL VS. SURGICAL ASEPSIS MICROORGANISMS NONPATHOGENIC—DO NOT PRODUCE DISEASE PATHOGENIC—PRODUCE SPECIFIC DISEASE OR INFECTIONS Some helpful Some dangerous Some travel to places they don’t belong

MEDICAL VS. SURGICAL ASEPSIS ASEPSIS—FREE OF PATHOGENIC MICROBES A = without Sepsis = contamination MEDICAL ASEPSIS Clean Technique SURGICAL ASEPSIS— Sterile Technique

Page 4 in Quantum Figure 12-1 The chain of infection.

CHAIN OF INFECTION INFECTIOUS PROCESS FOR MICROBES TO SPREAD OR LIVE, A CYCLE MUST BE PRESENT TO BREAK THE CYCLE: MEDICAL ASEPSIS & IMMUNIZATIONS BREAK THE CYCLE OF INFECTION BY ALTERING THE DEFENSES OF THE HOST

1ST LINK IN CHAIN OF INFECTION INFECTIOUS AGENTS—THE PATHOGEN BACTERIA BACTERIAL SHAPES COCCI—ROUND OR OVAL BACILLI—ROD SPIRILLA—SPIRAL (UNCOMMON) SHAPE HELPS IDENTIFY TYPE

Some common disease-producing bacteria. Figure 12-3 Some common disease-producing bacteria.

1ST LINK IN CHAIN OF INFECTION Quantum Page 5&6 1ST LINK IN CHAIN OF INFECTION INFECTIOUS AGENTS—THE PATHOGEN BACTERIA STREPTOCOCCUS BACTERIUM ***Responsible for more disease than any other organism STAPHYLOCOCCUS AUREUS Pus producing Staph epidermidis lives on human skin Nonpathogenic DIPLOCOCCUS Pneumoccus Gonococcus Meningococcus

1ST LINK IN CHAIN OF INFECTION - VIRUS SMALLEST KNOWN AGENTS THAT CAUSE DISEASE. NOT A COMPLETE CELL Example: common cold ***Treat the symptoms and not the virus

1ST LINK IN CHAIN OF INFECTION FUNGI—(Mycotic infections) Coccidioidomycosis Histoplasmosis Candida Albicans Normally inhabits the GI tract In the mouth (thrush) In the vagina (vaginitis) Diaper rash

2nd, 3rd, 4th LINKS IN THE CHAIN OF INFECTION RESERVOIR—any place the microbes are able to grow and reproduce. Carrier (Typhoid Mary) Requirements for microbe growth Body’s 1st response is fever—attempt to kill invading organisms. Often become dehydrated due to anorexia and fever. Hand washing is most important thing we can do.

2nd, 3rd, 4th LINKS IN THE CHAIN OF INFECTION EXIT ROUTE—Microbes must be able to leave the reservoir to infect others. TRANSMISSION Vehicle—means by which microbes are carried. Direct contact—nurse to patient Fomite Vector—living carrier (dog, insect) Airborne—droplet

5TH LINK IN CHAIN OF INFECTION ENTRANCE—often the same route they used to exit last host. Skin Saliva Respiratory tract Urinary tract GI tract Vagina

6TH LINK IN CHAIN OF INFECTION HOST PATIENTS MAKE GREAT HOSTS. SUSCEPTIBILITY AGE—VERY OLD, VERY YOUNG AT HIGH RISK STRESS NUTRITION HEREDITY DISEASE PROCESS ENVIRONMENTAL FACTORS MEDICAL THERAPY CHEMOTHERAPY RADIATION INVASIVE MEDICAL PROCEDURES LACK OF IMMUNIZATION OF CHILDREN

Nosocomial Infections Hospital or health agency acquired infection Approximately 10% of pts will acquire Common from Foley catheters 3% end in DEATH These can be prevented by proper medical/surgical asepsis and good hand washing…..

HANDWASHING HEAVILY SOILED HANDS SHOULD BE WASHED LONGER THAN LIGHTLY SOILED HANDS SOAP--MICROBES ARE WASHED AWAY RUNNING WATER—FLUSHES FRICTION—BREAKS BODY OIL DOWN TIME FRAME—THE LONGER, THE MORE MICROBES ARE GONE RINSING—FLUSHING WASH HANDS BEFORE AND AFTER PATIENT CARE AFTER CONTACT WITH BODY FLUIDS BEFORE INVASIVE PROCEDURES BEFORE CHANGING DRESSINGS BEFORE AND AFTER MEDICATION ADMINISTRATION AFTER REMOVING GLOVES

PERSONAL PROTECTIVE EQUIPMENT (PPE) GLOVES GOWNS MASKS/PROTECTIVE EYEWEAR DOUBLE BAGGING HEP B VACCINATION

Skill 12-2: Steps 6 & 7 Gloving. (From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.) Gloving.

Skill 12-3: Step 5a Gowning for isolation. (From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.) Gowning for isolation.

Skill 12-3: Step 5b Gowning for isolation. (From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.) Gowning for isolation.

Skill 12-3: Step 5c Gowning for isolation. (From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.) Gowning for isolation.

Skill 12-3: Step 6 Gowning for isolation. (From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.) Gowning for isolation.

Skill 12-4: Steps 2 & 5 Donning a mask. (From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.) Donning a mask.

Nurse wearing protective goggles and mask. Figure 12-5 (From Potter, P.A., Perry, A.G. [2003]. Basic nursing: Essentials for practice. [5th ed.]. St. Louis: Mosby.) Nurse wearing protective goggles and mask.

Skill 12-5: Step 4 Double bagging. (From Polaski, A.L., Warner, J.P. [1994]. Saunders fundamentals for nursing assistants. Philadelphia: Saunders.) Double bagging.

CATEGORIES FOR ISOLATION 1ST TIER STANDARD PRECAUTIONS USED FOR ALL PATIENTS 2ND TIER AIRBORNE DROPLET CONTACT REVERSE ISOLATION For the immunocompromised

DISINFECTION AND STERILIZATION DESTROYS PATHOGENS BUT NOT SPORES STERILIZATION DESTROYS PATHOGENS AND SPORES HEAT/RADIATION CHEMICAL

INFECTION CONTROL TEAM MANY NURSES WORK IN INFECTION CONTROL THE INFECTION CONTROL NURSE IS RESPONSIBLE FOR MONITORING INFECTION OUTBREAKS EDUCATING STAFF ABOUT ISOLATION ADVISE PERSONNEL ON POLICIES AND PROCEDURES REVIEW MEDICAL RECORDS GATHER STATISTICS COMMUNICATE WITH PUBLIC HEALTH DEPARTMENTS ON COMMMUNICABLE DISEASE IDENTIFY PROBLEMS WITH EQUIPMENT OR POLICIES

PATIENT AND FAMILY TEACHING FOR INFECTION CONTROL RECOGNIZE SOURCES OF INFECTION STEPS TO PREVENT TRANSMISSION NATURE AND TRANSMISSION OF INFECTION SUSCEPTIBILITY TO INFECTION SIGNS AND SYMPTOMS TO REPORT TO MD INCLUDE GOOD HANDWASHING WITH DRESSING CHANGES AND WOUND CARE INSTRUCTIONS

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