Standard Precautions

Basic Principles (disease transmission) Microorganisms- small living plants or animals. All microorganisms are not harmful to the body. Pathogen/non-pathogen- organisms that normally are non-pathogenic can become pathogenic because of malnutrition, injuries, and immune disorders Pathogen- disease producing non-pathogen- not disease producing

Continued…. Bacteria- Require food supply Can be bacilli-rod shaped, cocci-round shaped, or spirilla (spiral or corkscrew shaped) Protozoa- animal like Fungi- plant like Require food supply Two common forms that can be pathogenic Rickettsiae- parasite, transmitted by ticks and cause Rocky Mounted Spotted Fever Viruses- smallest microorganism Aerobic/anaerobic- Aerobic-requires oxygen Anaerobic- requires abstinence of oxygen

Continued again… Endogenous/exogenous- Endogenous- disease originates inside the body Exogenous- disease originates outside the body Nosocomial- health care facility acquired infection Opportunistic- occurs when body’s defenses are weak Chain of infection- causative agent reservoir exit portal means of transmission entrance portal susceptible host Asepsis- absence of disease producing microorgnism  Antisepsis- alcohol  Disinfectant- Lysol  Sterilization (kills all microorganisms) Hand washing- point fingers down to prevent contamination

Sometimes called “Universal” precautions Used to break the chain of infection Pathogens spread by blood and body fluids -Hepatitis B (HBV) -Human immunodeficiency virus (HIV)

OSHA passed regulations in 1991 requiring all health care facility employers to: - Determine which employees will have exposure to blood and body fluids - Provide Hepatitis B vaccine free to employees with exposure risk (or signed refusal) - Provide personal protective equipment (PPE) such gloves, gowns, lab coats, mask, and face shields - Provide adequate hand washing facilities and supplies Osha Regulations

- Ensure clean & safe work environment - Follow decontamination protocol for contaminated surfaces - Dispose of infections wastes correctly - No eating, drinking, smoking, handling contact lenses, applying lip balm, etc. in risk area - Provide color-coded containers labeled for sharps and other infectious wastes - Post signs in work areas where this is exposure risk

- Provide medical evaluation and follow- up for employees who’ve had an exposure incident - Provide training about the regulations to all employees at no cost during working hours

Standard precautions rules are developed by the CDC and FDA. All body fluids should be considered potentially infectious All pts should be considered potential sources of infection Wash hands before and after any pt If any surface comes in contact with blood or body fluids, was immediately and thoroughly Wash hands after removal of gloves

Wear gloves whenever contact with each patient Gloves should not be reused Gowns should be worn during any procedure with risk of splashing blood or body fluids Masks and protective eyewear to be worn during procedures that may produce blood or body fluids Extreme care should be taken while handling sharp objects. (Do not bend, break or recap needles. Dispose of them in puncture-resistant containers.)

Spills or splashes of blood or body fluids should be wiped up immediately. Wear gloves, and use a disinfectant solution. Mouthpieces or resuscitation devices should be used to avoid the need for mouth-to- mouth resuscitation. Know the requirements for disposal of waste materials and dispose of wastes in the proper container. Report any cut, injury, needle stick, or splashing of blood or body fluids immediately.

Sterilizing with an Autoclave Uses steam under pressure or gas Destroys ALL microbes, pathogenic and nonpathogenic – including spores and viruses Before wrapping, instruments must be clean Wraps must allow for penetration of steam -Muslin -Autoclave -Special plastic or paper bags -Autoclave containers

Indicators are used to ensure articles have been sterilized -Autoclave tape, sensitivity marks on bags or wraps, indicator capsules -Indicator will change appearance when sterile Autoclave must be loaded correctly Amount of time depends on the article to be sterilized – usually minutes If wrap becomes torn or wet, it is contaminated Expires in 30 days

Disinfection CHEMICAL frequently used for aseptic control They do not kill spores & viruses so its not sterilization Used to disinfect instruments that don’t penetrate body tissue: Dental instruments Percussion hammers thermometers

Examples 90% isopropyl alcohol Formaldehyde-alcohol 10% bleach solution Lysol Zephiran Boiling water disinfects but does not sterilize Satisfactory for home care where instruments/supplies used for one person only Usually minutes

Ultrasonic unit Used in dental & medical offices to disinfect Uses sound waves to produce millions of microscopic bubbles Cavitation –bubbles hit instrument and explode, driving cleaning solution into article

Sterile Technique - Principles Surgical Asepsis – procedures that keep an object or area free from living organisms Sterile – Free from all organisms, including spores and viruses Contaminated- organism/pathogens are present A clean, uncluttered work area necessary when working with sterile supplies Sterile field – sterile area- never reach across a sterile field – reach in from the side Never turn your back on a sterile field

2-inch border of sterile field is considered contaminated Common techniques: - Drop techniques - Mitten techniques - Transfer forceps Keep sterile field dry(pathogens travel through wet) and be careful when pouring fluids Be sure sterile field is open and ready before putting on sterile gloves Sterile gloves are contaminated on the inside – once on. Keep hands away from body and above waist When in doubt, consider it contaminated

Opening Sterile Packages Check to be sure the sterile package has not expired Open the distal end and pull it away from you, reaching around the package, not across Open the sides without touching the inside wrapper Pull the bottom down toward you Drop technique Mitten technique Transfer forceps