1. INFECTION CONTROL

2. There are several approaches to infection control:
Health care workers can take steps to prevent the spread of infectious diseases. These steps are part of infection control.
There are several approaches to infection control:
Hand Washing
Isolation Precautions
Standard and Universal Precautions
Cleaning & Sterilizing Equipment/Surfaces

3. Hand Washing

4. What are Standard and Universal Precautions?

5. Standard and Universal Precautions
Standard and Universal Precautions are designed to decrease the risk of transmission of recognized and unrecognized sources of infection.
Standard and Universal Precautions apply to the transmission of pathogens thru blood, all body fluids, nonintact skin, and mucous membranes.

6. Hand Washing
Hand washing is one of the most important considerations in the Standard and Universal Precautions.
Definition (p 201) :
activity of using soap and water, or alcohol-based solutions, to decrease the number of germs on the hands.
Purpose - decrease number of germs on hands - infection control (sepsis prevention)

7. Review microorganisms on page 201
The spreading of pathogenic microorganisms in health care facilities can cause nosocomial infection
(p 202)

8. Review CDC Guidelines for Hand Washing (page Dreeban 202-203)

9. When should you wash you hands in the clinical setting
When should you wash you hands in the clinical setting? Dreeban Page 203

10. What aseptic technique? (Minor, page 89)

11. Hand Washing Procedures for Medical Aspesis (Dreeban pg 203)

12. Infection Control

13. What is nosocomial infections? (see Minor pg. 89)
In addition to hand washing included in the Standard Precautions of the CDC are guidelines to prevent the transmission and spread of infectious disease and to control nosocomial infections .
What is nosocomial infections? (see Minor pg. 89)
Review Standard Precaution Guidelines – Minor pg 94

14. Note the term “standard precautions “ replaces the term “universal precautions” often used.

15. Personal Protection Equipment
PPE

16. Masks, eye protection,& face shields
These guidelines state that a mask and eye protection or a face shield should be worn if there is a possibility of splash or spray of blood, body fluids, secretions and excretions

17. Gowns
See Minor, pg 95

18. Handling of the patient care equipment (Minor, p 96)

19. Environmental control
Standard Precautions guidelines suggests following hospital/facilities procedures for routine care, cleaning, and disinfection of environmental surfaces, bdes, bedrails, bedside equipment, and other frequently touched surfaces.

20. Handling Linens
Standard Precautions guidelines suggests to handle, transport, and process used linen soiled with blood, body fluids, secretions or excretions in a manner that prevents skin and mucous membrane exposure and contamination of clothing and avoids transfer of microorganisms to other patients or environments.

21. Contact Precautions

22. Contact Precautions
Contact precautions are intended to prevent the transmission of infectious agents that can be spread by direct or indirect contact with a patient or a patient’s environment.

23. Contact Precaution Guidelines
Minor, pg 97

24. Airborne Precautions
Reduce the risk of airborne transmission of infectious agents thru evaporated droplets in air or dust particles containing infectious agents.
Examples: measles, chickenpox, and tuberculosis

25. Airborne Precautions
Private room with monitored air pressure. There are 6-12 air changes within the room every hour. This is done thru a special ventilation system.
Room door stays closed. Patient is transported outside the room only for essential purposes and wears a mask.

26. Airborne Precautions
Anyone entering the room wears respiratory protection (masks).

27. Droplet Precautions
Reduce the risk of droplet transmission of infectious agents thru contact with the mucous membrane of the mouth and nose and contact with the eyes. Transmission occurs thru coughing, sneezing, talking or suctioning.
Transmission requires close contact. Infectious agents can not suspend in air or travel over 3 feet.

28. Examples Bacterial: Meningitis - Pneumonia Diptheria - Pertusis
Streptococcal
Viral:
Adenovirus - Influenza
Mumps - Parovirus B19
Rubella

29. Droplet Precautions
Private room (may share if roommate has active infection of same microorganism)
Maintain 3 feet between patient and anyone else.
Room door can remain open.
Mask worn if working within 3 feet of patient.
Patient transport limited to essential purposes and patient wears a mask.

30. Contact Precautions
Reduce the risk of transmission of infectious agents thru direct or indirect contact.
Direct involve skin to skin transmission
Indirect involves a contaminated item usually within the patients environment
Examples:
Infections – GI, respiratory, skin or wound
C-Diff *Hepatitis A * Herpers Zoster
E Coli * Diptheria * Impetigo
Shigella * Herpes Simplex *Ebola

31. Minimal PPE Worn
Gloves
Gown

32. Aseptic Technique and Sterile Field

33. Sterile Field
The primary goal of using aseptic techniques is to prevent infections.
One aseptic technique is providing and maintaining a sterile field.

34. Requirements for Providing and Maintaining a Sterile Field
NOTE: There are 4 requirements for establishment and 4 requirements for maintenance

35. Requirement 1
All items in the area of the sterile field must be sterile.

36. Requirement 2
Once a sterile package is open, the edges are no longer considered sterile. Care must be taken not to allow the edges to touch the contents of the package or sterile gloved hands or sterile gown.

37. Requirement 3
Once put on (donned) properly, the sterile gown is considered sterile in the front from shoulder level to table level.
Hands must be kept above table level during and after scrubbing.

38. Requirement 4
Only the top surface is considered sterile. Sterile drapes cover the top of a surface and descend on all sides. Such draping can cover an instrument table or patient.

39. Requirement 5
Only sterile items and personnel in sterile attire may enter the sterile field or touch items in a sterile area.

41. Requirement 6
Activity in the sterile area should not render the area unsterile.
Personnel in the sterile area should not sit on or lean against unsterile surfaces.

42. Requirement 7
Penetration of a sterile covering or barrier is considered to cause contamination of a sterile field.
Liquids spilled are most likely to penetrate a sterile barrier.
Air flow can also contaminate a sterile area.

43. Requirement 8
Sterile fields should be prepared as close to the time of use as feasible.
They should never be left unattended.
They should not be prepared and covered for later use.

44. References
Minor, M., Minor, S. (2010) Patient Care Skills (6th Ed). Pearson Publishing.
Dreeban, O. (2007). Introduction to Physical Therapy for Physical Therapist Assistant. Jones and Bartlett, Sudbury, MA.