1. 1 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use.

2. 2 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. SECTION 1 Patient Assessment

3. 3 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. CHAPTER 1 Basics of Asepsis

4. 4 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Key Terms Asepsis –An absence of disease producing organisms –Appropriate for any procedure that is not invasive Sterility –Complete destruction of all forms of microorganisms –Appropriate for any invasive procedure (surgery) –Very difficult to obtain and maintain (continues)

5. 5 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Key Terms (continued) Hospital Acquired Infection –An infection a patient contracts during a hospital stay –Result in complications, additional expenses, and sometimes death Cross contamination –Transmission of microorganisms between places or persons (continues)

6. 6 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Key Terms (continued) Pathogen –Microorganism capable of causing disease in humans Virulence –Easily causing disease in many people

7. 7 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Microorganism Transmission Contact Transmission –Direct Occurs when microorganisms are transmitted from one person to another without an intermediate object or person –Indirect Occurs when microorganisms are transmitted through an intermediate object or person (continues)

8. 8 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Microorganism Transmission (continued) Airborne Transmission Air currents transport microorganisms from one area to another Droplet Transmission A form of contact transmission via droplets that are larger than 0.5 ‑ micrometer (µm) (continues)

9. 9 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Microorganism Transmission (continued) Vehicle Transmission Transmission of microorganisms via inanimate objects, termed fomites Vector Transmission Disease transmitted by an intermediate host – a mosquito or tick

10. 10 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Centers for Disease Control and Prevention Guidelines Guidelines for isolation precautions –Review of scientific data regarding transmission of infectious agents in health care settings –Fundamental elements needed to prevent transmission of infectious agents in health care settings –Precautions to prevent transmission of infectious agents and recommendations (continues)

11. 11 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Centers for Disease Control and Prevention Guidelines (continued) Standard Precautions –Combine Universal Precautions and Body Substance Isolation –Hand hygiene –Use of personal protective equipment –Proper handling of equipment and patient waste –Mask to mouth ventilation

12. 12 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Standard Precautions Hand hygiene –Use of soap and water or alcohol-based product –15 second scrub Between patients, prior to prep of meds, before and after eating, after use of contaminated equipment, after use of rest room –5 minute scrub Surgery, newborn care, ICU, burn unit –Most important way to prevent contact transmission (continues)

13. 13 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Standard Precautions (continued) Respiratory Hygiene/Cough Etiquette –Anyone with signs of respiratory illness –Use of mask or facial tissues –Hand hygiene –3 feet of physical space (continues)

14. 14 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Standard Precautions (continued) Personal protective equipment –Barrier devices such as gloves, mask, gown, goggles Gloves –Advised when procedures necessitate contact with blood, body fluids, secretions, excretions, and contaminated items (continues)

15. 15 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Standard Precautions (continued) Mask, eye protection, face shield –Use when at risk for being splashed or sprayed by blood, body fluids, secretions, or excretions Gowns –Protect the skin and soiling of clothing during procedures or patient care situations that may produce splashes or sprays of blood, body fluids, secretions, or excretions (continues)

16. 16 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Standard Precautions Equipment handling –Use appropriate PPE –Clean and disinfect as appropriate before using Patient Linens –Use appropriate PPE –Treat as biohazardous waste if contaminated with blood and body secretions (continues)

17. 17 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Standard Precautions (continued) Sharps –Needles, scalpels, and other sharp instruments –Dispose of in puncture proof containers Mask to mouth ventilation device –Allows a rescuer to perform pulmonary resuscitation without direct contact with the patient’s mucous membranes

18. 18 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Table 1-1: Transmission Based Precautions ContactDropletAirborne Private RoomYes (Cohorting okay if patients have same organism) Yes (negative pressure room with 6-12 air changes / hr) Gloves and GownGloves for patient contact. Gown if anticipate becoming soiled by equipment or patient. Always glove and gown Respiratory PrecautionsNoneSurgical maskNIOSH N-95 mask Patient TransportMinimize and potential for contact transmission Patient should wear a surgical mask during transport During transport patient should wear NIOSH N-95 mask

19. 19 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Hand Hygiene Remove jewelry Don’t touch sink with hands or body Adjust water flow and temperature Wet forearms, wrist, and hands Liberally apply soap Wash palms with friction Wash between fingers (continues)

20. 20 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Hand Hygiene (continued) Wash wrist with rotary motion Scrub under nails and around cuticles Rinse hands – don’t touch sink Dry hands using separate disposable towels Turn water off – use dry towel if no foot pedals

21. 21 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Aseptic Gowning Apply mask –Once saturated with moisture, dispose of it –Never reuse Apply gown –Slide hands into sleeves –Try not to touch front of gown Apply gloves aseptically

22. 22 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. Removal of PPE First remove gloves Then mask Then gown Wash hands