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Health
A state if complete physical, mental,a dn social well-being.
5 dimensions of health
Physical: Body is strong and fit, free of disease.
Emotional: Function well and adapt to circumstances, strong self-esteem, self-control, and self-awareness.
Spiritual: Belief in a purpose greater than oneself.
Intellectual: Keeping mind active and creative.
Social: Having stable and satisfying relationships.
12 determinants of health
Income and Social Status
Social Support Networks
Education and Literacy
Employment and Working Conditions
Social Supports
Physical Environment
Personal Health Practices
Healthy Child Development
Biology and Genetic Endowment
Health Services
Gender
Culture
Wellness
Achieving the best health possible in 5 dimensions.
Illness
The loss of physical of mental health
Disability
The loss of physical or mental function
Acute
Severe and sudden onset
Chronic
Long-developing
Medicare
Publicly funded health services, specifically the medically necessary services provided by a hospital or physician
Available to all permanent residents
Funded by the provincial and federal government
Tommy Douglas
Introduced free hospital care for much of the provincial population.
5 principles of medicare
Comprehensive: Insurance plan must pay for all medically necessary services.
Universal: Every permanent resident is entitled to receives health care services provided by the plan.
Portable: People can keep their health care coverage even if they are unemployed, change jobs, relocate to another province, or travel within Canada or abroad.
Accessible: People can receive medically necessary services regardless of their income, age, health status, gender, or geographical location.
Publicly administrated: Must be run by a public organization on a nonprofit basis.
What are the challenges facing healthcare today?
Shortage of physicians, nurses and other health care workers in rural areas
Financial issues (pharmaceuticals account for the majority of the cost increase)
Aging population
Long waiting times for common surgeries, diagnostics, or medical procedures
Expensive new technology
What is being done to meet the challenges?
Educate people about health and wellness, with emphasis on prevention
Efforts to improve housing, decrease poverty, monitor drinking water, etc
Cut costs by having physicians work together in a health centre (lower overhead expenses)
Coordinate the services of various medical team members to improve efficiency
Requirements of microbes to grow
Microbes need water and nourishment from the reservoir
Most need oxygen to live
A warm and dark environment is needed
Most grow best at body temperature
They are destroyed by heat and light
Patheogen
Harmful microbes that cause infections.
Non-patheogon
Microbes that do not usually cause an infection.
Normal flora
Microbes that live and grow in a certain area
They are non-pathogens when in or on a natural reservoir
When a non-pathogen is transmitted from its natural site to another site or host, it becomes a pathogen
Bacteria
One-celled microbes
Can multiply quickly and if necessary remain non-active, for long periods of time, surrounded by a protective shell called a spore coat
The spore coat can make it difficult to kill bacteria.
Infections caused by bacteria are usually treated by antibiotics
Some serious bacterial infections can be prevented through vaccination
Bacteria shapes
Cocci / Coccus: Spherical bacteria
Bacilli / Bacillus: Rod shaped bacteria
Spirilla / Spirillum: Spiral shaped bacteria
Diplo: Double
Strepto: Chains
Staphylo: Clusters
Gram Positive
Bacteria that is purple when stained because they have a thick cell wall that absorbs the stain
Lots of peptidoglycan
Gram Negative
Bacteria that does not retain stain very well in their thin cell walls, and turn pink when stained
Small layer of peptidoglycan
Toxic and usually the bad bacteria
Viruses
The smallest of the microorganisms
Very difficult to destroy
Grow and reproduce inside other living cells
Can also remain dormant protected by a spore coat
Spread by contact with blood and body fluids
A few antiviral medications that can kill specific viruses are available
Some diseases can be prevented by vaccination
Parasite
Microorganisms that live off of other organisms, or hosts, to survive.
Some parasites don’t affect the host.
Others grow, reproduce, or give off toxins that make the host sick resulting in a parasitic infection.
Ex: malaria, trichomoniasis, giardiasis, cryptosporidiosis, and toxoplamosis
Fungi
Two groups: yeasts and molds
An organism that lives off of dead matter
Responsible for conditions such as ringworm, athlete’s foot, thrush and yeast infections
Vaccinations
Proven to prevent serious communicable illnesses
Health care agencies require workers to have their routine vaccinations up to date before they start work
MROs
Microbes that can resist the effects of antibiotics.
Two common types of MROs are resistant to many antibiotics..
MRSA: Methicillin-resistant Staphylococcus aureus
VRE: Vancomycin-resistant Enterococcus
MROs are caused by..
Doctors prescribing antibiotics when they are not needed (over-prescribing)
Patients not taking antibiotics for the length of time prescribed
Carriers of a pathogen
People with weakened immune systems are at greatest risk (babies, older adults, people with serious medical conditions)
Antiseptic
Solutions that are applied directly to the skin
They prevent or slow the growth of pathogens but they are not useful against all microorganisms
Ex: Alcohol and betadine
Disinfection
Uses strong chemicals such as bleach and zephirin to kill many pathogens
Used mainly on objects (bedpans, countertops, tubs, furniture, commodes, etc.) and not on skin because they may cause skin irritation or trauma
Have limited effects against viruses and spores
Ex: Chlorine and bleach
Sterilization
Is the best way to kill microbes and their spores
An autoclave uses steam under pressure to sterilize medical equipment
Ex: The use of chemicals, radiation and gas
Systemic infection
Involves the whole body.
Localized infection
In a body part.
Chain of infection
Pathogen: A microbe capable of causing
disease.
Reservoir: Environment where the pathogen lives before it infects a person.
Portal of exit: The escape route.
Mode of transmission: The way in which a pathogen is transmitted from one source to the next.
Portal of entry: The entry point on the new host/environment.
Susceptible host: A susceptible host is a person at risk of infection.
A person with a weakened immune system is immunocompromised.
Pandemic
Occurs when a communicable infection spreads throughout the population of a country or even throughout the world.
Asepsis
Practices that are used to keep an area free of disease-producing microorganisms.
Medical asepsis
Maintaining a clean environment in order to:
Reduce the number of pathogens
Prevent the spread of pathogens from person-to-person
Includes hand washing, using personal protective barriers such as gloves and routine cleaning of the environment.
Surgical Asepsis
A sterile environment in which there are no microorganisms or spores.
Areas in the operating room are sterile
To remain sterile, only sterile items can come in contact with other sterile items. Even if a clean object touches a sterile area, the sterile area is considered contaminated.
HAI (Health care-associated infection)
An infection that develops in a client cared for in any setting where healthcare is given.
HAIs also are called nosocomial infections.
HAIs are caused by:
Normal flora
Microbes transmitted to the client from another source
When to use PPE
Wear gloves whenever contact with blood, body fluids, secretions, excretions, mucous membranes, and non-intact skin is likely.
Gowns and other attire protect your clothes and body from contact with blood, body fluids, secretions, and excretions.
Masks are worn for protection from contact with infectious agents from the client or resident and during sterile procedures to protect the client from infectious agents carried in your nose or mouth.
Goggles and face shields protect your eyes, mouth, and nose from splashing or spraying of blood, body fluids, secretions, and excretions.
Order for putting on PPE
Perform hand hygiene
Gown
Mask
Goggles
Gloves
Order for taking off PPE
Gloves
Gown
Perform hand hygiene
Goggles
Mask
Perform hand hygiene
Precautions
To prevent pathogens transmitted through blood, body fluids, secretions, and excretions.
Isolation precautions
Guidelines to prevent the spread of communicable diseases (contagious diseases).
Standard precautions
Reduce the risk of spreading pathogens
Reduce the risk of spreading known and unknown infections
Are used for all persons whenever care is given
Transmission-based precautions
3 types: airborne, droplet and contact precautions
Guidelines to contain pathogens in one area (usually the client’s room)
Client usually placed in private or semi-private room to isolate his/her germs from infecting others
Droplet
Patient should be in a private room (or placed with another patient with the same infection)
Wear a mask when working within 3 feet of patient or upon entering the room
Airborne
Diseases that are transmitted through air currents (ex: tuberculosis)
Anyone entering the client’s room must wear a high-efficiency particulate air (HEPA) filter or mask
Room is kept under negative pressure to keep the air in the room from being drawn into the other areas.
Door must remain closed
Contact
Skin wound or infections that could be transmitted by direct or indirect contact
Transmitted from skin to skin
Must don a gown and gloves
Careful handwashing
Extremely important with MRSA and VRE
Disposing of Sharps
Take precautions with any equipment or items that may pierce the skin; includes razors, blades, broken glass
Place into a container that is:
Tightly capped
Puncture-resistant
Leak proof
Infectious waste
Cultures and stocks of infectious agents
Wastes from infected patients
Wastes contaminated with blood and its derivatives
Discarded diagnostic samples
Infected animals from laboratories
Contaminated materials and equipment
Anatomic waste
Recognizable body parts and animal carcasses.
Disposable sharps
Syringes
Disposable scalpels
Blades
Disposable chemicals
Solvents
Disinfectants
Pharmaceuticals are disposable if they are..
Expired, unused, and contaminated; whether the drugs themselves or their metabolites.
Genotoxic waste
Highly hazardous drugs such as those used in cancer treatment
Radioactive matter
Originates from radiotherapy treatments, that has not been properly disposed of.
Wastes with high heavy metal content
Such as broken mercury thermometers
Health impacts of medical waste
Health-care waste is a reservoir of potentially harmful micro-organisms
Risk of the spread of, sometimes resistant, micro-organisms from health-care establishments into the environment.
Wastes and by-products can also cause injuries:
Radiation burns
Sharps-inflicted injuries
Poisoning and pollution
Producers of healthcare waste
Hospitals and other health-care establishments
Laboratories and research centres
Mortuary and autopsy centres
Animal research and testing laboratories
Blood banks and collection services
Nursing homes for the elderly
Risks associated with waste disposal
Landfilling can potentially result in contamination of drinking water.
Inadequate incineration, or incineration of materials unsuitable for incineration can result in the release of pollutants into the air.