found. - infection: Principles of medical and surgical asepsis

Hand hygiene

cleansing of hands

Handwashing

soap and warm water, no antimicrobial properties for regular soap, 20 to 30s HBD 2x

Alcohol based hand sanitizer

decreases number of micro organisms on hands. Minimum of 60% alcohol are highly effective (against gram + and

Antimicrobials

decrease microbe load

Antiseptics

used to cleanse skin examples are alcohol, chlorhexifine, chlorine, chloroxylenol and more

Spores

C. diffe, difficult to remove from skin (alcohol based products, antiseptics, antimicrobials are not effective in removing this)

Medical asepsis

reduction of disease causing micro organisms

Surgical asepsis

ensures items and equipment are sterile to prevent surgical site infections (SSIs)

Sterile/ sterilization

do not have micro organisms present on them

Methods of sterilizations

thermal, chemical, and radiation

Thermal sterilization

autoclaving, exposing items to dry steam

Chemical sterilization

used when items are vulnerable to heat, ethylene glycol hydrogen peroxide gas is used

Radiation

high energy gamma rays to sterilize single use items while still packaged

Sterile field

12 to 18 in away from walls or contaminating objects, 1 in border of sterile field is considered contaminated, place in middle of field

Sterile field setup

obtain supplies and check dates and packaging → setup field close to pt→ open other wrapping w/out touching contents → open sides furthest away → open side closest

Disinfection

cleans instrument so that almost all micro organisms are eradicated high ( some spores remain) or low levels (vegetative bacteria are destroyed but some spores, fungi and virus remain)

Examples of disinfection

pasteurization or chemicals.

Airborne

n95 respirator, gowns, gloves, eye protection if splash risk, private rooms, HEPA filter,

Droplet

surgical mask, gown, gloves if risk of contact with secretions, private rooms if possible

Contact

gown, gloves before room entry additional ppe if risk of splash

Standard

hang hygiene before and after pt contact gloves if needed

Protective isolation

immunocompromised after having allogenic hematopoietic stem cell transplant for first 100 days, HEPA filter, no plants

Health care associated inections (HAIs)

infections acquired in health care facilities, devices that are inplanted can serve as port of entry for infectious agents

Major kinds of HAIs

central line associated bloodstream infections (CLABSIs), catheter associated urinary tract infections (CAUTIs), surgical site infections (SSIs), ventilator assisted pneumonias (VAPs)

Infection control (care) bundles

guidelines for practice that are bundled together in effort to prevent HAIs. vary between facilities.

Multi drug resistant organisms (MDROs) cause MDRI (infections)

bacterium resistant to one or more classes of existing antimicrobials. Only responds to one or two meds

Examples of MDROs

MURSA (methicillin resistant s.aureus), VRE (vancomycin enterococcus), VISA (vancomycin resistant S. aureus), ESBL (extended spectrum beta

Enhanced barrier precautions

nursing home to decrease transmission. Gowns and gloves to prevent transfer when doing care activities

Glove techniques when donning

closed and open

Closed glove technique

gown is worn, both hands within cuff of gown and grabs as well as pulls gloves over the cuff

Open glove techniques

situations where gown is not worn (inserting catheter) or to replace gloves that are contaminated, donning with hands, first glove added with finger on folder potion of cuff second added by inserting fingers under cuff of the second glove