Aseptic technique and Wound care

• What are the universal precautions for healthcare providers?

• Treat every patient as if they are infected

What are the 2 agencies that shape infection control practice ?

• CDC : Centers for disease control and prevention -

• OSHA: Occupational safety and health administration ex- wash hands and bio hazard

Key terms: infection

• Pathogens invade body and multiply causing harm to the host.

Nasocomial Infection

• An infection acquired in a hospital or health care setting that was not present at admission.

The chain of infection ? in order 6

• Infectious agent: the organism multiples

• Reservoir: the source where it lives

• Portal of exit: How it leaves the source

• Means of transmission: How it travels

• Portal of exit: How it enters a new host

• Susceptible host: The New host’s immune system

5 Modes of transmission ?

• Contact: Direct body to body surface/indirect thru a contaminated object. EX- Sheets,dressings.

• Droplet: Cough and sneezes onto a host nose or mouth droplets do not stay in the air. 3 ft travels EX: Strep,Pneumonia whopping cough.

• Airborne: Tiny droplet or infected dust for long periods. Air stays EX:Chickenpox,measles,TB

• Common Vehicle: Single contaminated item spreads the agent. EX:Food water medications.

• Vectorborne: Living carriers spread the agent EX: Mosquitoes flies and rats

• Contact is most frequent ****

HEP A ,B,C What are they and differences ?

• Hep A: Spread by fecal route,contaminated food or water. Course:No chronic infections most people fully recover and then are immune. Vaccine : Yes

• Hep B: Spread by: Blood, sexual contact and mother to baby. Course: Can become chronic many carriers go unidentified. Vaccine: Yes a 3 dose series. Is this transmitted through the hospital? NO

• Hep C : Spread by: Blood and transfusion most new infections cone from drug use. Course: Chronic condition. Vaccine: NO

KEY NOTE: HEP: A,B,C

• A: Risk groups international travels and outbreaks.

• B: Highest workplace risk

• C: Blood screening makes transfusion cases very rare drug treatment exist but no cure.

4 Controls that limit Blood borne exposure

1. Exposure control plan: Purpose: u and ur employer do to minimize exposure and steps to take if happen. EX- Annual employee training

2. Engineering controls: Purpose: Isolate or keep infectious materials away from patients and staff. EX: Hand washing Facilities ,sharp containers specimen containers, regulated water containers and color coded laundry bags.

3. PPE: Purpose: Protects u from direct contact with blood and other infectious material. EX : Gloves gowns, mask ,eye protection

4. Environmental controls: Purpose: Rules for performing procedures in the safest way possible. EX: Hand washing sharps,Cleaning,Handling laundry and trash.

Nosocomial Infection ?

• an infection a patient develops while receiving medical care in a hospital.

2 Tiers of isolation precautions ?

• Standard precautions: Applies to all patients regardless of diagnosis or infection Status.

• Transmission based precautions: Specific patients with highly transmissible pathogens.

Standard precautions: hand hygiene and PPE

• Wash before and after each patient

• Scrub 20 seconds with soap

• NO artificial fingernails

• Gloves: Sterile- open from plastic; non-sterile - On wall in boxes

• Never reuse a gown

Standard precautions: cleaning equipment and coughs

• Patient care equipment: What it requires? - Polices for transporting and handling equipment and instruments contaminated with blood. Use EPA Registered disinfectants.

• Environmental control: Lines handled correctly, needles and sharp instruments disposed of properly

• Cough Etiquette: Post signs, educate staff patients and family to contain secretions.

Donning AND Doffing Definitions ?

• Donning: Putting on

• Doffing: Taking off

PPE In order

1. Cap

2. Gown

3. Mask

4. Gloves

• Never lower mask and pull it back over your mouth *****

Putting on a sterile gown - What side is sterile and not sterile

• inside of the gown is unsterile side

• Outside is sterile

Removing a gown in order Good to know ******

1. Untie the waist have someone untie back of gown.

2. Cross your arms and grasp outer front of each shoulder of the gown.

3. gently pull gown down over ur arms

4. roll the gown into a ball then dispose of it.

Soiled clean and sterile Definitions ? examples

• Soiled: used or exposed to blood, body fluids, or infectious material; handle as contaminated. EX: used lines, old dressings

• Clean: Free of visible dirt with a reduced number of microorganisms, but not sterile. EX: washed gloves, nonsterile gloves.

• Sterile: Completely free of all microorganisms, including spores. Pre-packaged EX: Sterile instruments and gloves

Medical Asepsis ? (clean techniques)

• Reduces number and spread of microorganisms, hand washing, cleaning, standard precautions.

Surgical Asepsis (Sterile Technique)

• keeps an area or object completely free of microorganisms sterile fields gowns and gloves.

8 Sterile field rules ?

1. Everything in the field must be sterile

2. Opened packages edges are not sterile (1 inch border not sterile)

3. A gown is sterile only in front (shoulder level to tabletop level )

4. Only the tabletop is sterile

5. Only sterile may touch sterile

6. Activity must not contaminate the field

7. A penetrated barrier means contamination

8. Prepare it just before use

Purpose of a dressing ?

• Promote healing

• Protect the site

• Keep bacteria out of the wound

• prevent transmission of infection

Types of dressings ?

1. dry to dry

2. wet to wet

3. wet to dry

4. Occlusive (air-tight seal)

5. rigid - (hard plastic)

Compression wrap ( figure 8 or spiral )

• Spiral for edema - More pressure distally then proximally wrap above and below the swelling

• Figure 8 for Joint support - Even pressure from distal to proximal.

Shelf life Definition ?

• Basically expiration date

Sterile field Def

• area free of microorganisms prepared to hold a sterile items during a procedure.

Strike-through

• Moisture soaks thru a sterile barrier this is why spills contaminate a field.