Chapter 12 Infection Control Measures Flashcards
Health Care–Associated Infections (HAIs) and Infection Control Overview
Health Care–Associated Infections (HAIs):
Also designated as nosocomial infections.
Defined as infections that patients acquire while receiving care inside a healthcare facility (such as a hospital).
Healthcare workers can also acquire these infections while providing care to patients.
Hands serve as the primary and most common vector for pathogen transmission.
Infection Control Principles:
Maintaining cleanliness directly decreases patient and worker exposure to pathogens.
Healthcare facilities enforce specific, standardized practices designed to decrease person-to-person transmission.
These collective practices are officially defined as infection control.
Methods of Infection Control
Four Major Methods:
Medical asepsis
Surgical asepsis
Barrier methods
Isolation precautions
Medical Asepsis and Cleaning Techniques
Definition and Mechanism:
Medical asepsis involves physically removing or killing pathogens to prevent their spread.
It is achieved through processes involving soap, water, antiseptics, disinfectants, or heat.
Four Techniques of Medical Asepsis:
Sanitization:
Refers to practices associated with basic cleanliness.
Includes basic hand hygiene, cleansing eating utensils and environmental surfaces with soap and water, and providing clean linens and clothing.
Removes pathogens to prevent transmission.
Antisepsis:
Kills microbes or stops them from growing.
Utilizes chemical agents that prevent micro-organism proliferation.
Safe to be used on skin as well as nonliving surfaces.
Chemical examples include rubbing alcohol, iodine, and alcohol-based hand rub.
Disinfection:
Utilizes stronger chemical agents to kill pathogens.
Disinfectants are chemically too strong to be applied to human skin.
Used exclusively to clean nonliving objects that come into contact with body fluids, such as bedpans, urinals, and tray tables.
Sterilization:
The most thorough method of infection control.
Renders objects completely free of all microbes.
Required for instruments that enter sterile body areas, including surgical instruments, needles, and intravenous (IV) catheters.
Equipment is sterilized using an autoclave or by soaking in specialized sterilizing chemicals that destroy all microbial life.
Boiling is explicitly noted as an ineffective method for achieving complete sterilization.
Environmental Sanitation Guidelines
Maintaining a Sanitary Environment:
Execute proper hand hygiene immediately after any contact with body fluids.
Perform proper hand hygiene when providing care for specific infections, particularly Clostridioides difficile (C. diff).
Wash hands frequently following routine activities.
Strictly practice cough and sneeze etiquette.
Provide each patient with individual personal care products, utilizing disposable products whenever possible.
Hold contaminated items away from the body during transport.
Avoid stirring up dust during environmental cleaning processes.
Dispose of trash properly following facility guidelines.
Follow strict procedures for preparing dirty linens for laundry, including placing them in designated soiled bags.
Maintain good personal hygiene and assist residents in maintaining their own personal hygiene.
Hand Hygiene Practices and Principles
Primary Prevention:
Handwashing is the number one method for preventing the spread of infection.
Handwashing must be performed thoroughly and consistently.
Mandatory Handwashing Occasions (Minimum Requirements):
Upon arriving at and leaving the healthcare facility.
Whenever hands are visibly dirty or have come into contact with blood or body fluids.
When caring for patients diagnosed with C. diff.
Before taking a break, eating, or inserting contact lenses.
After using the bathroom, coughing, sneezing, or blowing the nose.
After touching one's hair or applying lip gloss.
Microbial Reservoirs and Hiding Places:
Pathogenic microbes accumulate under long fingernails, within cracks in nail polish, and beneath false or acrylic nails.
Acrylic nails, false nails, and long fingernails cannot be worn to clinicals.
Microbes reside on hands after using the bathroom.
Jewelry such as rings and bracelets trap microbes and hinder effective hygiene.
Alcohol-Based Hand Rub Guidelines
Advantages:
Quicker to perform than standard handwashing with soap and water.
Gentler on human skin than traditional soap and water.
Can be conveniently utilized anywhere in a facility.
Very simple to use: apply the rub, rub hands together ensuring full coverage across all hand surfaces and fingers (both front and back), and continue rubbing until hands are completely dry.
Approved Clinical Indications for Use:
Used when hands are not visibly soiled.
Before entering a patient's room or clean supply room.
Before and after direct resident contact, or after contact with nonliving surfaces in a resident's room.
Before handling a patient's meal tray or clean linen cart.
After picking up an object from the floor.
After removing or changing disposable gloves.
When moving from a dirty body site to a clean body site while providing patient care.
Surgical Asepsis
Definition and Applications:
Used for clinical procedures that involve entering a person's body.
Examples include surgical procedures, administering injections, performing sterile dressing changes, and inserting urinary catheters.
Scope of Practice Guidelines:
Performing surgical asepsis is not within a Certified Nursing Assistant's (CNA) scope of practice.
Employers will provide specific training if sterile procedures are required as part of an employee's official job description.
Barrier Methods and Personal Protective Equipment (PPE)
Definition and Types:
Objects or equipment that prevent pathogenic microbes from reaching skin or mucous membranes.
PPE examples include disposable gloves, gowns, masks, respirators, and protective eyewear.
Gloves:
Indications for wearing gloves:
Any possibility of touching body fluids.
Providing care for a patient diagnosed with a communicable (contagious) disease.
Performing perineal care.
Caring for patients when the caregiver has open cuts or abrasions on their hands.
Shaving a resident or performing oral hygiene care.
Performing care on a patient with an open wound.
Handling soiled linens.
Cleaning equipment contaminated with body fluids.
Gloves must be fully intact and fit properly.
Perform hand hygiene (using alcohol-based hand rub) between glove changes.
The most common clinical error is healthcare workers becoming too comfortable while wearing gloves.
Gloves protect both the care provider and others: touching a contaminated surface while wearing gloves contaminates the gloves, and subsequently touching another item (such as a computer keyboard) transfers the contamination to that item.
Caregivers must be aware of latex allergies and utilize latex-free gloves when necessary.
Hands must always be washed immediately after removing gloves.
Gowns:
Used specifically to protect uniforms from contamination by body fluids.
Gowns are disposable and intended for single use only.
A gown is considered contaminated if it becomes wet.
Masks:
Prevent inhalation of airborne or droplet microbes from patients.
Surgical masks are worn for droplet precautions (e.g., meningitis, strep throat).
N95 masks/respirators are worn for airborne precautions (e.g., tuberculosis [TB], measles).
All masks must be used only once.
When removing a mask, handle only the ties or straps.
Protective Eyewear:
Used to shield eyes from splashing liquids or body fluids.
Must fit closely to the face and can be worn over standard glasses.
Donning and Doffing PPE Sequences
Sequence to Put On (Don) PPE:
Gown
Mask
Eyewear
Gloves
Sequence to Remove (Doff) PPE:
Gloves
Gown
Eyewear
Mask
Updated Standard Precautions
Respiratory Hygiene and Cough Etiquette:
Practiced to prevent the spread of any respiratory infection.
Cover mouth and nose with a tissue when coughing or sneezing, then immediately dispose of the tissue.
Wear a mask when within 3 feet of individuals exhibiting respiratory symptoms.
Wash hands or use hand sanitizer frequently.
Wear both masks and gloves when caring for a patient exhibiting signs and symptoms of a respiratory infection.
Lumbar Puncture Procedures:
Personnel are required to wear a mask when assisting with lumbar puncture procedures.
Transmission-Based Precautions
General Principles:
Utilized when a patient has a known transmissible disease.
Divided into Airborne, Droplet, or Contact precautions.
Equipment used for patient care should be disposable if possible, kept inside the resident's room, and not used for any other patient.
PPE must be put on before entering the room and removed when leaving the room.
Hands must be washed immediately when finished.
Airborne Precautions:
Implemented when pathogens are transmitted through the air.
Patient is placed in a private room called an Airborne Infection Isolation Room (AIIR) featuring a special ventilation and filtration system.
All individuals entering the room must wear an N95 mask before entering.
Gloves must be worn if planning to touch anything in the room.
When the resident leaves the room, the resident must wear an N95 mask.
Droplet Precautions:
Implemented when pathogens are transmitted by droplets expelled from the patient's mouth or nose.
All individuals entering the room must wear a surgical mask (and gloves if needed).
Disease examples include influenza, pertussis (whooping cough), and mumps.
Contact Precautions:
Implemented when pathogens are transmitted by direct physical contact.
All individuals entering the room must wear a gown and gloves.
Any soiled linen or waste materials must be properly contained and disposed of.
Health Care–Associated Infections (HAIs):
Comparable to pit stops where teams must manage tire changes, fuel, and inspections to ensure the car runs optimally and without error.
Infections are akin to unexpected mechanical issues arising while competing on a track. Both need immediate attention to prevent further problems.
Transmission of infections can be compared to how dirt, debris, or oil residue spreads in the racing environment, affecting performance.
Infection Control Principles:
Just as teams strategize to keep their cars clean and well-maintained to lessen the chance of issues mid-race, healthcare facilities must enforce cleanliness to prevent infections.
Methods of Infection Control
Four Major Methods:
Medical asepsis
Surgical asepsis
Barrier methods
Isolation precautions
Medical Asepsis and Cleaning Techniques
Definition and Mechanism:
Similar to ensuring that race cars are free from dirt and debris before the race to avoid performance issues, medical asepsis involves removing or killing pathogens to prevent spread.
Four Techniques of Medical Asepsis:
Sanitization:
Basic practices of cleanliness; akin to having well-maintained cars and clean garages.
Antisepsis:
Like using specialized fuel or oils to prevent engine failure.
Disinfection:
The use of stronger agents is similar to tire changes made with specialized tools to ensure peak performance.
Sterilization:
Ensuring parts are immaculate, just as racing teams do before they hit the track with their cars, preparing for the utmost precision in performance.
Environmental Sanitation Guidelines
Maintaining a Sanitary Environment:
Similar to how teams keep their pit stops clean and organized for efficiency during stops.
Hand Hygiene Practices and Principles
Primary Prevention:
Think of handwashing as reaching out for your team’s assist when making a strategic decision during a race to avoid a crash.
Alcohol-Based Hand Rub Guidelines
Advantages:
The quickness of using hand rubs parallels the rapid effectiveness of changing tires on race day.
Surgical Asepsis
Definition and Applications:
Skillful precision in executing tasks akin to a driver managing their moves to avoid collision.
Barrier Methods and Personal Protective Equipment (PPE)
Definition and Types:
PPE is just like a driver’s suit and helmets, protecting against the dangers of the track.
Donning and Doffing PPE Sequences
Sequence to Put On (Don) PPE:
Gown
Mask
Eyewear
Gloves
Updated Standard Precautions
Respiratory Hygiene and Cough Etiquette:
Like how racers manage their health during long races to ensure peak performance.
Transmission-Based Precautions
General Principles:
Taking extra measures similar to ensuring safety when navigating rain-soaked tracks.
Airborne Precautions:
Similar to a driver needing to manage airflow to maintain speed while navigating roads.