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توجواب لقای ایهرسئوال
شودبی ازتوحل مشکلوقال قیل
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ازدعای فرازیعرفه کانی • اخشاک اجعلنی اللهم
اراکبتقواک • واسعدنیبمعصیتک • والتشقنینفسی • فی غنای اجعلنی اللهمقلبی • فی والیقینفی • واالخالص
بصری. والنورفی عملیدینی فی والبصیرت
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Antimicrobial resistance research center Mazandaran university of medical sciences, Sari, Iran
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NOSOCOMIAL INFECTIONS
CONTROLDR.BABAMAHMOODI
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HOSPITAL TERMINOLOGY• INFECTION• DISINFECTION• STERILIZATION• CLEANING• DECONTAMINATION• GERMICIDE• ANTISEPTICS• CRITICAL,SEMICRITICAL,NON-CRITICAL ITEMS• CHEMICAL DISINFECTANTS(H,M,L) LEVEL
• ISOLATION
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ISOLATION
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PURPOSEprevent the transmission of microorganisms from infected or
colonized patients to other 1-
patients. 2-hospital visitors. 3- health care workers.
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Isolating patients 1-Expensive.
2-Time-consuming.
3-often uncomfortable for patients. 4-may impede care
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ISOLATIONShould be implemented only when necessary
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Failure to isolate 1-Morbidity. 2-Mortality. 3-
expensive. ,
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Expensive 1-Costs of an investigation of an outbreak
2- Excess length of stay. 3-The indirect costs of
lost productivity .
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practice of isolating patients1-separate infectious disease
hospitals.2-to separate wards for these
patients. 3- ultimately to providingprecautions in the general hospital environment.
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ISOLATING ROOMS1-single-patient
rooms.2 -double-patient
rooms.
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(Guidelines for isolation(2007 CDC
1-standard precautions, which
apply to all patients. 2-transmission-based
precautions.
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TRANSMISSION -BASEDprecautions. to patients which apply with documented or suspected infection or colonization with certain microorganisms.
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Standard PrecautionsAll patients maypotentially be colonized or infected with organisms that can transmitted wherever behealth care is provided.
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STANDARD PRECAUTIONSgloves should be worn to touch any of the following:
blood, all body fluids, secretions, and excretions. except sweat,
regardless of whether they are visibly bloody, non intact skin, and mucous membranes.
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STANDARD PRECAUTIONSHands should be washed immediately after
-gloves are removed,
-before and after patient contact. with items in the patient’s and after
contact environment that may be contaminated.
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Two new elements of standard precautions
1-In Lumbar puncture wear masks to prevent contamination
of the spinal needle or the procedure site with the oral flora of
the operator, which may occur when
the operator is talking.
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Two new elements of standard precautions2-respiratory hygiene, which includes instructing
patients to cover their nose and mouth with a tissue when coughing or sneezing.
placing a surgical mask on the coughing patient in common areas.
and spatially separating patients with respiratory infections from other patients when feasible.
-using hand hygiene after contact with respiratory secretions.
.
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STANDARD PRECAUTIONS1-gloves2-HAND WASHING. 3-mask with eye protection4-gown5-Needles and syringes.
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HAND HYGIENE•Hand hygiene is the single most important factor in preventing
nosocomial infections.
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HAND HYGIENEIt prevents transmissionof pathogens by contact and the fecal-oral route
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HAND HYGIENEThe principles of hand
washing are based on the work of
Semmelweis.
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HAND HYGIENEhand washing remains the single most importantmeans to prevent transmission of nosocomial pathogens.
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HAND HYGIENEIt has been estimated that an increase in hand washingcompliance by 1.5- to 2.0-fold would result in a 25% to 50%decrease in the incidence of HAIs.
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microorganisms on hands
1-transient flora2-resident flora
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Transient flora1-Are important causes of HAIs.
2-These organisms are acquired primarily by contact. 3- Loosely attachedto the skin
4-Easily washed off.
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RESIDENT FLORA1-organisms of low virulence
(e.g., coagulase-negative staphylococci, Micrococcus, Corynebacterium)
2-that are rarely transmitted to patients except when introduced by invasive procedures
3 -Not easily removed through hand washing.
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Purpose of hand washing Remove the transient flora recently acquired
by contact with patients or environmental surfaces.
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HANDS OF HCWSHAIs have been attributed to bacterial contamination of artificial fingernailstherefore, they should not be worn by health care workers.
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Alcohol-based hand rubsthe recommended agents for hand hygienein the health care setting.
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washing with soap1-visibly soiled, washing with soap(antimicrobial or non antimicrobial )
and water . 2-Clostridium difficile diarrhea.
CDC suggests that soap and water be used because of the poor sporicidal activity of .alcohols
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ALCOHOL -BASED HAND RUBS
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WHEN1-before and aftercontact with patients. 2-immediately after removing gloves.
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Wall-mounted dispensersalcohol-based, waterless hand rubs
should be installed in all hospital and
outpatient rooms .In areas in which this is not feasible, individual health care workersshould carry small containers of waterless agents.
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GLOVES1-to prevent contamination
of the hands with microorganisms .2-to prevent exposure of the health care
Worker to blood-borne pathogens. 3 -to reduce the risk of transmission
of microorganisms from the hands of the health care worker to the patient
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GLOVES1-gloves do not replace the need for hand hygiene
2-gloves should be changed during the careof a patient when moving from a contaminated or body site (e.g., wound perineal care) to a clean body site.
3-Gloves have small perforations that may allow to contaminate the hands.
-not as a substitute for hand hygiene.
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Transmission-Based precautions
patients based on a suspectedor confirmed clinical syndrome.
a specific diagnosis, or colonization or infection with epidemiologically important organisms.
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IMPORTANTIt is important to note that
transmission-based
precautions are always implemented in conjunction with standard precautions.
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TRANSMISSION-BASED PRECAUTIONS
•Three types•1-Airborne
•2-Droplet borne•3-Contact borne
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ISOLATION CATEGORYA few diseases varicella,
SARS, MERS-COV require more than one isolation category.
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TB-TRANSMISSION• COUGH• LAUGH• SPEAKS• SNEEZES• SPITS• SIGNS
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امام حسین)ع(این را 5کسیکه خصلت
لذت اززندگی باشد نداشتهنمیبرد.
ایمان-2عقل-1حیا-4ادب-3خوش- 5 اخالق
45
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