punya eva infecti control
TRANSCRIPT
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INFECTION CONTROL
Evangeline H, SKp
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Essential terms and facts about infections
Microorganism are everywhere in the environment : on the
skin, in the GI tract, in the air, in the soil and on clothes.
Those who produce disease are called pathogens.
Infection invasion and physiological response of the body to
pathogenic organism that multiply and overcome the flora
normally present.
If the infection can be passed on readily to others it is reffered
to as a communicable disease or infectious disease.
Etiology is the study of couses.
Etiology of infectious disease is the identification of invading
microorganisms.
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More medical terms
Asepsis refers to absence of all disease-producing microroganisms.
Sterilization is the absence of all organisms including bacteria, viruses, spores
and fungi. Medical asepsis or clean technique is those practices that limit the number
of microorganisms and their growth and spread. Aseptic measures are
protective measures in that are meant to prevent infections or the spread of
infections.
Surgical asepsis or sterile technique is intended to keep all microorganisms
from a specific area. Includes practices that destroy all microroganismsand
their spores. Ex. : sterile wound dressing technique
Spore is a round or oval stucture , with a tough resistant capsule. This structure
is formed in response to adverse conditions and is highly resistant to
destruction.
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Infections
Infections occur when pathogenic organisms of sufficient
numbers and virulance invade a susceptible host.
Virulance microrganisms vary in their abilities to produce
disease.
Microorganisms also vary in the severity of the diseases theyproduce and their degree of communicability.
Nosocomial infections are those infections contracted in
hospitals.
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Couses of nosocomial infections :
1. Dx or in terapeutic procedures (iatrogenic)
caused by phycisian.2. The presence in the hospital of resistant
strains of such mictoorganisms as serratia
marcescens.
3. The use of antibiotics.
4. Changes in diet and activity of patients
because they are hospitalized.
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Comom sources of infection in the
hospitals
Microroganisms Source Mode of
transmision
Infection or
disease
Bacteria
S.Aureus
S., b-hemolitic group D
S.ViridansToxigenic e.coli
Bacteroides speciesSerratia species
Colon, Nares, skin, hair,
Colon, vagina of adultfemalesNaso-oro-pharynxColon
ColonColon, perineum
Contact, vehicles,airborne, autogenous
Contact, vehicles,autogenousAutogenousContact, vehicles
Contact, autogenousDirect, airborne
Infected eounds,pneumonia, abcesses,food poisoningUTI, wound
Bacterial endocarditisEnteritis
Peritonitis, abcessPneumonia, UTI, etc
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Continued.
Microroganisms Source Mode of
transmision
Infection or
disease
Fungi and yeasts
Candida albicans
Viruses
Herpes viruses
Hepatitis A
Hepatitis B
Mouth, colon, genitaltract, skin
Lessions of mucousmembrane, genital tract,skin
Feces, blood, urine
Feces, blood, bodyexcretions and fluids
Contact,vehicles,outogenous
Contact, vehicles,outogenous
Contact, vehicles
Contac, vehicles,airborne, possibly vectors
Dermatitis
STD, cold sores
Infetious hepatitis
Serum hepatitis,infectious hepatitis
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Six factors are involved in the infectionprocess :
1. Etiologic agent
2. Source of the pathogen or reservoir
3. Method of escape from the source / exit
4. Method of transmission
5. Method of entry6. Susceptibility of the person (host) to the
pathogen.
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Etiologic agent
The extent to which any org., or parasite is capable of producing a
disease depends on these factors :
1. Number of organisms
2. Virulence and potency of organism
3. Source of the organisms
4. Their ability to enter the body
5. Their ability to establish themselves within the body.
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Source of the pathogen or reservoir
The reservoir of the pathogen must have certain characteristics for
the organisms to live and grow. Some of these are :
Food
Water
Oxygen (aerob S.aureus, anaerob - C.tetani)
Temperature
pH Light
Antibiosis
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Method of escape from the source / exit
1. Respiratory tract sneeze, cough, talk,
breathe2. GI tract feces, drainage, vomitus
3. Urinary tract - urine
4. Reproductive tract male- urine, female-
vaginal discharge
5. Blood
6. Tissues infected wounds
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Method of transmission
1. Contact direct contact, indirect contact
2. Vehicles food, water, medications, blood frominfected person.
3. Airborne droplets from infected person/carrier,
contaminated dust, mics. Sheed in to env., from
hair, skin, wounds or perineal area.
4. Vectors contaminated or infected mosquitos,
fleas, flies, etc
5. Auotgenous infection from the patients usual
microbal flora.
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Method of entry
The skin serves as a barrier to infections :
however any break in the sin can readilyserve as a portal of entry.
Microorganisms can enter the body
through the same routes they use toleave the body.
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Course of infection
Incubation period is the time between the entry of the
pathogen into body and the onset of the symptom ofthe infection.
Period of ilness the prodormal stage and full illness
stage.
Convalescent period the symptoms disapear and
there is a return to health.
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Nursing assesment
Susceptibility
1. Stress2. Nutritional status
3. Fatigue
4. Sex
5. Heredity
6. Age
7. Medical treatment and health habits
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Clinical signs
Clinical signs of localized infection are :
1. Swellling2. Redness
3. Pain or tenderness
4. Heat at the infected area5. Loss of function of the body part affected
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Systemic infection
1. Fever
2. Lassitude, malaise3. Anorexia, nausea
4. Headache
5. Lymph node enlargement and terderness6. Vomiting and diarrhea
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The nurses resposibilites forpreventing infection include :
Teaching individual preventive measures
Strengthening the bodys barriers againtsinfection immunization, nutirition, adequate
rest and sleep, normal stress level.
Encourages hygiene hand washing,
perineal care, reguler bathing, brushing teethregularly, blowing the nose, coughing, nail
care.
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Standard precautions
Hand washing and antisepsis (hand hygiene)
Use of PPE when handling blood, body substances,excretions and secretions.
Approriate handling of patient care patient and soiled
linen.
Prevention of needlestick/sharp injuries.
Environmental cleaning and spills-management
Approriate handling of waste.
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Hand washing and antisepsis
Can minimize microorganisms
Acquired on the hands during daily duties.Where is contact with the lood, body fluids,
secretions, excretions and known and
unknown contaminated equipment or
surfaces.
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Wash or decontaminate hands :
After handling any blood, body fluids, secretions,
excretions and contaminated items.
Between contact with different patients.
Between tasks and procedures on the same patient
to prevent cross contamination between different
body site.
Immediately after removing gloves
Using plain soap, antimicrobial agent (alcoholic hand
rub or waterless antieptic agent).
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Use of PPE
Using PPE provides physical barrier between
mo and the wearer. It offers protection byhelping to prevent mo from :
Contaminating eyes, hands, clothing, hair and
shoes.
Being transmitted to other patients and staff
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PPE includes :
Gloves
Goggles Mask
Apron
Gown Boot/shoe cover
Cap/hair cover
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PPE should be used by :
Health care worker who provide direct care to
patients and who work in situation where they may
have contact with blood, body fluids, excretions,
secretions.
Support staff including medical aides, cleaners, and
laundry.
Laboratory staff, who handle patients specimens
Family members who provide care to patients and
are in the situation.
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Principles for use PPE
PPE should be chosen according to the risk ofexposure.
Avoid any contact between contaminated (used)PPE and surfaces, clothing or people outside thepatient care area.
Discard the used PPE in approriate disposal bagsand dsipose of as per the policy of the hospital.
Do not share PPE Change PPE completely and thoroughly wash hands
each time you leave a patient to attend to anotherpatient or another duty.
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Remember !!!!
It is important to use PPE effectively,correctly and at all times where
contact with patients blood, body
fluids. Excretions and secretionsmay occur.
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Gloves
Wear gloves (clesn, non sterile) when
touching blood, body fluids, secretions,excretions or mucous membranes.
Change gloves between contact with
different patient.
Change gloves between tasks/procedures onthe same patient to prevent cross
contamination between different body sites.
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Cont
Remove gloves immediately after use and before
attending to another patient.
Wash hands immediately after removing gloves.
Disposible gloves should not be reused but should
be dsiposed of according to the health care facility
protocol.
Use a plain soap, antimicrobial agent or waterless
antiseptic agent.
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Masks
Wear a masks to protect mucous membrane of the
mouth and nose when undertaking procedures that
are likely to generate splashes of blood, body fluids,
secretions and excretions.
Wear surgical maks rather than cotton material or
gauze masks.
Do not reuse disposible masks. They shoul bedisposed of according to rhe health care facility
protocol.
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Protective eye
wear/goggles/visors/face shield
Wear them to protect mucous membrane of
the eyes when conducting prod.
If possible discard appropriately after used.
If they are reuseable, decontaminate them
according to the manufacturers instructions.
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Gowns and plastic aprons
Wear a gown (clean, non-sterile) to protect
the skin and prevent soiling of clothing duringprocedures that are likely to generate
splashes of blood, body fluids secretions or
excetions. Impermeable gowns are
preferable. Remove a soiled or wet gown as soon as
possible.
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Cont
A plastic apron may be worn on top of the
gown. Launder gowns and apron appropriately if
thay are reusuable, according to the hospital
guidelines.
Do not reuse disposable gowns and aprons.
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Boots/shoe cover
Wear caps/boots/shoecover if necessary.
Launder them if reusable, according to thehospital guidelines.
Do not reuse the disposible ones.
Clean and desinfect reuse boots.
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Patient care equipment
Handle spoiled patient care.
Ensure all reusable equiment is cleaned and
reprocessed appropriately before being used
another patient.
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Linen
Handle, transport and process used
linens that is soiled with blood, etc withcare to ensure that there is no leaking
of fluid.
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Prevention of needle stick/sharps
injuries
Place used sharps items in a puncture-resistant
container with a lid that closes and is located close
to the area in which the item is used.
Take extra care when cleaning sharps items.
Never recap or bend needles.
Sharps must be appropriate disinfect pr destroyed as
per the national santdards or guidelines.
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Additional precautions
Airborne precautions
droplet < 5 micron, TB, chicken pox, etc.1. Implement standard precautions
2. Place pt in a single room that has a monitored
negative airflow pressure.
3. Keep doors closed4. Use N 95 mask
5. Limit movement and transport the patient. If it is
necessary masking the patient.
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Droplet precautions
Droplet > 5 micron, pneumonias, pertussis,
diptheria, mump sneezing, influenza,meningitis.
Coughing, sneezing, talking or when
healthcare workers undertake the
procedures such as tracheal suctioning.
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Cont
Implement standard precautions.
Place pt in a single room or in a room withanother pt infected by the same pathogen.
Wear surgical mask when working within 1-2
m of the patient.
Masking the patient if transport is necessary.
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Contact precautions
Implement standard precautions.
Place pt in a single room or in a room withanother pt infected by the same pathogen.
Wear clean non sterile gloves and gowns
when entering the room
Masking the patient if transport is necessary.
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Protect yourself
Prevention
better thancure