Foundations of Nursing Ch 7 "Asepsis and Infection Control"

Bacteria

(microbiology) single-celled or noncellular spherical or spiral or rod-shaped organisms lacking chlorophyll that reproduce by fission

Vector

A carrier, or a vector, is a person or animal that does not become ill but harbors and spreads an organism, causing disease and others.

Mode of transmission

A contaminated vehicle is the means by which micro organisms are carried about the transported to the next hose once they have left the reservoir.

Standard precautions

A strict form of infection control that is based on the assumption that all blood and other body fluids are infectious. Standard precautions include hand hygiene, gloves, mask, and protection, face shield, and gown.

Reservoir

An environment that supports organism growth include an available food source, oxygen, water, light, and desirable temperatures and levels of acidity or alkalinity. Any natural habitat of a microorganism that promotes growth and reproduction is a reservoir.

Fomite

An inanimate object used as a vehicle for mode of transmission

Anaerobic bacteria

Bacteria that grow only in the absence of oxygen

Aerobic bacteria

Bacteria that grow only in the presence of oxygen

Medical Asepsis

Consists of techniques that inhibit the growth and transmission of pathogenic microorganisms. Medical asepsis is also known as clean technique.

Virulent

Exceedingly pathogenic

Airborne precautions (tier 2)

In addition to standard precautions, use airborne precautions for patients known or suspected to have serious illnesses transmitted by airborne droplet nuclei. 1. Measles 2. Varicella zoster virus, responsible for chickenpox and shingles. 3. Tuberculosis (it is mandatory that healthcare workers wear an N 95 or higher particulate respirator mask or a powered air purifying respirator when entering and I said fast bacillus isolation room).

Droplet precautions (tier 2)

In addition to standard precautions, use droplet precautions for patients known or suspected to have serious illness is transmitted by large particle droplets. 1. Invasive Haemophilus influenza, including meningitis, pneumonia, Epiglottitis, and sepsis. 2. Invasive neisseria meningitis disease, including meningitis pneumonia and sepsis. 3. Diphtheria (pharyngeal) 4. Mycoplasma pneumonia 5. Pertussis 6. Pneumonic plague 7. Streptococcal pharyngitis, pneumonia and scarlet fever in infants and young children 8. Adenovirus 9. Influenza 10. Mumps 11. Parvovirus B19 12. Rubella

Inflammatory response

Inflammation is The body's response to injury or infection at the cellular level. Information is a protective vascular reaction that delivers fluid, blood products, and nutrients to the interstitial tissues in the area of an injury. The process neutralizes and illuminates pathogens or in a chronic tissues and establishes a means of repairing cells and tissues.

Host

Is an organism in which another organism is nourished and harbored.

Protozoa

Protozoa are single celled animals; in some form, they exist everywhere in nature. Some of the parasitic forms of protozoa are found in the intestinal tract, the genitourinary tract, the respiratory track, and the circulatory system of humans and other animals. Protozoa are responsible for malaria, amebic dysentery, and African sleeping sickness.

Implementation

Recognizing and assessing a patient's risk factors and implementing appropriate measures, the nurse has the capacity to help reduce the risk of transmitting infections

Managing sterile packages

Sterile items such as syringes, guys dressings, and catheters are packaged in paper or plastic containers that are in pervious to micro organisms as long as the items remain dry and intact. Paper packages are permeable to steam and this allow for steam auto cleaning. It is advantage of paper wrappers is that they tear or puncture relatively easily.Never use or allow use of sterile item or piece of equipment after the expiration date

Expected outcomes and planning

The plan of care focuses on achieving specific goals and outcomes related to the patient problems chosen. Interventions are determined with the aid of the patient, the family, the physician, and other members of the healthcare team.

Bacillus anthracis

The spore forming bacterium causes the acute infection disease of anthrax. Anthrax infection occurs in three forms cutaneous, gastrointestinal, and inhalation.

standard precautions (tier 1)

Use standard precautions for the care of all patients. This general mandate is necessary because whether the patient is colonized or infected with certain pathogenic microorganisms is sometimes not now. Barrier precautions reduce the need to handle sharps.

Portal of entry

a way for the infectious agent to enter a new reservoir or host. If skin is punctured with a contaminated needle, micro organisms are able to enter the bloodstream.

Preparing a sterile field

• Work area must have enough room for handling and placing sterile items • Usually inner surface of sterile wrapper Sterile solutions • Bottle inside of bottle cap sterile • "Lip" the bottle by pouring a small amount 1-2 ml • Cleans the lip of the bottle • Don't splash Sterile gloves Open method- drsg changes, catheters Closed method- operating room Proper size

Gloving

(Donning gloves) 1. Remove gloves from dispenser. 2. Inspect gloves for perforations. 3. Dawn gloves when ready to begin patient care. Wearing gloves with a gown does not necessitate any special technique for putting them on; wear them pulled over cuffs of gown. 4. Change gloves after direct handling of infectious materials such as wound drainage. 5. Do not touch side rails, tables, or bed stands with contaminated gloves. (Removing gloves) 6. Remove first glove by grasping outer surface at palm with other gloved hand and pulling gloves inside out and off. Place this glove in the hand that is still gloved. 7. Remove second glove by placing finger under cuff and turning glove inside out and over other glove. Drop gloves into waste container. 8. Perform hand hygiene. 9. Provide patient teaching. 10. If contamination occurs, it is necessary to reassess technique.

infectious process

1. Incubation period 2. Prodromal stage 3. Acute stage 4. Convalescence

CDC linen handling

1. Play soiled linen in a laundry bag in the patient's room. 2. Tree all live in as though it were infectious.

CDC guidelines for surgical hand antisepsis

1. Surgical hand antisepsis reduces the resident microbial count on the hands to a minimum. 2. The CDC recommends using an antimicrobial soap to scrub hands and forearms for the length of time recommended by the manufacture. Referred to agency policy for time required. 3. When using an alcohol-based surgical hand scrub product with persistent activity, follow the manufacturers instructions. Before applying the alcohol solution, pre-wash hands and forearms with non-antimicrobial soap and dry hands and forearms completely. After application of the alcohol-based product as recommended, allow hands and forearms to dry thoroughly before donning sterile gloves.

Infection prevention and control team

Administratively, infection control nurses and other members of the infection prevention and control team function within the hospital via the infection prevention and control committee.

Surgical asepsis

Consists of techniques designed to destroy all microorganisms and their spores (the reproductive cells of some microorganisms, such as fungi or protozoa). Surgical asepsis is known as sterile technique and is used in specialized areas.

Infection

Contamination or invasion of body tissue by pathogenic organisms

Exogenous

Growing outside the body. Infection is caused by microorganisms from another person (an infection transmitted to the patient by a healthcare worker).

incubation period

Interval between entrance of pathogen into body and appearance of first symptoms. The host may be infectious during this period.

Surgical asepsis (sterile technique)

Is the complete removal of all microorganisms, including spores, from an object.

Disinfection

Is used to destroy microorganisms. However, it does not destroy spores. The solution using used during disinfection are called disinfectants, or possibly bactericidal solutions.

Contamination

Means a condition of being soiled, stand, touch by, or otherwise exposed to harm for agents (i.e., the entry of infectious materials into the previously clean or sterile environment), which makes an object potentially unsafe for use

Pulmonary tuberculosis precautions

The best way to prevent the transmission of pulmonary TB is to quickly identify, isolate, and treat patients with the TB. The nurse should suspect a patient has pulmonary TV if the patient has respiratory symptoms that lasts longer than two weeks. Other suspicious symptoms include fatigue, unexplained weight loss, dyspnea, fever, night sweats, and hemoptysis. Isolation for patients with known or suspected TV includes a negative pressure isolation room.

Gowning

The nurse should Don a gown when preparing to provide care for a patient in isolation to help protect the nurses clothing from becoming soiled. The girl and also provides protection against unknown infectious Microorganisms

Mask and protective eyewear

When a mask is applied correctly if it snugly below the healthcare workers chin and securely over the nose and mouth; the top edge fits below the eyeglasses if worn. 1. They protect the wearer from inhaling microorganisms that travel on airborne droplets for short distances or that remain suspended in the air for longer periods and from splashing if it should occur. Mask also prevent the mucous membranes of the nose and mouth from coming into contact with contaminants. 2. They prevent the patient from inhaling pathogens if resistance is reduced or if patient with an airborne respiratory infection is being transported to another care area. 3. I wear shields protect the membranes and conjunctiva of the eye.

Asepsis

absence of pathogenic microorganisms

Infection prevention and control

involve the implementation of policies and procedures in hospitals and other health care facilities to minimize the spread of health care-associated or community-aquired infections to patients and other staff members

When hand hygiene is essential

1. After contact with organic material, such as feces, wound drainage, and mucus. 2. After removing disposable gloves or handling contaminated equipment. 3. At the beginning and end of the shift. 4. Before and after caring for a patient. 5. Before and after eating. 6. Before and after using the toilet. 7. Before changing a dressing or having contact with open wounds. 8. Before preparing and administering medication's. 9. In preparation for an invasive procedure, such as suctioning, catheterization, or injections. 10. When hands are visibly soiled.

Donning a sterile gown

1. Don surgical cap, shoe covers, protective eyewear, and mask, and then perform surgical hand hygiene. 2. Ask the circulating nurse to open the sterile gown package in the sterile gloves package. 3. Don the gown A. If available, the scrub nurse assists by pulling the gown over your extended hands and arms. If no assistance from a scrub nurse is available I. Pick up the ground touching only the inner surface below the neck II. Maintain constant control of the folded layers of the gown III. While holding the ground at arms length, allow the ground to unfold from top to bottom. Be sure that the ground does not touch the floor. IV. While holding the inside of the gown near the shoulders and below the neck band, slide hands and arms into the sleeves with your finger stopping at the end of the cuffs. V. Ask another staff member to grasp the cord that is attached to the ties of the gown to draw the ties around to the back with the gown overlapping itself. The staff member should now tie the gown, avoiding touching any part of the gown except the ties.

Physical method of disinfection and sterilization

1. Steam under pressure, or moist heat, is the most practical and dependable method for destruction of all micro organisms. This process is called sterilization. Auto clave is used in the hospital. Pressure cooker is used at home. 2. Boiling water is the best method for home use and is the least expensive. However, this technique does not destroy bacterial spores and some viruses. The article must be boil for a minimum of 15 to 20 minutes for disinfection. 3. Radiation is used to sterilize pharmaceutical goods, foods, and heat sensitive items. This is extremely effective on articles that are difficult to sterilize with other methods. 4. Dry heat is a method used for disinfecting articles that are destroyed by moisture. Health agencies seldom use methods, but in the home, an article can be disinfected by being placed in the oven for two hours at 320 degrees Fahrenheit or For 45 minutes at 350 Fahrenheit

Antiseptic

A substance that tends to inhibit the growth and reproduction of microorganisms and maybe used on humans

Fungi

Fugal (mycotic) infections are among the most common diseases found in humans. They belong to the plant kingdom, and although many of them are harmless, some are responsible for infections. Mycotic infections are diseases caused by yeast and mold.

Endogenous

Growing within the body. And then section is caused by the patient's all normal microorganisms, which become altered and overgrow or are transferred from one body site to another. (Microorganisms and people material or transferred to skin by hand and inspected wound).

Cleaning

Is the removal of foreign materials, such as soil and organic materials, from objects. Generally, cleaning involves use of water and mechanical action with or without detergents.

Infection control nurse

They are responsible for advising hospital personnel on the development and implementation of safe patient care delivery and practices and for monitoring infection within the healthcare agency.

Second tier isolation

This tear condenses the disease-specific approach to isolation into transmission categories: airborne, droplet, and contact precautions. These precautions are designed to be used in the care of patients with specific type of confirmed or suspected infection.

Microorganisms

Tiny, usually microscopic, entities capable of carrying on living processes

Use of alcohol-based waterless antiseptic

1. Apply an ample amount of product to palm of one hand. 2. Rub hands together, covering all surfaces of hands and fingers with antiseptic. 3. Rub hands together for several seconds until alcohol is dry. Allow hands to dry before applying gloves. If an adequate volume is used, 15 to 25 seconds are needed for hands to dry. 4. If hands are dry or chapped, a small amount of facility approve lotion or barrier cream can be applied.

Hepatitis B vaccination and follow up care for healthcare workers

1. Federal law requires that healthcare employers make available at no cost they hepatitis B vaccine and vaccination series to all employees who have occupational exposure. If an employee declines the vaccine, the employee is required to sign a declination form. Evaluation and follow-up care are available to all employees who have been exposed. 2. A blood test (titer) is offered in some facilities 1 to 2 months after completion of the three dose vaccine series. 3. after exposure, no treatment is needed if a positive blood titer is on file. If no positive titer is on file, it is mandatory to follow the CDC guidelines.

Human Immunodeficiency Virus

1. If the patient test positive for HIV infection, a viral load study is performed to determine the amount of virus present in the blood. 2. If the exposure meets the CDC criteria for HIV prophylactic treatment, or postexposure prophylaxis, it optimally is started as soon as possible to establish a baseline, preferably within hours rather than days after exposure. Follow-up postexposure testing should occur at 6 weeks, 12 weeks, and six months. All medical evaluation's and procedures, including the vaccine and vaccination series and evaluation after exposure (prophylaxis), or made available at no cost to at-risk employees. A confidential written medical evaluation is available to employees who have experienced exposure incidents.

Gowning for isolation

1. Push-up long sleeves if you have them. 2. Perform hand hygiene. 3. Don gown and tie it securely at neck and waist. 4. Remove down after providing necessary patient care. 5. Discard soiled gown appropriately. 6. Perform hand hygiene 7. Record use of gown and isolation procedure if required by a healthcare agency. Some agencies charge a daily rate for isolation precautions. 8. Provide patient teaching. 9. If contamination occurs, it is necessary to reassess technique.

Donning a mask

1. Remove mask from container. 2. Don mask when ready to begin patient care by covering your nose, mouth, and eyes (or glasses) with the device. Wear a mask with a protective eye shield when there is a risk of squashing. Secure mask in place with elastic band or by tying the string behind your head. 3. Wear a mask until it becomes moist, but no longer than 20 to 30 minutes. 4. Remove mass by untying the strings or moving the elastic. Be certain not to touch contaminated area. 5. Dispose of soil mask in appropriate container. 6. Wash hands thoroughly. 7. Record use of mass during patient care. 8. Provide patient teaching. 9. If contamination occurs, it is necessary to reassess technique.

Portal of exit

A micro organism does not have the capacity to cause disease in another hose without finding a point of escape from the reservoir. And example of exit routes and human or any body fluids produce from the patient, such as those from the gastrointestinal, respiratory, and genitourinary systems or from an open area on the patient's body

Hand hygiene

Is the single most important and basic preventative technique that healthcare workers can use to interrupt the infections process. Performing hand hygiene provide the necessary protection before the nurse cares for the patient.

Infectious agent

Pathogenic microorganisms are infectious agents. Pathogens can be bacteria, viruses, yeast, fungi, and protozoa.

Patient teaching for infection prevention and control

Patients and families often have to learn to use infection prevention and control practices at home. The nurse should educate patient about the nature of infection and the techniques to use in planning or controlling it spread.

Patients with immuno compromised conditions

Patients with immunocompromise conditions vary in their susceptibility to healthcare associated infections depending on the severity and the duration of their immunosuppression. In such instances, the physician or infection control nurse instruct nursing staff about the necessary protective measures.

Patient problems

Possible patient problems for patient susceptible to or affected by an infection include the following 1. Compromise tissue integrity 2. Potential for infection 3. Social seclusion

Sterilization

Refers to the methods used to kill microorganisms, including spores.

Duties of an infection control nurse

1. Assessing microorganism sensitivity to antibiotics presently in use and communicating with medical staff regarding current sensitivity and resistance patterns. 2. Compiling data and analyzing the results regarding the epidemiology of healthcare associated infection. 3. Conferring with various hospital departments and other resources to investigate unusual events or clusters of infection. 4. consulting with occupational health departments concerning recommendations to prevent and control the spread of infection among healthcare personnel, such as testing for Tuberculosis. 5. Educating patients and families in the prevention and control of infection. 6. Identifying infection control problems associated with medical or patient equipment. 7. Notifying the local public health department of incidences of specific reportable communicable diseases. 8. Providing staff education on infection prevention and control. 9. Reviewing and revising infection prevention and control policies and procedures to ensure they are in compliance with local, state, and federal regulations and with hospital accrediting agencies. 10. Reviewing patient medical records and laboratory reports and recommending appropriate transmission-based isolation procedures. 11. Screening patient records for community-acquired infections. These infections often are distinguish from HAIs by the type of organisms that affect patients who are recovering from a disease or injury.

CDC guidelines in the care of all patients

1. Continue practice of washing hands with either facility approve soap or antimicrobial soap and water whenever hands are visibly soiled. 2. Use an alcohol-based hand sanitizer to routinely decontaminate the hands in the following clinical situations: a. Before and after patient contact. b. Before donning sterile gloves when inserting central intravascular catheters. c. Before performing non-surgical invasive procedures. d. After contact with body fluids or excretion, mucous membranes, non-intact skin, and wound dressings. e. If moving from a contaminated body site to a clean body site during patient care. f. After contact with inanimate objects in the immediate vicinity of the patient. g. After removing gloves. h. Before eating and after using a restroom, wash hands with facility approved soap and water. 3. Anti-microbial impregnated wipes are not a substitute for using an alcohol-based hand sanitizer or anti-microbial soap. 4. If exposure to bacillus and thoracic is suspected or proven, wash hands with facility approved soap and water. The physical action of washing and rinsing hands is recommended because alcohols, chlorhexidine, iodophors and other antiseptic agents have poor activity against spores.

Isolation precautions (Nursing action) rationale

1. Determine causative microorganism and patients immune system status 2. Recognize mode of transmission and how the microorganisms may exit the body 3. Follow agency policy for specific type of transmission based precautions used 4. Ensure that the environment has the equipment and supplies for the types of isolation. A. Private or isolation room with anteroom B. Adequate hand hygiene facilities C. Containers for trash, soiled linen, and sharp instruments. 5. Provide explanation of isolation precautions to patient, family, and visitors. 6. Post sign on door of patients room or wall outside room stating the type of protective measures in use for patient care. 7. Be certain to supply the room with lined containers designated for soiled linens and for trash 8. Assess vital signs with designated equipment if possible, administer medication, administer hygiene, and collect specimens 9. Report any changes in patient's health status to primary healthcare provider or supervisor. 10. Record assessments and performance of trans mission-based precautions. Document per agency policy. 11. Determine patient's understanding of activities in room. 12. Provide patient teaching. 13. Additional techniques for acid-fast bacillus (AFB) isolation (airborne precautions) A. Before entering the room, Don and 95 respirator mask that for which you have undergone a fit test B. Educate patient, family, and other visitors about how AFB is transmitted C. Explain to patient that TB is transmitted by inhalation of droplets that remain suspended in the air when patient cough sneezes or speaks. Offer opportunity for questions D. Instruct patient to cover mouth with tissue and coughing, educate patient about when to perform hand hygiene, and educate about the importance of wearing a regular disposable surgical mask while out of the room. E. Record assessment and performance of patient care.

Chemical process of disinfection and sterilization

1. Gas (ethylene oxide) is used for sterilization. It destroys spores formed by bacteria. 2. Chemical solutions often are used to disinfect instruments because they are effective in destroying microorganisms. One way to store clinical thermometers is in a chemical solution, and some articles are soaked in a solution to prepare them for another, more definitive method of disinfection or sterilization.

Performing open sterile gloving

1. Have package of properly size sterile gloves at treatment area 2. Perform thorough hand hygiene 3. Remove outer glove package wrapper by carefully separating and pulling apart sides. 4. Grasping inner side of package, lay package on clean flat surface just above waist level. Open package, keeping gloves on wrappers inside surface. 5. Identify right and left gloves. Each glove has a cuff approximately 2 inches deep 6. Glove dominant hand first. With thumb and first two fingers of non-dominant hand, grasp edge of cuff of glove for dominant hand. Touch only gloves inside surface 7. Carefully pull glove over dominant hand, leaving cuff; be sure cuff does not roll up wrist. Be sure thumb and fingers are in proper spaces. 8. With glove dominant hand, slip fingers underneath second gloves cuff in such a fashion that the cuff will protect the gloved fingers. 9. Carefully pull second glove over non-dominant hand. Do not allow fingers and thumb of gloved dominant hand touch any part of exposed non-dominant hand. Keep thumb of dominant hand abducted back 10. After second glove is on, interlock hands (Glove removal and disposal) 11. Grasp outside of one cuff with other gloved hand; avoid touching wrist 12. Pull glove off, turning it inside out. Discard in receptacle 13. Take fingers of bare hand and tuck inside remaining glove cuff. Peel glove off, inside out. Discard in receptacle

Chain of Infection

1. Infectious agent: a pathogen 2. Reservoir: where the pathogen can grow 3. portal of exit: exit route from the reservoir 4. Mode of transmission: method or vehicle of transportation, such as exudate, feces, air droplets, hands, and needles 5. Portal of entry: entrance through skin, mucous lining, or mouth 6. Post: another person or animal that is susceptible to the pathogen

Surgical hand hygiene

1. Inspect hands for a presence of abrasions, cuts, or open lesions. 2. Apply surgical shoe covers, cap or hood, facemask, and protective eyewear. 3. Perform surgical hand hygiene A. Turn on water using the 4 foot controls and adjust to comfortable temperature. B. Wet hands and arms under running lukewarm water and lather with detergent to 5 cm above elbows. (Keep hands above elbows at all times, has become clean as part of upper extremity.) C. Rinse hands and arms thoroughly under running water. Remember to keep hands above elbows. D. Under running water, clean under nails of both hands with no pick. Discard after use I. Wet clean sponge and apply antimicrobial detergent. Scrub nails of one hand with 15 strokes. Holding sponge perpendicular to hand, scrub palm, each side of thumb and fingers, and posterior side of hand with 10 strokes each. II. mentally divide your arm into thirds and scrub each third 10 times entire scrub should last 5 to 10 minutes rinse sponge and repeat sequence for other arm. It is permitted to substitute with a to sponge method. E. Discard sponge and rinse hands and arms thoroughly. Turn off water with foot or knee control and back into room entrance with hands elevated in front of and away from the body. I. Walk up to sterile tray and lean forward slightly to pick up a sterile towel. II. Dry one hand thoroughly, moving in sequence from fingers to elbow. Dry in a rotating motion. Dry from cleanest to least clean area. F. Repeat drying method for other hand by carefully reversing towel or using a new sterile towel G. Discard towel H. Proceed with sterile gowning 4. Alternate method of surgical hand hygiene using alcohol-based antiseptic A. Wash hands with soap and water for 15 to 30 seconds to remove soil B. Under running water clean under nails of both hands with no pick. Discard after use and dry hands with a paper towel C. Apply enough alcohol-based waterless antiseptic to one palm to cover both hands thoroughly. Spread the antiseptic over all surfaces of the hands and the fingernail. Follow product instructions for length of time to rub over hand surfaces. Allowed to air dry. D. Repeat the process and allow hands to air dry before applying sterile gloves

Steps performing hand hygiene

1. Inspect hands, observing for a visible soiling, breaks, or cuts in the skin and cuticles. 2. Determine amount of contaminant on hands. 3. Assess areas around the skin that are contaminated. 4. Adjust the water to appropriate temperature and force. 5. Wet hands and wrist under running water, always keeping hands lower than elbows. 6. Lather hands with liquid soap. 7. Wash hands thoroughly with firm, circular motion and friction on back of hands, palms and wrist. Wash each finger individually, paying special attention to areas between the fingers and knuckles by interlacing fingers and thumbs and moving hands back-and-forth, causing friction. 8. Watch for at least 20 seconds. 9. Rinse wrists and hands completely, again keeping hands lower than elbows. 10. dry hands thoroughly with paper towels. Start by patting at fingertips, then hands, and then wrist and forearms. 11. If it is necessary to turn off faucets manually, use a dry paper towel. 12. Use hospital-approved and lotion if desired. 13. Inspect hands and nails for cleanliness. 14. If hands are not visibly soiled, use an alcohol-based waterless antiseptic for routine decontamination of hands and in all clinical situations, unless you are caring for a patient with clostridium difficile or candida infection. These spores are unaffected by alcohol, so soap and water must be used in these instances. 15. Provide patient teaching. 16. Explain to the patient the importance of hand hygiene. 17. If contamination occurs, it is necessary to reassess technique.

Principles of sterile technique

1. Only sterile objects can touch sterile objects 2. Place only sterile objects on a sterile field 3. A sterile field out of the range of vision or an object held below a persons waist is contaminated. Never turn your back on a sterile field or leave it unattended. 4. A sterile object or field becomes contaminated by prolonged exposure to air. 5. When a sterile surface comes in contact with a wet, contaminated surface, the sterile object or field becomes contaminated. 6. Fluid flows in the direction of gravity, the sterile object becomes contaminated if gravity causes a contaminated liquid to flow over the object surface 7. Consider the edges of sterile field or container to be contaminated. Frequently, you please sterile objects on a sterile towel or drape. Consider 1 inch of the edge of the drape unsterile

Opening sterile packages

1. Perform hand hygiene 2. Please the item flat in the center of the work surface 3. remove the tape or seal that indicates the sterilization date 4. Grasp the outer surface of the tip of the outer most flap 5. Open the outer flap away from your body, keeping your arms outstretched and away from the sterile field 6. Grasp the outside surface of the first side flap 7. Open the side flap, allowing it to live flat on the table surface. Keep your arm to the side and not over the sterile surface. Do not allow flaps to spring back over the sterile contents 8. Grasp the outside surface of the second side flap and allow it to lie flat on the table surface 9. Grasp the outer surface of the last and innermost flap 10. Stand away from the sterile package and pull the flap back, allowing it to fall flat on the surface 11. Use the inner surface of the package cover as a sterile field to handle this or additional sterile items. Grasp the 1 inch border to maneuver the entire field on the table surface 12. When opening a small sterile item, hold it in your hand so that you can pass it to a person wearing sterile gloves or transfer it to a sterile field. Hold the package in your non-dominant hand while you open the top flap and pull it away from you. With your dominant hand, carefully open the side and top flaps away from the enclosed sterile item in the same order in the previous steps

Preparing for disinfection and sterilization

1. Prepare equipment and supplies A. Disinfectant to use for cleaning B. Method of sterilization C. Gloves D. Running water E. Scrub brush F. Cloth wrapper 2. Don gloves 3. Rinse article under cool running water 4. Wash article with detergent 5. Use scrub brush to remove material in grooves 6. Dry article thoroughly 7. Prepare article for sterilization by wrapping it in cloth wrapper 8. Clean work area and put in order 9. Perform patient teaching

Preparing a sterile field (Step by step)

1. Prepare sterile field just before planned procedure. Be sure to use supplies immediately. 2. Select clean work surface that is above waist level. 3. Assemble necessary equipment A. Sterile drape B. Assorted sterile supplies 4. Check dates, labels, and condition of packages for sterility of equipment 5. Wash hands thoroughly 6. Place package containing sterile drape on worksurface and open 7. With fingertips of one hand, pick up folded top edge of sterile drape. 8. Gently lift drape up from its outer cover and let it unfold by itself without touching any object. Discard outer cover with your other hand. 9. With other hand, grasp adjacent corner of drape and hold the entire edge straight up and away from your body. Now, properly placed drape while using two hands to be sure to keep the drape away from unsterile surfaces. A. Holding drape, first position the bottom half over intended work surface. B. Allow top half of drape to be placed over work surface last. 10. Perform procedure using sterile technique.

Steps for cleaning equipment

1. Rinse a contaminated object or article with cold running water to remove organic material. Hot water causes the proteins in organic material to coagulate and stick to the objects, making removal difficult. 2. After rinsing, wash the object with soap and warm water. Soap or detergent reduces the surface tension of water and emulsifies dirt and remaining material. Rinse the object early to remove the emulsified dirt. 3. Use a brush to remove dirt or material present in the equipment grooves or seams. Friction dislodge is contaminated material for easy removal. Open any hinged items for cleaning. 4. Rinse the object in warm water. 5. Dry the object and prepare it for disinfection or sterilization if indicated by the intended use of the item. 6. The brush, the gloves, and the sink in which the equipment is cleaned or considered contaminated and must be cleaned and dried per facility policy.

Hepatitis C vaccination and follow up care for healthcare workers

1. The employee is offered a baseline blood test to test for the presence of the disease within 48 hours. 2. Additional testing is conducted to monitor for the disease approximately three weeks after exposure. If the source patient is identified and test positive for hepatitis C the employee may receive a baseline test. 3. If results are positive, the employee is started on treatment. 4. Early treatment for infection has the potential to prevent chronic infections.

CDC general recommendations for a hand hygiene

1. Use facility-approved hand lotions or creams to minimize the occurrence of irritant contact dermatitis associated with hand antisepsis or hand washing. 2. Do not wear artificial fingernails or no polish when having direct contact with patients at high risk. 3. Keep natural nail tips less than a 1/4" long. 4. Wear gloves when contact with blood or other potential infection as materials, mucous membranes, and non-intact skin could occur. 5. Remove gloves after caring for patient. Do not wear the same pair of gloves for the care of more than one patient, and do not wash gloves between uses with different patients. 6. Change gloves during patient care if moving from a contaminated body say to a clean body site.

Assessment

By evaluating signs and symptoms revealed during assessment, the nurse can determine whether the patient's clinical condition indicates a risk for infection. Early recognition of infection helps the nurse identify a patient problem and thus establishing appropriate treatment plan. In addition, how will the patient is dealing with their disease and whether any resources could benefit the patient. Prompt assessment of laboratory data will provide information about potential infections.

Contact precautions (tier 2)

In addition to standard precautions, use contact precautions for patients known or suspected to have serious illnesses easily transmitted by direct patient contact or buy contact with items in the patient's environment environment. 1. Gastrointestinal, respiratory, skin, or wound infections or colonization with multi-drug resistant bacteria judged by the infection prevention and control committee, and currency, regional and national recommendations, to be of special clinical and epidemiologic significance. 2. Enteric infections with low infectious does or prolonged environmental survival; A. Clostridium Difficile B. Diapered or incontinent patients with the following I. Escherichia coli O157:H7 II. Shigella III. Hepatitis A IV. Rotavirus 3. Respiratory syncytial virus, parainfluenza virus, and enteroviral infections in infants and young children 4. Skin infections that are highly contagious or that tend to occur on dry skin. A. Diphtheria (cutaneous) B. Herpes simplex virus (neonatal or mucocutaneous) C. Impetigo D. Major (non-contaminated) abscesses, cellulitis, or decubitus ulcer's E. Pediculosis F. Scabies G. Staphylococcal furunculosis and infants and young children H. Methicillin-resistant staphylococcus aureus ( MRSA) I. Vancomysin resistant enterococci (VRE) J. Extended-spectrum beta-lactamase (ESBL); this enzyme attaches to the cell wall of E. coli and some klebsiella organisms, which turn makes the organism multi-drug resistant. K. Varicella zoster virus (disseminated or in the Immunocompromise host). L. Viral or hemorrhagic conjunctivitis M. Viral hemorrhagic infections (Ebola, Lassa, Marburg)

Pouring sterile solutions

Inside the bottle is sterile the outside is contaminated. After removing lead place inside upwards. When pouring solution old bottle on label to prevent solutions from wetting the label. Pour the solution slowly to avoid splashing the drape or field

Prodromal stage

Interval from onset of nonspecific signs and symptoms (malaise, low-grade fever, fatigue) to more specific symptoms; during this time, microorganisms grow and multiply, and patient is more capable of spreading disease to others.

Convalescence

Interval when acute symptoms of infection disappear; length of recovery depends on severity of infection and patient's general state of health, and recovery takes from several days to months.

Acute stage

Interval when patient manifests signs and symptoms specific to type of infection (e.g. common cold manifested by sore throat, sinus congestion, rhinitis; mumps manifested by earache, high fever, parotid and salivary gland swelling). this is the period in which the individual is most contagious.

Evaluation

Is by nature ongoing because the patient's condition can change at any time. The nurse is then in a position to decide to continue nursing interventions, revise them as necessary, or determined that the problem has been resolved.

Centers for Disease Control and Prevention (CDC)

Is part of the US department of health and human services, provides facilities and services for investigation, prevention, and control of disease.

Infection Prevention And Control for Home and hospice settings

Patients are discharged from acute care to their homes. They often require care from home health personnel. An infection that develops within 30 days after discharge, and such as a wound infection at an operative site, may be an outcome of hospitalization, and the acute care facilities infection control department must receive a report. Home care and hospice programs continue to expand, questions emerge about infection prevention and control in the settings. Hospitalized patients need to receive education and instruction at discharge about reporting the occurrence of any signs and symptoms of infection such as pain, erythema , edema, drainage or exudate, and fever to the appropriate acute care personal after discharge.

Occupational health service

Plays in important role in the prevention or control of an infection in healthcare setting by taking measures to protect a healthcare worker and patients from certain infections.

Spore

The reproductive cells of some micro organisms such as fungi or protozoa. These cells are highly resistant to heat and chemicals. Under proper environmental conditions they may revert to an actively multiplying form of bacterium

Nursing process

The role of LPN/LVN in the nursing process is 1. Participates in planning care for patients based on patient needs 2. Reviewed patient's plan of care and recommends revisions as needed 3. Reviews and follows defined prioritization for patient care 4. Uses clinical pathways, care maps, or care plans to guide and review patient care

Disinfection

The use of a chemical that can be applied to objects to destroy microorganisms

Healthcare-associated infection (HAI)

These infections previously referred to as nosocomial infections and include infections patients get when undergoing medical treatment in a healthcare facility.

First tier isolation

This tier contains precautions designed for healthcare workers to use when caring for all patients in healthcare facilities regardless of their diagnosis or presumed infectiousness. The first tier is called standard precautions.

Viruses

Viruses are the smallest known agents to cause disease. They are not complete cells but are composed of either RNA or DNA. They consist of a protein coat around a nucleus acid core and depend on the bed metabolic processes of the cell they enter