Hand Washing, Routine Practices and Disease Specifics Practical Nursing Diploma Program Skill Labs...
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Transcript of Hand Washing, Routine Practices and Disease Specifics Practical Nursing Diploma Program Skill Labs...
Hand Washing, Routine Practices and Disease
Specifics
Practical Nursing Diploma Program Skill Labs 1
Chain of infection
1. Infectious agent – bacteria, virus, fungi
2. Reservoir – where an infection can grow: humans, animals, food, water, inanimate objects, “carriers”
3. Portal of exit – how the infectious agent is transmitted: respiratory, GI, GU, skin breaks, blood, tissue
4. Means of transmission: Contact: direct/indirect Vehicle: blood, food, water, inanimate
objects Vector: mosquito, lice, ticks Airborne: droplets
5. Portal of entry – how the infectious agent gets into the host
6. Susceptible host – the young, elderly, sick
Breaking the Chain…
The chain can be broken at any ring Most important thing you can do is to wash
your hands!!! Make sure that you are generally healthy, take
precautions for example the flu shot Assess skin; intact skin and mucous
membranes will resist infection Reduce use of invasive medical devices
Noscomial infections
Hospital acquired infections Significant cost to the health care system Highly preventable but can have huge
costs Nurses have a significant role in
preventing the development of nosocomial infections
Medical Asepsis
Clean techniques Practices that reduce the number and
transfer of pathogens
Principles of Medical Asepsis
Wash hands Keep soiled items away from uniform Keep items off the floor – linen, drainage
bags Cover mouth when coughing, sneezing
etc. Then wash your hands! Clean equipment away from you Wash from clean to dirty
Dispose of soiled items promptly and following proper procedure
Pour dirty liquids directly into drain to avoid splash back: WEAR GOGGLES.
Sterilize items that may be contaminated –make sure that proper protocol is followed
Practice good personal hygiene
The need for a dress code…
To protect you and your patients Short nails harbour fewer pathogens…
concerns specifically with artificial nails Jewelry is also a reservoir for pathogens It is alarmingly easy to transfer from
patient to patient and from you to your family
Handwashing
Perform it to remove transient and resident bacteria
Soaps: make sure you are using an appropriate cleansing agent
Perform a 10-15 second scrub with jewelry off...unless you had it on when performing care
Wash with the hands lower than the wrists, scrub 1” above the wrist
Use an orange stick to clean under the fingernails
Rinse hands thoroughly Dry hands beginning with the fingers and
moving up Use a clean paper towel to turn off taps Use lotion, make sure to check skin
integrity
When to wash your hands
Start of shift, end of shift, between patients, before and after breaks/meals, after you sneeze or use the washroom, when you remove gloves You can never do this too often Good hand washing should become a habit
How to wash your hands
Wet hands and wrist area. Keep hands lower than elbows to allow water to flow toward fingertips.
Cover all areas of the hands with soap. Use firm rubbing and circular motions,
wash the palms and backs of the hands, each finger, area between the fingers, knuckles, wrists, & forearms.
Wash at least one inch above area of contamination. If hands are not visibly soiled, wash to one inch above the wrists.
Continue this motion for 10-15 seconds Dry hands beginning with fingers &
moving upward toward forearms
Routine Practices
May also be known as Universal Precautions Precautions taken with all patients, especially
when there is potential exposure to body fluids, especially blood, excretions, non-intact skin
Designed to protect all from risk of infection through transfer of infectious material from patient - patient or from patient -staff
Routine Practices include:
Gloves, gowns, masks, goggles worn whenever risk of exposure to body fluids is present (emptying a urinal, suctioning a patient)
Sharps disposal in puncture resistant containers
Elimination of needle recapping
Immunization of personnel, e.g flu shot Garbage- use of bags as indicated by
policy
Disease specific precautions
Always read the sign on the door before entering the room
Airborne precautions – for patients with infections that spread through the air i.e. TB, chicken pox, measles
Droplet precautions – infections that spread through large particle droplets, i.e. mumps, rubella, diptheria
Contact precautions – for patients with infections that spread through contact, i.e. MRSA,VRE, C. Diff.
Each type of precaution has different guidelines related to type of room, protective clothing required, patient transport, sharing of equipment etc.
Protective Clothing
Gloves: use once only and then discard Not a substitute for hand washing Latex allergies are a growing problem Not needed for routine tasks that will not
bring you into contact with bodily fluids
Gowns
Used to prevent soiling of your clothing More common to use paper gowns Put on immediately prior to entering
room and take off when leaving the room!
Use once and discard
Masks
Prevent from inhaling large particle aerosols and small particle droplets
Also discourages you from touching your face thus limiting contact
Sometimes the patient also needs to wear a mask
Need to be aware of various types of masks
Debate about how long a mask is effective
Special masks are available, e.g. HEPA masks, N95
Eye Wear
Goggles and face shields should be worn when any risk of eye contamination is present
Simply wearing eye glasses is not enough!
Now seeing more face shields and other devices
Protective Clothing
Putting on:, gown, glove, mask, eyewear.
Taking off: remove gloves, wash hands, untie front waist string, gown (if soiled slide out), wash hands, masks & eye wear last.
Wash hands!!