Infection ControlUnit 13

Disease Prevention• Asepsis: absence of disease-producing

microorganisms

• Medical Asepsis: medical practice that reduces the numbers of microorganisms or interrupts transmission from one person to another person or from person to place or object.• Handwashing• Using nonsterile gloves when in contact with blood,

moist body fluid (except sweat), secretions, excretions, mucous membranes or non-intact skin

• Cleaning and/or disinfecting equipment

Disease Prevention• Guidelines for maintaining asepsis:

• Wash and dry hands well• Wash breaks in skin immediately, clean with

antiseptic & report injury to supervisor• Use gloves when necessary• Bath or shower daily• Wear clean clothing• Keep your hair clean and away from your face• Keep fingernails short and neat• Other than plain wedding band, avoid wearing rings• Assist patients with personal hygiene

Disease Prevention• Guidelines for maintaining asepsis:

• Cover bedpans and urinals during transfers and avoid “splashes” during this time.

• Avoid contaminating environmental surfaces when wearing used gloves

• Use the overbed table only for clean items, such as food trays, water pitcher, and clean supplies

• Keep the water pitcher covered at the bedside• Keep food and water supplies clean• Carry soiled linen away from your uniform• Dispose of soiled linen according to policy• Do not store items on floor

Disease Prevention• Guidelines for maintaining asepsis:

• Avoid items that have been on the floor until they have been disinfected

• Avoid activities that raise dust into the air• Avoid shaking linen!• Fold soiled linen inward and dispose of properly• Keep soiled linen hamper, housekeeping cart from

clean linen cart and food cart by at least one room’s width

• Clean from least soiled area to most soiled area• Keep work areas clean

Disease Prevention• Handwashing: most important measure the nursing

assistant can take to prevent the spread of disease• Vigorous rubbing together of soap-lathered hands,

followed by rinse in running water• Most important aspect of handwashing is friction

created when the hands are rubbed together, thereby removing germs

• Prevents cross-contamination between one patient and another, the equipment, and the nursing assistant

• Most important measure to break the chain of infection

Disease Prevention• Handwashing: most important measure the nursing

assistant can take to prevent the spread of disease• Should always occur before and after:

• Direct patient care• Handling food• Touching a wound• Using the bathroom

• Should last a minimum of 30 seconds, or longer if visibly soiled

• Use soap from dispenser instead of bar soap• Alcohol-based cleaners can be used for routine

handwashing, unless hands are visibly soiled

Protecting Yourself• Occupational Exposure Incident: contact with

potentially infectious material, such as blood or body fluids containing pathogens• Occurs when eyes, mouth or non-intact skin comes

in contact with potentially infectious material• If this occurs:

• Rinse immediately and report the incident to your supervisor

Standard Precautions• Standard precautions: used in the care of ALL

patients without regard for disease or diagnosis• Apply in all situations in which the nursing assistant

may have contact with blood, body fluids (except sweat), secretions, excretions, mucus membranes, and non-intact skin

• Involve the use of Personal Protective Equipment (PPE)

Standard Precautions• Guidelines:

• Proper handwashing or use of alcohol-based product

• Wear gloves when potential contact with blood or body fluids exist OR when the health care workers skin (on their hands) is not intact

• NOTE: gloves are provided in patient care areas, but the nursing assistant should carry a pair, so they are available quickly, if needed

• Get new pair of gloves for every patient, every situation

• Replace gloves you keep at beginning of shift

Standard Precautions• Guidelines:

• If sensitivity to latex exists (patient or health care worker) use non-latex gloves.

• Properly dispose of gloves, according to facility policy

• Waterproof gowns, or plastic aprons; goggles, masks or face shields are to be worn if possibility of splashing exists

• Mask to mouth resuscitation devices should be used during CPR

• Sharp objects should be carefully handled & should be disposed of in puncture-resistant container

Standard Precautions• Guidelines:

• Blood spills should be cleaned up immediately with a disinfectant or bleach solution

• Do not eat, drink, smoke, apply cosmetics or contact lenses in work areas

• Do not store food/drinks in refrigerators where they may be exposed to blood or other body fluids

• Do not pick up broken glass with hands – even if wearing gloves – use brush, tongs or forceps and a dust pan

• All specimens are considered to be infectious

Transmission-Based Precautions• Transmission-based precautions: used to interrupt

the mode of transmission of the causative agent• Three major categories:

1. Airborne precautions: negative pressure ventilation system; door to room is kept closed and caregivers must wear special N95 mask when entering room

2. Droplet precautions: surgical mask if working within 3 feet of patient; patient wears mask if leaving room

3. Contact precautions: gloves and gown are required (gloves/gowns/masks are for SINGLE USE ONLY!)

Transmission-Based Precautions• Isolation Techniques: methods of caring for patient

with easily transmittable disease• Each person working in isolation room must take

responsibility to using proper techniques to prevent the spread of infection

• Isolation Unit: an area or private room used for patients who:• Are highly infectious• Have poor personal hygiene• Require special air control procedures within the

room

Transmission-Based Precautions• Containment of contaminated articles:

• Should be handled as little as possible• Fold dirtiest side inward• Do not shake linen• Bag linen before leaving the room• Keep contaminated linen separate from regular

linen• Transport soiled, wet linen in leak-proof bag

Transmission-Based Precautions• Transporting the patient in isolation:

• Notify receiving agency staff of type of precaution being used to ensure they are prepared to receive patient

• If airborne or droplet precautions exists, patient is to wear a mask when out of the room

• If patient is on contact precautions, infected areas should be covered

• NOTE: The nursing assistant wears protective equipment in the room only – not in the hallway!

Disinfection & Sterilization• Disinfection: process by which chemicals are used to

eliminate harmful pathogens; the nursing assistant may be required to disinfect reusable patient equipment

• Sterilization: Elimination of all microorganisms from an item• Autoclave used to accomplish this process (uses

steam and pressure)

Disinfection & Sterilization• Sterilization of equipment: is specially wrapped;

indicator strips change color when the contents of the package are sterile

• Sterile procedures: surgical asepsis is used when the patient care environment must be free of all microorganisms; all equipment and supplies are sterile

• Sterile field: area of sterile equipment and materials; special procedures are used when working with a sterile field• 1” border• NEVER reach over sterile field• If moist or wet = contaminated

The End