Isolation Class 10 Last Class. Preventing the spread of infection What do we do when a client has a...
-
Upload
louisa-manning -
Category
Documents
-
view
212 -
download
0
Transcript of Isolation Class 10 Last Class. Preventing the spread of infection What do we do when a client has a...
Isolation Class 10
Last Class
Preventing the spread of infection
• What do we do when a client has a highly infectious disease?
Specific Infection Control Policies
• Isolation – the principle is to create a physical barrier that prevents the transfer of microorganisms.
What are appropriate barriers? Depending on -
• Organism Transmission• Airborne• Vehicle• Contact
• Direct• Indirect• Droplet
Types of Barriers
• PPE (personal protective equipment)• Gowns• Gloves• Masks• Eyewear
• Each institution is required to have infection control policies and guidelines.
What about when we don’t know?
• 3 systems• Universal precautions• Body substance precautions• Standard precautions
Precautions to guard against the unknown
• Apply to everyone• General public• May or may not carry an infection
History Lesson
• Initially concerned with patient to patient
• Followed by concern for health care professionals
• 1970 – Hepatitis B• 1987 – HIV
• Universal precautions by Center for Disease Control (CDC)
Universal precautions
Stated : All blood & body flds should be
treated as potentially infectious.
Body Substance Isolation (BSI)
• Infection control practitioners in Seattle and SanDiego
• Canada adopted policy but renamed it Body Substance Precautions (BSP)
Standard Precautions
• 1996- newest guidelines by CDC combined the major features of universal precautions & BSP
2 Tier System
• 1996 CDC new guidelines
1st Tier – Standard Precautions• Most important• Universal precautions + BSP• Applies to everyone• Primary strategies for prevention
of infection• Standard precautions
• Blood, body flds., nonintact skin, mucus membranes
2nd Tier
• Specific infections/diagnosis• Droplet, airborne, contact with
contaminated surface
3 Types Transmission Based Precautions
• Airborne, droplet, contact• Some infections combination
(chicken pox)• These extra precautions are in
addition to Standard Precautions
Airborne
• Travels on small particles• Air currents• Portal of entry – nose, mouth,
mucus membranes• Measles, chicken pox, TB
Requirements for Airborne
• Negative pressure room – door closed
• TB = HEPA filter • Do not enter if not immune to
measles/chickenpox• Client wears mask when required
to leave room
Droplet
• Large droplets of moisture• Coughing, sneezing, talking
• Travels 3 ft. or less• Enters nose / mouth• Mumps, pertusis, influenza
• Private room• Staff regular mask for 3 ft. • Client mask for transport
Contact
• Dry skin to dry skin = Direct • Dry skin to object = Indirect• Impetigo, herpes zoster, scabies• Gloves – for direct care or
touching anything in the room• Private room or semi if cohort has
same diagnosis
• Remove gloves prior to exiting and wash hands
• Gown for • patient contact• Changing linen• Handling objects in the room
• Remove gown prior to exiting• Wash hands• Careful clothing does not touch
room surfaces
Protective Isolation / Reverse isolation
• Compromised or suppressed immune system
• Highly susceptible to infections• Protection from environmental
pathogens
Protective Isolation / Reverse isolation
What do you need ?• Private room – door closed• Gown, mask, gloves if direct
contact• Wash hands• No plants / flowers
Procedure
• Before instituting• EXPLAIN to client & family
•Disease•Purpose of isolation•Steps to follow•Time frame
Room Preparation
• Private with BR facilities• Sign on door• Isolation cart outside door• Laundry hamper in room• Waste basket with plastic bag• Thermometer, B/P cuff, stethoscope in
room• Sharps receptacle
• Be organized• Gather equipment prior to entering
room• Remove rings and wash hands• Don PPE• Gown usually disposable• Gloves up over cuff of gown
• Put your watch in a plastic bag if no clock in room
• Linen is placed in a water soluble bag & then cream/yellow bag
• No special treatment for dishes / trays
Exiting Room
• Untie gown at waist • Remove gloves properly• Remove mask• Untie gown at neck, drop over
shoulders, don’t touch outside, fold inwards, and discard
Exiting Room
• Wash hands • Use paper towel on door handle• Wash hands again outside roomImportant to do as much client
care as you can while you are in the room….CLUSTER ACTIVITY.
Basic Principles
• Wash hands prior to entering & exiting room
• Careful disposal of contaminated materials
• Knowledge of disease and mode of transmission
• Protection of client and public during transport
Client Consideration
• Isolation• Loneliness• Self – esteem, body image• Boredom
Sterile Technique / Surgical Asepsis
Purpose – to eliminate all microorganisms from objects that come into contact with the tissues of the body that are normally sterile.
Practice Areas
• Operating room• Labor and delivery• Major diagnostic area• At the bedside in 3 main
situations1. Procedures requiring intentional
perforation of the skin
2. When the skin’s integrity is broken due to surgery or burns
3. During procedures involving insertion of devices into normally sterile body cavities
• Any break in technique could result in contamination increasing clients risk for infection.
Methods of Sterilization
• Steam – most common• Dry heat• Ethylene oxide gas• Chemicals• Indicator of sterility –
• tape on pkg. turns color or forms lines• Expiration Date
Examples of sterilization processes• Moist heat /steam
• Radiation
• Autoclave- instruments, parental solutions, dressings
• Drugs, foods, heat sensitive items
Examples of sterilization processes• Chemicals
• All types microorganisms
• Rapid action• Work with water• Stable in heat &
light• Inexpensive • Not harmful to
body tissue
• Instruments• Glass
thermometers• Ex. Chlorine –
used to disinfect water & for housekeeping purposes
Examples of sterilization processes• Ethylene oxide
gas• Destroys
microorganisms by altering cells’ metabolic processes.
• Rubber • Plastic
Examples of sterilization processes• Boiling water
• Cheap• Imp. – bacterial
spores andsome viruses resist boiling. Not used in hospitals!
• Items should be boiled for at least 15 min.
Practical Exam
• Prepare a sterile field• Add an item• Add a liquid• Don sterile gloves