Mandatory EducationMandatory Education

Nursing DepartmentNursing Department

WelcomeWelcome

The purpose of this presentation is to The purpose of this presentation is to meet the required annual education meet the required annual education for our Department of Nursing.for our Department of Nursing.

Directions: read through the Directions: read through the presentation.presentation.

Sign the required forms.Sign the required forms. Return the forms to the MSU Return the forms to the MSU

Department of Nursing.Department of Nursing.

MSU MissionMSU Mission

The mission of Minot State University The mission of Minot State University is to advance knowledge, critical and is to advance knowledge, critical and creative thinking, and the vitality of creative thinking, and the vitality of community and cultures.community and cultures.

MSU Core ValuesMSU Core Values

Student Learning firstStudent Learning first Pursuit of ExcellencePursuit of Excellence ResponsibilityResponsibility RespectRespect Learning CommunityLearning Community

Philosophy of the Department Philosophy of the Department of Nursingof Nursing

The Department of Nursing, within the The Department of Nursing, within the College of Education and Health Sciences College of Education and Health Sciences of MSU, supports the mission of the of MSU, supports the mission of the University to advance knowledge, critical University to advance knowledge, critical and creative thinking, and the vitality of and creative thinking, and the vitality of community cultures.community cultures.

Department of Nursing Department of Nursing Mission Mission

The Minot State University The Minot State University Department of Nursing is an integral Department of Nursing is an integral part of the parent institution and is part of the parent institution and is dedicated to pursuit of higher dedicated to pursuit of higher learning grounded in the arts, learning grounded in the arts, sciences, and humanities. sciences, and humanities.

The mission of the Department of The mission of the Department of Nursing is to educate individuals for Nursing is to educate individuals for professional roles in nursing and for professional roles in nursing and for graduate education.graduate education.

PeoplePeople

The Nursing Department faculty The Nursing Department faculty recognizes people are unique, complex, recognizes people are unique, complex, and evolving. Persons interact with a and evolving. Persons interact with a changing environment to maintain life and changing environment to maintain life and achieve purposes as individuals and as achieve purposes as individuals and as members of society. The person within the members of society. The person within the context of nursing is identified as a client.context of nursing is identified as a client.

A client may be further defined as A client may be further defined as individual, family, a group and/or a individual, family, a group and/or a community. People are dynamic, community. People are dynamic, complex, adaptive, and self determined in complex, adaptive, and self determined in achieving a meaningful existence. People achieving a meaningful existence. People utilize their cognitive, affective, and utilize their cognitive, affective, and psychomotor capacities to achieve self-psychomotor capacities to achieve self-actualization.actualization.

Environment Environment

The environment is dynamic, The environment is dynamic, complex, and multidimensional. The complex, and multidimensional. The environment is further defined as the environment is further defined as the context, surroundings, settings, foci, context, surroundings, settings, foci, or backgrounds within which or backgrounds within which individuals interact. individuals interact.

HealthHealth A condition of the life cycle that is A condition of the life cycle that is

dynamic, adaptive, responsive to both dynamic, adaptive, responsive to both internal and external stimuli, and internal and external stimuli, and influenced by the behaviors of the person. influenced by the behaviors of the person.

Health refers to the person’s state of well Health refers to the person’s state of well being at the time that nursing occurs. being at the time that nursing occurs. Health is personal and can range from Health is personal and can range from high-level wellness to terminal illness.high-level wellness to terminal illness.

NursingNursing

Is defined as an application of Is defined as an application of scientific knowledge enhanced by scientific knowledge enhanced by artful practice in a socially artful practice in a socially responsible manner.responsible manner.

Nursing EducationNursing Education

Nursing education is viewed as Nursing education is viewed as process designated to facilitate process designated to facilitate learning. Students and faculty are learning. Students and faculty are active and responsible participants in active and responsible participants in learning. learning.

Nursing education at the baccalaureate Nursing education at the baccalaureate level integrates content from the arts and level integrates content from the arts and humanities and social and physical humanities and social and physical science. The key curricular components science. The key curricular components emphasized within the curriculum are emphasized within the curriculum are derived from the Dept. of Nursing’s derived from the Dept. of Nursing’s Mission and Philosophy. Mission and Philosophy.

The Following Threads Are The Following Threads Are Woven Throughout Our Woven Throughout Our

ProgramProgram ProfessionalismProfessionalism ResearchResearch Holistic healthHolistic health GlobalizationGlobalization

ProfessionalismProfessionalism Professionalism in nursing includes adherence to Professionalism in nursing includes adherence to

professional nursing practice and performance professional nursing practice and performance standards.standards.

The professional nurse possesses leadership and The professional nurse possesses leadership and management skills, is capable of delegation and management skills, is capable of delegation and supervision of health care providers and may supervision of health care providers and may practice autonomously within the legal/ethical practice autonomously within the legal/ethical scope of practice of the licensing organization.scope of practice of the licensing organization.

The professional nurse assumes a The professional nurse assumes a variety of roles including but not variety of roles including but not limited to provider of client centered limited to provider of client centered care, educator, researcher, leader, care, educator, researcher, leader, manager, evaluator, advocate, manager, evaluator, advocate, and/or counselor.and/or counselor.

ResearchResearch

Research is a systematic inquiry that Research is a systematic inquiry that uses various approaches to answer uses various approaches to answer questions and solve problems. questions and solve problems. Nursing research is a process that Nursing research is a process that allows nurses to ask questions to allows nurses to ask questions to gain knowledge for improving patient gain knowledge for improving patient care.care.

Holistic HealthHolistic Health

Nursing supports a holistic view of Nursing supports a holistic view of diverse persons and requires its diverse persons and requires its practitioners to have achieved a practitioners to have achieved a substantial knowledge base in the substantial knowledge base in the sciences, arts, and humanities.sciences, arts, and humanities.

The caring, competent nurse uses self and The caring, competent nurse uses self and presence, recognizing the importance of presence, recognizing the importance of spirituality, diversity, community and spirituality, diversity, community and social justice in the promotion of health social justice in the promotion of health through the life span. Communication of through the life span. Communication of information is critical in educating people information is critical in educating people toward health and healing.toward health and healing.

GlobalizationGlobalization

The baccalaureate nurse is prepared The baccalaureate nurse is prepared to practice professional nursing in a to practice professional nursing in a global society, with an awareness of global society, with an awareness of diversity and varied cultures. diversity and varied cultures.

Globalization, cont.Globalization, cont. As members of a global community of nurses, the As members of a global community of nurses, the

faculty is dedicated to support the education and faculty is dedicated to support the education and professional development of nurses working to professional development of nurses working to improve the health of the world’s people. With a improve the health of the world’s people. With a commitment to social justice, the Department of commitment to social justice, the Department of Nursing prepares nurses to confront the issues of Nursing prepares nurses to confront the issues of people living in poverty and underserved areas.people living in poverty and underserved areas.

Theoretical ConstructsTheoretical Constructs The Department of Nursing’s theoretical beliefs The Department of Nursing’s theoretical beliefs

are eclectic in nature with key concepts drawn are eclectic in nature with key concepts drawn from the works of Florence Nightingale, from the works of Florence Nightingale, Madeleine Leininger, and M. Jean Watson.Madeleine Leininger, and M. Jean Watson.

Faculty embrace these theoretical beliefs as Faculty embrace these theoretical beliefs as important to nursing and baccalaureate important to nursing and baccalaureate education. education.

Major Theoretical Major Theoretical ConstructsConstructs

Nightingale’s (1969) emphasis on Nightingale’s (1969) emphasis on environment to optimize healthenvironment to optimize health

Leininger’s (1978) advocating for Leininger’s (1978) advocating for cultural carecultural care

Watson’s (1979) premise that caring Watson’s (1979) premise that caring is the soul of nursingis the soul of nursing

MSU Nursing Department MSU Nursing Department Specific InformationSpecific Information

Department of Nursing Department of Nursing CommitteesCommittees

The Department of Nursing has The Department of Nursing has student representatives on 2 student representatives on 2 committees. They are:committees. They are:– Student Faculty AffairsStudent Faculty Affairs– Curriculum CommitteeCurriculum Committee

Curriculum CommitteeCurriculum Committee

Deals with course/class concerns and Deals with course/class concerns and

text books.text books. Meets 3Meets 3rdrd Friday of month, watch the Friday of month, watch the

bulletin board for notices.bulletin board for notices.

Student Faculty AffairsStudent Faculty Affairs

Plans for scholarships, handbook Plans for scholarships, handbook changes, policies & parties.changes, policies & parties.

Also 3Also 3rdrd Fridays. Check the bulletin Fridays. Check the bulletin board for notices.board for notices.

Student ScholarshipsStudent Scholarships

Awards CeremonyAwards Ceremony

24 scholarships24 scholarships– criteria is located in the back of your criteria is located in the back of your

handbook.handbook.

ND State Board LoanND State Board Loan

Board of Nursing Education Loan. Board of Nursing Education Loan. – You do not have to pay it back if you You do not have to pay it back if you

work in the state for X years.work in the state for X years.– Applications can be obtained from the Applications can be obtained from the

State Board. Deadline is July1.State Board. Deadline is July1.

Safety InformationSafety Information

Fire Regulations and Fire Regulations and Emergency Evacuation Plan for Emergency Evacuation Plan for

MSUMSU Fire alarms and extinguishers are located Fire alarms and extinguishers are located

near each exit door on each floor.near each exit door on each floor. In the event of fire, sound the alarm and In the event of fire, sound the alarm and

evacuate the building.evacuate the building. Do not use the elevators.Do not use the elevators. At the clinical settings, follow their policy.At the clinical settings, follow their policy.

Policies & ProceduresPolicies & Procedures

Clinical facilities have their own Clinical facilities have their own specific policies & procedures. specific policies & procedures.

Faculty will point out their location at Faculty will point out their location at the clinical settings.the clinical settings.

Infection ControlInfection Control The Occupational Safety and Health The Occupational Safety and Health

Administration (OSHA) Bloodborne Pathogen Administration (OSHA) Bloodborne Pathogen Standard, became the Federal law in July, 1992. Standard, became the Federal law in July, 1992. All hospital/agency policies and procedures All hospital/agency policies and procedures directed by this standard are found in the directed by this standard are found in the agency’s “Exposure control Plan” and in the agency’s “Exposure control Plan” and in the Infection Control section of the agency’s policy Infection Control section of the agency’s policy and procedure manual.and procedure manual.

Students and healthcare workers are Students and healthcare workers are to receive orientation and annual to receive orientation and annual education to comply with these education to comply with these OSHA Standards.OSHA Standards.

The following information is based on The following information is based on OSHA Standards.OSHA Standards.

Standard PrecautionsStandard Precautions Apply to all patients at all times regardless of Apply to all patients at all times regardless of

diagnosis.diagnosis. Standard precautions applies toStandard precautions applies to

– BloodBlood– Body fluidsBody fluids– SecretionsSecretions– Excretions (whether or not blood is present or visible) Excretions (whether or not blood is present or visible)

except with sweatexcept with sweat– Non-intact skin and mucous membranesNon-intact skin and mucous membranes

Personal Protective Personal Protective EquipmentEquipment

PPE examples are:PPE examples are:– GlovesGloves– MasksMasks– GownsGowns– Plastic apronsPlastic aprons– Goggles with protective shieldsGoggles with protective shields

Hand HygieneHand Hygiene

Must take place between patients, Must take place between patients, after procedures and when in contact after procedures and when in contact with patient equipment, linens, with patient equipment, linens, supplies and immediate supplies and immediate environment.environment.

Hand HygieneHand Hygiene

Hand washing with an antimicrobial Hand washing with an antimicrobial soap under a running stream of soap under a running stream of water, applying friction to fingers, water, applying friction to fingers, hands, wrists for at least 15 seconds; hands, wrists for at least 15 seconds; drying hands with paper towel; drying hands with paper towel; shutting off the faucet with a paper shutting off the faucet with a paper towel. towel.

Soap & WaterSoap & Water

Soap and water must be used:Soap and water must be used:– When you first get to workWhen you first get to work– For contact with proteinaceous materialFor contact with proteinaceous material– If visibly soiledIf visibly soiled– Before eatingBefore eating– After using the restroom After using the restroom – When caring for patients diagnosed with When caring for patients diagnosed with

spore producing organism, such as spore producing organism, such as Anthrax or Clostridium Difficile.Anthrax or Clostridium Difficile.

Alcohol Based Hand Alcohol Based Hand AntisepticsAntiseptics

Foam and gel antiseptics can be Foam and gel antiseptics can be used at any other time when in used at any other time when in contact with patients, their contact with patients, their equipment, linen, supplies and equipment, linen, supplies and immediate environment.immediate environment.

GlovesGloves

Must be worn when in contact with Must be worn when in contact with blood or other potentially infectious blood or other potentially infectious materials, mucous membranes, and materials, mucous membranes, and non-intact skin.non-intact skin.

Wear gloves if Wear gloves if you the caregiveryou the caregiver have non-intact skin.have non-intact skin.

Important!Important!

Perform hand hygiene before and Perform hand hygiene before and after using gloves!after using gloves!

Gloves are changed between all Gloves are changed between all client contacts.client contacts.

Fluid Resistant GownsFluid Resistant Gowns

Must be worn whenever the potential Must be worn whenever the potential exists for soiling of uniforms or exists for soiling of uniforms or clothing.clothing.

These gowns are also worn for These gowns are also worn for contact isolation precautions.contact isolation precautions.

Masks Masks

Must be worn when there is a risk of Must be worn when there is a risk of exposure to spraying or splashing of exposure to spraying or splashing of blood or fluids that contain blood. blood or fluids that contain blood. This is typically a regular surgical This is typically a regular surgical mask. mask.

(N95) masks are worn only for (N95) masks are worn only for airborne transmission organisms.airborne transmission organisms.

Eye Protection Eye Protection

Goggles or face shields must be worn for Goggles or face shields must be worn for risks of exposure to spraying or splashing risks of exposure to spraying or splashing of blood. Your own glasses are not of blood. Your own glasses are not sufficient protection unless you use “add-sufficient protection unless you use “add-on” side pieces. on” side pieces.

Eye protection and masks are worn in Eye protection and masks are worn in conjunction with one another. conjunction with one another.

Sharps Sharps

Must be disposed of in an OSHA Must be disposed of in an OSHA approved puncture resistant approved puncture resistant container. Contaminated needles container. Contaminated needles are NOT to be recapped, bent, are NOT to be recapped, bent, broken or other wise manipulated by broken or other wise manipulated by hand.hand.

Safety DevicesSafety Devices

Agencies use a variety of safety Agencies use a variety of safety engineered devices and must be used engineered devices and must be used according to their instructions. according to their instructions.

Examples: needle less IV therapy systems, Examples: needle less IV therapy systems, syringes, venipuncture devices, scalpels, syringes, venipuncture devices, scalpels, blunted suture needles, lancets and blood blunted suture needles, lancets and blood collection devices.collection devices.

Biohazard WasteBiohazard Waste

Defined as waste “likely to release Defined as waste “likely to release infectious material in liquid or semi-liquid infectious material in liquid or semi-liquid form”.form”.

Waste contaminated with blood or fluids Waste contaminated with blood or fluids that contain blood likely to pose a risk of that contain blood likely to pose a risk of exposure must be red-bagged.exposure must be red-bagged.

LinenLinen

Linen should be placed in linen bags Linen should be placed in linen bags at bedside and not on the floor.at bedside and not on the floor.

Linen soiled with biohazard waist Linen soiled with biohazard waist need to placed in fluid resistant bags need to placed in fluid resistant bags at the point of use. (bedside)at the point of use. (bedside)

Contaminated EquipmentContaminated Equipment

Follow your agency policy. Place items in Follow your agency policy. Place items in soiled utility rooms for pickup and soiled utility rooms for pickup and reprocessing (decontamination, reprocessing (decontamination, disinfection of sterilization) by Central disinfection of sterilization) by Central Processing Unit personnel. Processing Unit personnel.

Small surgical instruments should be Small surgical instruments should be placed in soaking basins containing an placed in soaking basins containing an enzymatic.enzymatic.

Equipment, contEquipment, cont

Some equipment may be disinfected on Some equipment may be disinfected on the unit with appropriate disinfectant.the unit with appropriate disinfectant.

Multi-use equipment, such as wheelchairs, Multi-use equipment, such as wheelchairs, BP cuffs, glucose monitoring devices and BP cuffs, glucose monitoring devices and thermometers, should be disinfected thermometers, should be disinfected between patient use.between patient use.

Blood SpillsBlood Spills Facilities are required by OSHA to have Facilities are required by OSHA to have

spill kits available for clean up.spill kits available for clean up.

Blood spills are cleaned up in a two-part Blood spills are cleaned up in a two-part process.process.

First wipe up the spill and then disinfect First wipe up the spill and then disinfect the area with one of the following:the area with one of the following:– Sodium Hypochlorite (Hilex or Clorox 1:100, Sodium Hypochlorite (Hilex or Clorox 1:100,

with Dispatch, or Vesphene.with Dispatch, or Vesphene.

MSDS SheetsMSDS Sheets

Material Safety Data SheetsMaterial Safety Data Sheets– OSHA requires the various clinical OSHA requires the various clinical

settings to maintain these sheets on settings to maintain these sheets on chemicals. Examples: cleaning chemicals. Examples: cleaning solutions, copy machine toner, paints.solutions, copy machine toner, paints.

Exposure Control PlanExposure Control Plan

Clinical facilities are required to have Clinical facilities are required to have Exposure control Plans. We will point Exposure control Plans. We will point the location of these out to you when the location of these out to you when we get to the clinical settings.we get to the clinical settings.– Application examples: safety devices for Application examples: safety devices for

injections or for IV starts.injections or for IV starts.

Blood Exposure Incidents Blood Exposure Incidents Examples: needle stick injuries, cuts with Examples: needle stick injuries, cuts with

a scalpel or blood splashes.a scalpel or blood splashes. Wash areaWash area Notify your instructorNotify your instructor Seek medical treatment immediately Seek medical treatment immediately

Fill out an incident reportFill out an incident report

Report to the ETC immediately. Receiving Report to the ETC immediately. Receiving HIV prophylaxis may prevent as many as HIV prophylaxis may prevent as many as 80% of healthcare workers infections. 80% of healthcare workers infections. – Risk of HIV after an exposure to an positive Risk of HIV after an exposure to an positive

patient is 0.4%patient is 0.4%– Risk of HBV (Hepatitis B) is 6-30%Risk of HBV (Hepatitis B) is 6-30%

Rapid HIV testing is done to determine Rapid HIV testing is done to determine results of source patient within 2 hours.results of source patient within 2 hours.

Subsequent testing or treatment as the Subsequent testing or treatment as the result of exposure (positive source patient) result of exposure (positive source patient) will be at the student expense (Trinity will be at the student expense (Trinity policy, other agencies may have a policy, other agencies may have a different policy)different policy)

Blood Exposure, contBlood Exposure, cont

Tests will be completed based on Tests will be completed based on agency policy. Patient results are to agency policy. Patient results are to be kept confidential.be kept confidential.

It is a Class C Felony to breach this It is a Class C Felony to breach this confidentiality to individuals who confidentiality to individuals who have no involvement in their care.have no involvement in their care.

Blood Exposure, Cont.Blood Exposure, Cont.

Results will be returned to you. Results will be returned to you. Follow-up testing or treatment will Follow-up testing or treatment will depend on the test results. depend on the test results.

Hepatitis B Vaccine (HBV)Hepatitis B Vaccine (HBV) What is it?What is it?

– A series of three injections given to prevent Hepatitis B, A series of three injections given to prevent Hepatitis B, a liver disease. The 1a liver disease. The 1stst is given initially, 2 is given initially, 2ndnd in one in one month, 3month, 3rdrd in six months. in six months.

– Contraindications include allergy to yeast, and mercury. Contraindications include allergy to yeast, and mercury. If you are pregnant seek the advise of an obstetrician. If you are pregnant seek the advise of an obstetrician.

How it works:How it works:– Production of antibodies is 96%Production of antibodies is 96%– A test for antibody response should occur in 1-2 months A test for antibody response should occur in 1-2 months

post vaccination.post vaccination.– If negative response, one repeat series is recommended If negative response, one repeat series is recommended

with a subsequent antibody test (AntiHBs) If a negative with a subsequent antibody test (AntiHBs) If a negative response continues, further vaccination is not response continues, further vaccination is not recommend.recommend.

HBVHBV

The vaccine is recommended for The vaccine is recommended for students but is not mandatory.students but is not mandatory.

Hepatitis CHepatitis C

There is no prophylaxis for Hepatitis There is no prophylaxis for Hepatitis C.C.

Isolation PrecautionsIsolation Precautions

Tier: 1 Standard PrecautionsTier: 1 Standard Precautions Tier 2: Transmission-Based Tier 2: Transmission-Based

PrecautionsPrecautions

Standard PrecautionsStandard Precautions

Used for the care of all persons Used for the care of all persons regardless of their diagnosis or regardless of their diagnosis or possible infections.possible infections.

New Elements of Standard New Elements of Standard Precautions (CDC 2007)Precautions (CDC 2007)

Protection of patientsProtection of patients– Infection control outbreak investigations Infection control outbreak investigations

indicated the need for new indicated the need for new recommendations or reinforcement of recommendations or reinforcement of existing infection control existing infection control recommendations to protect patients.recommendations to protect patients.

Siegel JD, Rhinehart E, Jackson M, Chairello L, and the Healthcare Infection Control Siegel JD, Rhinehart E, Jackson M, Chairello L, and the Healthcare Infection Control Practices Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing Practices Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, June 2007Transmission of Infectious Agents in Healthcare Settings, June 2007

http://www.cdc.gov/ncidod/dhqp/pdf/isolation2007.pdfhttp://www.cdc.gov/ncidod/dhqp/pdf/isolation2007.pdf

Changes or clarifications in Changes or clarifications in terminologyterminology

The term The term nosocomial infectionnosocomial infection is retained to is retained to refer only to infections acquired in hospitals. refer only to infections acquired in hospitals.

The term The term healthcare-associated infection healthcare-associated infection (HAI)(HAI) is used to refer to infections associated is used to refer to infections associated with healthcare delivery in any setting (i.e., with healthcare delivery in any setting (i.e., hospitals, long-term care facilities, ambulatory hospitals, long-term care facilities, ambulatory settings, home care). settings, home care).

– This term reflects the inability to determine with This term reflects the inability to determine with certainly where the pathogen is acquired since patients certainly where the pathogen is acquired since patients may be colonized with or exposed to potential may be colonized with or exposed to potential pathogens outside of the health care, or may develop pathogens outside of the health care, or may develop infections caused by those pathogens when exposed to infections caused by those pathogens when exposed to the conditions associated with delivery of healthcare.the conditions associated with delivery of healthcare.

ChangeChange

Per the 2007 Guidelines, the term Per the 2007 Guidelines, the term “Airborne Infection Isolation Room “Airborne Infection Isolation Room (AIIR)” replaces “Airborne (AIIR)” replaces “Airborne Precautions”Precautions”

New Elements Include New Elements Include

Respiratory Hygiene/Cough etiquetteRespiratory Hygiene/Cough etiquette Safe Injection PracticesSafe Injection Practices Masks for Special Lumbar Puncture Masks for Special Lumbar Puncture

ProceduresProcedures

Respiratory Hygiene/Cough Respiratory Hygiene/Cough EtiquetteEtiquette

This strategy is targeted at patients This strategy is targeted at patients and accompanying family members and accompanying family members and friends with undiagnosed and friends with undiagnosed transmissible respiratory infections, transmissible respiratory infections, and applies to any person with signs and applies to any person with signs of illness including cough, of illness including cough, congestion, rhinorrhea, or increased congestion, rhinorrhea, or increased production of respiratory secretions production of respiratory secretions when entering a healthcare facility.when entering a healthcare facility.

Elements of Respiratory Elements of Respiratory Hygiene/Cough EtiquetteHygiene/Cough Etiquette

1.1. Education of healthcare facility staff, patients, and visitorsEducation of healthcare facility staff, patients, and visitors2.2. Posted signs in languages appropriate to the population Posted signs in languages appropriate to the population

served, with instructions to patients and accompanying served, with instructions to patients and accompanying family members or friendsfamily members or friends

3.3. Source control measures (e.g., covering the mouth/nose Source control measures (e.g., covering the mouth/nose with a tissue when coughing and prompt disposal of used with a tissue when coughing and prompt disposal of used tissues, using surgical masks on the coughing person when tissues, using surgical masks on the coughing person when tolerated and appropriatetolerated and appropriate

4.4. Hand hygiene after contact with respiratory secretionsHand hygiene after contact with respiratory secretions5.5. Spatial separation, ideally >3 feet, of persons with Spatial separation, ideally >3 feet, of persons with

respiratory infections in common waiting area when respiratory infections in common waiting area when possible. possible.

Covering sneezes and coughs and placing masks on Covering sneezes and coughs and placing masks on coughing patients are proven means of source containment coughing patients are proven means of source containment that prevent infected persons from dispersing respiratory that prevent infected persons from dispersing respiratory secretions into the air.secretions into the air.

Safe Injection PracticesSafe Injection Practices

Adhere to basic principles of aseptic Adhere to basic principles of aseptic technique for the preparation and technique for the preparation and administration of parenteral medications.administration of parenteral medications.– These include the use of a sterile, single-use, These include the use of a sterile, single-use,

disposable needle and syringe for each disposable needle and syringe for each injection given and prevention of injection given and prevention of contamination of injection equipment and contamination of injection equipment and medication. Whenever possible, use of single-medication. Whenever possible, use of single-dose vials is preferred over multiple-dose vials, dose vials is preferred over multiple-dose vials, especially when medications will be especially when medications will be administered to multiple patients. administered to multiple patients.

Practices for Special Lumbar Practices for Special Lumbar Puncture ProceduresPuncture Procedures

Use masks for insertion of catheters Use masks for insertion of catheters

or injection of material into spinal or or injection of material into spinal or epidural spaces via lumbar puncture epidural spaces via lumbar puncture procedures (e.g., myelogram, spinal procedures (e.g., myelogram, spinal or epidural anesthesia. or epidural anesthesia.

Transmission Based Transmission Based PrecautionsPrecautions

There are 3 categories, which are There are 3 categories, which are used in addition to Standard used in addition to Standard Precautions. Precautions.

They are:They are: AirborneAirborne DropletDroplet ContactContact

Airborne TransmissionAirborne Transmission

Used in addition to Standard Used in addition to Standard PrecautionsPrecautions

Per the 2007 Guidelines, the term Per the 2007 Guidelines, the term “Airborne Infection Isolation Room “Airborne Infection Isolation Room (AIIR)” replaces “Airborne (AIIR)” replaces “Airborne Precautions”Precautions”

For clients with known or suspected For clients with known or suspected illnesses that are transmitted by illnesses that are transmitted by airborne droplet nuclei smaller than 5 airborne droplet nuclei smaller than 5 micronsmicrons

Airborne Transmission, contAirborne Transmission, cont Private room with negative air pressure, 6-12 air Private room with negative air pressure, 6-12 air

exchanges per hour, air discharge to outside or exchanges per hour, air discharge to outside or have a filtration system for the room air.have a filtration system for the room air.

If private room isn’t available, room with a client with If private room isn’t available, room with a client with the same illnessthe same illness

Wear a respiratory device (N95 respirator)Wear a respiratory device (N95 respirator) Limit movement in room. Place mask on client Limit movement in room. Place mask on client

when transporting out of roomwhen transporting out of room

Airborne Transmission, cont.Airborne Transmission, cont.

Examples:Examples:Varicella (chicken pox)Varicella (chicken pox)TBTBSARSSARSMeasles (rubeola)Measles (rubeola)

Droplet Precautions Droplet Precautions Used in addition to Standard PrecautionsUsed in addition to Standard Precautions Used for clients with illnesses transmitted Used for clients with illnesses transmitted

by particle droplets larger than 5 microns.by particle droplets larger than 5 microns.– Private roomPrivate room

Or with a client with the same illnessOr with a client with the same illness– Wear mask if working within 3 ft of clientWear mask if working within 3 ft of client– Limit movement in roomLimit movement in room

Client must wear a mask if transported out of roomClient must wear a mask if transported out of room

Droplet Precautions, cont.Droplet Precautions, cont.

Examples:Examples:– DiphtheriaDiphtheria– Myoplasma pneumoniaMyoplasma pneumonia– PertussisPertussis– MumpsMumps– RubellaRubella– Streptococcal pharyngitisStreptococcal pharyngitis– Scarlet fever in childrenScarlet fever in children

Contact Precautions Contact Precautions

Used in addition to Standard Precautions.Used in addition to Standard Precautions. Used for clients with known or suspected Used for clients with known or suspected

serious illnesses transmitted by direct serious illnesses transmitted by direct client contact or by contact with items in client contact or by contact with items in the client’s environment.the client’s environment.

Contact Precautions, cont.Contact Precautions, cont.– Private roomPrivate room

If not available, with a client with the same microorganismIf not available, with a client with the same microorganism– Wear glovesWear gloves

Change gloves after contact with infectious materialChange gloves after contact with infectious material Remove gloves b/4 leaving roomRemove gloves b/4 leaving room Cleanse hands immediately after removing gloves. Cleanse hands immediately after removing gloves.

(antimicrobial agent)(antimicrobial agent)– Wear gown, remove in roomWear gown, remove in room– Keep equipment in room (B/P cuff, thermometer)Keep equipment in room (B/P cuff, thermometer)

Contact Precautions, cont.Contact Precautions, cont.

Examples:Examples:– Certain Gastrointestinal and respiratory Certain Gastrointestinal and respiratory

illnessesillnesses– Wound infectionsWound infections– Colstridium difficileColstridium difficile– ImpetigoImpetigo– Shigella (dysentery)Shigella (dysentery)– RSVRSV

HIPAAHIPAA

HIPAA is the Health Insurance HIPAA is the Health Insurance Portability and Accountability Act of Portability and Accountability Act of 1996.1996.

Each facility is required to inform the Each facility is required to inform the people they care for (patients or people they care for (patients or residents) about this law.residents) about this law.

It is your responsibility to understand It is your responsibility to understand what information HIPAA rules and what information HIPAA rules and regulations protect. You could be regulations protect. You could be held legally accountable if you reveal held legally accountable if you reveal patient or resident information.patient or resident information.

HIPAA sets up strict guidelines that HIPAA sets up strict guidelines that define a patient or resident’s define a patient or resident’s protected health information and protected health information and who has the right to know or access who has the right to know or access this information. HIPAA defines this information. HIPAA defines Protected Health Information (PHI) as Protected Health Information (PHI) as personal medical information that personal medical information that includes:includes:

demographic information-name, address, phone demographic information-name, address, phone number, birthdates, religious affiliation, etc.number, birthdates, religious affiliation, etc.

medical historymedical history diagnosesdiagnoses tests and diagnostic procedurestests and diagnostic procedures treatments and surgical procedurestreatments and surgical procedures medicationsmedications charging and billing informationcharging and billing information insurance carrier or third party payerinsurance carrier or third party payer any other information specific to that patient or any other information specific to that patient or

residentresident

HIPAA also states that part of PHI is HIPAA also states that part of PHI is Highly Confidential Information. Highly Confidential Information. There are even more rules about who There are even more rules about who may have access to this information. may have access to this information. Highly Confidential Patient Highly Confidential Patient Information includes information Information includes information about:about:

mental health and developmental mental health and developmental disabilities servicesdisabilities services

alcohol and drug abuse prevention, alcohol and drug abuse prevention, treatment and referraltreatment and referral

HIV/AIDS testing, diagnosis or treatmentHIV/AIDS testing, diagnosis or treatment venereal disease(s)venereal disease(s) genetic testinggenetic testing child abuse and neglectchild abuse and neglect domestic abuse of an adult with a domestic abuse of an adult with a

disabilitydisability sexual assaultsexual assault

The facility is allowed to use protected The facility is allowed to use protected health information in order to treat the health information in order to treat the person or obtain payment for services person or obtain payment for services provided. The facility can also use PHI for provided. The facility can also use PHI for internal administration and planning or to internal administration and planning or to improve the quality and cost effectiveness improve the quality and cost effectiveness of care. For example, PHI may be used to of care. For example, PHI may be used to evaluate the quality and competence of evaluate the quality and competence of health care workers. PHI may be disclosed health care workers. PHI may be disclosed to certain individuals in the facility to to certain individuals in the facility to resolve complaints.resolve complaints.

The facility may disclose PHI:The facility may disclose PHI: So another health care provider can treat the So another health care provider can treat the

patient, receive payment for services they patient, receive payment for services they provide, or conduct their health care operations.provide, or conduct their health care operations.

For public health activities.For public health activities. To report abuse, neglect or domestic violence.To report abuse, neglect or domestic violence. To ensure compliance with the rules of To ensure compliance with the rules of

government health programs such as Medicare or government health programs such as Medicare or Medicaid.Medicaid.

For organ, eye or tissue procurement, banking or For organ, eye or tissue procurement, banking or transplantation.transplantation.

To units of the government with special functions, To units of the government with special functions, such as the U.S. military or the U.S. Department such as the U.S. military or the U.S. Department of State under certain circumstances.of State under certain circumstances.

The patient or resident has the right The patient or resident has the right to ask to inspect their medical record to ask to inspect their medical record file and billing records. file and billing records.

They may request copies of the They may request copies of the records. records.

They may also ask the facility who They may also ask the facility who has received their PHI.has received their PHI.

Student ResponsibilityStudent Responsibility

You (student) will need to print the You (student) will need to print the verification form after completing verification form after completing this education program. It is located this education program. It is located on the next slide.on the next slide.– Sign the form and give it to your course Sign the form and give it to your course

instructor.instructor.

The form will be kept in your Nursing The form will be kept in your Nursing Department file.Department file.

Verification FormVerification Form

You have completed You have completed your Annual your Annual Mandatory Mandatory Education Education Requirements for Requirements for MSU Department of MSU Department of Nursing.Nursing.

Name: ____________Name: ____________ Date: ____________Date: ____________

– Turn in to your course instructor.Turn in to your course instructor.– Instructor will give to department secretary Instructor will give to department secretary

Yearly Education07Yearly Education07