N.C. Nurse Aide I Curriculum · Your 5 Moments for Hand Hygiene [WHO] 1.Before touching a resident...

DHSR/HCPR/CARE NAT I Curriculum - July 2013 1

N.C. Nurse Aide I Curriculum

MODULE BInfection Prevention


Objectives

n Relate the chain of infection to the work of a nurseaide in long-term care facilities.

n Explain the concept of breaking the chain ofinfection and its importance to infection prevention.

n Compare Standard Precautions and Transmission-base Precautions.

n Discuss the use of Personal Protective Equipmentby the nurse aide.

n Explain why residents in long-term care facilities areat risk for infection.


Infection Prevention

All of the things thatpeople do to controland prevent thespread of infection


Infection

A disease or a condition when harmfulgerms get into the body and grow innumbers

EXAMPLES

?

Two Types1.Localized2.Systemic


Localized Infection

n One body part andsymptoms limited

n Example – infectedfinger

n Symptoms –painful, red, hot,puffy, drainage


Systemic Infection

n Entire body part orsystem

n Symptoms arefever, chills, fatigue,nausea, vomiting,other specificsymptoms

n Example?

DHSR/HCPR/CARE NAT I Curriculum - July 2013

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How do you feel when someonecoughs or sneezes on you?

How do you feel when someone hands you a moist,crumpled up, used tissue with yellow, thick, slimy

globs of mucus on it to throw away?


What kind of symptoms do youthink a female resident wouldhave if she had…………………….

a bladder infection?


Bladder Infection - Symptoms

n Fever and chills

n Pain when usingbathroom

n Urine will smell bad and might looklike it contains blood

n “My urine stinks and it hurts when Ihave to go to the bathroom”


A Person with a Stomach

Infection will Probably………


Have you everhad someonevomit on you?

Have you ever had to clean upafter someone has vomited?

How did you feel if you got thevomited liquid on your hand?

What did you do?


Microorganisms

n Also called germs

n Live almost everywhere

n Some help people and others harmful

n Requirements to survive?

n Examples?


Medical Asepsis

n Also called clean technique

n Used to removeor destroymicroorganismsand preventspread


Chain of Infection


1st Link – Infectious Agent

n A harmful germ that causes aninfection

n Can be bacteria, avirus, a fungus,ora parasite


2nd Link - Reservoir

n Place where harmful germs live, grow,and increase in number

n Can be a person; an animal;or dirt, water, or other placesin the environment



n Blood

n The skin

n Digestive tract

n Respiratory tract

When reservoir is a person, some placeswhere harmful germs may be livinginclude:



Can you look at a person and

ALWAYS tell if he has an

infection?

“NO, NOT ALWAYS!”



n 1st group – not infected

n 2nd group – infected and showingsymptoms

n 3rd group – carriers; are not showingsymptoms, but can still infect you

People as reservoirs for harmful germs


People We KnowWho Are Infected

Carriers -People WhoAre InfectedThat We DoNot Know

About



The to prevent you, yourco-workers, and your residentsfrom getting infected is to treat

everyone – EVERYONE – as

possible reservoirs or hidingplaces for harmful germs.


3rd Link – Portal of Exit

n The noseand mouth

n The GI tract

n The skin

Any way that harmful germs escapefrom the reservoir and include:


4th Link – Mode of Transportation

How germs get around from placeto place


THE NUMBER ONE WAYA HARMFUL GERMTRAVELS FROM PLACETO PLACE IS BY OUR

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DRAFT – August 2012

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How do our hands provide

transportation for germs?



Harmful Germs Travel by Direct ContactWith Body Fluids Where Germs Live

n Blood

n Sputum

n Pus or wound fluid

n Saliva

n Stool

n Vomit

Examples of Direct Contact?



Harmful Germs Travel by Indirect ContactWith Body Fluids Where Germs Live

Examples of Indirect Contact?

INDIRECT CONTACT means that theharmful germs were spread by an objectthat had touched body fluids from aninfected person



DROPLDROPLETS

DROPLETS

DROPLETSDROPLETS

DROPLETS

DROPLETS


The to prevent you,your co-workers, and yourresidents from getting

infected is to treat ALLbody fluids as possiblecarriers of harmful germs



Other ways that germs travel or getaround from place to place


5th Link – Portal of Entry

n The noseand mouth

n The GI tract

n The skin

Any body opening on a person that allowsharmful germs to enter into the body.Examples include:


6th Link – Susceptible Host

A person who does

not have an infection

now, but is at riskfor becoming

infected from

harmful germs

What are some reasons why a person’s bodycannot fight off an infection?


6th Link – Susceptible Host

Reasons Why aPerson’s Body

Cannot Fight OffInfection

AGE

CHRONIC

ILLNESSES

POOR NUTRITION STRESS

OPEN

CUTS/SKIN

BREAKDOWNFATIGUE

NOVACCINATIONS


RESIDENTS LIVING IN LONG-TERM CAREFACILITIES ARE MORE LIKELY TO GET AN

INFECTION THAN OTHER PEOPLE WHOLIVE IN OUR COMMUNITY

Why?


Chain of Infection


If YOU can break any link in the

Chain of Infection, YOU can

prevent the occurrence of a newinfection



Healthcare-associatedInfection


n Agency of the federalgovernment

n In charge of control/prevention of disease

n Two-tiered way toprotect the public

Centers for Disease Control and Prevention

The CDC

Two tiers are Standard Precautionsand Transmission-based Precautions


Standard Precautions

n 1st level to prevent and control infection

n The basic tasks health care workers do

when caring for EACH and EVERYRESIDENT in order to prevent and

control the spread of infection


Review of Terms

BODY

FLUID

S

NON-INTAC

T

SKI N

MUCUS

MEMBRANESALL body fluids, non-intact skin, and

mucus membranesmust be treated as if they were infected


Why must Standard Precautions be used

with EACH and EVERY RESIDENT?

Without using Standard Precautions,

YOU CAN GET SICK AND PASS ITALONG TO OTHERS!!!!!!!


Nurse Aides Must…………

n Self

n Co-workers

n Residents

Follow Standard Precaution Rules to Protect

FROM GETTING

INFECTIONS


Hand Hygiene

n Soap and water

n Alcohol-based hand rubs

The CDC defines hand hygiene aswashing your hands with:



Performing Hand

Hygiene

is the number 1 way to stop the

transmission of infections!


Nurse Aide Should Perform Hand Hygiene……

At the Point of Care

RESIDENT

CARE

NURSE AIDE


Your 5 Moments forHand Hygiene [WHO]

1.Before touching a resident

2. Before clean/aseptic procedure

3.After body fluid exposure risk

4. After touching a resident

5.After touching residentsurroundings

5 Points

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Perform Hand Hygiene

GLOVING

EATING

RESTROOM

}{CLEAN

LINEN{



ARRIVAL AT WORK

HANDLING TRASH

SOILED HANDS }

LEAVING WORK

RETURNING HOME

TOUCHING OBJECTS/PEOPLE



TOUCHING HAIR

SNEEZING IN HAND

BLOWING NOSE

}TOUCHING OTHER

BODY PARTS


W

H

E

N

DO YOUHAND WASH?


W

H

E

N

MAY YOUHAND RUB?


Personal Protective Equipment

A group of items used to block harmful germsfrom getting on skin and clothes

What nurse aides put on at work to keep blood, urine,stool, spit, and sputum off of the skin and clothes

P E

P



Protect skin on hands

Protect skin & clothes

Protect mouth & nose

Plus goggles that protect eyes and face shields thatprotect whole face



How will I know

which equipment I

will need?


Gloves


Gown

DHHS/DHSR/CARE Branch NAT I Curriculum DRAFT – August 2012


Mask


Sharps - items that have corners, edges,

or projections that can cut or pierce the skin

n Wear gloves and be carefuln Do not cut self or resident

during shavesn Do not jab self when using

sharpsn NEVER, EVER re-cap a needle or other sharp

objectn NEVER, EVER put anything sharp in a regular

trashcan


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SHARPS

Container


SPILLS on the floor…What do I do now?

n Put on gloves

n Absorb spill and clean area

n Discard waste in appropriatecontainer

n Apply disinfectant to area

n Place a warning cone orsign in area


Spill?

Why are spills on the floor involving bodyfluids especially dangerous in a long-termcare facility?


Clean all Surfaces…

n Any time blood or bodyfluids get on any surface

n Use products availablewhere you work

n Follow facility proceduresand product instructions

n Examples?


Transmission-basedPrecautions

n 2nd level to prevent and controlinfections

n Specific measures and taskswhen caring for residents whoare infected/may be infectedwith specific types of infections

3 Types1. Contact Precautions

2. Droplet Precautions

3. Airborne Precautions


Contact Precautions

Purpose – prevent spread of harmful germsspread by direct contact

PPE = Standard Precautions + Gown + Gloves

Examples:

•MRSA

•Norovirus


Dr plet Precauti nsPurpose – prevent spread of harmfulgerms that travel by

Spread when an infected residentcoughs, sings, sneezes, or laughs

PPE?

Examples?


Airborne Precautions

Purpose – prevent spread of harmfulgerms that travel in air at a distance

Harmful germs can float around for awhile and can be carried by moisture,air currents, and dust

PPE = Standard Precautions +Respirator (depending on disease)

Examples?


“OUTBREAK!!!!!”


Influenza &Norovirus aredangerous for

people aged 65and older


The Flu


Norovirus


Bloodborne Pathogens



Hepatitis B Virus (HBV)

n Causes Hepatitis B, a disease of the liver

n About 1/3 of persons infected with HBV donot show symptoms

n Can live outside body on equipment and onsurfaces like table tops or blood glucosemeters for seven days; can infect othersduring that time

n GREAT NEWS! Vaccine is available toprevent you from getting the disease


SEVEN DAYS



Nurse Aide Should:

n Always wear gloves when there is a chance ofexposure to blood

n Handle used sharpscarefully and discardappropriately

n Follow facility’s exposureplan if any part of bodyis exposed to blood orjabbed with contaminatedsharp

WHAT ISWRONG

WITH THISPICTURE?



NEVEREVER DO

THIS82DHSR/HCPR/CARE NAT I Curriculum - July 2013


NEVEREVER DO



NEVEREVER DO



NEVEREVER DO


The End

DHHS/DHSR/CARE Branch NAI Curriculum

DRAFT - August 2012


N.C. Nurse Aide I Curriculum · Your 5 Moments for Hand Hygiene [WHO] 1.Before touching a resident...

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