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Pp chapter 28_audio_part_2

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  • 1. Implementation Health promotion  Preventing an infection from developing or spreading Acute care  Treating an infectious process includes eliminating the infectious organisms and supporting the patient’s defenses. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 1
  • 2. Implementation (cont’d) When implementing care, consider:  Medical and surgical asepsis  Control or elimination of infectious agents  Control or elimination of reservoirs  Control of portals of entry  Control of transmission  Hand hygiene  Isolation precautions Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 2
  • 3. Implementation: Asepsis Asepsis = Absence of pathogenic (disease- producing) microorganisms. Aseptic technique = Practices/ procedures that assist in reducing the risk for infection.  Medical asepsis, or clean technique, includes procedures for reducing the number of organisms present and preventing the transfer of organisms.  Surgical asepsis or sterile technique prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 3
  • 4. Standard Precautions Standard precautions prevent and control infection and its spread.  Apply to contact with blood, body fluid, nonintact skin, and mucous membranes from all patients.  Hand hygiene includes using an instant alcohol hand antiseptic before and after providing patient care, washing hands with soap and water when they are visibly soiled, and performing a surgical scrub.  Handwashing is the act of washing hands with soap and water, followed by rinsing under a stream of water for 15 seconds. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 4
  • 5. Disinfection versus Sterilization Disinfection: a process that eliminates many or all microorganisms, with the exception of bacterial spores, from inanimate objects  Disinfection of surfaces  High-level disinfection, which is required for some items such as endoscopes Sterilization: the complete elimination or destruction of all microorganisms, including spores Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 5
  • 6. Infection Prevention and Control Patient safety  Separate personal care items  Handling solid and fluid waste  Wound cleaning Patient education Cough etiquette Isolation and isolation precautions Surgical asepsis Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 6
  • 7. Cough Etiquette Cover your nose/mouth with a tissue when you cough, and promptly dispose of the contaminated tissue. Place a surgical mask on a patient if it does not compromise respiratory function or is applicable; this may not be feasible in pediatric populations. Perform hand hygiene after contact with contaminated respiratory secretions Maintain spatial separation greater than 3 feet from persons with respiratory infection Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 7
  • 8. Isolation and Isolation Precautions Isolation is the separation and restriction of movement of ill persons with contagious diseases.  Standard precautions  Isolation precautions: airborne, droplet, contact, and protective environment Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 8
  • 9. Isolation Psychological implications Isolation environment Personal protective equipment Specimen collection Bagging of trash or linen Patient transport Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 9
  • 10. Surgical Asepsis Patient preparation Sterile field: an area free of microorganisms and prepared to receive sterile items Principles Performing sterile procedures Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 10
  • 11. Principles of Surgical Asepsis1. A sterile object remains sterile only whentouched by another sterile object.2. Only sterile objects may be placed on asterile field.3. A sterile object or field out of the range ofvision or an object held below a person’s waistis contaminated.4. A sterile object or field becomescontaminated by prolonged exposure to air. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 11
  • 12. Principles of Surgical Asepsis (cont’d)5. When a sterile surface comes in contact witha wet, contaminated surface, the sterile objector field becomes contaminated by capillaryaction.6. Fluid flows in the direction of gravity.7. The edges of a sterile field or container areconsidered to be contaminated. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 12
  • 13. Performing Sterile Procedures Donning and removing caps, masks, and eyewear Opening sterile packages  Opening a sterile item on a flat surface  Opening a sterile item while holding it Preparing a sterile field Pouring sterile solutions Surgical scrub Applying sterile gloves Donning a sterile gown Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 13
  • 14. Evaluation See through the patient’s eyes:  Have the patient’s expectations been met? Patient outcomes  Measure the success of the infection control techniques.  Compare the patient’s actual response with expected outcomes.  If goals are not achieved, determine what steps must be taken. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 14
  • 15. Evaluation (cont’d) Exposure issues  Patients and health care personnel are at risk for acquiring infection from accidental needlesticks. • Report any contaminated needlestick immediately.  Follow-up for risk of acquiring infection begins with source patient testing. • Access to testing the source patient is stated in the testing law for each state. Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 15