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NurseReview.Org - Isolation Nursing Precautions Presentation Transcript

  • 1. Isolation Class 10 Last Class
  • 2. Preventing the spread of infection
    • What do we do when a client has a highly infectious disease?
  • 3. Specific Infection Control Policies
    • Isolation – the principle is to create a physical barrier that prevents the transfer of microorganisms.
  • 4. What are appropriate barriers? Depending on -
    • Organism Transmission
      • Airborne
      • Vehicle
      • Contact
        • Direct
        • Indirect
        • Droplet
  • 5. Types of Barriers
    • PPE (personal protective equipment)
      • Gowns
      • Gloves
      • Masks
      • Eyewear
  • 6.
    • Each institution is required to have infection control policies and guidelines.
  • 7. What about when we don’t know?
    • 3 systems
      • Universal precautions
      • Body substance precautions
      • Standard precautions
  • 8. Precautions to guard against the unknown
    • Apply to everyone
    • General public
    • May or may not carry an infection
  • 9. 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)
  • 10. Universal precautions
    • Stated :
    • All blood & body flds should be treated as potentially infectious.
  • 11. Body Substance Isolation (BSI)
    • Infection control practitioners in Seattle and SanDiego
    • Canada adopted policy but renamed it Body Substance Precautions (BSP)
  • 12. Standard Precautions
    • 1996- newest guidelines by CDC combined the major features of universal precautions & BSP
  • 13. 2 Tier System
    • 1996 CDC new guidelines
  • 14. 1 st 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
  • 15. 2 nd Tier
    • Specific infections/diagnosis
    • Droplet, airborne, contact with contaminated surface
  • 16. 3 Types Transmission Based Precautions
    • Airborne, droplet, contact
    • Some infections combination (chicken pox)
    • These extra precautions are in addition to Standard Precautions
  • 17. Airborne
    • Travels on small particles
    • Air currents
    • Portal of entry – nose, mouth, mucus membranes
      • Measles, chicken pox, TB
  • 18. 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
  • 19. 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
  • 20. 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
  • 21.
    • Remove gloves prior to exiting and wash hands
    • Gown for
      • patient contact
      • Changing linen
      • Handling objects in the room
  • 22.
    • Remove gown prior to exiting
    • Wash hands
    • Careful clothing does not touch room surfaces
  • 23. Protective Isolation / Reverse isolation
    • Compromised or suppressed immune system
    • Highly susceptible to infections
    • Protection from environmental pathogens
  • 24. Protective Isolation / Reverse isolation
    • What do you need ?
    • Private room – door closed
    • Gown, mask, gloves if direct contact
    • Wash hands
    • No plants / flowers
  • 25. Procedure
    • Before instituting
      • EXPLAIN to client & family
        • Disease
        • Purpose of isolation
        • Steps to follow
        • Time frame
  • 26. 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
  • 27.
    • Be organized
    • Gather equipment prior to entering room
    • Remove rings and wash hands
    • Don PPE
    • Gown usually disposable
    • Gloves up over cuff of gown
  • 28.
    • 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
  • 29. 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
  • 30. Exiting Room
    • Wash hands
    • Use paper towel on door handle
    • Wash hands again outside room
    • Important to do as much client care as you can while you are in the room….CLUSTER ACTIVITY.
  • 31. 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
  • 32. Client Consideration
    • Isolation
    • Loneliness
    • Self – esteem, body image
    • Boredom
  • 33. 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.
  • 34. Practice Areas
    • Operating room
    • Labor and delivery
    • Major diagnostic area
    • At the bedside in 3 main situations
      • Procedures requiring intentional perforation of the skin
  • 35.
      • When the skin’s integrity is broken due to surgery or burns
      • During procedures involving insertion of devices into normally sterile body cavities
  • 36.
    • Any break in technique could result in contamination increasing clients risk for infection.
  • 37. 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
  • 38. Examples of sterilization processes
    • Moist heat /steam
    • Radiation
    • Autoclave- instruments, parental solutions, dressings
    • Drugs, foods, heat sensitive items
  • 39. 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
  • 40. Examples of sterilization processes
    • Ethylene oxide gas
      • Destroys microorganisms by altering cells’ metabolic processes.
    • Rubber
    • Plastic
  • 41. 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.
  • 42. Practical Exam
    • Prepare a sterile field
    • Add an item
    • Add a liquid
    • Don sterile gloves