Hand hygeine
It may mean using soap and water to wash the hands as in typical handwashing, using alcohol-based hand sanitizers, using an antiseptic handwash or hand rub, and surgical hand antisepsis
How long should u wash your hands
15-30 sec
Alcohol-based hand sanitizers
These products, which contain varying amounts of alcohol, may be used to decrease the number of micro-organisms (bacteria, viruses, and fungi) on the hand
Antimicrobial handwashes
These handwashes are used to wash the hands in combination with water. The hand rubs are applied to the surfaces of the hands to decrease microbe load, using the same hand hygiene techniques as are used with hand sanitizer
Antiseptics
a chemical agent that slows or stops the growth of microorganisms on external surfaces of the body and helps to prevent infection.
Types of Anticeptic Agents
Alcohols
Chlorhexidine
Chlorine
Chloroxylenol (parachlorometaxylenol [PCMX])
HexachloropheneIodine/iodophors
Quaternary ammonium compounds
Triclosan
Best for removing spores?
Hand washing (soap and water)
(T/F)Alcohol-based products, antiseptics, and antimicrobials have not been shown to be effective in removing spores and should not be used for this purpose
True, soap and water best meathod
Fingernail Concerns
Less than 0.25
No chipped nail polish
Artificial nails discouraged
gel nail polish discouraged,
harbor bacteria
Medical Asepsis
(clean Technique)
reduction of disease causing microorganisms on a surface as a means of red infection
Surgical Asepsis
ensures that items such as gloves and equipment are sterile, meaning that they do not have micro-organisms present on them.
SSIs
surgical-site infections (SSIs)
that is, postsurgical infections that arise in either the incision, the tissue around the incision, or the organs.
Performing Surgical Asepsis
remove all watches rings bracelets
10 min scrub with brush and sponge
Applying a mixture of chlorhexidine and ethanol to the hands
scrub under nails with a nail brush to remove pathogens
Sterilization
cleaning instruments so that all micro-organisms, including bacterial spores, are eradicated. This process may be achieved with steam and then dry heat, with ethylene oxide gas, or with chemicals, depending on the item to be sterilized
Sterile Field
Created to assure that the smallest number of microorganisms possible are present; used for procedures where surgical asepsis is indicated.
Disinfection
cleans instruments so that almost all micro-organisms are eradicated, but not all. There are two levels of disinfection: high level and low level.
High level disinfection
only some spores remain. This process involves pasteurization or chemicals and is applied to some procedural instruments, such as equipment used for endoscopies and some respiratory therapy equipment
Low Level Disinfection
most vegetative bacteria are destroyed, but some spores, fungi, and viruses may still remain. This type of disinfection is achieved by using hospital-grade disinfectants on surfaces.
What level disinfectant should be used to clean bedrails, bedside tables, computer equipment, blood pressure cuffs, pulse oximeters, and other items contaminated after contact with clients.
Whats the exception
Low level
If theres blood, do neither
Standard Precaution
Infection prevention practices and these apply to all clients, whether or not they are known to have an infectious agent.
Standard precaution used:
to protect self and others from blood, body fluids, secretions, excretions (except sweat), nonintact skin, and mucous membranes
Contact Precaution
help prevent transmission of infectious agents by direct or indirect contact with body secretions
(Gloves and Gown Minimum)
Contact Precaution Pathogens
vancomycin-resistant Enterococcus (VRE)
Clostridium difficile
noroviruses
intestinal tract pathogens
respiratory syncytial virus (RSV)
PT with drainage from wounds, fecal incontinence, or drainage from other sites in the body should be under:
Contact Precaution
Droplet Precaution
should don a surgical mask when entering the room or coming into close contact with the client.
(T/F)
Clients who require droplet precautions should have a private room, if possible. If the client is placed in a room with another client, it is preferred that the other client have the same infection (client cohorting). Otherwise, there should be at least 3 feet of separation between clients
True
Infectious agents that may be transmitted by droplets include
influenza virus
adenovirus
SARS-CoV1
rhinovirus (common cold)
Mycoplasma pneumoniae
(T/F) Nurses should wear surgical masks to prevent droplets from entering their own respiratory tract via the mucous membranes, which can occur within 1 to 5 feet of the client.
False, 6-10 feet
Airborne Precautions
Used when a client has an infectious agent that can be transmitted through the air should don an N95 mask or a high-level respirator when entering the room of a client.
Negative pressure room used (air cycled 12x hour (6 if old/renovated)
Protective Isolation
Used during approximately the first 100 days after the transplant, specific engineering and hospital designs that decrease the risk of environmental fungi to the client who had HSCT.
HEPA filtration, 12x hour exchanges
4 major HAIs
Central line–associated bloodstream infections (CLABSIs)
Catheter-associated urinary tract infections (CAUTIs)
Surgical-site infections (SSIs)
Ventilator-assisted pneumonias (VAPs)
HAIS
Infections that are acquired in a health care facility (ex. hospital, nursing home, ambulatory care facility).
(CLABSIs)
Central line–associated bloodstream infections
(CAUTIs)
Catheter-associated urinary tract infections
(VAPs)
Ventilator-assisted pneumonias
Infection Control Bundles
are guidelines for practice that are bundled together in an effort to prevent HAIs such as CAUTIs, CLABSIs, VAPs, and SSIs
Bundles are used as a measure to
improve client safety and decrease mortality
When dealing with a patient with a MDROs, the nurse should
do Proper handwashing, wearing gloves, and using contact precautions
6 MDROs
Methicillin-resistant Staphylococcus aureus (MRSA)
Vancomycin-resistant Enterococcus (VRE)
Vancomycin-resistant Staphylococcus aureus (VRSA)
Vancomycin-intermediate Staphylococcus aureus (VISA)
Extended-spectrum beta-lactamase (ESBL)–producing organisms
Multidrug-resistant Streptococcus pneumoniae (MDRSP)
(MRSA)
Methicillin-resistant Staphylococcus aureus
(VRE)
Vancomycin-resistant Enterococcus
(VRSA)
Vancomycin-resistant Staphylococcus aureus
(VISA)
Vancomycin-intermediate Staphylococcus aureus
(ESBL)–producing organisms
Extended-spectrum beta-lactamase (ESBL)–producing organisms
(MDRSP)
Multidrug-resistant Streptococcus pneumoniae
Enhanced barrier precautions
Nursing home staff must wear gown and gloves to prevent transfer of organisms to themselves or their clothing when engaging in certain client care activities.
Factors that Increase risk of infection in PT
being in a healthcare enviroment
being around other PTs with pathogens
having an invasive medical device (tube, cath, drain, line)
having a wound
When should gloves be used
* anytime there is the potential for direct contact with blood or bodily fluids, nonintact skin, mucous membranes, or materials that are potentially infectious
* Direct contact with clients colonized/infected with pathogens listed under contact precautions.
Closed Glove technique
Used to don sterile gloves using surgical asepsis after the individual has performed a surgical hand scrub and donned a sterile gown; hands are kept inside the sterile gown until gloves are donned.
the nurse keeps both hands within the cuffs of the gown, keeping hands inside the cuff edges. The nurse grasps the gloves with hands still inside the gown, pulls the gloves over the cuff, and positions the hands inside the gloves
open-glove technique
Used to don sterile gloves using surgical asepsis; gloves are touched directly with the hands.
When should Gowns be used
whenever there is the potential for contact with infected material or the potential for blood or body fluids to penetrate and contaminate the nurse
Nurses should wear masks when
as needed when the client is on standard or droplet precautions
(T/F)Goggles may be used with masks to protect the eyes, nose, and mouth.
T
(T/F) Face shield can be used in place of a mask and google combination
T
Face shield used when
Protecting the eyes is necessary during certain procedures in which blood or body fluids may potentially be splashed into the eyes.
PPE Removal
1) Gloves
2)Googles/Faceshield
3)Gown
4)Mask
Hand Hygeine