Download Safety and Infection Control - Dynamics of Health Care in Society

Chapter 13: Safety and Infection
Control
Dynamics of
Care in Society
Infection Disease
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Aerobic or anaerobic
• Disease-Producing Factors
– Number of organisms in exposure
– Virulence of organism
– Relative strength of person’s immune system
– Length & intimacy of contact between person &
microorganism
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
• The Chain of Infection: video clip
– Pathogen: disease causing organism
– Reservoir: person infected (carrier)
– Exit from reservoir: nose, mouth, rectum, open
wound
– Vehicle/method of transmission: direct or
indirect:
– Portal of entry: nose, mouth, GI system, wound
– Susceptible host: person who becomes infected
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Classification of
Infections and Diseases
Endogenous – begins inside the body
Exogenous – caused by something outside the
body
Opportunistic – occur when the body’s
defenses are weak
Communicable - can be transmitted from one
person to another person.
Nosocomial or Hospital Acquired Infection –
(HAI) acquired by an individual within a
health care facility
Read handout
Local infection - is in a body part.
Systemic infection - involves the whole body
Multi-drug resistant organisms (MDRO) Organisms that can resist the effects of
antibiotics. (they can cause infections such as
bloodstream infections, wound infections,
pneumonia, urinary tract infections and
meningitis, according to the CDC)
MRSA –Methicillin Resistant Staphylococcus Aureus
VRE – Vancomycin Resistant Enterococcus
CRE - carbapenem-resistant enterobacteriaceae
*Causative agent:
________________
Chain of infection
Causative agent –
Bacteria:
Borrelia burgdorferi
1 ticks on mammals
5 human skin in tall grass
Chain of infection
4 skin break from bite
3 via ticks on
Mammals, in grass
2 tick
mouth
Name ___________________________ Date ______ Period _____
On each line, use the correct term(s) to identify the point in the CHAIN OF INFECTION
This is an example of a “nosocomial” infection, a UTI (Urinary Tract Infection).
Circle any unfamiliar terms.
__________
E. Coli leaves
body in feces
_______________________
This second patient (with the
Foley), was elderly and had a
chronic illness necessitating
complete bed rest. The Foley
catheter contaminated by the
E. coli
organism provided a direct
route into the urinary bladder.
______________________________
The second patient receiving care had a
Foley catheter. The nurse manipulated
the tubing attached to the catheter. The
E. coli organism on the nurse’s hands
contaminated
the catheter tubing & ascended to the
patient’s urethral opening and then to the
urinary bladder.
_____________________
The nurse removed the
contaminated linen from the
bed.
The E. coli contaminated the
hands of the nurse who then
provided morning care to
another patient.
______________
Escherichia Coli, a
bacterium
_________________
E. Coli normally found
as part of normal
intestinal flora in the
large intestine
Dynamics:
Create your own
CHAIN OF
INFECTION for
infectious disease
you have
chosen….
Project Requirements:
1.Infecting organism full name
2.Reservoir
3.Exit from reservoir
4.Vehicle of transmission
5.Portal of entry
6.Susceptible host
7.Must be set up as an illustration of the chain of infection,
with information printed so it is easily read.
8. Evidence of Accuracy, Time and Effort
Clostridium difficile
(C. difficile, or C. diff).
bacteria release toxins
that attack the lining
of the intestines,
causing diarrhea.
Can be mild or
Life-threatening.
Let’s practice…
How do nurses break
the “Chain of Infection”
Modes of Transmission: Direct
– Touching contaminated blood or body fluids
– Shaking hands with contaminated person
– Inhaling infected air droplets
– Intimate contact (kissing, sexual intercourse)
with infected person
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Modes of Transmission: Indirect
– Contaminated food or water
– Disease-carrying insects
– Soil
– Fomite : any object or substance capable of
carrying infectious organisms (ex: glass,
utensils…)
– Improperly disinfected medical instruments
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Sources of Transmission
– Human hosts with infectious disease
– Carriers of disease who are not ill with it
– Those incubating a disease but not yet showing
symptoms
– Infected animals: dogs, cats, birds, cattle,
rodents, flies, roaches, ticks, mosquitoes
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Airborne Diseases
–
Tuberculosis
–
Chickenpox
–
Common cold
–
Diphtheria
–
Influenza
–
Measles
–
Meningitis
–
Pneumonia
–
Whooping cough
Blood-Borne Diseases
•Human immunodeficiency virus (HIV)
Evolution: Library: HIV Immunity genes & HIV
•Hepatitis B
•Hepatitis C
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Watch Ebola Virus Explained 5min
Hunting the Nightmare Bacteria |
FRONTLINE | PBS
(54 min)
Lets play disease jeopardy
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Preventing the Spread of Disease
• Standard Precautions: Overview
– Procedures to reduce transmission of
microorganisms
– The basic level of infection control that should be
used in the care of all patients all of the time.
– Must be used when touching:
• Blood
• Body fluids
• Damaged skin
• Mucous membranes
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• Standard Precautions: Requirements
– Hand washing Song 2 min
– Alcohol rubs
– Personal Protective Equipment (see next slide)
Video 6min
– Disposal of single-use items & sharps in proper
containers
– Avoiding sharps injuries
– Not recapping, bending, or breaking needles
– Not eating, drinking, or putting anything in your
mouth while working
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Medical Asepsis
Hand Washing
Healthcare Worker Hand Hygiene Training Video 3:10
• Before & after every patient contact
• After contact with blood, body fluids, or
contaminated material
• After handling specimens
• After coughing, sneezing, or blowing your nose
• After using the restroom
• Before & after lunch, taking breaks, & leaving for
the day
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Cleaning- Use of soap or detergent & water, Reduces
# of microorganisms to safe level
Disinfectants- agents to destroy many, but not all,
pathogens on non-living surfaces ex. Lysol
Antiseptics- agents to destroy many, but not all,
pathogens on living surfaces ex. alcohol
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Preventing the Spread of Disease (cont’d)
• Sterilization
– Total destruction of all microorganisms on
objects & surfaces
– Bactericidal or germicidal means
– 4 methods
• Steam under pressure in an autoclave
• Specific gases, such as ethylene oxide
• Dry heat ovens
• Immersion in a chemical agent
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Preventing the Spread of Disease (cont’d)
• Regular Waste
– Paper
– Plastic
– Disposable tray wrappers
– Packaging materials
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Preventing the Spread of Disease (cont’d)
• Sharps Waste
– Needles
– Microscope slides
– Used ampules
– Razors
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Preventing the Spread of Disease (cont’d)
• Biohazard Waste
– Soiled dressings & bandages
– Soiled examination gloves
– Soiled examination table
paper
– Cotton balls & applications
used on body
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Reporting an Exposure: Criteria for Submitting Report
(incident report)
–
Work-related exposure requiring medical treatment
–
Loss of consciousness or medical removal
–
Loss of days at work or transfer to other job
–
Injury involving sharp contaminated with blood
–
Exposure to tuberculosis
–
Positive blood test for contagious disease
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Your Body Protects You From Infectious Agents
Prevention…Vaccines
A vaccine is made
from weakened or
dead viruses or
bacteria,
they stimulate the
body to produce
antibodies against a
specific virus for
prevention
*ANTIBIOTICS
Do Not Work
against viruses,
they are designed
to kill bacteria.
Birth through 3 Years
• Chickenpox
• DTaP (diphtheria, tetanus,
Immunizations at Every
pertussis/ whooping cough)
• Flu, yearly
• Hepatitis A
• Hepatitis B
4 through 6 Years
• Hib (Haemophilus influenzae type b)
• Chickenpox
• MMR (measles, mumps, rubella)
• DTaP
• Pneumococcal
• Flu, yearly
• Polio
• MMR
• Rotavirus
• Polio
7 through 10 Years
• Flu, yearly
• Tdap (tetanus, diphtheria,
pertussis/whooping
cough – if any dose
of DTap was missed)
Age
11 through 12 Years
• Flu, yearly
• HPV (human papillomavirus)
• Meningococcal
• Tdap (Tetanus Diptheria Pertussis) Immunizations at Every Age
13 through 18 Years
• Flu, yearly
• Meningococcal, booster dose
19 through 26 Years
• Flu, yearly
• HPV
• Tdap/Td,
women need a dose
of Tdap with each
pregnancy
27 through 59 Years
• Flu, yearly
• Tdap/Td, women need a dose of
Tdap with each pregnancy
60+ Years
• Flu, yearly
• Pneumococcal
• Shingles
• Tdap/Td
Rx for Survival DVD
Disease Warriors & Rise of the Superbugs
• 1. What problems or issues prevent basic vaccines
getting to those in need?
• 2. How can vaccines be used to eradicate a disease?
Delivering the Goods
Pre Activity Video
Clips:
Oral Rehydration
Part I AIDS in
Thailand
Rx for Survival .
Program Video |
PBS
(also have DVD)
Watch Using Polio to cure cancer
60 min – 2015
Part I 14 m
Part II 12 m
At end of unit:
Online Activities | Disease Detectives
Additional research activity
Infectious Disease WebQuest
TeacherWeb ® Home Page
http://teacherweb.com/WQ/HighSchool/InfectiousDiseases/index.html
Chapter 13: Safety and Infection
Control
Dynamics of
Care in Society
Safety & Infection Control
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Role of Regulatory Agencies
• Occupational Safety and Health Administration (OSHA)
–
Federal agency
–
Ensures safety of workers
–
Enforces safety & health legislation
–
Requires health care facilities to establish practices
–
Requires facilities keep practices in policy & procedure manual
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Center for Disease Control and Prevention (CDC)
–
Federal agency
–
Dedicated to prevention of disease, injury, & disability
–
Part of Department of Health and Human Services
–
Developed guidelines to prevent spread of infection
–
Requires that all bodily substances be treated as if infectious
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Principles of Safety
• Developmental Considerations for Safety
– Unborn children: exposure to drugs, alcohol,
or smoke
– Children: increase in hazards as motor skills
develop
– Adolescents: danger from drugs, alcohol, risky
sexual activity
– Older adults: risk of abuse & injury from falls
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Factors Affecting Safety:
• 1. Physiological
– Musculoskeletal system
• Injury to or aging of bones, joints, or muscles
• Affects mobility & increases risk of injury
– Neurological system
• Impairment to brain, spinal cord, or nerves
• Interferes with judgment & motor control
– Fatigue
• Leads to poor perception of danger, faulty
judgment, poor problem solving
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Factors Affecting Safety:
2. Environmental
Home
•Poor ventilation
•Gas leaks
•Faulty electrical systems & appliances
•Lack of smoke detectors
•Unlabeled toxic substances
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Factors Affecting Safety:
2. Environmental
Workplace
• Dust
• Chemicals
• Noise
• Heights
• Dangerous machines
• Heavy lifting
• Repetitive motions
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Factors Affecting Safety:
2. Environmental
Community
• Air pollution
• Crime
• Hazardous waste sites
• Dilapidated housing
• Poor sanitation
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Safety Precautions and Actions
• Patient Safety
–
Orientation to facility layout, safety features, & equipment
–
Adjustable bed & side rails
–
Call system
–
Use of safety straps & side rails during patient transport
–
Identification bracelets
(name, dob, allergies, falls precaution….)
–
Elimination of fall hazards, such as debris or objects on ground
–
Proper use & maintenance of equipment
–
Special attention to avoid:
Medication Errors
Wrong site surgery
Nosocomial (health care acquired) infections
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Watch: Reducing Patient Falls 5min
• Health Care Worker Safety
–
Proper posture
–
Proper body mechanics
–
Proper ergonomics
–
Prevention of exposure to:
• Pathogens
• Chemicals
• Radiation
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Fire: Prevention Measures
– Regular maintenance of electrical equipment
– Strict smoking policies
– Fire safety plan
– Emergency exits
– Fire extinguishers
– Instructions for reporting a fire
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• Fire Response Procedures: RACE
– Rescue anyone in immediate danger
– Activate the fire code system & notify the
appropriate person
– Confine the fire by closing doors & windows
– Evacuate patients & other people to a safe area
or extinguish fire, if safe to do so
STOP – DROP - ROLL
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• Classes of Fires
• Classes of Fire Extinguishers
–
– A—Ordinary
combustibles:
wood, cloth,
paper, plastic
– B—Flammable
liquids
A
• For A fires only; do NOT use on
B or C fires
• Cool & smother fire with
ordinary water
–
BC
• For B or C fires only; do NOT
use on A fires
– C—Live
electrical
• Use dry chemical or carbon
dioxide
–
ABC
• For any type of fire
• Uses baking soda-like material
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• Directions for Operating a Fire Extinguisher: PASS
– Pull the locking pin
– Aim the nozzle at the base of the fire
– Squeeze the handle
– Sweep from side to side
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• Electrical Hazards
– Do not handle electrical devices & cords:
• With wet hands
• When wearing wet shoes
– Mop up spilled fluids
– Make sure all plugs are grounded
– Report any equipment damage
– Service equipment regularly
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• Oxygen Equipment
– Avoid open flames near oxygen equipment
– Place “No Smoking” signs nearby
– Make sure all electrical equipment is:
• Grounded
• In good working order
– Avoid synthetic fabrics that build up static
electricity
– Avoid use of oils in area
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• Chemical Hazards
– Alcohol
• Used as a disinfectant
• Eye irritant, combustible, flammable
– Ethylene oxide
• Used for sterilizing
• Eye irritant, explosive, flammable
– Cleaning & disinfecting agents: eye, skin, &
respiratory tract irritant
– Gases used for anesthetics or gas-powered
equipment
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• Radiation
– Wear radiation detection badge
– Minimize time of exposure to source
– Maximize distance from source
– Use appropriate shielding (lead shields or
aprons, gloves)
International radiation symbol
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• Workplace Violence: Factors
– Prevalence of handguns & other weapons
– Criminal holds & care of disturbed, violent people
– Release of mentally ill patients without follow-up care
– Presence of drugs & money
– Unrestricted movement of public in clinics & hospitals
– Long waits in emergency or clinic areas
– Presence of gang members, drug/alcohol abusers,
trauma patients, distraught family members
– Isolated work with clients during examinations or
treatment
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• Emergency Action Plan (have one)
– Method for reporting fires & other emergencies
– Evacuation policy
– Emergency escape procedures
– Names & contact info of key people
– Procedures for shutting down critical operations
– Procedures for operating fire extinguishers
– Designated rescue & medical duties
– Site of alternative communications center
– Secure onsite or offsite location for storing
records
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