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Pp chapter 28_audio_part_2
- 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 Asepsis
1. A sterile object remains sterile only when
touched by another sterile object.
2. Only sterile objects may be placed on a
sterile field.
3. A sterile object or field out of the range of
vision or an object held below a person’s waist
is contaminated.
4. A sterile object or field becomes
contaminated 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 with
a wet, contaminated surface, the sterile object
or field becomes contaminated by capillary
action.
6. Fluid flows in the direction of gravity.
7. The edges of a sterile field or container are
considered 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