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Medical Asepsis and OSHA Standards Why are germs important? What is a germ? How are germs spread? Should we all be doing the same thing, in terms of cleaning? Medical Asepsis • • Asepsis = free of microorganisms Microorganisms – Tiny organisms….microscopic • – Types of microorganisms • • • • • – Animals or plants Bacteria – single cell organisms Virus – not living, smallest of organisms Fungi – parasitic plants Parasites – live off of a host Amoebas and paramecium. – multi-celled organisms Pathogens – disease causing microbes Growth requirement for microorganisms. • Nutrition – food and chemicals • Oxygen – some need it some don’t – Aerobes live in oxygen – Anaerobes live without oxygen • • • • Temperature – optimum growth Light or darkness Moisture pH – acidity or alkaline (basic) How microorganisms are spread • Need a germ (what’s another word) • Need a host – carrier • Need a way to get that germ from one person to another. – Examples? • Need someone to give it to and a way into that person. – Examples? Infection cycle Protective mechanisms of the body • The skin – barrier protection. • Mucous membranes – skin on parts of the body that “turn in” • Mucus and cilia – mucus traps and cilia brushes it out of the body • Mechanical – cough, sneeze and tears. • pH – sweat, urine, stomach and secretions Medical asepsis • Hand hygiene – Hand washing • Routine Hand washing • Antiseptic or surgical hand washing • Alcohol based – “Quick wash” – Not soiled • Gloves – not a substitute for hand washing! – Flora – microorganisms • Resident – normal • Transient–not normally there • Hand washing – Most important! • • • • Warm to hot water Soap/detergent Friction Time (how long?) – When to wash your hands? • Start and end of day • Before & after each pt. • Before & after eating. – See pg 54 in text. Wash, gloves. Questions about microorganisms and medical asepsis? What is the best way to prevent the spread of disease? What things do you need to spread disease? OSHA Standards • Occupational Safety and Health Administration – Establish rules for a safe working environment – All health care workers must follow these rules. • Bloodborne pathogens – Viruses • Hepatitis B • HIV – Human Immunodeficiency Virus – AIDS – Acquired Immune deficiency Syndrome Means of transmission by contact • Direct contact – Involves directly touching a susceptible host – Examples • • • • Taking vital signs Handshake Sexual contact etc • Indirect contact – Does NOT involve direct contact – Examples • Airborne particles • Droplets • Residual pathogens Stages of infection • Incubation period – From initial infection until signs of first symptoms. • Prodromal period – Vague, early symptoms • Period of illness – disease is at it’s peak • Declined period – decline of symptoms • Period of convalescence – body returns to pre-disease state Stages of infection How to prevent exposure • Control in the workplace – – – – – – – – – – All body fluids are contaminated Observe warning labels Bandage cuts before work Wash your hands! If mucous contact, rinse the area Needle safety. Sharps container. Never re-cap! No eating, drinking, etc. Hand to mouth gestures. 3 refrigerators Make sure equipment is working properly before use If and accident happens, get help immediately! • Personal protective equipment – Types of equimpent • Gloves, gown, faceshield – Blocks bloodborne pathogens – Provided by employer – Alternatives to those who are allergic to certain things – Wear gloves properly – Eye, face protection. – If blood or body fluid penetrates fabric, it must be removed immediately Universal Precautions • All body fluids are considered to be contaminated. – Hepatitis B – Hepatitis C – HIV – ETC Hepatitis B Virus • A bloodborne virus that causes liver disease – -it is mean inflammation • Can be transmitted from patient to health care worker • Very strong virus outside of the body. • How do we protect ourselves? Hepatitis B Vaccination • Must be offered by your employer within 10 working days of start of employment. – Hepatitis B vaccination • 3 shot series – 1st, then 2nd 1month later, final one 6 months later. – Reasons why someone would not get a Hep B shot • Previously immunized • Antibody testing (titers) • Contraindications Hep B Vaccine Refusal Refusal of the Hepatitis B Vaccine I, _________________________________, understand that due to my clinical exposure to blood or other potentially infectious material I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been notified of the availability of the hepatitis B vaccine and realize that it is a requirement of the Athletic Training Education Program to receive this vaccine. However, I decline the hepatitis Bvaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious and potentially fatal disease. If in the future I want to be vaccinated with hepatitis B vaccine, I can choose to do so. Employee Signature____________________________________________ Social Security Number __________________________ Date _________ Regulated Medical Waste • Where to dispose of medical waste and disposable medical equipment? – Regular trash container • Not saturated with body fluids. Band-aid – Biohazard Sharps container • Anything sharp. Used or not. “drug paraphernalia” – Biohazard “red bag” container • Saturated in blood – Sanitary sewer • Large volumes of biohazard liquids Housekeeping • Specific procedures must be followed – Clean and decontaminate equipment and surfaces after all procedures. Example in lab. • Detergent. What else can be used? – Do not pick up glass, even with gloves! – Handle all laundry as if it is soiled – Biohazard (sharps) containers • Dirty? Clean it. Full? Replace it. Review • • • • • • What is OSHA? What are way disease can be spread? What are the stages of infection? What is Universal Precautions? What is Hepatitis B? How do we get rid of contaminated medical waste?