Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
HIV and pregnancy wikipedia , lookup
Dental emergency wikipedia , lookup
Public health genomics wikipedia , lookup
Hygiene hypothesis wikipedia , lookup
Compartmental models in epidemiology wikipedia , lookup
Marburg virus disease wikipedia , lookup
Transmission (medicine) wikipedia , lookup
Canine parvovirus wikipedia , lookup
Unit four Mr. Ahmad Ata RN,CNS,MSN 1 Lecture Objectives At the end this lecture the students will able to: Define concept related to asepsis. Identify the types of infection. Describe the chain of infection and nursing interventions to break the chain. Know CDC and prevention guideline. Ability to implement technique correctly. Ability to use isolation and precaution system. 2 Introduction: Micro organisms exist every where in the environment: in water, soil, on body surface such as skin, intestinal tract, mouth. The bacteria which found in intestine produce substance called bacterocin which are lethal to other bacteria, these bacteria called normal flora. 3 INTRDUCTION: Example of resident bacteria: staphylococcus epidermidis and cornybacterium xerosis founds in skin. Some infections are asymptomatic or sub clinical for example cytomegalovirus (CMV) which transmitted from animal specifically cats to pregnant woman can lead to unborn child disease 4 Definitions terms: Infection: is an invasion of bacteria in the body tissue by microorganism and their proliferation there. Virulence: their ability to produce disease. 5 CONT Communicable disease: is condition which transmitted microorganism to individual by direct or indirect contact through air borne infection, vector or vehicle borne disease. 6 CONT Nosocomial infections: Infection associated with the delivery health care services in health care facilities Example: urinary tract infection due to catheterization technique. 7 CONT: Asepsis: Is freedom from disease - causing micro organism order to decrease the possibility of transferring microorganism. Sepsis: is the opposite of asepsis state. 8 There are two basic types of asepsis: Medical asepsis: includes all type of practice intended to confine specific microorganism to specific area in order to limiting number or decrease transmission of microorganisms. Medical asepsis is referred to: Clean: the absence of almost all microorganism. Dirty: contaminated the likely presence microorganism. 9 Examples of medical asepsis: Hand washing: practice that involve scrubbing with antimicrobial soup and water. Personal protective equipment: uniform, gown, gloves. 10 CONT Using anti microbial agent. Anti microbial agent: are chemical to hat limit the number of infection microorganism by destroying them or suppressing their growth. antiseptic: organism. inhibit growth but don’t kill micro Disinfectant: chemical destroy active micro organism in dead space. 11 CONT: Surgical asepsis (sterile technique): refer those practice that keep an area free of all micro organism. 12 Sterilization technique Purpose: elimination of microorganisms Steam (Autoclaving) instruments, dressings Dry heat instruments that could be corroded Gas ethylene oxide if heat sensitivity (rubber, plastic materials, endoscopic instruments) Radiation gamma rays solutions, catheters, sealed plastic materials 13 Type of organism causing infection: Bacteria: the most common infection causing microorganism can live in water, soil, air. Viruses: consist primarily of nucleic acid ( rhino virus cause common called). Fungi. Parasite. 14 Classification of bacteria: 1) Shape: spherical (cocci), rod shaped (bacilli), corkscrew (spirochetes). 2) Reaction to gram stain: gram negative and gram positive. 3) Need of oxygen: aerobic and anaerobic. 15 Types of infection: 1) Local infection: is limited to the specific part of the body where microorganisms remain. 2) Systematic infection: when microorganisms spread and damage different part of body. Bacteremia: when culture of persons blood reveals microorganisms. 16 CONT Septicimia: when Bacteremia results in systematic infection. 3) Acute infection: infection appears suddenly or in short time. 4) Chronic infection: infection may occur slowly and takes long time. 17 Chain of infection: 1. Etiologic agent: bacteria, virus. Factors effect on the infection agent: Number of organism. Virulence. Pathogenicity: ability to produce disease. Invasiveness: the ability of microorganism to enter the body. 18 CONT 2. Reservoir: Human, animal, plants and general environment. Example: the person who have influenza virus is frequently spread to other people. Insects, birds and other animals are common reservoir of infection. Food, water and milk also can be reservoirs. 19 CONT 3. portal exist: After microorganism leave its reservoir, its need to method to reach to another person these methods are: Direct transmission: involves direct transfer of microorganism from person to another through, touching, biting, kissing or sexual intercourse sneezing and coughing. 20 CONT 3. portal exist: After microorganism leave its reservoir, its need to method to reach to another person these methods are: Direct transmission: involves direct transfer of microorganism from person to another through, touching, biting, kissing or sexual intercourse sneezing and coughing. 21 Indirect transmission may be: vehicle born transmission: is any substance that serves as intermediate means to transport infectious agent such as surgical instrument, cooking, water and milk. Vector borne transmission: is animal or flying or insect that serve intermediate mean of transportation. 22 Common portal exist: Respiratory Gastrointestinal Genitourinary tract. Blood Breaks skin. 23 CONT 4) Portal entry: microorganism must enter the body through same route that exist. 5) Susceptible host: is any person who is at risk for infection 24 Stages of infection: 1. 2. 3. 4. Incubation period: organism growing and multiplying. Prodromal stage: person is most infectious and non specific sign and symptom. Full stage of illness: presence of specific sign and symptom. Convalescent period :recovery from infection. 25 Body defense against infection are: 1) Non specific defense such as: Anatomic barrier. Inflammatory response. 2) Specific defense: Anti body Cell mediated defense. 26 Factors increase susceptibility to infection: Age. Intact skin. Normal ph level. Decreased WBC. Stress 27 Assessment: Lapratory data indicating infection: Increased leukocyte ( 4.500 – 11,000). Increased specific type of leukocyte. Erythrocyte sedimentation rate. Positive culture in blood, urine and sputum. 28 Sign of local infection includes: Swelling Pain Tenderness Palpable heat at infected area. Loss of function body part in affected area. 29 Sign of systematic infection: Fever Increased pulse and respiratory rate Malaise and loss of energy Enlargement and tenderness of lymph node. 30 Nursing diagnosis: Risk for infection related to broken skin. Risk for infection related to immunosuppression Fever related to physiological effect of infection. 31 Planning: Demonstrate effective hand washing. Identify sign of infection. Maintain adequate nutritional intake. Demonstrate proper disposals of soiled articles Use appropriate disinfecting technique. Demonstrate awareness of immunization. 32 Implementation: Teaching about infection control: Wash hand. Preventing Nasocomial infection. Invasive medical device. Antibiotic Resistant Organism Strategies to protect patients 33 Wearing personal protective equipment (PPE) such as: Uniforms. Gown Mask and gloves. Head caps 34 Isolation Precautions Hand hygiene Patient placement Patient Transport PPE Isolation Precautions Linen & laundry Decontamination Waste Management 35 Hand hygiene Perform hand hygiene: Before and after patient contact After removing gloves or any other PPE item After touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn After contact with patient surroundings Routine hand hygiene by alcohol hand rub (preferably) or by washing hands with soap and water 36 PPE - Gloves 1. 3. When expose to blood, body fluids, secretions, excretions, mucous membranes and nonintact skin, and contaminated items Perform hand hygiene immediately after glove removal 2. Change gloves when heavily contaminated 4. Disposable glove should not be reused 37 PPE - Gown 1. When splashes or sprays of blood and body fluids, secretions and excretions to skin and working clothes are likely 2. When working 3. Select an appropriate gown for the procedure clothes has substantial contact with patient, environmental surfaces or patient items 38 PPE – Respiratory & eye protection Surgical masks and eye protection: When splashes or sprays of blood and body fluid, secretions and excretions are likely Droplet precautions Airborne isolation precautions Change PPE promptly if heavily contaminated during the procedure 39 Strategy of Patient Placement Isolate suspected or confirmed cases in a negative pressure isolation room When single rooms are fully occupied Cohort patients with same confirmed diagnosis in same cubicles, maintaining a minimum of 1 metre distance from each other Confirmed and suspected cases should be nursed in separate 40 Transport of Suspected or confirmed patient Limit patient transport unless clinically indicated Encourage patients to wear surgical mask if no contraindication 3. Inform the receiving service/department of concern beforehand 4. Clean / disinfect transport vehicles after use 41 Decontamination Environmental Control Disinfect isolation and procedure rooms after use by a high risk patient Clean and disinfect the environment regularly and additional session for frequently touched surfaces Contaminated area should be disinfected by one part of hypochlorite solution add in 49 parts of water If blood spills occur: Use one part of hypochlorite solution add in 49 parts of water for non-metallic and 70% alcohol for metallic items. If spills involve large amount of blood, the blood should be removed by disposable material soaked with one part of hypochlorite solution add in 4 parts of water before further cleaning and disinfection 42 Linen and laundry management Proper handling of soiled linen: Avoid sorting Minimum agitation and shaking Well pack soiled linen to prevent leakage Wear appropriate PPE when handling soiled linen Clean linen should be transported and stored separately to prevent recontamination Follow hospital policy 43 Patient teaching for medical asepsis at home. For further information please visit: www.cdc.org Center of disease control and prevention 44 PLEASE REVIEW CHAPTER 27 FROM REFFRENCES BOOK THE END 45