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Chapter 29 Safety, Infection Control, and Hygiene Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Creating a Culture of Client Safety • National Patient Safety Goals: – – – – – Identify patients correctly Improve staff communications Use medicines safely Prevent infection Check patient medicines (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Creating a Culture of Client Safety • National Patient Safety Goals: – – – – – Prevent patients from falling Help patients be involved in own care Identify patient safety risks Watch patients closely for changes Prevent errors in surgery Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Factors Affecting Safety • • • • • Age Lifestyle Sensory and perceptual alterations Mobility Emotional state Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Types of Accidents • Client behavior • Therapeutic procedure • Equipment Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Potential Occupational Hazards • Nurses at risk in workplace – Latex allergies – Work-related musculoskeletal disorders • OSHA – Enforces safety standards – Cites and disciplines agencies not in compliance Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection Control Principles • Pathogens – Microorganisms that produce disease • Infection – Invasion and multiplication of microorganisms – Results in injury (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infection Control Principles • Colonization – Invasion and multiplication of microorganisms without tissue injury Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chain of Infection • Agent, host, and environment – – – – – Biological agents Chemical agents Physical agents Susceptible host Compromised host (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chain of Infection • Modes of transmission – – – – Contact Airborne Vehicle Vector-borne • Break chain Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Normal Defense Mechanisms • Nonspecific immune defense: – Skin and normal flora – Mucous membranes and sneeze, cough, and tearing reflexes – Elimination and acidic environment – Inflammation (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Normal Defense Mechanisms • Specific immune defense: – Humoral immunity – Acquired immunity • Vaccination Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Stages of the Infectious Process • Infectious responses: – Localized • Limited to defined area or single organ – Systemic • Affects entire body and multiple organs (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Stages of the Infectious Process • • • • Incubation period Prodromal stage Illness stage Convalescent stage Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Emerging Infections • Tuberculosis • Severe acute respiratory syndrome (SARS-CoV) • Hepatitis • West Nile virus • Viral hemorrhagic fevers • Human immunodeficiency virus (HIV) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Health Care-Associated Infections • Acquired in hospital or other health care facilities • Hospitalized clients at risk for nosocomial infections • Multidrug-resistant organisms (MDROs) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hygiene • Factors influencing hygienic practice: – – – – – Body image Social and cultural practices Personal preferences Socioeconomic status Knowledge Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Assessment – Health history • General health perception and management status – Physical examination • Risk factors • Client in inpatient setting • Client in home (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Assessment – Diagnostic and laboratory data • Blood profile – Altered clotting – Anemic conditions – Leukocytosis (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Diagnosis – NANDA statements • • • • Risk for injury Risk for infection Self-care deficits Others (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Outcome identification and planning – Manipulate external environment to reduce risk of injury and infection – Client and caregiver education • Identification of hazards • Health promotion practices (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Raise safety awareness and knowledge – Prevent falls • Restraints – Physical – Chemical • Environment (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – – – – – Prevent fire Ensure safe operation of electrical equipment Reduce exposure to radiation Prevent poisoning Reduce noise pollution (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Ensure asepsis • Medical – Reduces number, growth, and spread of microorganisms – Clean technique – Hand hygiene (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Ensure asepsis • Surgical – – – – – – Eliminates microorganisms and spores Sterile technique Sterile gloves Surgical attire Surgical hand antisepsis Gown and closed glove (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Reduce or eliminate infectious agents • • • • • • Cleansing Disinfection Sterilization Home health care Disposal of infectious waste Sharps-related hazards (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Practice standard and isolation precautions • Contact • Droplet • Airborne (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Employ alternative therapies • Herbal baths – Bath for specific body part – Full body bath • Herbs for infections (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Provide for client bathing needs • Cleaning baths – – – – – Shower Tub bath Self-help bath Complete bed bath Partial bath (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Provide for client bathing needs • Therapeutic bath – Hot or warm water tub bath – Cool or tepid bath – Sitz bath (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Provide clean bed linen • Unoccupied • Occupied – Provide skin care • Perineal care • Back rubs (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Provide foot and nail care – Provide oral care • • • • Fluoride Flossing Brushing Care for unconscious client (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Provide hair care • • • • Brushing and combing Shampooing Shaving Mustache and beard care (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Implementation – Provide eye, ear, and nose care • Eyes – Contact lenses • Ears – Hearing aids • Nose (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety, Infection Control, Hygiene and the Nursing Process • Evaluation – Client free from injury – Client free from infection – Self-care needs met Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.