Infection Control and Environmental Safety PDF

Infection Control and environmental safety 1  Out lines ❖ Introduction. ❖ Definition of Infection. ❖ Chain of infection. ❖ Stages of infection ❖ Types of Infections ❖ Clinical signs and symptoms of infection ❖ Normal body defenses ❖ Universal precautions. Le...

Infection Control and environmental safety 1  Out lines ❖ Introduction. ❖ Definition of Infection. ❖ Chain of infection. ❖ Stages of infection ❖ Types of Infections ❖ Clinical signs and symptoms of infection ❖ Normal body defenses ❖ Universal precautions. Learning objectives: At the end of lecture, the student will be able to: 1. Define Infection 2. List the elements of chain of infection 3. Describe normal body defenses. 4. Enumerate universal precautions 5. Explain what is patient safety 6. Give examples of restraints 2  Infection control Introduction  Microorganisms are naturally present in the environment; some are beneficial and other are not. Some are harmless to most people and other are harmful to many people. Preventing the transmission of microorganisms is a concern of all health care personnel.  The nurse helps to protect clients from infections by controlling or eliminating sources. It is one of the most important functions a nurse perform. The nurse becomes the client's advocate by understanding the infectious process and practicing infection control principles. ❖ Definition of Infection: An invasion of pathogens or microorganisms into the body that are capable of producing disease. ❖ Nosocomial infections are defined as infections acquired after hospitalization that occur > 48 hours after admission. ❖ Infection prevention and control: is the discipline concerned with preventing healthcare-associated infections; Includes all of the practices used to prevent the spread of microorganisms that could cause disease in a person. Chain of Infection (Infection cycle): 3  Chain of Infection Pathogen Susceptible Host Reservoir Portal of Entry Portal of Exit Mode of Transmission Pathogen/ Infectious agent: is a disease producing microorganisms (bacteria, viruses). Reservoir: * Inanimate objects which include medications, air, food, water, soil (as gas gangrene and tetanus), or any other material on which organisms can find nourishment and survive. * Animals as rabies especially dogs * Human beings that include other clients, health care personnel, family members, visitors and clients themselves. * Carriers: are persons or animals who show no symptoms of illness but who have pathogens on or in their bodies that can be transferred to others. Portal of Exit: From the reservoir, exit through the skin, respiratory tract, blood. Site where microorganism leaves. Mode of Transmission: Body fluids – tears, saliva, sputum (mucus coughed up), urine, feces, semen, vaginal secretions, pus or other wound drainage, blood. 4 The four main routes of transmission: 1- Contact transmission: that occurs by direct or indirect contact. Direct involves body surface to body surface contact causing the physical transfer of organisms between an infected person and a susceptible host as kissing and sexual intercourse. But indirect occurs when susceptible host is exposed to a contaminated object such as dressing, needle or surgical instrument. 2- Droplet transmission: that occurs when mucous membranes of the nose, mouth, or conjunctiva are exposed to secretions of an infected person who is coughing, sneezing or talking. 3- Vehicle transmission: that involves the transfer of microorganisms by way of vehicle (contaminated items) as food that can carry Salmonella, water, drugs and blood that can carry hepatitis and AIDs. 4- Airborne transmission: that occurs when fine particles are suspended in the air for a long time or when dust particles contain pathogens. These organisms can be inhaled by or deposited on the skin of a susceptible host. Portal of entry: Anybody opening of an uninfected person which allows pathogens to enter. Nose, mouth, eyes, rectum, genitals and other mucous membranes. Cuts, abrasions or breaks in the skin. Organisms can enter the body through the same routes they use for exiting. Susceptible host/ WHO IS AT RISK?? Susceptibility to an infectious agent depends on the individual's degree of resistance to pathogens. 5  Reasons for lowered resistance: age, nutritional status, existing illnesses, fatigue and stress. The elderly have weaker immune systems and a lower resistance to pathogens. Chain of infection https://youtu.be/IBX3jj2uUjo?si=itLiaROo_Fdxd1fx Stages of infection: An infection progress through the following phases: 1-Incubation Period: There is an interval between entrance of pathogen into the body and appearance of first symptoms. During this stage, the organisms are growing and multiplying. Its length may vary (e.g., common cold 1 to 2 days while tetanus is 2- 21 days). 6 2-Prodromal Stage of Illness: A person is most infectious during it. early signs and symptoms of disease are present but are vague and non-specific ranging from fatigue, malaise to a low- grade fever. It lasts from several hours to several days. 3-Full Stage of Illness: Client manifests signs and symptoms specific to type of infection (e.g., common cold manifested by sore throat, sinus congestion, rhinitis, and mumps manifested by earache, high fever, parotid and salivary gland swelling). 4- Convalescence: Acute symptoms of infection disappear and the person returns to a healthy state. Length of recovery depends on severity of infection and client's general state of health; recovery may take several days to months. Clinical signs and symptoms of infection: 1) Systemic (general) manifestations: Fever, fatigue, malaise, lymph node enlargement, loss of appetite, nausea, and vomiting may be found. 2) Localized manifestations: Redness, swelling, pain or tenderness, and restricted movement of a body part occur. There may be drainage from open lesions or wounds. Normal body defenses: -Physical barriers and the immune system defend the body against organisms that can cause infection. Physical barriers include the skin, mucous membranes, tears, earwax, mucus, and stomach acid. Also, the normal flow of urine washes out microorganisms that enter the urinary tract. 7 Physical Barriers: 1- The skin: Usually, the skin prevents invasion by microorganisms unless it is damaged—for example, by an injury, insect bite, or burn. 2- Mucus membrane: Mucous membranes are coated with secretions that fight microorganisms. For example, the mucous membranes of the eyes are bathed in tears, which contain an enzyme called lysozyme that attacks bacteria and helps protect the eyes from infection. 3- Stomach Acid: The digestive tract has a series of effective barriers, including stomach acid, pancreatic enzymes, bile, and intestinal secretions. The contractions of the intestine (peristalsis) and the normal shedding of cells lining the intestine help remove harmful microorganisms. 4- The Blood: The body also defends against infection by increasing the number of certain types of white blood cells (neutrophils and monocytes), which destroy invading microorganisms. 8 5- Inflammation: Any injury, including an invasion by microorganisms, causes inflammation in the affected area. During inflammation, the blood supply increases. An infected area near the surface of the body becomes red and warm. The walls of blood vessels become more porous, allowing fluid and white blood cells to pass into the affected tissue. The increase in fluid causes the inflamed tissue to swell. The white blood cells attack the invading microorganisms and release substances that continue the process of inflammation. Other substances trigger clotting in the tiny vessels (capillaries) in the inflamed area, which delays the spread of the infecting microorganisms and their toxins. 6-Immune Response: When an infection develops, the immune system responds by producing several substances and agents that are designed to attack the specific invading microorganisms. For example, the immune system may produce killer T cells (a type of white blood cell) that can recognize and kill the invading microorganism. Also, 9 the immune system produces antibodies that target the specific invading microorganism. 7-Fever: Body temperature increases as a protective response to infection and injury. An elevated body temperature (fever) enhances the body's defense mechanisms, although it can cause discomfort. -A part of the brain called the hypothalamus controls body temperature. ASEPSIS Means the absence of disease-producing microorganisms or any activities that prevent infection or break the chain of infection, the two types of aseptic technique that the nurse practices are medical asepsis and surgical asepsis. 1- Medical Asepsis: Clean technique; procedures used to reduce & prevent spread of microorganisms ** Hand washing** 2- Surgical Asepsis: Sterile technique; procedures used to kill microorganisms **Sterilization**. Cleaning: It is the process of removing foreign materials (e.g., organic material such as blood or inorganic material such as soil) from objects. Generally, this is accomplished by the use of water, a detergent, and proper mechanical scrubbing action. Cleaning must occur before disinfection and sterilization procedures. 10 Disinfection: It is a process that eliminates almost all pathogen organisms on objects, with the exception of bacterial spores. Sterilization: It is a process by which all forms of microorganisms including spores are destroyed. Universal precautions: Are infection control guidelines designed to protect workers from exposure to diseases spread by blood and certain body fluids. Universal precautions guidelines: Hand washing and antisepsis (hand hygiene). Use of personal protective equipment when handling blood, body substances, excretions and secretions. Appropriate handling of patient care equipment and soiled linen. Prevention of needle stick/ sharp injuries. Environmental cleaning and management. Appropriate handling of waste. Standard precautions (infection control) https://youtu.be/QiphVDqkAJg?si=FIGtjxHOWxgeWR2E Hand washing and antisepsis (hand hygiene). 11 Use of personal protective equipment when handling blood, body substances, excretions and secretions Masks should be worn: if an airborne infection is suspected or confirmed to protect an immune compromised patient. Gloves must be worn for: ✓ All invasive procedures. ✓ Contact with sterile sites. ✓ Contact with non-intact skin or mucous membranes. ✓ All activities assessed as having a risk of exposure to blood, bodily fluids, secretions and excretions, and handling sharps or contaminated instruments. 12  Appropriate handling of patient care equipment and soiled linen. Prevention of needle stick/ sharp injuries. ✓ Do not recap needles; bend or break after use. ✓ Discard each needle into a sharps container at the point of use. ✓ Do not overload a bin if it is full. ✓ Do not leave a sharp bin in the reach of children. Environmental cleaning and management. Appropriate handling of waste. Safety: ▪ Freedom from danger, risks, and injury. ▪ Quality health care begins with the safety of the patient and the health care worker. ▪ You must know how to: ▪ Respond if an emergency occurs. “SAFETY FIRST”! 13 Patient Safety guidelines: ▪ When you work directly with a patient you must always identify the patient to avoid mistakes. ▪ Ambulation devices must be structurally safe and covered with rubber tips to prevent slipping. ▪ Transporting devices (eg. Wheelchairs) brakes should be locked except when you are moving, secure straps or put up side rails, never leave patients unattended. ▪ Postural supports/restraints – a physician’s order is required by law, only used when a patient’s safety is in jeopardy. Check patients frequently. ▪ Side rails – falls from beds are a common cause of injury. o Always in place at night. o Small children, heavily medicated patients, and confused or restless patients require side rails at all times. ▪ Provide privacy for all patients. ▪ Always identify the patient. Also identify yourself. ▪ Explain the procedure so the patient knows what you are going to do – informed consent. ▪ Answer any questions. ▪ Be alert to the patient’s condition at all times. Patients at risk of fall: ▪ Impaired mobility due to injury, disease. ▪ Receiving medications that alter mental status. ▪ Be disoriented due to change in environment or medical disorder. ▪ Impaired hearing/vision. 14 Restraints: Device used to immobilize a client or an extremity. A temporary means to control behavior Restraints are used to: ▪ Prevent falls. ▪ Protect from self-injury (pulling out tubes). ▪ Prevent violence toward others. Physical Restraints – device that limits a client's ability to move. ▪ Side rails – stop patient from rolling out, but does not stop them from climbing out – side rail down when working on that side. ▪ Jackets & Belts – patient who is confused & climbing over rails may need a jacket or belt to restrain them to bed. Limb restraint Wheelchair belt Jacket restraint Geriatric chairs Vest restraint Hand mitt 15 Chemical Restraints ▪ Medication: Patient must be closely observed and assessed frequently post medication. ▪ Remains a high risk for injury. 16