NSE 111 Week 2 IPAC - 2 HOUR SESSION - DM - for Fall 23.pptx
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NSE 111 WEEK 2 (PART 2) INFECTION PREVENTION & CONTROL 1 NSE 111 Week 2 Objectives 1. Explain how an infection develops in relation to the elements that make up the chain of transmission. 2. Explain how the body protects itself against infection. 3. Describe what a Hospital Acquired Infection (...
NSE 111 WEEK 2 (PART 2) INFECTION PREVENTION & CONTROL 1 NSE 111 Week 2 Objectives 1. Explain how an infection develops in relation to the elements that make up the chain of transmission. 2. Explain how the body protects itself against infection. 3. Describe what a Hospital Acquired Infection (HAI) is, how they develop, and relate the development of HAIs to clients who are most susceptible. 4. Explain what an antimicrobial resistant organism (ARO) is. 5. Differentiate between medical and surgical asepsis/ technique and recognize practices that are consistent with both. 6. Explain the rationale and demonstrate the practices of routine and additional precautions including contact, droplet, airborne, combination, and COVID precautions. 7. Explain the psychological effects a person on isolation precautions might experience, and how the nurse could decrease the risk. 8. Examine a risk assessment approach for decision-making related to the use of isolation precautions. 9. Discuss the role of the nursing process and clinical judgment to determine infection prevention and control strategies. In Person Lab Outcomes and Activities: a. Perform proper procedure for hand hygiene and properly don and remove personal protective equipment (PPE) i.e. mask, goggles, gown, & gloves. b. Distinguish how routine practices and isolation precautions break the chain of transmission. 2 3 Your primary resource for IPAC… Introduction to Infection Prevention and Control Practices for the Interprofessional Learner Open Educational Resource https://ecampusontario.pressbooks.pub/introductiont oipcp/ Please read the ONLINE version so that you may benefit from the interactivity of the OER!! 4 Let’s pick up from the first slide deck…… Breaking the Chain of Infection 5 Breaking one of the links in the chain of infection is the key to the prevention and control of an infection Breaking the chain of infection involves a variety of strategies Identifying patient’s at risk & implementing appropriate strategies are important in preventing the spread of infection How to Break the Chain of Infection What strategies would you implement at every link of the chain of infection to break the links and prevent a new infection from occurring? 6 7 Controlling or Eliminating Infectious Agents To reduce & eliminate microorganisms, proper cleaning is required Cleaning Physical removal of foreign material including microorganisms using water, mechanical with cleaning products Disinfection Includes the elimination of all pathogens except bacterial spores Usually includes chemical, hear or ultraviolet light Items must be cleaned prior to disinfection Sterilization Includes the destruction of all microorganisms including bacterial spores Uses moist heat (steam), chemicals, gas & boiling water Breaking the Chain: Infectious Agent CLEANING TO REDUCE OR ELIMINATE MICROORGANISMS DISINFECTIN G TO REDUCE OR ELIMINATE MICROORGANISMS STERILIZING TO REDUCE OR ELIMINATE MICROORGANISMS EDUCATING OTHERS HOW TO TO REDUCE OR ELIMINATE MICROORGANISMS 8 9 Breaking the Chain: Reservoir Eliminate or control sources of body fluids, drainage or solutions that might harbor microorganisms Change bandages or dressings when wet or soiled Assist patients to carry out hygiene practices (bathing, oral care) Discard articles appropriately that have been contaminated with infectious wastes Know how to dispose of soiled dressings & contaminated needles & other equipment Breaking the Chain: Portal of Exit Prevent organisms from leaving the body Wear a mask wen necessary Cover mouth when coughing or sneezing Avoid speaking directly in a patients’ face Avoid talking over wounds or sterile fields Educate Nurses patients about coughing & sneezing etiquette & hand hygiene who have a respiratory tract infection should remain at home when Careful handling of blood, body fluids, secretions or excretions as previously noted Routine practices What does this mean? Dispose soiled items appropriately as previously noted 10 Breaking the Chain: Modes of Transmission From: Routine Practices & Additional Precautions in All Health Care Settings, 3rd. Ed. Provincial Infectious Diseases Advisory Committee, November 2012 11 Breaking the Chain: Modes of Transmission Have knowledge of different modes of transmission Appropriate hand hygiene & routine practices as previously discussed Do not share equipment between patients & if necessary, clean according to guidelines Careful handling of blood, body fluids, secretions or excretions as previously noted Contaminated or soiled equipment should avoid touching the nurses’ uniform Use fluid resistant linen bags for soiled linen 12 Breaking the Chain: Portal of Entry See breaking the chain: portal of entry Maintain the integrity of the skin & mucus membranes Moisten dry skin Assess the skin of those that are susceptible to skin breakdown & implement appropriate strategies Avoid Oral positioning patients on tubes or other objects hygiene to ensure mucus membranes remain moist Water soluble ointments for lips Appropriate hygiene practices (bathing, perineal care) Dispose of contaminated equipment appropriately 13 Breaking the Chain: Susceptible Host Maintain the integrity of patient’s skin & mucous membranes Adequate fluid intake and nutrition Maintenance of immunization schedule Regular oral hygiene, bathing & lubrication of skin Coughing & breathing techniques for dependent or immobilized patients 14 15 Routine Practices…what does it mean? Include the appropriate use of: Gowns Gloves Masks Why is mask fit testing necessary? Eye wear And other protective devices or clothing Include rules on appropriate handwashing, cleaning of equipment, and disposal of contaminated linen and sharps All clients have the potential to transmit infection via blood and body fluids, which can be unknown Routine Practices First tier of the isolation guidelines from the Centers for Disease Control (CDC) & Health Canada’s Guidelines Precautions designed to care for all clients in any setting, regardless of their diagnosis or presumed infectiousness Applied when a health care worker is or potentially may be exposed to Blood All body fluids, secretions, and excretions except sweat Non-intact skin Mucous membranes 16 17 Routine Practices From: Routine Practices & Additional Precautions in All Health Care Settings, 3 rd. Ed. Provincial Infectious Diseases Advisory Committee, November 2012 18 From: Routine Practices & Additional Precautions in All Health Care Settings, 3rd. Ed. Provincial Infectious Diseases Advisory Committee, November 2012 Routine Practices Changes & Post-COVID Watch this this video from the University of Toronto on ”The New Normal” as it relates to routine practices and using PPE in a COVID era https://www.youtube.com/watch?v=diLN21IGimo&feature= youtu.be Answer the following question: How have routine practices changes in the “post” COVID era? 19 20 From: Routine Practices & Additional Precautions in All Health Care Settings, 3rd. Ed. Provincial Infectious Diseases Advisory Committee, November 2012 Risk Assessment Approach for DecisionMaking related to use of Isolation Precautions Remember…anytime you are working with a client you must perform a risk assessment for decision-making related to the use of isolation precautions in order to protect yourself and the client. RISK ASSESSMENT How to Perform a Personal Risk Assessment: Taskquestions about the task: AskThe yourself Do I have the equipment I need to do this task? Gather the equipment and supplies needed before starting the task. RISK ASSESSMENT How to Perform a Personal Risk Assessment: Taskquestions about the task: AskThe yourself Will I be touching blood, body fluids, secretions, excretions or other potentially infectious material? Wear gloves if the task involves contact with blood, body fluids, secretions or excretions and clean your hands. RISK ASSESSMENT How to Perform a Personal Risk Assessment: Taskquestions about the task: AskThe yourself Will my face be exposed to a cough or spray of saliva or blood? Wear facial protection if the task exposes your face to saliva, blood or other body fluids. RISK ASSESSMENT How to Perform a Personal Risk Assessment: Taskquestions about the task: AskThe yourself Wear a gown if the task exposes your clothing or skin to blood or body fluids. Will my clothing or skin be exposed to splashes or sprays? RISK ASSESSMENT How to Perform a Personal Risk Assessment: Taskquestions about the task: AskThe yourself Ask someone to assist you if necessary. How skilled am I at this task? Can I safely perform this task myself or do I need assistance? RISK ASSESSMENT How to Perform a Personal Risk Assessment: Ask yourself questions about the cognitive (mental) and physical status of Client/Patient/Resident Status this client/patient/resident. Will he/she be able to follow directions? You may need to change how you are going to provide the care for this client, patient, or resident. RISK ASSESSMENT How to Perform a Personal Risk Assessment: Ask yourself questions about the cognitive (mental) and physical status of Client/Patient/Resident Status this client/patient/resident. Is he/she cooperative ? Remember to consider the extremes of age in your Risk Assessment because they may not be able to understand what you are trying to do. RISK ASSESSMENT How to Perform a Personal Risk Assessment: Client/Patient/Resident Status Is he/she agitated or resistant? You may need to change how you are going to provide the care for this client, patient, or resident. RISK ASSESSMENT How to Perform a Personal Risk Assessment: Ask yourself questions about the cognitive (mental) and physical status of Client/Patient/Resident Status this client/patient/resident. Is he/she coughing, sneezing, vomiting or having diarrhea? Wear gloves and a gown if you may be touching body fluids or excretions such as vomit or faeces. Wear a gown if your clothing or arms may be soiled with body fluids or excretions. Wear facial protection if your face may be exposed to a cough or sneeze. RISK ASSESSMENT How to Perform a Personal Risk Assessment: Ask yourself questions about the cognitive (mental) and physical status of Client/Patient/Resident Status this client/patient/resident. Wear gloves if you may be touching a client, patient, or resident with a rash. Has he/she got a rash or fever? RISK ASSESSMENT How to Perform a Personal Risk Assessment: Client/Patient/Resident Status Wear gloves and a gown to clean the contaminated environment, and then clean your hands. Is he/she incontinent or does he/she have uncontrolled drainage? RISK ASSESSMENT How to Perform a Personal Risk Assessment: Environment and Administrative Controls Ask yourself questions about controls already in place: Are there facilities for cleaning my hands? Know where your facility’s alcoholbased hand rub stations and hand washing sinks are located. RISK ASSESSMENT How to Perform a Personal Risk Assessment: Environment and Administrative Controls Ask yourself questions about controls already in place: Are there any policies and procedures for me to follow? Know the infection prevention and control policies and procedures in your health care setting. RISK ASSESSMENT How to Perform a Personal Risk Assessment: Environment and Administrative Controls Ask yourself questions about controls already in place: Assess the need and availability for the client, patient, or resident to be in a single room, to be segregated from others or to have single toileting facilities. Is a special environment necessary for this client/patient/residen t to contain transmission? RISK ASSESSMENT How to Perform a Personal Risk Assessment: Environment and Administrative Controls Ask yourself questions about controls already in place: Be sure there is a sharps container within reach. Use safety-engineered needles and medical sharps. Be aware of your health care setting’s protocol for exposure management. Will I be using a sharp item or potentially be exposed to a sharp? 37 From: Routine Practices & Additional Precautions in All Health Care Settings, 3rd. Ed. Provincial Infectious Diseases Advisory Committee, November 2012 38 Video and group discussion… What might happen when infection & prevention control strategies are not implemented? Watch this video and be prepared to discuss in the lab. http://willinteractive.com/demos/partnering-to-h eal/ Let’s reflect… In small groups, let’s talk about the video… What was the infectious agent? **How to break? What was the reservoir? What was the portal of exit? What was the mode of transmission? **How to break? **How to break? Was there more than one noted? What was the portal of entry? Who was susceptible? **How to break? **How to break? **How to break? 41 Questions? Next week… Minimizing effects of immobility – Lifting, Moving, Positioning & Preventing the Complications of Immobility Remember: Performance Testing Week #6 (talk and think out loud!!) “provide the rationale” – look at your rubric!! Keep practicing at home
