UNIVERSAL PRECAUTION ETC.

Define the following terms: Communicable disease

Is an illness caused by an infectious agent to its toxic products that are transmitted directly or indirectly to a well person through an agent, vector, or inanimate object. Ex: dengue, rabies, amoebiasis, tetanus

Contagious disease

Is one that is easily transmitted from one person to another through direct or indirect means. Ex: Poliomyelitis, Herpes Labialis, Measles, Colds Infection

Is the implantation and successful replication of an organism in the tissue of the host, resulting in signs and symptoms, as well as immunologic response

Nosocomial infection

An infection that can be acquired in a hospital, at least 72 hours after hospitalization Ex: hospital-acquired pneumonia Isolation

Is separation from other persons of an individual suffering from a communicable disease. Ex: Respiratory Isolation is used for diseases that are spread through particles that are exhaled Negative pressure isolation room

isolation rooms used for patients with an airborne transmitted disease. Airflow goes from the corridor into the patient's room.

Double bagging

is a technique which consists of placing contaminated materials into a bag and is then placed inside a clean bag.

Quarantine

Is the limitation of the freedom of movement of persons or animals which have been exposed to a communicable disease/s for a period of time equivalent to the longest incubation period of that disease.

2. Isolation Technique 2.1 Purpose

to prevent the spread of infectious microorganisms to health personnel, clients and visitors to prevent transmission of blood borne and moist body substance pathogens to limit the spread of infection.

2.2 Guidelines

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Wash hands thoroughly before and after client care and when gloves are removed. Wearing gloves doesnt eliminate the need to wash hands. Consider every person potentially infectious / susceptible to infection. Wear clean gloves before contact with any body fluids mucous membranes , non intact skin and any moist areas (e.g. site of an indwelling venous catheter) Wear gowns, plastic aprons, masks, protective eyewear (e.g. goggles), hair covers and shoe covers as required to keep moist body substances (e.g. blood, serous drainage) off clothing, skin, hair and mucous membranes. Discard all needles and sharps in a puncture-proof container at the place of use. Bag soiled linen securely before it is transported to laundry area. Place disposable trash in plastic bags and dispose of it according to agency protocol. Handling and reprocessing practices are the same for all equipment used on all clients. Place all specimens in plastic bags, seal bags and arrange for transport to the laboratory. 10. 11. 12. 2.3 Dont recap and remove needles from syringes. Dont break or bend needles by hand. Use mouthpieces when doing CPR. Principles

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The patient is a source of pathogenic microorganisms. The patients microorganisms leave through specific routes. There are always microorganisms in the environment which in some individuals and under certain circumstances can cause illness. Microorganisms harmful to man can be transmitted by direct/indirect contact. Spread of infection for source to others can be prevented by various methods to stop the spread as close to the source as possible. The effectiveness of medical/surgical aspesis is dependent on the conscientiousness of those carrying them out. In observing medical asepsis, areas are considered contaminated if they bear or are suspected of having pathogens.

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In observing surgical asepsis, areas are considered contaminated if touched by any object that is not sterile.

Purpose of Double bagging 1. 2. Prevent the transmission of infection Remove the contaminated articles and/or linens from the room if a patient on isolation precaution.

Guidelines: Double bagging technique is used for packaging non-disposable or disposable contaminated articles that are removed from an isolation room such as; Waste, linens, reusable supplies, laboratory specimens, patients personal items All isolation precaution bags must be correctly identified Reusable supplies such as instruments and basins must be rinsed to remove all gross contamination before bagging and double bagging Labeled plastic bags for contaminated items have been specifically manufactured to withstand steam and gas sterilization for processing patient care equipment and reusable supplies Double bagging is done in the doorway in the patients room prior to removing the bag from the room Prevent any wet linens from dissolving the water-soluble bag by wrapping all wet linen in dry, used linens. Have a supply of each type of plastic bag readily available outside the isolation room. COLORS OF THE BAG: Color Purpose Contents Black To avoid contaminating dry non-infectious waste from infectious waste Helps in minimizing the amount of waste to be treated besides enabling more efficient treatment of each category of waste. dry non-infectious waste Ex: used plasters, plastic containers Yellow To prevent the transmission of diseases via direct, indirect, or any mode of transmission that may cause health related problems infectious; contagious waste Ex: anatomical, pathological, soiled dressings like gauze, cotton, linen, etc. contaminated with blood or other body fluids. Green Separating wet, non-infectious wastes helps in the disposal and care of items. Also to prevent further contamination from other fluids wet; non-infectious waste Ex: plastics like IV sets, tubings, catheters micro-biological waste etc. Stainless steel or Translucent puncture proof container for metal sharps. Red To prevent injury to the health care providers and transmission via punctures and/or blood borne diseases sharp objects Ex: Needles, Scalpels, Blades, Broken Glass, etc., which have the capability to injure by piercing and cutting through the skin. Yellow with black stripes To be able to identify, separate and dispose wastes that may cause chemical injuries, and to take safety hazards chemical waste Ex: Sodium chlorate, Untreated bleaches, flammable solutions Orange

Separate disposal of radioactive waste provides additional protection against radioactive substances radioactive waste ex: active and reactive substances

Universal Precautions - precautions designed preventing the transmission of blood-borne diseases such as human immunodeficiency virus, hepatitis B, and other bloodborne pathogens when first aid or health care is provided. Under Universal Precautions, blood and certain body fluids of all patients are considered potentially infectious. Universal Precautions 1. 2. 3. 4. 5. 6. wash hands before and after each medical procedure (may use a waterless hand cleaner) wear gloves whenever there is a possiblity of coming in contact with blood or other potentially infectious materials (body fluids and tissues) wear full-body gowns whenever there is a possibility of blood splashing onto the rescuer wear face masks and eye protection whenever there is a possibility of blood splashing into the rescuer's face dispose of all contaminated sharp objects in an appropriate puncture-proof container dispose of all contaminated personal protective equipment in an appropriate container marked for bio-hazardous waste

Preparing disindectants

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Define the following terms:

Asepsis - Is the practice of reducing or eliminating contaminants from entering a particular environment

Bacteriostatic - Preventing or arresting the growth of bacteria - Capable of inhibiting the growth or reproduction of bacteria - Example: sulfanomides, tetracyclines, chloramphenicols

Bactericidal - Destructive to bacteria - Capable of killing bacteria outright - Example: Hydrogen peroxide, Vancomycin,

Antiseptic - A substance which destroys or inhibits the growth of microorganisms on living tissues - This term is generally restricted to agents that are sufficiently non-toxic for superficial application to living tissues - Example: chlorhexidine gluconate ( Nolvassan), Povidone iodine ( Betadine)

Disinfection - Process by which most microorganisms are destroyed with exception of spores

Disinfectant - An agent that disinfects, particularly one used in inanimate objects - Example: bleach, hydrogen peroxide, chlorine, ethyl alcohol

Fungicide - An agent that destroys or inhibits the growth of fungi - Example: Daconil, Neem oil, Baking soda

Germicide - An agent that kills germs, especially pathogenic microorganisms, more specifically one capable of killing microorganisms, except for spores - Example: Chlorhexidine, alcohols, detergents and soaps, hydrogen peroxide

Sporicide - Any agent effective in destroying spores, such as compound of chlorine and formaldehyde, and the glutaraldehyde

Sanitizer - A sanitizing product capable of cleaning and disinfecting; usually a formulation containing a disinfectant and a detergent - Example: purell, bactigel

Factors affecting the effectiveness of disinfection and sterilization

Number and location of microorganisms - The larger number of microbes, the more time a germicide needs to destroy all of them. - Aggregated or clumped cells are more difficult to inactivate than monodispersed cells. - The location of the microorganisms also must be considered when factors affecting the efficacy of germicides are assessed. Medical instruments with multiple pieces must be disassembled and equipment such as endoscope are more difficult to disinfect than are flat- surface equipment because penetration of the disinfectant of all parts of the equipment is more difficult. Only surfaces that directly contact the germicide will be disinfected.

Innate resistance of microorganisms - Many organisms have naturally high tolerances for certain disinfectant solution.

- Bacterial spores for example have extremely high tolerances for many disinfectants and require a different solution than a less resistant lipid virus.

Concentration and potency of disinfectants - The more concentrated the disinfectants, the greater its efficacy and the shorter the time necessary to achieve microbial kill.

Physical and chemical factors - Several physical and chemical factors also influence disinfectant procedures: temperatures, pH, relative humidity, and water hardness. Temperature

too great an increase in temperature causes the disinfectant to degrade and weakens its germicidal activity pH

An increase in pH improves the antimicrobial activity of some disinfectants (glutaraldehyde, quaternary ammonium compounds) but decreases the antimicrobial activity of others (phenols, hypochlorites, and iodine).

Relative humidity

the single most important factor influencing the activity of gaseous disinfectants/sterilants, such as EtO, chlorine dioxide, and formaldehyde. Water hardness

(high concentration of divalent cations) reduces the rate of kill of certain disinfectants because divalent cations (magnesium, calcium) in the hard water interact with the disinfectant to form insoluble precipitates

Organic and inorganic matter - Organic matter in the form of serum, blood, pus, or fecal or lubricant material can interfere with the antimicrobial activity of disinfectants through:

interference occurs by a chemical reaction between the germicide and the organic matter resulting in a complex that is less germicidal or non-germicidal, leaving less of the active germicide available for attacking microorganisms. organic material can protect microorganisms from attack by acting as a physical barrier - The effect of inorganic contaminants on the sterilization process was from the occlusion in crystal salts.

Duration of exposure

- Longer contact times are more effective than short contact time, in general.

Biofilms - Microorganisms may be protected from disinfectants by production of thick masses of cells and extracellular materials or biofilms. - Biofilms are microbial communities that are tightly attached to surfaces and cannot be easily removed.

Age - The age of the disinfectant solution being used also affects its effectiveness. Many chemicals diminish in potency with the passage of time and their exposure to air and the other chemicals in the solution. Types of Isolation (table ni, supposedly..:D) Type of Isolation Purpose Guidelines

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Strict Isolation - designed for highly contagious infections that are spread by airborne droplet nuclei and contact transmission

Examples include: - varicella, - Disseminated herpes zoster, -Viral hemorrhagic fevers. -the patient must stay in a private room with negative airflow -use of mask, gowns, and gloves for all person entering the room

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Contact Isolation -highly transmittable infections that are not spread by airborne droplet nuclei but are transmitted primarily by close and direct contact

Examples: -viral respiratory infections such as respiratory syncytial virus (RSV) -Patients with large draining wounds require contact precautions. -private room, masks for those personnel providing close direct care to patient -gowns if soiling is likely -gloves for touching infective materials

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Respiratory Isolation -designed to prevent transmission of disease spread over short distances through the air(droplet transmission)

Examples include : -children with Haemophilus influenza -epiglottitis - meningitis -pneumonia - patients with serious meningococcal disease - mumps and pertussis -private room -cohering patient with the same organism -mask for those personnel providing close direct care to patient

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Tuberculosis -designed for patients suspected or known to have pulmonary or laryngeal tuberculosis

Example: -Pulmonary Tuberculosis -includes a private room with negative airflow -use of appropriate respiratory protection

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Enteric Precautions -designed to prevent infections that are transmitted by direct or indirect contact with fecal material

Examples include :

-Salmonella gastroenteritis -private room only if patient has poor hygiene and is likely to contaminate the environment -gowns if soiling is likely -gloves for touching infective materials

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Drainage/secretion precautions -designed to prevent infections transmitted by direct or indirect contact with purulent material or other drainage from an infected body site -gowns if soiling is likely -gloves for touching infective materials

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Reverse Isolation -isolation procedure designed to protect a patient from infectious organisms that might be carried by the staff, other patients, or visitors or on droplets in the air or on equipment or materials

-hand washing, gowning, gloving, sterilization or disinfection of materials brought into the area