Safety/Hygiene/Infxn Control

  1. Asepsis vs. Sepsis
    • Asepsis: lack of infxn
    • Sepsis: infxn
  2. Chain of Infection
    • all components are interdependent; control infection by breaking a chain connection
    • --infectious agent
    • --reservoir
    • --portal of exit
    • --means of transmission
    • --portal of entry
    • --susceptible host
  3. Infectious Process
    • Incubation Period: organisms growing and multiplying
    • Prodromal Stage: person is most infectious, vague and nonspecific signs of disease
    • Full Stage of Illness: presence of specific signs and symptoms of disease
    • Convalescent Period: recovery from infections
  4. Infectious Agent
    • Bacteria: most significatnt and most prevalent in hospital settings, treated with anitbodies
    • Viruses: smallest, common cold
    • Fungi: plantlike organisms present in water, air, soil
    • Factors: number, virulence, immunocompetence, length and intimacy of contact between person and microorganism
  5. Reservoir
    • natural habitat of the organism
    • Other humans, animals, soil, food, water, milk, inanimate objects (fomites), carriers
  6. Portal of Exit
    • point of escape for the organism
    • Respiratory, gastrointestinal, genitourinary tracts, breaks in sking, blood
    • Can be transmitted by direct contact (person is touched by infected person or carrier), or indirect contact (person touches inanimate object that has organism on it—fomites), or airborne (only stays short time in air)
    • Organisms can enter through some portal it exits through
  7. Means of Transmission
    direct contact, indirect contact, airborne route
  8. Portal of Entry
    points at which organisms enter a new host
  9. Susceptible Host
    must overcome resistance mounted by host’s defenses

    Factors: intact skin and mucous membranes, normal pH levels, body’s WBC, age/sex/race/hereditary, immunization (natural or acquired), fatigue/climate/nutritional and general health status, stress, use of invasive or indwelling medical devises
  10. Defenses Against Infection
    • Body’s normal flora
    • Inflammatory response: most rapid
    • Immune response
    • Humoral immunity: Antigen/ Antibody
    • Cell mediated immunity: increased WBC’s including lymphocyte
  11. Exogenous vs. Endogenous vs. Iatrogenic Infections
    • Exogenous: acquired from other people
    • Endogenous: comes from microbial life harbored in the person
    • Iatrogenic: infection resulting in treatment or diagnostic procedure
  12. 5 Cardinal Signs of Infxn
    • redness
    • swelling
    • warmth
    • pain
    • decrease in function
  13. Systemic/Lab Signs of Infections
    • Systemic infection: fever, change in lab values, gone through and affected body
    • --Lethargy, anorexia, enlarge lymph
    • Lab Data: can show systemic infection
    • -- Normal WBC 5,000-10,000
    • --Elevated WBC = infection
  14. Medical Asepsis
    • Clean Technique: reduce number of organisms (through hand hygiene, gloves, PPE)
    • -- Transient bacterial flora: easily removed by handwashing
    • --Resident bacterial flora: hand is the carrier
    • --Cleansing agents can be non-antimicrobial, antimicrobial, or alcohol run (60-90% alcohol)
  15. Surgical Asepsis
    • Sterile Technique: zero organisms
    • for indwelling catheter, IV catheter
  16. Standard Precautions vs.
    • Standard Precautions: (Tier 1)
    • --always used
    • --Personal Protective Equipment and Supplies: Gloves, gowns, masks, protective eye gear
    • Transmission-Based Precautions: (Tier 2) Isolation Category
    • --specific instructions
    • --1. Airborne Precautions
    • --2. Droplet Precautions: mask within 3 feet of patient
    • --3. Contact Precautions
  17. Disinfect vs. Sterilization
    • Disinfect: agent, get rid of most pathogenic organisms; destroy all pathogenic organisms, except spores
    • Sterilization: destroy all microorganisms, including spores
  18. Nation Patient Safety Goals
    • improve the accuracy of patient identification
    • improve the effectiveness of communication among caregivers
    • improve the safety of using medications
    • reduce the risk of healthcare-associated infections
    • accurately and completely reconcile medications across the continuum of care
    • reduce the risk of patient harm resulting from falls
  19. Risks at Developmental Stages
    • Physical and cognitive changes, problems at certain age groups
    • Disabilities: increased risk for falls
  20. Risks in the Health Care Agency
    • Risk of Falls: medications increase risk for falling, incident reported in QMM, not in pt file
    • Safety considerations for older adults
    • Restraints: always under physician order, least necessary measure, physical restraints, chemical restraints, long-term facilities have very strict guidelines, concern in circulation/skin/nerve damage
    • Medication Errors: mechanisms for reducing errors (machines that alert warnings before administering medications)
  21. QMM: Quality Management Memo
    • doesn’t go into patient’s chart
    • aim is only for institution quality care purposes, not in the patient’s purposes
    • Record in Chart: fall, status of patient, notification of physician, nursing intervention, and explanation of incident
    • (Don’t mention QMM)
  22. Safety Risks:
    Fires, Poisoning, Suffocation/Choking, Firearm Injuries
    • Fires: (RACE: rescue, activate alarm, contain, evacuate)
    • Poisoning: avoid by medications well labels, no access to children, carbon monoxide detector
    • Suffocation and Choking: drowning (swimming, bathtub)
    • Firearm Injuries: lock up firearms
  23. Risk for Falling:
    Related Factors
    • #1 is previous incident of falling
    • confusion
    • medication
    • impaired judgment
    • over 65 yrs
    • sensory deficit
    • incontinence
    • meds affecting blood pressure (orthostatic [postural] hypotension/dizziness)
    • attached equipment (IV, catheter)
  24. OSHA:
    Occupational Safety & Health Org
    identifies risks and develops standards to prevent serious injury/illness caused by work-related musculoskeletal disorders
  25. Skin:
    • protection
    • secretion
    • excretion
    • temp regulation
    • sensation
    • psychosocial
    • hygiene related to skin care
  26. Necrosis
    • pressure ulcer caused by lack of blood circulation to area
    • black, dead tissue
  27. Promote skin health
    • soap cleansers
    • topical emollients
    • moisturize
    • establish protective barrier
  28. Feet, Hands, and Nails:
    special care with diabetes patients
    • Nails: nail base may have redness, swelling, bleeding, discharge, tenderness
    • Feet: cleanliness, intactness of skin; note swelling, inflammation, lesions, tenderness; wash/dry feet thoroughly, avoid soaking, clean interdigital area
  29. The Oral Cavity:
    inflammation of the gingival (gums)
  30. Oral Cavity:
    • (periodontal disease)
    • marked inflammation of the gums
    • degeneration of the dental periosteum and bone
  31. Oral Cavity:
    hard deposits along the gum lines that eventually attacks bone tissue
  32. Oral Cavity:
    • strong mouth odor or persistent bad taste in mouth
    • (first indication of periodontal diease)
  33. Oral Cavity:
    • inflammation of oral mucosa
    • (heat, pain, increased flow of saliza, halitosis)
  34. Oral Cavity:
    • inflammation of the tongue
    • (B12, folic acid, iron deficient)
  35. Oral Cavity:
    • ulceration of the lips
    • (vitamin B complex deficient)
  36. Hair:
    • itching
    • flaking
    • (daily brushing and shampooing)
  37. Hair:
    • hair loss
    • (partial, complete, local, or generalized loss)
  38. Hair:
    • hair lice
    • pediculosis humanus capitis: on hair and scalp
    • pediculosis humanus coporis: on the body, especially pubic hair
  39. Hair:
    • Lyme disease
    • Rocky Mountain spotted fever
    • tularemia
  40. The Eyes, Ears, and Nose:
    • Identify patient personal hygiene habits, special measure
    • Assess position, alignment, appearance
    • History of related problems or related treatments
  41. Eye Care
    • wear gloves
    • patient lays on same side as eye being cleaned
    • one cotton ball (water, saline) per swipe
    • inner to outer canthus
  42. Ear Care
    • cerumen (wax)
    • dry outer ear/not inner
    • battery-check for hearing aid
  43. Nose Care
    • blow debris out both nostrils same time
    • loosen hardened crusts
  44. Hygiene:
    • SocialPpractices
    • Personal Preferences
    • Body Image
    • Socioeconomic Status
    • Health Benefits and Motivation
    • Cultural Variables
    • Physical Condition
  45. Immunocompetent
    all different parts and functions of inflammatory and immune response are working well
  46. Purpose of Inflammatory Response and Immunity
    • meet human need for protection
    • eliminate, neutralize, destroy invaders
    • protection action only: distinguishes own cells
  47. Self vs. Nonself
    • NonSelf: infected by cells, cancer cells, all invading cells/organisms
    • Self-Tolerance: determines self fro nonself so self cells are not destroyed w/invaders
    • each self has a cellular fingerprint unique to that person
  48. Antigens
    proteins capable of stimulating an immne response
  49. Leukocyte (WBC)
    • protects from effects of invasion
    • recognizes self vs. nonself
    • destroy invaders, debri, unhealthy/abnormal self cells
    • produce antibodies to invaders
    • complement activation
    • produce cytokines to incr. leukocyte formation and specific activity
  50. Inflammation
    • (natural immunity)
    • provides immediate protection against effects of tissue injury and invaders
    • immediate but short term
    • nonspecific: anything can start it
    • PURPOSE: ridding body of harmful organisms, start antibody/cell mediated actoin to activate full immune response
  51. Types of Leukocytes Involved in Inflammation
    • neutrophil
    • macrophage
    • basophil
    • eosinophil
Card Set
Safety/Hygiene/Infxn Control
Test 2