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Unit 3: Your Working Environment. Competent Healthcare Basic Nurse Assistant Training Program. Key Terms. Antibiotic Asepsis Biohazardous waste Carrier Clean technique (medical asepsis) Communicable disease Contamination Disinfection Healthcare-associated infection (HAI) Immunity - PowerPoint PPT Presentation


Unit 3: Your Working Environment

Competent HealthcareBasic Nurse Assistant Training Program

Unit 3: Your Working Environment1

1Key Terms2AntibioticAsepsisBiohazardous wasteCarrierClean technique (medical asepsis)Communicable diseaseContaminationDisinfectionHealthcare-associated infection (HAI)ImmunityInfectionInfection controlMedical asepsisMicrobe (microorganism)Non-pathogenNormal floraPathogenReservoirSporeSterile Sterile fieldSterile technique (surgical asepsis)SterilizationVaccinationVaccineVectorVehicle


Preventing Infection

334An infection is a disease state resulting from the invasion and growth of microbes in the body. Infection is a major safety and health hazard. Minor infections cause short illnesses. Some infections are serious and can cause death. Infants, older persons, and disabled persons are at risk. The health team follows certain practices and procedures to prevent the spread of infection (infection control). The goal is to protect patients, residents, visitors, and staff from infection.MicroorganismsA microorganism (microbe) is a small living thing (organism). It is only seen with a microscope.Microbes are everywhere-in the mouth, nose, respiratory tract, stomach, and intestines. They are on the skin and in the air, soil, water, and food. They are on animals, clothing, and furniture.Some microbes are harmful and can cause infections. They are called pathogens.Microbes that do not usually cause infection are non-pathogens.55Types of microbesThere are five types of microbesBacteria- one-celled organisms that multiply rapidly. Often called germs, they can cause an infection in any body system.Fungi- plant-like organisms that live on other plants or animals. Mushrooms, yeasts, and molds are common fungi. Fungi can infect the mouth, vagina, skin, feet, and other body areas.Protozoa- one-celled animals. They can infect the blood, brain, intestines, and other body areas.Rickettsiae- found in fleas, lice, ticks and other insects. They are spread to humans by insect bites. Rocky Mountain spotted fever is an example. The person has fever, chills, headache, rash and other signs and symptoms.Viruses- grow in living cells. They cause many diseases. The common cold, herpes, acquired immunodeficiency syndrome (AIDS), and hepatitis are examples.66Requirements of Microbes7Microbes need a reservoir to live and grow. The reservoir (host) is the environment in which a microbe lives and grows.People, plants, animals, the soil, food, and water are common reservoirs. Microbes need water and nourishment from the reservoir. Most need oxygen to live. A warm and dark environment is needed. Most grow best at body temperature. They are destroyed by heat and light.Normal Flora8Normal flora are microbes that live and grow in a certain area. Certain microbes are in the respiratory tract, in the intestines, and on the skin. They are non-pathogens when in or on a natural reservoir. When a non-pathogen is transmitted from its natural site to another site or host, it becomes a pathogen. For example, Escherichia coli (E. coli) is normally found in the colon. If it enters the urinary system, it can cause an infection.Multidrug-Resistant OrganismsMultidrug-resistant organisms (MDROs) are microbes that can resist the effect of antibiotics. Antibiotics are drugs that kill certain microbes that cause infections. Some microbes can change their structures. This makes them harder to kill. They can survive in the presence of antibiotics. Therefore the infections they cause are hard to treat.MDROs are caused by prescribing antibiotics when they are not needed (over-prescribing). Not taking antibiotics for the length of time prescribed is another cause.99Two types of MDROs10Methicillin-resistant Staphylococcus aureus (MRSA): Staphylococcus aureus (staph) is a bacterium normally found in the nose and on the skin. MRSA is resistant to antibiotics often used for staph infections. MRSA can cause serious wound and bloodstream infections and pneumonia.Vancomycin-resistant Enterococcus (VRE): Enterococcus is a bacterium normally found in the intestines and in feces. It can be transmitted to others by contaminated hands, toilet seats, care equipment, and other items that the hands touch. When not in their natural site (the intestines), enterococci can cause urinary tract, wound, pelvic, and other infections. Vancomycin is an antibiotic often used to treat such infections. Enterococci resistant to Vancomycin are Vancomycin-resistant enterococci (VRE).

Infection11A local infection is in a body part. A systemic infection involves the whole body. (systemic means entire). The person has some or all of the signs and symptoms.

Chain of InfectionSource (Causative Agent)ReserviorPortal of exitMethod of transmissionPortal of entrySusceptible host

1212Chain of infection13The source is a pathogen. It must have a reservoir where it can grow and multiply. Humans, animals, and objects are reservoirs.A carrier is a human or animal that is a reservoir for microbes but does not develop the infection. Carriers can pass pathogens to others. A vector is a carrier (animal, insect) that transmits disease. Common vectors are:Dogs, which carry rabiesMosquitoes, which carry malariaTicks, which carry Rocky Mountain spotted feverMites, which cause scabies.Chain of infection14To leave the reservoir, the pathogen must be transmitted to another host.A vehicle is any substance that transmits microbes. The pathogen enters the body through a portal of entry. Portals of entry and exit are the same-the respiratory, GI, urinary, and reproductive tracts; breaks in the skin; and the blood. A susceptible host is needed for the microbe to grow and multiply. Susceptible hosts are persons at risk for infection.Susceptible hosts15Susceptible hosts include persons who:Are very young and who are olderAre illWere exposed to the pathogenDo not follow practices to prevent infection

The human body can protect itself from infection. The ability to resist infection relates to age, nutrition, stress, fatigue, and health. Drugs, disease, and injury also are factors.Some persons are at great risk for infection. Burn, transplant, and chemotherapy patients are examples. Severe infections can be deadly for these persons.Healthcare-Associated InfectionA healthcare-associated infection (HAI) is an infection that develops in a person cared for in any setting where care is given. The infection is related to receiving health care. Also, called nosocomial infections.Microbes can enter the body through equipment used in treatments, therapies, and tests. Staff can transfer microbes from one person to another and from themselves to others.

1616Medical AsepsisAsepsis is being free of disease-producing microbes.Microbes are everywhere. Measures are needed to achieve asepsis.Medical asepsis (clean technique) is the practices used to:Remove or destroy pathogens (number of pathogens reduced)Prevent pathogens from spreading from one person or place to another.Contamination is the process of becoming unclean. In medical asepsis, an item or area is clean when it is free of pathogens. The item or area is contaminated when pathogens are present.

1717Surgical asepsis18Microbes cannot be present during surgery or when instruments are inserted into the body. Open wounds require the absence of microbes. They are portals of entry for microbes. Surgical asepsis (sterile technique) is the practices that keep items free of all microbes. Sterile means the absence of all microbes-pathogens and non-pathogens. Sterilization is the process of destroying all microbes (pathogens and non-pathogens).Common Aseptic Practices19Aseptic practices break the chain of infection. To prevent the spread of infection, wash your hands.After urinating or having a bowel movementAfter changing tampons or sanitary padsAfter contact with your own or another persons blood, body fluids, secretions, or excretions. This includes saliva, vomitus, urine, feces, vaginal discharge, mucus, semen, wound drainage, pus, and respiratory secretionsAfter coughing, sneezing, or blowing your noseBefore and after handling, preparing, or eating foodAfter smoking a cigarette, cigar, or pipe

Wash your hands

After urinating or having bowel movementAfter contact with your own or another persons body fluids.After coughing, sneezing or blowing your noseBefore and after handling, preparing, or eating food.When they are visibly dirtyBefore and after patient contact.After removing gloves.2020Also, take these measures21Provide all persons with their own linens and personal care itemsCover your nose and mouth when coughing, sneezing, or blowing your nose. If tissues are not available, cough or sneeze into your upper arm. Do not cough or sneeze into your hands.Bathe, wash hair, and brush your teeth regularly.Wash fruits and raw vegetables before eating or serving themWash cooking and eating utensils with soap and water after use.Hand Hygiene22Is the easiest and most important way to prevent the spread of infection. Your hands are used for almost everything. They are easily contaminated. They can spread microbes to other persons or items.Practice hand hygiene before and after giving care.Handwashing

23Lather and rub at least 20 seconds23EquipmentSoapPaper towelsOrange stick or nail fileWastebasket2424Performance Skill #1: Wash HandsGather equipmentTurn on water and adjust temperature to warm, leave water running.Wet wrists and hands; keep hands lower than level of elbow throughout procedure.Apply soap Wash hands and wrists using friction for 30 seconds.Rinse hands and wrists well under running water with fingertips pointed down.Dry hands thoroughly with paper towel(s) from fingertips to wrists.Dispose of used paper towel(s).Use dry paper towel between hand and faucet to turn off waterDispose of used paper towels.

2525Special ConsiderationsDo not let your