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Monday, May 5, 2008

Isolation Nursing Precautions

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Isolation Nursing Precautions Slide Transcript
Slide 1: Isolation Class 10 Last Class

Slide 2: Preventing the spread of infection • What do we do when a client has a highly infectious disease?

Slide 3: Specific Infection Control Policies • Isolation – the principle is to create a physical barrier that prevents the transfer of microorganisms.

Slide 4: What are appropriate barriers? Depending on - • Organism Transmission • Airborne • Vehicle • Contact • Direct • Indirect • Droplet

Slide 5: Types of Barriers • PPE (personal protective equipment) • Gowns • Gloves • Masks • Eyewear

Slide 6: • Each institution is required to have infection control policies and guidelines.

Slide 7: What about when we don’t know? • 3 systems • Universal precautions • Body substance precautions • Standard precautions

Slide 8: Precautions to guard against the unknown • Apply to everyone • General public • May or may not carry an infection

Slide 9: History Lesson • Initially concerned with patient to patient • Followed by concern for health care professionals • 1970 – Hepatitis B • 1987 – HIV • Universal precautions by Center for Disease Control (CDC)

Slide 10: Universal precautions Stated : All blood & body flds should be treated as potentially infectious.

Slide 11: Body Substance Isolation (BSI) • Infection control practitioners in Seattle and SanDiego • Canada adopted policy but renamed it Body Substance Precautions (BSP)

Slide 12: Standard Precautions • 1996- newest guidelines by CDC combined the major features of universal precautions & BSP

Slide 13: 2 Tier System • 1996 CDC new guidelines

Slide 14: 1st Tier – Standard Precautions • Most important • Universal precautions + BSP • Applies to everyone • Primary strategies for prevention of infection • Standard precautions • Blood, body flds., nonintact skin, mucus membranes

Slide 15: 2nd Tier • Specific infections/diagnosis • Droplet, airborne, contact with contaminated surface

Slide 16: 3 Types Transmission Based Precautions • Airborne, droplet, contact • Some infections combination (chicken pox) • These extra precautions are in addition to Standard Precautions

Slide 17: Airborne • Travels on small particles • Air currents • Portal of entry – nose, mouth, mucus membranes • Measles, chicken pox, TB

Slide 18: Requirements for Airborne • Negative pressure room – door closed • TB = HEPA filter • Do not enter if not immune to measles/chickenpox • Client wears mask when required to leave room

Slide 19: Droplet • Large droplets of moisture • Coughing, sneezing, talking • Travels 3 ft. or less • Enters nose / mouth • Mumps, pertusis, influenza • Private room • Staff regular mask for 3 ft. • Client mask for transport

Slide 20: Contact • Dry skin to dry skin = Direct • Dry skin to object = Indirect • Impetigo, herpes zoster, scabies • Gloves – for direct care or touching anything in the room • Private room or semi if cohort has same diagnosis

Slide 21: • Remove gloves prior to exiting and wash hands • Gown for • patient contact • Changing linen • Handling objects in the room

Slide 22: • Remove gown prior to exiting • Wash hands • Careful clothing does not touch room surfaces

Slide 23: Protective Isolation / Reverse isolation • Compromised or suppressed immune system • Highly susceptible to infections • Protection from environmental pathogens

Slide 24: Protective Isolation / Reverse isolation What do you need ? • Private room – door closed • Gown, mask, gloves if direct contact • Wash hands • No plants / flowers

Slide 25: Procedure • Before instituting • EXPLAIN to client & family • Disease • Purpose of isolation • Steps to follow • Time frame

Slide 26: Room Preparation • Private with BR facilities • Sign on door • Isolation cart outside door • Laundry hamper in room • Waste basket with plastic bag • Thermometer, B/P cuff, stethoscope in room • Sharps receptacle

Slide 27: • Be organized • Gather equipment prior to entering room • Remove rings and wash hands • Don PPE • Gown usually disposable • Gloves up over cuff of gown

Slide 28: • Put your watch in a plastic bag if no clock in room • Linen is placed in a water soluble bag & then cream/yellow bag • No special treatment for dishes / trays

Slide 29: Exiting Room • Untie gown at waist • Remove gloves properly • Remove mask • Untie gown at neck, drop over shoulders, don’t touch outside, fold inwards, and discard

Slide 30: Exiting Room • Wash hands • Use paper towel on door handle • Wash hands again outside room Important to do as much client care as you can while you are in the room….CLUSTER ACTIVITY.

Slide 31: Basic Principles • Wash hands prior to entering & exiting room • Careful disposal of contaminated materials • Knowledge of disease and mode of transmission • Protection of client and public during transport

Slide 32: Client Consideration • Isolation • Loneliness • Self – esteem, body image • Boredom

Slide 33: Sterile Technique / Surgical Asepsis Purpose – to eliminate all microorganisms from objects that come into contact with the tissues of the body that are normally sterile.

Slide 34: Practice Areas • Operating room • Labor and delivery • Major diagnostic area • At the bedside in 3 main situations 1. Procedures requiring intentional perforation of the skin

Slide 35: 1. When the skin’s integrity is broken due to surgery or burns 2. During procedures involving insertion of devices into normally sterile body cavities

Slide 36: • Any break in technique could result in contamination increasing clients risk for infection.

Slide 37: Methods of Sterilization • Steam – most common • Dry heat • Ethylene oxide gas • Chemicals • Indicator of sterility – • tape on pkg. turns color or forms lines • Expiration Date

Slide 38: Examples of sterilization processes • Moist heat /steam • Autoclave- instruments, parental solutions, dressings • Radiation • Drugs, foods, heat sensitive items

Slide 39: Examples of sterilization processes • Chemicals • Instruments • All types • Glass microorganisms thermometers • Rapid action • Ex. Chlorine – • Work with water used to disinfect • Stable in heat & water & for light housekeeping • Inexpensive purposes • Not harmful to body tissue

Slide 40: Examples of sterilization processes • Ethylene oxide • Rubber gas • Plastic • Destroys microorganisms by altering cells’ metabolic processes.

Slide 41: Examples of sterilization processes • Boiling water • Items should be • Cheap boiled for at • Imp. – bacterial least 15 min. spores andsome viruses resist boiling. Not used in hospitals!

Slide 42: Practical Exam • Prepare a sterile field • Add an item • Add a liquid • Don sterile gloves





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