Unit 5
Importance of infection prevention and control
Infection prevention and control (IP&C) practices are important in maintaining a safe environment for everyone by reducing the risk of the potential spread of disease. This will help reduce the number of disease-producing microorganisms(pathogen). Microorganisms are always present in the environment. Elderly people and individuals with chronic diseases often have impaired immune systems.
Infection control should prevent cross-infection, such as a nosocomial infection. Nosocomial infection is an infection acquired within the facility. The new term for this is HAIs (Healthcare Associated Infection).
The purpose of infection prevention and control:
Prevent reinfection.
Provide a safe environment
The nature of Microorganisms
Microorganisms or microbes are microscopic organisms that exist as unicellular, multicellular, or cell clusters. Microorganism are widespread in nature and are beneficial to life, but some can cause serious harm. They can be divided into six major types: bacteria, archaea, fungi, protozoa, algae, and viruses.
Conditions that affect growth:
Food-most microorganisms need organic material for nourishment
Moisture and light-most microorganisms grow well in moist locations and in darkness.
Oxygen-most microorganisms, need oxygen to live
Temperature-most pathogens thrive at body temperature
How pathogens are transmitted:
Direct contact-touching the source of infection
Indirect contact-infection is picked up on an object
Droplet spread-pathogens are transmitted by droplets given off by coughing, sneezing, and talking.
Airborne spread-pathogens are spread with small particles like dust.
Vehicle spread-pathogens are carried by contaminated food, water, or blood.
Terms used to describe processes of removing microorganisms:
Disinfection is using a chemical to remove most pathogens
Sterilization is using boiling water or extreme heat (autoclave) to remove all microorganisms, leaving no living microbes.
Systems of Precaution Used for Infection Control
Centers for Disease Control and Prevention (CDC) has outlined two systems of practice for limiting the spread of bloodborne and other pathogens:
Standard Precautions- Are to be used on ALL residents. i.e. gloves when coming in contact with bodily fluids
Transmission Based Precautions- Additional precautions determined by the type of transmission a particular infection uses to spread.(i.e. gowning for contact transmission like MRSA in a wound; masking for droplet like with a cough or covid; or negative pressure room with N95 masks or hazmat masks for airborne like TB)
Potential sources of infection include:
Blood
All body fluids, secretions and excretions, except sweat
Non-intact skin
Mucous membranes
Overview of standard precaution activities
Wash your hands-before and after contact with a resident, and anytime hands are visibly soiled and use personal protective equipment (PPE).
Wear gloves, changing frequently after contact with infected material and before applying something clean- brief, clothes, or drink
Wear mask and eye protection if body substance could splash or spray
Wear fluid resistant gown to protect skin and clothing
Handle resident care equipment with caution and disinfect between residents
Handle linens with care. Treat as if it has touched a source of infection:
Avoid contact with one's clothing
Handle so microorganisms are not transferred to other residents or the environment. Roll linen in on themselves.
Put linens in trash bags to take out of the room.
Use approved environmental control measures when cleaning up a spill, disposing of trash, or cleaning the resident's unit.
Prevent injuries from needles and other sharp devices by using a sharps container
Hand care as part of standard infection control:
Jewelry, watches, and rings provide a place for microorganisms to hide.
Artificial nails and chipped polish provide a place for microorganisms to hide.
Intact skin provides a protective barrier.
A waterless cleaner (hand sanitizer) is also effective for routine hand care but should not substitute for washing when hands are visibly soiled
Handwashing is the single most important measure in infection prevention and control.
Key points of handwashing routine
Wash hands:
when visibly soiled,
when gloves have been removed,
after using the restroom,
before and after eating,
before and after resident care,
after contact with bodily fluids or excretions'
and any time you have touched contaminated material.
How to wash your hands:
Use warm, running water, keeping hands lower than the elbows allowing water to flow toward fingertips.
Use firm, rubbing motions to clean all surfaces of wrists, hands, fingers, and nails.
Was for an adequate length of time (15-30 Seconds) Sing ABC, Happy Birthday, or Twinkle Twinkle Little Star, twice.
Rinse with finger tips down.
Dry hands with paper towels.
Get a dry paper towel to turn off the faucet and open the door.
Avoid touching skin with clothing or body
Key points for using waterless hand cleaner:
Follow facility policies regarding use.
Rub adequate amount of cleaner onto all surfaces of wrist, hands, and fingers.
Rub until the cleaner dries.
If hands are visibly soiled, use soap and water.
Waterless hand cleaner is not to be used in food preparation areas.
Key points for using gloves:
Gloves are to be used when hands have contact with blood, body fluids, broken skin, or mucous membrane.
Gloves may be used to protect CNA's hands if skin is not intact.
Hands should be clean before putting on gloves. Hands should be washed after gloves are removed.
Remove and discard soiled gloves immediately after completion of the task.
Remove gloves without contaminating hands.
Gloves are not to be reused.
Gloves may be made of different materials to protect individuals who have latex allergy.
Transmission-Based Precautions or Isolation
These are infection control precautions based on the way a particular disease is spread. They are used in addition to standard precautions.
Types of transmission-based precautions:
Contact transmission precautions
Droplet transmission precautions
Airborne transmission precautions
The nurse will identify the type of isolation or precautions required for a resident's infection. The facility will have written description of the isolation procedure.
The needs of the resident in isolation:
Personal care needs are the same as if the resident were not in isolation
Basic needs continue for safety and security, belonging and caring.
Resident and family need to be educated about isolation procedure.
Reverse or Protective Isolation
Protective isolation or reverse isolation denotes the practices used for protecting vulnerable persons for contracting an infection. When people with weakened immune systems are exposed to organisms, it could lead to infection and serious complications. The purpose is to protect the resident with a weakened immune system, this is less commonly seen in long-term facilities.
Correcting breaks in infection control procedures:
If CNA catches a break in procedure, he/she can use the hint "stop, correct, resume" as a reminder for the action to take.
Example:
When providing incontinent care, the CNA forgets to apply gloves. Stop, leave the resident in a safe condition, wash hands, apply gloves, and resume incontinent care.
While changing linens on a resident's bed, the CNA places soiled linen on the bedside table. The corrective actions are to stop, remove the dirty linens and place them in a hamper or plastic bag, clean the top of table with disinfectant, then complete resident care.