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1. Define infection prevention and discuss types of infections

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Title: 1. Define infection prevention and discuss types of infections


1
1. Define infection prevention and discuss types
of infections
  • Define the following terms
  • infection prevention
  • the set of methods practiced in healthcare
    facilities to prevent and control the spread of
    disease.
  • microorganism/microbe
  • a living thing or organism that is so small that
    it can be seen only under a microscope.
  • infection
  • the state resulting from pathogens invading the
    body and multiplying.

2
1. Define infection prevention and discuss types
of infections
  • Define the following terms
  • pathogens
  • microorganisms that are capable of causing
    infection and disease.
  • localized infection
  • an infection that is limited to a specific
    location in the body and has local symptoms.
  • systemic infection
  • an infection that is in the bloodstream and is
    spread throughout the body, causing general
    symptoms.
  • healthcare-associated infection (HAI)
  • an infection acquired within a healthcare
    setting during the delivery of medical care.

3
1. Define infection prevention and discuss types
of infections
  • It is important to observe and report the
    following signs and symptoms of localized
    infections
  • Pain
  • Redness
  • Pus
  • Swelling
  • Drainage (fluid from a wound or cavity)
  • Heat

4
1. Define infection prevention and discuss types
of infections
  • It is important to observe and report the
    following signs and symptoms of systemic
    infections
  • Fever
  • Body aches
  • Chills
  • Nausea, vomiting
  • Weakness
  • Headache
  • Mental confusion
  • Drop in blood pressure

5
2. Describe the chain of infection
  • Define the following terms
  • chain of infection
  • a way of describing how disease is transmitted
    from one being to another.
  • causative agent
  • a pathogenic microorganism that causes disease.
  • reservoir
  • a place where a pathogen lives and grows.

6
2. Describe the chain of infection
  • Define the following terms
  • portal of exit
  • any body opening on an infected person that
    allows pathogens to leave.
  • mode of transmission
  • the method of describing how a pathogen travels.
  • direct contact
  • a way of transmitting pathogens through touching
    the infected person or his or her secretions.
  • indirect contact
  • a way of transmitting pathogens from touching
    something contaminated by the infected person.

7
2. Describe the chain of infection
  • Define the following terms
  • portal of entry
  • any body opening on an uninfected person that
    allows pathogens to enter.
  • mucous membranes
  • the membranes that line body cavities that open
    to the outside of the body, such as the linings
    of the mouth, nose, eyes, rectum, or genitals.
  • susceptible host
  • an uninfected person who could get sick.
  • transmission
  • passage or transfer.

8
2. Describe the chain of infection
  • Define the following terms
  • infectious
  • contagious.
  • medical asepsis
  • refers to practices such as handwashing that
    reduce, remove, and control the spread of
    microorganisms.
  • surgical asepsis
  • the state of being free of all microorganisms
    also called sterile technique.

9
Transparency 5-1 The Chain of Infection

10
2. Describe the chain of infection
  • REMEMBER
  • If even one link in the chain of infection is
    broken, the spread of infection is stopped.

11
2. Describe the chain of infection
  • Think about these questions
  • What is an example of each link in the chain of
    infection?
  • How could that link be broken?

12
Handout 5-1 Infection Prevention Definitions
  • Microorganism Microorganisms are single-celled
    organisms that only can be viewed with the aid of
    a microscope. Microorganisms can be divided into
    five basic categoriesbacteria, viruses, fungi,
    protozoa, and helminthes. Most microorganisms are
    harmlesssome are even beneficial. Others are
    capable of causing infection or disease.
    Microorganisms are often classified as either
    pathogenic or nonpathogenic.
  • Nonpathogenic microorganism A nonpathogenic
    microorganism is a type of microorganism that is
    incapable of causing or unable to cause infection
    or disease.
  • Pathogenic microorganism A pathogenic
    microorganism is a type of microorganism that is
    capable of causing infection or disease it is
    also called a pathogen.

13
Handout 5-1 Infection Prevention Definitions
(contd)
  • Bacteria Bacteria are single-celled
    microorganisms that lack nuclei and organized
    cell structures. Bacteria can exist independently
    (on their own) or as parasites, dependent upon a
    host for life. Bacteria can be found in three
    basic shapesround, rod, or spiral. While some
    bacteria are capable of causing disease, most are
    non-infectious and many have critical roles in
    decay, fermentation, and nutrient recycling.
  • Bacteria help people digest food. Some bacteria
    destroy disease-causing cells, and some produce
    important vitamins in the gastrointestinal tract.
    Bacteria also play a role in food processing,
    such as in the production of yogurt and cheeses.
  • Pathogenic bacteria can cause cell damage or
    death by producing substances known as toxins.
    Other cell damage can occur when the hosts
    immune system produces substances to eliminate
    bacteria, and these substances damage the
    infected cells and adjacent cells.

14
Handout 5-1 Infection Prevention Definitions
(contd)
  • Virus Viruses are small packages of DNA or RNA
    encased in protein shells that invade a cell
    (host cell) and incorporate themselves into the
    host cells DNA. When the infected host cell
    begins to produce (replicate) new viral
    particles, the infected cell dies.
  • Fungi Fungi are multi-celled or single-celled
    organisms. They can be pathogenic, causing
    infections in healthy persons, or opportunistic,
    causing infections in people with weakened immune
    systems. Fungi can be nonpathogenic as well, and
    some types of fungi are even beneficial, such as
    those used to make antibiotics. A few types of
    fungi are considered delicacies, such as truffles
    and edible mushrooms.
  • Yeasts and molds are examples of fungi. Fungi are
    the most common causes of disease in crops and
    plants. Fungi receive their nourishment by
    secreting enzymes that break down surrounding
    cells. When this happens on living tissue, it is
    irritating and uncomfortable.

15
Handout 5-1 Infection Prevention Definitions
(contd)
  • Parasite A parasite is an organism that lives on
    or in an organism of a different speciesa host.
  • Infection An infection occurs when
    microorganisms enter and multiply within the
    tissue of a host, causing damage to that tissue.
    Symptoms may be apparent, or the host may display
    no symptoms.
  • Disease A disease occurs when tissue that has
    been damaged due to the entry and multiplication
    of microorganisms results in clinical signs and
    symptoms of a recognizable process.
  • Host A host is an organism or cell on or in
    which a microorganism lives or feeds.

16
3. Explain why the elderly are at a higher risk
for infection
  • Define the following terms
  • malnutrition
  • poor nutrition due to improper diet.
  • dehydration
  • a serious condition resulting from inadequate
    fluid in the body.

17
3. Explain why the elderly are at a higher risk
for infection
  • The following factors place the elderly at a
    higher risk for infection than the general
    public
  • Weakened immune systems
  • Decreased circulation
  • Slow wound healing
  • Malnutrition
  • Dehydration
  • Limited mobility
  • Hospitalization
  • Difficulty swallowing
  • Incontinence
  • Feeding tubes and other tubing

18
4. Explain Standard Precautions
  • Define the following terms
  • Occupational Safety and Health Administration
    (OSHA)
  • a federal government agency that makes rules to
    protect workers from hazards on the job.
  • Centers for Disease Control and Prevention (CDC)
  • a government agency under the Department of
    Health and Human Services (HHS) that issues
    information to protect the health of individuals
    and communities.
  • isolate
  • to keep something separate, or by itself.

19
4. Explain Standard Precautions
  • Define the following terms
  • Standard Precautions
  • a method of infection prevention in which all
    blood, body fluids, non-intact skin, and mucous
    membranes are treated as if they were infected
    with an infectious disease.
  • sharps
  • needles or other sharp objects.

20
4. Explain Standard Precautions
  • The CDC defines body fluids as including the
    following substances
  • Saliva
  • Sputum (mucus coughed up)
  • Urine
  • Feces
  • Semen
  • Vaginal secretions
  • Pus or other wound drainage
  • Vomit

21
4. Explain Standard Precautions
  • Think about this question
  • Why should Standard Precautions be followed with
    every resident in an NAs care?

22
4. Explain Standard Precautions
  • REMEMBER
  • It is impossible to tell from looking at a person
    whether he or she has an infectious disease.

23
4. Explain Standard Precautions
  • Standard Precautions include the following
    measures
  • Wash hands.
  • Wear gloves.
  • Remove gloves immediately when finished with a
    procedure.
  • Immediately wash skin surfaces.
  • Wear a disposable gown.
  • Wear a mask and goggles.

24
4. Explain Standard Precautions
  • Standard Precautions (contd)
  • Wear gloves when handling sharp objects.
  • Never attempt to recap needles or sharps.
  • Avoid nicks and cuts.
  • Bag all contaminated supplies.
  • Clearly label body fluids.
  • Dispose of contaminated waste properly.

25
5. Explain hand hygiene and identify when to wash
hands
  • Define the following terms
  • hand hygiene
  • washing hands with either plain or antiseptic
    soap and water and using alcohol-based hand rubs.
  • antimicrobial
  • an agent that destroys, resists, or prevents the
    development of pathogens.

26
5. Explain hand hygiene and identify when to wash
hands
  • REMEMBER
  • It is very important to wash hands with soap and
    water. NAs should not rely solely on
    alcohol-based rubs.

27
5. Explain hand hygiene and identify when to wash
hands
  • NAs should wash their hands at the following
    times
  • When first arriving at work
  • Any time they are visibly soiled
  • Before, between, and after all resident contact
  • Before putting on gloves and after removing
    gloves
  • After contact with body fluids, mucous
    membranes, non-intact skin, wound dressings
  • After handling contaminated items
  • After contact with objects in residents room

28
5. Explain hand hygiene and identify when to wash
hands
  • Times to wash hands (contd)
  • Before and after touching meal trays or
    handling food
  • Before and after feeding residents
  • Before getting clean linen
  • Before and after using the toilet
  • After touching garbage or trash
  • After picking up things from the floor

29
5. Explain hand hygiene and identify when to wash
hands
  • Times to wash hands (contd)
  • After blowing nose or sneezing into hand
  • Before and after eating
  • After smoking
  • After touching areas on the body
  • Before and after applying makeup
  • After any contact with pets/pet care items
  • Before leaving facility

30
5. Explain hand hygiene and identify when to wash
hands
  • REMEMBER
  • Hand-washing is the single most important thing
    an NA can do to prevent the spread of disease.

31
Washing hands (hand hygiene)
  • Equipment soap, paper towels
  • 1. Turn on water at sink. Keep your clothes dry,
    because moisture breeds bacteria.
  • Wet hands and wrists thoroughly.
  • 3. Apply soap to your hands.

32
Washing hands (hand hygiene)
  • Keep your hands lower than your elbows and your
    fingertips down. Rub hands together and fingers
    between each other to create a lather. Lather all
    surfaces of wrists, fingers, and hands, using
    friction for at least 20 seconds. Friction helps
    clean.
  • 5. Clean your nails by rubbing them in the palm
    of your other hand.

33
Washing hands (hand hygiene)
  • 6. Being careful not to touch the sink, rinse
    thoroughly under running water. Rinse all
    surfaces of your hands and wrists. Run water down
    from wrists to fingertips. Do not run water over
    unwashed arms down to clean hands.

34
Washing hands (hand hygiene)
  • 7. Use a clean, dry paper towel to dry all
    surfaces of your hands, wrists, and fingers. Do
    not wipe towel on unwashed forearms and then wipe
    clean hands. Dispose of paper towel into waste
    container without touching the container. If your
    hands touch the sink or wastebasket, start over.

35
Washing hands (hand hygiene)
  1. Use a clean, dry paper towel to turn off the
    faucet then dispose of paper towel into waste
    container. Do not contaminate your hands by
    touching the surface of the sink or faucet.

36
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • Define the following terms
  • personal protective equipment (PPE)
  • equipment that helps protect employees from
    serious workplace injuries or illnesses resulting
    from contact with workplace hazards.
  • don
  • to put on.
  • doff
  • to remove.

37
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • Define the following terms
  • perineal care
  • care of the genitals and anal area.
  • non-intact skin
  • skin that is broken by abrasions, cuts, rashes,
    acne, pimples, lesions, surgical incisions, or
    boils.

38
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • PPE must be worn when a caregiver might come into
    contact with any of the following
  • Body fluids
  • Mucous membranes
  • Open wounds

39
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • REMEMBER
  • NAs must wear gowns, masks, goggles, and face
    shields any time splashing or spraying of body
    fluids or blood could occur

40
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • NAs should remember these points about gowns
  • Gowns protect exposed skin
  • They prevent soiling of clothing
  • They should fully cover the torso, and the
    sleeves should fit snugly.

41
Putting on (donning) and removing (doffing) gown
  • 1. Wash your hands.
  • 2. Open the gown. Hold out in front of you and
    allow gown to open/unfold. Do not shake it.
    Facing the back opening of the gown, place your
    arms through each sleeve.
  • Fasten the neck opening.
  • Reaching behind you, pull the gown until it
    completely covers your clothing. Secure gown at
    waist.

42
Putting on (donning) and removing (doffing) gown
  • 5. Use a gown only once and then remove and
    discard it. If gown becomes wet or soiled during
    care, remove it. Check your clothing, and put on
    a new gown. OSHA requires non-permeable
    gownsgowns that liquids cannot penetratewhen
    working in a bloody situation.
  • 6. Put on your gloves after putting on gown. The
    cuffs of gloves should overlap the cuffs of the
    gown.

43
Putting on (donning) and removing (doffing) gown
  • 7. When removing a gown, remove and discard
    gloves properly (see procedure later in the
    chapter). Unfasten gown at neck and waist. Remove
    the gown without touching the outside of gown.
    Roll the dirty side in, while holding gown away
    from your body. Dispose of gown properly and wash
    your hands.

44
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • NAs should remember these points about masks and
    goggles
  • Masks are worn when the resident has a
    respiratory illness.
  • Masks should fully cover the nose and mouth.
  • Masks should fit snugly over nose and mouth.
  • It is important to change masks between
    residents.
  • Goggles should fit snugly over eyes or
    eyeglasses.

45
Putting on (donning) mask and goggles
  • 1. Wash your hands.
  • 2. Pick up the mask by top strings or elastic
    strap. Do not touch the mask where it touches
    your face.
  • 3. Pull elastic strap over your head, or if mask
    has strings, tie top strings first, then bottom
    strings. Do not wear a mask hanging from only the
    bottom tie or strap. Masks must always be dry or
    they must be replaced

46
Putting on (donning) mask and goggles
  • 4. Pinch the metal strip at the top of the mask
    (if part of the mask) tightly around your nose so
    that it feels snug.
  • Put on the goggles over your eyes or eyeglasses.
    Use the headband to secure them to your head.
    Make sure they are on snugly.
  • 6. Put on gloves after putting on mask and
    goggles.

47
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • Gloves must be worn in the following situations
  • If the NA might touch blood or any body fluid
  • During mouth care or care of any mucous
    membrane
  • During perineal care
  • When providing personal care on non-intact skin
  • When providing personal care if NA has cuts on
    hands
  • When shaving resident
  • When disposing of soiled linens, gowns,
    dressings, and pads
  • When touching contaminated surfaces or
    equipment

48
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • Gloves must be changed in these situations
  • Immediately before contact with mucous
    membranes or broken skin
  • If gloves become soiled, worn, or damaged

49
Putting on (donning) gloves
  • 1. Wash your hands.
  • 2. If you are right-handed, slide one glove on
    your left hand (reverse if left-handed).
  • 3. Using your gloved hand, slide the other hand
    into the second glove.
  • 4. Interlace fingers to smooth out folds and
    create a comfortable fit.
  • 5. Carefully look for tears, holes, or
    discolored spots. Replace the glove if needed.

50
Putting on (donning) gloves
  • 6. If wearing a gown, pull the cuff of the
    gloves over the sleeves of the gown.

51
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • Gloves should be removed
  • After use
  • Before caring for another resident
  • Before touching non-contaminated items or
    surfaces

52
Removing (doffing) gloves
  • Touch only the outside of one glove. With one
    gloved hand, grasp the other glove at the palm
    and pull the glove off.
  • With the fingertips of your gloved hand, hold the
    glove you just removed. With your ungloved hand,
    slip two fingers underneath cuff of the remaining
    glove at wrist. Do not touch any part of the
    outside of glove.

53
Removing (doffing) gloves
  • 3. Pull down, turning this glove inside out and
    over the first glove as you remove it.
  • 4. You should now be holding one glove from its
    clean inner side and the other glove should be
    inside it.
  • 5. Drop both gloves into the proper container
    without contaminating yourself.
  • 6. Wash your hands.

54
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • The proper order for donning PPE is as follows
  • Wash hands.
  • Put on gown.
  • Put on mask.
  • Put on goggles or face shield.
  • Put on gloves.

55
6. Discuss the use of personal protective
equipment (PPE) in facilities
  • The proper order for doffing PPE is as follows
  • Remove and discard gloves.
  • Remove goggles or face shield.
  • Remove and discard gown.
  • Remove and discard mask.
  • Wash hands.

56
7. List guidelines for handling equipment and
linen
  • Define the following terms
  • clean
  • in health care, a condition in which objects are
    not contaminated with pathogens.
  • dirty
  • in health care, a condition in which objects have
    been contaminated with pathogens.
  • disinfection
  • process that kills pathogens, but not all
    pathogens it reduces the pathogen count to a
    level that is considered not infectious.

57
7. List guidelines for handling equipment and
linen
  • Define the following terms
  • sterilization
  • a method used to decrease the spread of pathogens
    and disease by destroying all microorganisms,
    including those that form spores.
  • disposable
  • only to be used once and then discarded.

58
7. List guidelines for handling equipment and
linen
  • NAs should follow these guidelines regarding
    equipment, linen, and clothing
  • Prevent skin/mucous membrane contact.
  • Prevent contamination of clothing.
  • Prevent transfer of disease to other residents
    or environments.
  • Do not use reusable equipment until it has been
    cleaned properly.
  • Dispose of all single-use equipment properly.

59
7. List guidelines for handling equipment and
linen
  • Guidelines regarding equipment, linen, and
    clothing (contd)
  • Clean and disinfect all environmental surfaces,
    beds, bedrails, bedside equipment, and all
    frequently touched surfaces (such as doorknobs
    and call lights).
  • Handle, transport, and process soiled linens and
    clothing in a way that prevents skin and mucous
    membrane exposure, contamination of clothing
    (hold linen away from uniform), and transfer of
    disease to other residents and environments.
  • Bag soiled linen at point of origin.
  • Sort soiled linen away from resident care areas.
  • Place wet linen in leak-proof bags.

60
8. Explain how to handle spills
  • NAs should follow these guidelines for cleaning
    spills involving blood, body fluids, or glass
  • Put on gloves (industrial strength).
  • Use proper product to absorb spill.
  • Scoop up absorbed spill and dispose of it in
    designated container.
  • Apply disinfectant.
  • Use proper cleaning solution.
  • Use tools, never hands, to pick up glass.
  • Properly bag waste.

61
8. Explain how to handle spills
  • REMEMBER
  • It is important the absorb a spill and remove the
    fluid before treating the area with disinfectant.
    If the spilled fluid is not absorbed and removed
    first, it may neutralize the disinfectant on
    contact.

62
9. Explain Transmission-Based Precautions
  • Define the following terms
  • Transmission-Based Precautions
  • method of infection prevention used when caring
    for persons who are infected or suspected of
    being infected with a disease.
  • multidrug-resistant organisms (MDROs)
  • microorganisms, mostly bacteria, that are
    resistant to one or more antimicrobial agents
    that are commonly used for treatment.

63
9. Explain Transmission-Based Precautions
  • REMEMBER
  • Transmission-Based Precautions are always used in
    addition to Standard Precautions.

64
Transparency 5-2 Airborne Diseases

65
9. Explain Transmission-Based Precautions
  • Airborne diseases spread when pathogens are
    transmitted through the air after being expelled.
    The pathogens can remain floating for some time.
    The following illnesses are caused by airborne
    pathogens
  • Tuberculosis (TB)
  • Measles
  • Chicken pox

66
9. Explain Transmission-Based Precautions
  • The following precautions can help prevent the
    spread of airborne diseases
  • Using a face mask
  • Wearing a gown
  • Handwashing
  • Proper ventilation

67
Transparency 5-3 Droplet Diseases

68
9. Explain Transmission-Based Precautions
  • Droplet diseases spread when pathogens are
    transmitted through droplets in the air. The
    droplets normally do not travel more than three
    feet, but they may travel further. The following
    illnesses are examples
  • Mumps
  • Influenza

69
9. Explain Transmission-Based Precautions
  • The following precautions can help prevent the
    spread of droplet diseases
  • Using a face mask
  • Covering nose and mouth when sneezing or coughing
  • Handwashing

70
9. Explain Transmission-Based Precautions
  • The CDC recommends the following measures (part
    of Standard Precautions) to prevent the
    transmission of respiratory illnesses in
    healthcare settings
  • Alerts should be posted instructing patients and
    visitors to inform staff of respiratory symptoms
    and to practice respiratory hygiene/cough
    etiquette, which includes
  • Cover noses/mouths with a tissue when coughing or
    sneezing
  • Dispose of used tissues in nearest waste
    container after use
  • Wash hands after contact with respiratory
    secretions or contaminated objects

71
9. Explain Transmission-Based Precautions
  • CDC measures for respiratory etiquette (contd)
  • Healthcare facilities must make these items
    available to staff, patients, and visitors
  • Tissues and no-touch receptacles for disposal
  • Conveniently located hand rub dispensers and
    handwashing supplies
  • During times of increased respiratory infections,
    masks should be offered to anyone who is coughing
    and coughing people encouraged to sit at least
    three feet away from others.
  • Healthcare personnel should observe droplet
    precautions, in addition to Standard Precautions,
    when interacting with a patient with symptoms of
    a respiratory infection.

72
Transparency 5-4 Contact Diseases

73
9. Explain Transmission-Based Precautions
  • Contact diseases can be spread when an uninfected
    person comes into contact with the skin, wound,
    or infection of an infected person. The following
    illnesses are spread by contact
  • Conjunctivitis (pink eye)
  • Clostridium difficile
  • Lice
  • Scabies

74
9. Explain Transmission-Based Precautions
  • The following precautions can help prevent the
    spread of contact diseases
  • Using PPE
  • Washing hands with antimicrobial soap
  • Not touching infected surfaces without gloves
  • Not touching uninfected surfaces with
    contaminated gloves
  • Not sharing towels, linens, and clothing
  • Using disposable equipment when possible

75
9. Explain Transmission-Based Precautions
  • When isolation precautions are required, the NA
    should remember these points
  • Transmission-Based Precautions always used in
    addition to Standard Precautions
  • Nurses will set up the isolation unit.
  • Use PPE as instructed. Do not wear PPE outside
    residents room, and perform hand hygiene
    following removal of PPE.

76
9. Explain Transmission-Based Precautions
  • Guidelines for isolation precautions (contd)
  • Do not share equipment between residents.
  • Wear proper PPE when serving food and drink.
  • Follow Standard Precautions in dealing with
    body waste removal.
  • Wear proper PPE required to take specimen.
  • Reassure residents that the disease, not the
    person, is being isolated.

77
10. Define bloodborne pathogens and describe two
major bloodborne diseases
  • Define the following terms
  • bloodborne pathogens
  • microorganisms found in human blood, body fluid,
    draining wounds, and mucous membranes that can
    cause infection and disease in humans.
  • human immunodeficiency virus (HIV)
  • the virus that attacks the bodys immune system
    and gradually disables it eventually can cause
    AIDS.
  • hepatitis
  • inflammation of the liver caused by certain
    viruses and other factors, such as alcohol abuse,
    some medications, and trauma.

78
10. Define bloodborne pathogens and describe two
major bloodborne diseases
  • Define the following terms
  • jaundice
  • a condition in which the skin, whites of the
    eyes, and mucous membranes appear yellow.

79
10. Define bloodborne pathogens and describe two
major bloodborne diseases
  • Bloodborne diseases may be transmitted in the
    following ways
  • Infected blood
  • Infected semen or vaginal secretions contacting
    mucous membranes
  • Sexual contact
  • Needle sharing
  • Infected mothers
  • Contact with infected blood or certain other
    body fluids in healthcare setting

80
10. Define bloodborne pathogens and describe two
major bloodborne diseases
  • REMEMBER
  • It is safe to touch and spend time with residents
    who have bloodborne diseases. Residents with
    these illnesses need the same thoughtful,
    personal attention NAs give to all their
    residents.

81
11. Explain OSHAs Bloodborne Pathogens Standard
  • Define the following terms
  • Bloodborne Pathogens Standard
  • federal law that requires that healthcare
    facilities protect employees from bloodborne
    health hazards.
  • exposure control plan
  • plan designed to eliminate or reduce employee
    exposure to infectious material.

82
11. Explain OSHAs Bloodborne Pathogens Standard
  • The Bloodborne Pathogens Standard designates the
    following as a significant exposure
  • Needle stick
  • Mucous membrane contact
  • Cut from an object containing potentially
    infectious body fluid
  • Contact with non-intact skin

83
11. Explain OSHAs Bloodborne Pathogens Standard
  • Employers must take the following steps to
    protect employees from bloodborne pathogens
  • Maintain a written exposure control plan
  • Provide proper PPE
  • Provide biohazard containers for disposal of
    sharps and other infected waste
  • Offer free hepatitis B vaccine to employees
  • Affix warning labels to waste containers,
    refrigerators, and freezers that contain
    potentially infectious material
  • Keep a log of injuries from contaminated sharps
  • Provide in-service training on the Bloodborne
    Pathogens Standard

84
12. Define tuberculosis and list infection
prevention guidelines
  • Define the following terms
  • tuberculosis (TB)
  • a highly contagious lung disease caused by a
    bacterium that is carried on mucous droplets
    suspended in the air.
  • latent TB infection
  • type of tuberculosis in which the person carries
    the disease but does not show symptoms and cannot
    infect others.
  • TB disease
  • type of tuberculosis in which the person shows
    symptoms of the disease and can spread TB to
    others.

85
12. Define tuberculosis and list infection
prevention guidelines
  • Define the following terms
  • multidrug-resistant TB(MDR-TB)
  • type of tuberculosis that can develop when a
    person with TB disease does not take all the
    prescribed medication.
  • resistant
  • a state in which drugs no longer work to kill
    specific bacteria.
  • phlegm
  • thick mucus from the respiratory passage.

86
12. Define tuberculosis and list infection
prevention guidelines
  • NAs should be familiar with these signs and
    symptoms of TB disease
  • Fatigue
  • Loss of appetite
  • Weight loss
  • Slight fever and chills
  • Night sweats
  • Prolonged coughing
  • Coughing up blood
  • Chest pain
  • Shortness of breath
  • Trouble breathing

87
12. Define tuberculosis and list infection
prevention guidelines
  • When caring for residents with tuberculosis, NAs
    should follow these guidelines
  • Follow Standard Precautions and Airborne
    Precautions.
  • Wear PPE as instructed.
  • Handle sputum or phlegm carefully.
  • Ensure proper ventilation.
  • If resident is in AIIR isolation room, open and
    close door slowly.
  • Follow isolation procedures if ordered.
  • Help resident remember to take medications.

88
13. Discuss MRSA, VRE, and C. Difficile
  • Define the following terms
  • MRSA (methicillin-resistant Staphylococcus
    aureus)
  • an infection caused by specific bacterial that
    have become resistant to many antibiotics.
  • Vancomycin-resistant enterococcus (VRE)
  • bacteria (enterococci) that have developed
    resistance to antibiotics as a result of being
    exposed to vancomycin.
  • Clostridium difficile (C. diff, C. difficile)
  • bacterial illness that can cause diarrhea and
    colitis spread by spores in feces that are
    difficult to kill.

89
13. Discuss MRSA, VRE, and C. Difficile
  • There are two types of MRSA
  • Hospital-associated MRSA (HA-MRSA)
  • Community-associated MRSA (CA-MRSA)

90
13. Discuss MRSA, VRE, and C. Difficile
  • REMEMBER
  • MRSA can be spread by direct and indirect
    contact. Handwashing is the single most important
    measure to control the spread of MRSA.

91
13. Discuss MRSA, VRE, and C. Difficile
  • REMEMBER
  • VRE can be spread by direct and indirect contact.
    Prevention of VRE is very important, and proper
    handwashing is an important part of prevention.

92
13. Discuss MRSA, VRE, and C. Difficile
  • C. Difficile is spread in the following ways
  • By spores via direct contact
  • When intestinal flora is altered due to enemas,
    nasogastric tube, GI tract surgery, or overuse of
    antibiotics

93
13. Discuss MRSA, VRE, and C. Difficile
  • REMEMBER
  • Proper handwashing and proper handling of wastes
    can help prevent C. Difficile. Soap and water
    must be used each time hand hygiene is performed.
    Disinfecting surfaces and limiting antibiotic use
    can also help.

94
14. List employer and employee responsibilities
for infection prevention
  • The following are an employers responsibilities
    regarding infection prevention
  • Establish procedures and exposure control
    plan.
  • Provide in-service education.
  • Have written procedures for exposures.
  • Provide proper PPE.
  • Provide HBV vaccination.

95
14. List employer and employee responsibilities
for infection prevention
  • The following are an employees responsibilities
    regarding infection prevention
  • Follow Standard Precautions.
  • Follow facilitys policies and procedures.
  • Follow care plans and assignments.
  • Use PPE.
  • Take advantage of free hepatitis B vaccine.
  • Report any exposure immediately.
  • Participate in education programs.

96
Exam
  • Multiple Choice. Choose the correct answer.
  • Infection prevention is
  • (A) The way in which infections occur
  • (B) An infection that is prevented from traveling
    from one part of the body to another
  • (C) A set of methods used to prevent the spread
    of disease
  • (D) An object that has been prevented from being
    contaminated with pathogens
  • The following are necessary links in the chain of
    infection. When an NA wears gloves, which link is
    broken, thus preventing the spread of disease?
  • (A) Reservoir (place where the pathogen lives and
    grows)
  • (B) Mode of transmission (a way for the disease
    to spread)
  • (C) Susceptible host (person who is likely to get
    the disease)
  • (D) Causative agent (pathogenic microorganism
    that causes disease)

97
Exam
  • The following are necessary links in the chain of
    infection. When an NA gets a vaccination shot for
    hepatitis B, which link will be affected and thus
    prevent hepatitis B infection?
  • (A) Reservoir (place where the pathogen lives and
    grows)
  • (B) Mode of transmission (a way for the disease
    to spread)
  • (C) Susceptible host (person who is likely to get
    the disease)
  • (D) Portal of entry (body opening that allows
    pathogens to enter)
  • A nursing assistant (NA) will come into contact
    with microorganisms
  • (A) Only in high-traffic areas of the facility
  • (B) Only during direct contact with residents
  • (C) Only during personal care procedures
  • (D) Every time the NA touches something

98
Exam
  • The single most important thing the NA can do to
    prevent the spread of disease is to
  • (A) Carry dirty linen close to her uniform so as
    not to spread contaminants
  • (B) Wash and dry her disposable gloves before
    reusing them
  • (C) Remove gloves before cleaning spills
  • (D) Wash her hands
  • The elderly are at a higher risk of infection
    because
  • (A) They have strong immune systems
  • (B) They are rarely hospitalized
  • (C) They are always well-nourished
  • (D) They may have limited mobility

99
Exam
  • With whom should an NA use Standard Precautions?
  • (A) With residents who have infectious diseases
  • (B) With residents he suspects might have
    infectious diseases
  • (C) With every resident in his care
  • (D) With residents who request that they be used
  • Under Standard Precautions, the term body
    fluids includes
  • (A) Sweat
  • (B) Water
  • (C) Juice
  • (D) Urine

100
Exam
  • Hand hygiene is
  • (A) Washing hands with either plain or
    antiseptic soap and water or using alcohol-based
    hand rubs
  • (B) Washing hands with soap and water only
  • (C) Using alcohol-based hand rubs only
  • (D) Wearing gloves when performing care
    procedures
  • When washing hands, an NA should use friction for
  • (A) At least 25 seconds
  • (B) At least 20 seconds
  • (C) At least 15 seconds
  • (D) At least 5 seconds

101
Exam
  • Which of the following is true of wearing gloves?
  • (A) Disposable gloves can be washed and reused.
  • (B) Gloves should be changed before contact with
    mucous membranes.
  • (C) After giving care, gloves are not
    contaminated.
  • (D) Gloves can continue to be worn if they are
    torn as long as the hole is covered.
  • Which of the following is the proper order to don
    PPE?
  • (A) Put on mask and goggles, gown, and gloves.
  • (B) Put on gloves, gown, and mask and goggles.
  • (C) Put on mask and goggles, gloves, and gown.
  • (D) Put on gown, mask and goggles, and gloves.

102
Exam
  • Which of the following statements is true of
    disinfection?
  • (A) Disinfecting an item means that all pathogens
    on the item are destroyed.
  • (B) Disinfection is carried out with an
    autoclave.
  • (C) Disinfection kills some pathogens but not all
    of them.
  • (D) Disinfection can be accomplished with regular
    soap and cold water.
  • If an NA needs to clean up a spill, what is the
    first step that she should take?
  • (A) Put the waste directly into the nearest trash
    can.
  • (B) Spray bleach solution on the spill.
  • (C) Put on gloves.
  • (D) Vacuum the spill.

103
Exam
  • Which of the following is true of
    Transmission-Based Precautions?
  • (A) An NA does not need to practice Standard
    Precautions if he practices Transmission-Based
    Precautions.
  • (B) They are exactly the same as Standard
    Precautions.
  • (C) They are practiced in addition to Standard
    Precautions.
  • (D) They will not be listed in the care plan so
    as not to alarm anyone.
  • What is one way that bloodborne pathogens can be
    transmitted?
  • (A) By hugging an infected person
  • (B) By contact with blood or body fluids
  • (C) By standing too close to an infected person
    when he coughs
  • (D) By touching something an infected person has
    touched

104
Exam
  • Which of the following statements is true of
    hepatitis B (HBV)?
  • (A) HBV is a relatively minor disease and poses
    no real threat to healthcare workers.
  • (B) The vaccine for HBV helps prevent the
    disease.
  • (C) More people in the U.S. have HIV than have
    HBV.
  • (D) HBV causes some unpleasant symptoms but
    cannot cause death.
  • The Bloodborne Pathogen Standard requires that
  • (A) Employers educate a select group of employees
    who will be in contact with residents with
    bloodborne diseases
  • (B) Employers provide hepatitis B vaccinations to
    employees at a reduced cost
  • Employers keep one set of personal protective
    equipment on hand for visitors to use
  • Employers have an exposure control plan

105
Exam
  • Tuberculosis may be transmitted
  • (A) Through a protective mask
  • (B) By dancing
  • (C) By wearing gloves
  • (D) By coughing
  • Tuberculosis is
  • (A) A bloodborne disease
  • (B) A sexually transmitted disease
  • (C) An airborne disease
  • (D) Completely eradicated (no longer exists)

106
Exam
  • A person with TB disease
  • (A) Can spread it to others
  • (B) Does not show symptoms
  • (C) Cannot infect others
  • (D) Has what is called latent TB
  • How is MRSA most often spread?
  • (A) By direct physical contact
  • (B) By indirect contact
  • (C) By being in enclosed spaces
  • (D) Through the air

107
Exam
  • What is the best way to control the spread of
    MRSA?
  • (A) By taking medication
  • (B) Through proper handwashing
  • (C) By using masks
  • (D) By taking vancomycin
  • What is the best way to control the spread of C.
    difficile?
  • (A) By limiting contact of the infected person
    with others
  • (B) By using more powerful antibiotics
  • (C) By giving more enemas to clean out the GI
    tract
  • (D) Through proper handwashing and handling of
    contaminated wastes

108
Exam
  • Which of the following is an NA responsibility
    related to infection prevention?
  • (A) Deciding which residents need
    Transmission-Based Precautions
  • (B) Telling all visitors which patients have
    bloodborne diseases
  • (C) Following Standard Precautions in caring for
    all residents
  • (D) Capping needles and other sharps before
    disposing of them in the trash
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