Question

asss a nurseee  whhyy doo u think stanndard pprecautions are effeective in thhe preveention of infecctions>>?

Answer 1

QUESTION: AS A NURSE WHY DO U THINK STANDARD PRECAUTIONS ARE EFFEECTIVE IN THE PREVENTION OF INFECTIONS?

ANSWER:

STANDARD PRECAUTIONS ARE EFFEECTIVE IN THE PREVENTION OF INFECTIONS

Introduction

All people potentially harbour infectious microorganisms. As such, it must be assumed that all blood and body fluids/substances are potentially infectious. Standard precautions are the work practices required to achieve a basic level of infection prevention and control. The use of standard precautions aims to minimise, and where possible, eliminate the risk of transmission of infection, particularly those caused by blood borne viruses.

Standard precaution

Group of practices of infection prevention and control infectious agents,based on a principle that all blood, body fluids secretions, excretions (except sweat), non intact skin and mucous membranes may contain transmissible pathogen. It applies to all patients regardless of their diagnosis

Standard precaution are control guidelines designed to protect guidelines designed to protect workers from exposure to Diseases workers from exposure to Diseases spread by Blood and other Body spread by Blood and other Body fluids -(CDC)

Need of Standard (universal) health Precautions as per CDC

The concept of Standard (universal) Health Precautions emphasizes that all the patients should be treated as though they have potential blood born infections and can infect the caring health care workers.

Chain of Infection

Infectious Agent----Reservoir----Means of Exit----Mode of Transmission----Means of Entry

----Susceptible Host----Infectious Agent

Ways of Exposures to infection

• Most common: needle sticks injuries
• Cuts from other contaminated sharps (scalpels, broken glass, etc.)
• Splashes of blood into mucous membranes (for example, the eye, nose, mouth) or broken skin (cut or abraded) with contaminated blood
• Contamination where clothes soaked by blood
• Bites (which break the skin)
• By blood from someone who is infected with the virus getting into someone else's body:
• Needle stick injuries
• Damaged or cut skin including bites
• Sharing needles, syringes, razors & tooth brushes
• Mother to baby around the time of birth
• Through unprotected sexual intercourse
• By tattooing, body piercing or acupuncture if instruments are not properly sterilised

Highly Infectious human materials/tissues

• Blood
• Blood stained body fluids
• Semen
• Vaginal secretions
• Tissues
• CSF, amniotic, pericardial, pleural fluids

Human materials/tissues which are less likely to contain pathogens

• Body fluids less likely to contain pathogens:
• Tears
• Nasal secretions
• Sweat
• Saliva (more likely if blood present)

Spread of Infection

• Blood borne viruses CANNOT be caught from:
• Coughing, sneezing
• Shared use of facilities such as toilets, water fountains or telephones
• Sharing glasses, plates and cutlery
• Shaking hands
• Swimming in a pool
• If blood or body fluids fall onto intact skin (For infection to spread, infected blood (body fluid) needs to enter body)

Elements of Standard Precaution

1. Hand Hygiene

2. Gown

3. Mask

4. Face Protection

5. Gloves

6. Safe injection practices

7. Patient Care Equipment/ Devices

8. Environmental Control

9. Textile and laundry

10. Worker Safety

11. Patient Placement and Transport

12. Respiratory Hygiene / Cough Etiquette

13. Infection Control Practices for Lumbar Puncture

Hand Hygiene -Types of Hand Hygiene

• Hand wash - 40-60 seconds
• Hand rub - 20-30 seconds
• Hand scrub –

5 minutes (first wash of the day);

2-3 minutes (in between operations)

5 Moments for Hand Hygiene

• Before touching a patient,
• Before clean/aseptic procedures,
• After body fluid exposure/risk,
• After touching a patient, and
• After touching patient surroundings.

Personal Protective Equipment (PPE)

A variety of barriers to protect HCW’s mucous membranes, airways, skin, and clothing (whenever blood/body fluids splashes are expected)

PersonalProtectiveEquipment (PPE) include:

• Gloves – Use when touching blood, body fluids, secretions, excretions, contaminated items; for touching mucus membranes and nonintact skin.

• Gowns – Use during procedures and patient care activities when contact of clothing/ exposed skin with blood/body fluids, secretions, or excretions is anticipated.

• Mask, goggles or face shield – Use during patient care activities likely to generate splashes or sprays of blood, body fluids, secretions, or excretions

Textile and Laundry Key principles for handling soiled laundry

1) not shaking the items

2) avoiding contact of one’s body and personal clothing

3) dispose soiled items water soluble bag

4) dispose non soiled items in blue bag

Safe Work Practices

• Prevention of needle sticks and other sharps-related injuries
• Precautions during aerosol-generating procedures
• Prevention of mucous membrane contact
• Safe Injection Practices
• Do not RE-CAP the needle

Needles / Sharps

• Disposed immediately after use in puncture resistant container
• Not placed on environmental surfaces
• Not recapped if recapping is essential use one hand technique (scoop)
• Close sharp container when ¾ full and 7 days maximum.
• Never reuse needles, syringes, or lancets.
• Never administer medications from the same syringe to more than one patient, even if the needle is changed or injecting through an intervening length of IV tubing.
• Do not enter a medication vial, bag, or bottle with a used syringe or needle.
• Never use medications packaged as single-dose or single-use for more than one patient. This includes ampoules, bags, and bottles intravenous solutions.
• Always use aseptic technique when preparing and administering injections

Patient Placement and Transport

Healthcare worker transporting a patient with transmissible infection should contain the site of infection e.g. apply a dressing over a surgical site infection & offer a surgical mask for a coughing patient. Health care workers should not wear PPE in hospital corridors.

Determine patient placement based on:

• Route(s) of transmission of the known / suspected infectious agent, Availability of single rooms and options for cohorting (patients with the same pathogen in the same room)

• Patients with higher risk for pathogen transmission are prioritize to be admitted in a single room (e.g., uncontained secretions, or wound drainage;) .

Respiratory Hygiene / Cough Etiquette

A measures to contain respiratory secretions in patients and accompanying individuals who have signs and symptoms of a respiratory infection.

• Cover the mouths/noses when coughing or sneezing.
• Use and dispose of tissues.
• Perform hand hygiene if hands have been in contact with respiratory secretions.
• Post signs at entrances and in strategic places (e.g., elevators, cafeterias) within ambulatory and inpatient settings with instructions to patients and other persons with symptoms of a respiratory infection
• Provide tissues and no-touch receptacles (e.g., foot- pedal operated lid or open, plastic-lined waste basket) for disposal of tissues.
• Provide resources and instructions for performing hand hygiene in or near waiting areas in ambulatory and inpatient settings; provide conveniently-located dispensers of alcohol- based hand rubs and, where sinks are available, supplies for hand washing.

Patient Care Equipment and instruments/devices

All patient care equipment that is soiled with blood, body fluids, secretions or excretions shall be handled in a manner that will prevent skin and mucous membrane exposures.

• Wear PPE (e.g., gloves, gown), according to the level of anticipated contamination, when handling patient-care equipment and instruments/devices that is visibly soiled or may have been in contact with blood or body fluids.
• Remove organic material from critical and semi-critical instrument/devices, using recommended cleaning agents before high level disinfection and sterilization to enable effective disinfection and sterilization processes.
• Single use, disposable items must be disposed of properly.
• Make sure that reusable equipment has been cleaned and reprocessed appropriately, prior to use on another patient.

Infection Control Practices for Special Lumbar Puncture Procedures

Healthcare Infection Control Practices Advisory Committee (HICPAC) recommend that : individual placing a catheter or injecting material into the spinal or epidural should wear a face mask

Conclusion

Worldwide escalation of the use of standard precautions would reduce unnecessary risks associated with health care. Promotion of an institutional safety climate helps to improve conformity with recommended measures and thus subsequent risk reduction. Provision of adequate staff and supplies, together with leadership and education of health workers, patients, and visitors, is critical for an enhanced safety climate in health-care settings.