1. Implementation Health promotion Preventing an infection from developing orspreading Acute care Treating an infectious process includes eliminatingthe infectious organisms and supporting thepatients defenses.Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 1

2. Implementation (contd) When implementing care, consider: Medical and surgical asepsis Control or elimination of infectious agents Control or elimination of reservoirs Control of portals of entry Control of transmission Hand hygiene Isolation precautions Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 2 3. Implementation: Asepsis Asepsis = Absence of pathogenic (disease-producing) microorganisms. Aseptic technique = Practices/ proceduresthat assist in reducing the risk for infection. Medical asepsis, or clean technique, includesprocedures for reducing the number of organismspresent and preventing the transfer of organisms. Surgical asepsis or sterile technique preventscontamination of an open wound, serves to isolatethe operative area from the unsterile environment,and maintains a sterile field for surgery.Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 3 4. Standard Precautions Standard precautions prevent and controlinfection and its spread. Apply to contact with blood, body fluid, nonintactskin, and mucous membranes from all patients. Hand hygiene includes using an instant alcoholhand antiseptic before and after providing patientcare, washing hands with soap and water whenthey are visibly soiled, and performing a surgicalscrub. Handwashing is the act of washing hands withsoap and water, followed by rinsing under astream of water for 15 seconds. Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 4 5. Disinfection versus Sterilization Disinfection: a process that eliminates manyor all microorganisms, with the exception ofbacterial spores, from inanimate objects Disinfection of surfaces High-level disinfection, which is required for someitems such as endoscopes Sterilization: the complete elimination ordestruction of all microorganisms, includingsporesCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 5 6. Infection Prevention and Control Patient safety Separate personal care items Handling solid and fluid waste Wound cleaning Patient education Cough etiquette Isolation and isolation precautions Surgical asepsisCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 6 7. Cough Etiquette Cover your nose/mouth with a tissue when youcough, and promptly dispose of the contaminatedtissue. Place a surgical mask on a patient if it does notcompromise respiratory function or is applicable; thismay not be feasible in pediatric populations. Perform hand hygiene after contact withcontaminated respiratory secretions Maintain spatial separation greater than 3 feet frompersons with respiratory infectionCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 7 8. Isolation and Isolation Precautions Isolation is the separation and restriction ofmovement of ill persons with contagiousdiseases. Standard precautions Isolation precautions: airborne, droplet, contact,and protective environment Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 8 9. Isolation Psychologicalimplications Isolation environment Personal protectiveequipment Specimen collection Bagging of trash orlinen Patient transport Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 9 10. Surgical Asepsis Patient preparation Sterile field: an area free ofmicroorganisms andprepared to receive sterileitems Principles Performing sterileprocedures Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 10 11. Principles of Surgical Asepsis1. A sterile object remains sterile only whentouched by another sterile object.2. Only sterile objects may be placed on asterile field.3. A sterile object or field out of the range ofvision or an object held below a persons waistis contaminated.4. A sterile object or field becomescontaminated by prolonged exposure to air.Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 11 12. Principles of Surgical Asepsis(contd)5. When a sterile surface comes in contact witha wet, contaminated surface, the sterile objector field becomes contaminated by capillaryaction.6. Fluid flows in the direction of gravity.7. The edges of a sterile field or container areconsidered to be contaminated.Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 12 13. Performing Sterile Procedures Donning and removing caps, masks, and eyewear Opening sterile packages Opening a sterile item on a flat surface Opening a sterile item while holding it Preparing a sterile field Pouring sterile solutions Surgical scrub Applying sterile gloves Donning a sterile gownCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 13 14. Evaluation See through the patients eyes: Have the patients expectations been met? Patient outcomes Measure the success of the infection controltechniques. Compare the patients actual response withexpected outcomes. If goals are not achieved, determine what stepsmust be taken.Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 14 15. Evaluation (contd) Exposure issues Patients and health care personnel are at risk foracquiring infection from accidental needlesticks. Report any contaminated needlestick immediately. Follow-up for risk of acquiring infection begins withsource patient testing. Access to testing the source patient is stated in the testing law for each state.Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 15