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BNS Exam 2- Ch7 p2 Asepsis & Infection Control

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icorojo's version from 2018-04-14 21:58

INFECTION PREVENTION AND CONTROL TEAM

Question Answer
Infection Control Nursenurses who are specially trained in infection control
Infection Control Nurse: responsibilityfor advising hospital personnel on the development and implementation of safe PT care delivery practices and for monitoring infection within the health care agency
Employee Health Serviceplays a role in infection control by taking measures to protect the HCW from disease carried by patients and to protect patients from disease carried by staff
memorize

HAND HYGIENE

Question Answer
Hand hygieneis the most important and basic preventive technique for interrupting the infectious process
When is hand washing necessary?•before/after PT care •after touching blood, bodily fluids, secretions, excretions, and contaminated items •immediately after gloves are removed •between PT contact •before/after using the toilet •before/after eating •beginning/end of shift •when otherwise indicated
Antibacterial soapsmost likely to cause skin irritation because they kill all normal flora on hands
Antimicrobial soapscause less skin irritation; does not kill all of normal flora on hands; kills pathogens
Alcohol-based waterless antisepticshave excellent germicidal activity and are more effective than their plain soap or antimicrobial soap and water; emollients are added to prevent drying of the skin
When is it NOT appropriate to use alcohol based waterless antiseptics?if caring for a PT with Clostridium difficile (C. diff) diarrhea or Candida species infection; the spores are unaffected by the alcohol in the hand sanitizer
Hand washing standard15 to 30 seconds (per textbook p126)
Surgical hand washing lasts5 to 10 minutes (per textbook p143)
*in class* how long to wash hands at beginning and end of shift?2 minutes
*in class* how long to wash hands in between PT's ?30 seconds
*in class* how long is surgical hand washing?15 minutes
memorize

GLOVING

Question Answer
Don glovesif there is any possibility of contact with infectious material
Gloves are wornonly once and then placed into infectious waste containers
Hands should be washedafter gloves are removed
If the nurse has not completed care, but has come into contact with infectious materialthe gloves should be changed before continuing PT care
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GOWNING

Question Answer
Gowningto protect skin and prevent soiling of clothing during procedures and PT care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions or cause soiling of clothing
Another rationale for use of a gownprotection of a PT whose immune system is inadequate; in this situation a gown prevents transfer of microorganism to PT
memorize

MASK/PROTECTIVE EYEWEAR

Question Answer
Change maskat least every 20 to 30 minutes and when it becomes moist
Mask should NOTbe reused or allow it to dangle around the neck and then reuse it
Mask protectsthe wearer from inhaling microorganisms that travel on airborne droplets
Mask preventsinhaling pathogens if resistance is reduced or during transport to another area
Discourage the mask wearerfrom touching the mouth, nose, and eyes and from transmitting infectious material
memorize

DISPOSING OF CONTAMINATED EQUIPMENT

Question Answer
Disposal of sharps (needles, blades)must be put in a puncture-proof container
Disposal of contaminated equipmentspecially labeled bagging and either sanitary burial or incineration (burning of waste) are required
Double bagginginvolves placing a bag of contaminated items into another clean bag that is held outside an isolation room by other personnel
Double bagging recommendwhen it is impossible to keep the outer surface of a single bag free from contamination
What is BMW? When is it used and for what?biomedical waste; any solid or liquid waste which may present a threat of infection to humans, including non-liquid tissue, body parts, blood, blood products, and body fluids; and discarded sharps.
memorize

ISOLATION TECHNIQUE

Question Answer
Thorough hand washingshould be performed before entering and after leaving a PT's room
Determining appropriate PPErequires an understanding of the PT's specific disease process and method of transmission of the infectious microorganism
Contaminated equipment and articles are to bedisposed of in a safe and effective manner to prevent transmission of pathogens to other individuals
If the PT is transported to other areas in the hospitalnecessary measures should be taken to protect those who may be exposed; have PT wear a gown and mask
PT with an infectious diseaseshould be placed in a private or isolation room with the appropriate hand washing and toilet facilities
Private rooms used for isolationhave negative-pressure airflow to prevent infectious particulates from flowing out of the closed environment
Special rooms with positive-pressure airflowalso used for highly susceptible PT such as transplant recipients; no organisms are able to enter the room
All articles that come into contact with the PTare contaminated and should be handled appropriately to maintain protective asepsis
2 tiers of isolation guidelinesTier 1: Standard precautions and Tier 2: Transmission precautions
Isolation: Tier 1precautions designed to care for all PT's in health care facilities regardless of their diagnosis of presumed infectiousness
Isolation: Tier 2condenses the disease-specific and categories approach to isolation into new transmission categories: airborne, droplet, contact precautions
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SURGICAL ASEPSIS

Question Answer
Surgical asepsisthe complete removal of all microorganisms, including spores, from an object.
The nurse working with a sterile field or with sterile equipmentmust understand that the slightest break in technique results in contamination
This is practicedin the OR, labor and delivery area, and major diagnostic areas, as well as at the PT's bedside, when inserting IV lines or urinary catheters, or when reapplying sterile dressing
What is the primary reason for Surgical Asepsis?to prevent microorganisms from entering the body during invasive procedures; to reduce the risk of PT's postoperative infection
Explain what the PT can do to avoid contaminating sterile items•avoid sudden movements of body parts covered by sterile drapes •refrain from touching sterile supplies, drapes, or the nurse's gloves and gowns •avoid coughing , sneezing, or talking over a sterile area
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PRINCIPLES OF STERILE TECHNIQUE

Question Answer
A sterile object remains sterileonly when touched by another sterile object
Only sterile objectsmay be placed on a sterile field
A sterile object or field out of vision or object held below the waistis contaminated
A sterile object or field also becomes contaminated byprolonged exposure to air
The edge of the sterile field or containeris considered contaminated
When a sterile surface comes in contact with a wet, contaminated surfacethe sterile object or field becomes contaminated
If an object becomes contaminated during the procedureit should be discarded immediately per facility policy
memorize

MANAGING STERILE PACKAGES

Question Answer
Sterile items are placedin plastic or paper containers that are impervious to microorganisms as long as they are dry and intact
Reusable suppliesmay be wrapped in a double thickness or in linen or muslin
Sterile supplies havedated labels or chemical tapes that indicate the date when the sterilization expires
If the integrity of the sterile package is questionablethe item should NOT be used
Nurses performsa thorough hand washing
The suppliesare assembled at the work area
Commercially packaged itemsare usually designed so that the nurse only has to tear away or separate the paper or plastic cover
The item is heldin one hand while the wrapper is pulled away with the other
Care is takento keep the inner contents sterile before use
memorize

PREPARING A STERILE FIELD

Question Answer
When performing sterile proceduresthe nurse needs a sterile work area that provides room for handling and placing of sterile items
A sterile field is an areathat is free of microorganisms and is prepared to receive sterile items
The field may be prepared byusing the inner surface of a sterile wrapper or by using a sterile drape
memorize

POURING STERILE SOLUTIONS

Question Answer
A bottle containing sterile solutionis sterile on the inside and contaminated on the outside
The bottle'sneck is also contaminated, but the inside of the bottle cap is considered sterile
Before pouring the solution into the containerthe nurse pours a small amount (1 to 2 ml) into a disposable cap or waste receptacle; this cleans the lip of the bottle and is referred to as "lipping"
Pour solutionslowly to avoid splashing
The bottle should be heldoutside the edge of the sterile field
The nurse should hold the bottlewith its label in the palm of the hand to prevent the solution from wetting the label
memorize

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