Module 5 Flashcards
(38 cards)
1
Q
Who should use routine practices?
A
All health care workers (HCW) to protect themselves, patients and visitors
2
Q
When should HCW use routine practices?
A
Whenever you expect to have contact with:
- blood
- all body fluids including secretions and excretions (except sweat)
- mucous membranes
- non-intact skin
3
Q
Secretions
Excretions
(Definitions)
A
Secretions: functionally useful fluids released from glandular cells
Excretions: fluids containing body waste products
4
Q
Fluids included in routine practice precautions
A
- blood (blood products) -spinal fluid
- vaginal secretions -synovial fluid
- breast milk -pleural fluid
- semen -peritoneal fluid
- saliva -pericardial fluid
- tears -amniotic fluid
- sputum -nasal secretions
- vomitus -urine
- feces
NOT INCLUDED: sweat (perspiration)
5
Q
Guidelines for Routine practice include
A
- Wash hands (plain soap)
- Wear gloves
- Wear mask and eye protection/ face shield
- Wear gown
- Patient care equipment
- Environmental control
- linen
- Occupational health and blood born pathogens
- patient placement
6
Q
Personal protective equipment consists of: (5)
A
- Gloves
- Masks
- Goggle and face protection
- Gowns
- Hand hygiene using hand wash or alcohol based hand rubs
7
Q
Gloves:
When
A
- touching blood, body fluids, excretions and secretions
- touching/cleaning contaminated items
- performing invasive procedures (phlebotomy, starting IVs)
- performing test procedures
- handling patient specimens
- touching mucous membranes and non intact skin
8
Q
Gloves:
Remove/Wash
A
- promptly after use
- before next patient
- when soiled or damaged.. if heavily contaminated, place in biohazardous container
- when touching non-contaminated items and environmental surfaces (phones/keyboards/doorknobs)
9
Q
Gloves:
Selection criteria
A
- suitable to task
- fit well
- of good quality and thickness
- no holes
- vinyl now used extensively due to latex allergies
10
Q
Contact Dermatitis
A
- may be caused by allergy to latex, powder, chemicals
- avoid if possible because:
- breaks the protective barrier provided by skin
- staphylococcus aureus infections follow making condition worse and a reservoir of infectious bacteria
- preventative measure:
- take action before out of control
- barrier cream on hands
- cotton liners, gloves without powder
- different type of latex ex. Low protein
- vinyl gloves
11
Q
Precautions to take when using latex gloves
A
- moisturizing creams used on hands must be certified not to affect latex
- do not expose latex gloves to light during storage
- do not store boxes of gloves near high voltage equipment capable of producing ozone
- do not expose to UV for more than a few minutes
- store boxes of gloves in dark, dry, cool place
- record the date of which the box of gloves is opened on box; dispose of gloves after 3 months
- if there is an expiry date on an unopened box, comply with it
- examine the gloves before using; a damaged glove changes colour and becomes less elastic
- if you think the gloves is not good, test it. The glove should stretch atleast half its length without tearing
12
Q
Sweat on gloves
A
- makes gloves porous
- after 50minutes of hydration, 50% of latex gloves become permeable to Hep B and C viruses and HIV
- gloves should be changed after 30 minutes of work
13
Q
Masks:
When
A
If danger of aerosols or splashes of infectious material
14
Q
Masks:
Types(5)
A
- procedure (most common)
- surgical (most common)
- HEPA
- N95 (most common)- airborne
- Airline (external air source)
15
Q
Masks:
Use
A
- cover nose, mouth, and under chin
- metal nosepiece at top
- white (smoothest side) is in- against wearers skin
- coloured (fluid resistant side) is always out
- pleats downwards away from nose (called “waterfall” pleats)
- use once and discard
- do not wear around neck
- replace if wet
- HEPA/N95 for airborne infections such as tuberculosis
- if ties-tie top first-untie bottom first
16
Q
Goggles/Face shields:
When
A
-danger of splashes of infectious material on mucous membranes of eye/mouth/nose
17
Q
Gown/Apron:
When
A
- if danger of contamination with infectious material
- to prevent transfer of microbes between patients
18
Q
Gown/Apron:
Use
A
- ties down back with waist tied at back
- when noted on the door
- anticipate splashes
- patient has MRSA
19
Q
Gown/Apron:
Removal
A
- gloves off first
- untie back the waist
- shoulders loose as untie back
- remove arms avoiding contact with outer surface
- fold gown with outer surface in
- place in proper container
20
Q
When is hand hygiene required?
A
- immediately after unprotected exposure to blood, body fluids, secretions or excretions
- after hands have contacted contaminated equipment
- immediately after removing gloves
- after a glove tear or suspected leak
- before leaving a work area
- between patients
- after going to the bathroom
- after blowing the nose or muffling a sneeze
- before eating or drinking
- a the beginning and end of work shift
21
Q
Proper way to wash hands: (also refer to booklet)
A
- Remove jewelry/gloves
- Adjust water
- Wet hands
- Apply soap
- Vigorous rubbing and circular motion
- Lower hand and rinse
- Dry hands and forearms
- Turn off tap (using paper towel)
- Use hand lotion
22
Q
Put on PPE (donning PPE)
A
- hand hygiene
- gown
- mask
- eye/face protection
- gloves
23
Q
Take off PPE (doffing PPE)
A
- gloves
- gown
- hand hygiene
- eye/face protection
- mask
- hand hygiene
24
Q
4 moments of hand hygiene:
A
- Before initial patient/patient environment contact
- Before aseptic procedure
- After body fluid exposure
- After patient /patient environment contact
25
Soaps for hand washing
- non-antibacterial:
- reduces surface tension (wetting agent) allowing bacteria to be washed away
- used for routine hand washing
- antibacterial :
- reduces surface tension and kills some microbes
- use for:
- critical care units/nurseries
- emergency, operation, delivery, medication rooms;areas where surgical and diagnostic testing performed
- burn, dialysis and transplant units
- after contact with patients with antibiotic resistant bacteria
26
Alcohol hand cleansers
-70% ethanol or isopropyl best
A. Dispense (about 5 ml) into palm
B. Rub fingers nails/pour in to other palm/rub nails
C. Rub fingers/palms/backs of hands
D. Air dry
27
Precautions to prevent injury with sharp objects
Care of needles
- activate safety device-discard immediately after use-no not recap
- use puncture resistant container-discard when 3/4 full
Clean up
- uncontaminated broken glass:
- broom/dust pan or wet paper towel and discard
- contaminated broken glass
- decontaminate 10 mins before cleaning up and discard
28
Blood/body fluid spill clean up:
| Patient care and client areas
Can use incintinent pads/absorbent wipes/paper towels for clean up
Large spills:
- wear suitable PPE
- contain spill then sweep or scoop (use disinfectant absorbent if possible)--> clean up and put in lined biohazardous container
- decontaminate with disinfectant (ex. 1/100 fresh bleach) for 10 min
- clean up
Moderate spills:
- Wear suitable PPE
- wipe up with paper towels--> lined biohazardous container
- decontaminate with disinfectant for 10 min
- clean up
Small spill/dried blood or body fluid:
- gloves
- if dried moisten first
- wipe with disinfectant soaked paper towel or disinfectant wipe--> lined biohazardous container
29
Blood/body fluid spill clean up:
| Laboratory specimen spills
- wear suitable PPE
- decontaminate with disinfectant (1/10 fresh bleach) clean up with paper towel--> plastic lined biohazardous container
- decontaminate surface for 10 min with fresh disinfectant
- clean up
30
Biohazardous waste
- anything contaminated with blood or body fluids
- DO NOT DISCARD in regular garbage
- place in container with biohazard symbol
31
Laundry
- place in leak proof bags if wet
| - handle carefully --> regular laundry
32
Collecting and transporting laboratory specimens
- wear appropriate PPE
- avoid contaminating collection container and requisition
- store in sealed container
33
Occupational exposure to blood and body fluids:
| What is it and protocol
What is it?
- skin is pierced by contaminated needle or sharp object
- blood or body fluid splashes on mucous membrane
- blood or body fluid on non intact skin
- human bite
Protocol?
A. First aid as required
B. Allow bleeding
C. Wash with soap/antiseptic and water
D. Bandage if necessary
E. Flush mucosal surfaces with lots of water
F. Report incident immediately to: supervisor--> occupational health--> emergency department
34
Added precautions/isolation procedures
- to minimize the spread of infection in health care setting
- separate patients with transmissible infections
- protect immunocompromised patients
-physician and infection control practitioners make decision
- airborne
- droplet
- contact
35
Types of roos of isolation
Negative pressure (protect others)
- air flows into room from hallway
- keeps microorganisms from leaving room and spreading into hallways (ex. Tuberculosis)
- rooms have Hepa filtration system to remove microorganisms from room air, keep door closed as much as possible
Positive pressure (protect patient)
- air is allowed to flow from room into hallway
- protects immunosuppressive patients from outside microorganisms
36
Protective environment (formerly called Reverse) isolation
Designed to protect patient from hospital and other peoples microorganisms
- burn units, immunosuppressed patients, transplant patients
- usually includes: private room, hand washing especially before entering room, gloves, gown
- contaminated articles not brought into room
37
Disposal of items from isolation rooms
- supplies and equipment
- have dedicated equipment for patient
- leave in room
- thermometers, tourniquets, BP cuff, blood collection, other therapeutic equipment
- serving food trays (usually only gloves required)
- leftover food and disposable dishes discarded into dedicated trash
- non disposable dishes bagged for transport to clean up area
38
Patient movement
| Transporting patient out of isolation
- avoid if possible
- surgical mask on patient of air borne or droplet isolation
- if contact isolation- cover draining areas
- protect wheelchair with sheet
- receiving department must be notified
