Ch. 9

• What are the 2 Tiers of precautions from the Health Infection Control Practice Advisory Committee from 1996?

  1. Standard precautions= care of hospital patients regardless of their diagnosis or assumed infection
  2. Transmission-based precautions (precautions designed for the care of specific patients)
• Standard Precautions - care of all patients, regardless of diagnosis assumed infection
• standard precautions includes

  blood, all body fluids and excretions (except sweat), nonintact skin, mucous membranes
• the purpose of standard precautions

  to reduce the risk of transmission of from known and unknown sources of infection
• Always practice standard precautions.
• droplet precaution PPE

  masks, eye protection, and face shields
• transmission-based precaution is for confirmed/suspected diagnosis
• Transmission based precautions consists of

  airborne

  droplet

  contact
• wear gloves during tattoos for therapy treatment
• single most crucial way to prevent the spread of HAIs

  hand hygiene
• hand hygiene prevents HCW contracting something from the patient and spreading something to the patient

  AKA contact spread through direct or indirect
• underside of nail harbors the highest number of microorganisms
• Use water and soap hand hygiene when 


  -visibility dirty or contaminated by blood or other bodily fluid/excretion, mucous membrane contact, nonintact skin, wound dressing

  -before eating

  -after using restroom

  -after caring for patient known to have C-diff or diarrhea
• use alcohol-based hand rub hand hygiene when 


  -simple routine touching of patient or patient environment

  -before having direct contact with patient

  -before inserting urinary catheter or other invasive nonsurgical procedure

  -after contact with patient's intact skin (lifting or shaking hand)

  -when moving from contaminated body site to clean body site during same patient care

  -after contact with inanimate objects (including medical equipment) in the immediate vicinity of patient (bed rails, wheelchairs, treatment couch)

  -after removing gloves
• nonalcohol-based hand rubs that smell good are available in the stores/malls are not FDA approved unless so stated
• alcohol-based hand rubs are flammable and should be stored only in approved areas
• Why we wear gloves?

  -Provider barrier for HCW-keep hands from becoming contaminated

  -Keep patient safe from microorganisms on HCW's hands

  -Cannot serve as fomite to infect other patients
• examples of fomites


  food, water, medications, medical supplies
• what are fomites?

  vehicles for transmitting disease
• Why do we wear masks, respiratory protection, eye protection, and face shields?

  -Protect HCW from contact with infectious material

  -Placed on a coughing patient to protect HCW

  -Worn by HCW performing a sterile procedure to protect patient
• Particle respirator 


  protect against small droplet nuclei pathogens that are transmitted via airborne route
• particle respirator example

  N95
• Why do HCWs wear gowns?

  to protect over uniform or street clothes
• patient placement 


  private room to isolate infectious patients
• transport of infectious patients

  wear masks, dressings, or other necessary barriers
• laundry

  use clean linens for every patient

  label and put aside contaminated linen

  specific spot for contaminated linen

  *handle laundry as little as possible and with little agitation, place in bag or container at specific location
• routine cleaning of environment 


  clean equipment and room after each patient

  wipe down anything that touches the patient with specific wipes (for each material with different wait time to dry)
• blood and body fluid spills

  clean immediately and call environmental (for certain cleaning supplies)
• OSHA

  Occupational Safety and Health Administration
• HCWs can lawfully refuse to work in truly unsafe conditions and have the right to insist on wearing protective equipment
• Central Services Department


  responsible for preparing, processing, sorting, and distributing the medical supplies and equipment for patient care
• after a package is disinfected in must be stored

  in a dry, clean, closed, low-traffic area
• After package is disinfected or sterilized, it must be handled as little as possible and removed from high-traffic areas
• critical items

  products/instruments inserted into normally sterile areas of the body or into bloodstream and must be sterile
• semicritial items

  contact mucosal surfaces but do not usually penetrate body mucosal surfaces, including nonintact skin
• noncritial items

  do not touch the patient or touch only intact skin; these do not need to be sterile
• endoscopes and thermometers are examples of what level of critical item?

  semicritical
• surgical instruments, needles, implants, and urinary catheters are examples of what level of critical item?

  critical
• crutches, bedpans, tabletops, and BP cuffs are examples of what level of critical items?

  noncritical
• What is a process that destroys all microbial life life forms including resistant spores?

  sterilization