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NurseReview.Org - Isolation Nursing Precautions

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Information about NurseReview.Org - Isolation Nursing Precautions

Published on April 30, 2008

Author: nclexvideos

Source: slideshare.net

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http://Forum.NurseReview.Org
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Isolation Class 10 Last Class

Preventing the spread of infection What do we do when a client has a highly infectious disease?

What do we do when a client has a highly infectious disease?

Specific Infection Control Policies Isolation – the principle is to create a physical barrier that prevents the transfer of microorganisms.

Isolation – the principle is to create a physical barrier that prevents the transfer of microorganisms.

What are appropriate barriers? Depending on - Organism Transmission Airborne Vehicle Contact Direct Indirect Droplet

Organism Transmission

Airborne

Vehicle

Contact

Direct

Indirect

Droplet

Types of Barriers PPE (personal protective equipment) Gowns Gloves Masks Eyewear

PPE (personal protective equipment)

Gowns

Gloves

Masks

Eyewear

Each institution is required to have infection control policies and guidelines.

Each institution is required to have infection control policies and guidelines.

What about when we don’t know? 3 systems Universal precautions Body substance precautions Standard precautions

3 systems

Universal precautions

Body substance precautions

Standard precautions

Precautions to guard against the unknown Apply to everyone General public May or may not carry an infection

Apply to everyone

General public

May or may not carry an infection

History Lesson Initially concerned with patient to patient Followed by concern for health care professionals 1970 – Hepatitis B 1987 – HIV Universal precautions by Center for Disease Control (CDC)

Initially concerned with patient to patient

Followed by concern for health care professionals

1970 – Hepatitis B

1987 – HIV

Universal precautions by Center for Disease Control (CDC)

Universal precautions Stated : All blood & body flds should be treated as potentially infectious.

Stated :

All blood & body flds should be treated as potentially infectious.

Body Substance Isolation (BSI) Infection control practitioners in Seattle and SanDiego Canada adopted policy but renamed it Body Substance Precautions (BSP)

Infection control practitioners in Seattle and SanDiego

Canada adopted policy but renamed it Body Substance Precautions (BSP)

Standard Precautions 1996- newest guidelines by CDC combined the major features of universal precautions & BSP

1996- newest guidelines by CDC combined the major features of universal precautions & BSP

2 Tier System 1996 CDC new guidelines

1996 CDC new guidelines

1 st Tier – Standard Precautions Most important Universal precautions + BSP Applies to everyone Primary strategies for prevention of infection Standard precautions Blood, body flds., nonintact skin, mucus membranes

Most important

Universal precautions + BSP

Applies to everyone

Primary strategies for prevention of infection

Standard precautions

Blood, body flds., nonintact skin, mucus membranes

2 nd Tier Specific infections/diagnosis Droplet, airborne, contact with contaminated surface

Specific infections/diagnosis

Droplet, airborne, contact with contaminated surface

3 Types Transmission Based Precautions Airborne, droplet, contact Some infections combination (chicken pox) These extra precautions are in addition to Standard Precautions

Airborne, droplet, contact

Some infections combination (chicken pox)

These extra precautions are in addition to Standard Precautions

Airborne Travels on small particles Air currents Portal of entry – nose, mouth, mucus membranes Measles, chicken pox, TB

Travels on small particles

Air currents

Portal of entry – nose, mouth, mucus membranes

Measles, chicken pox, TB

Requirements for Airborne Negative pressure room – door closed TB = HEPA filter Do not enter if not immune to measles/chickenpox Client wears mask when required to leave room

Negative pressure room – door closed

TB = HEPA filter

Do not enter if not immune to measles/chickenpox

Client wears mask when required to leave room

Droplet Large droplets of moisture Coughing, sneezing, talking Travels 3 ft. or less Enters nose / mouth Mumps, pertusis, influenza Private room Staff regular mask for 3 ft. Client mask for transport

Large droplets of moisture

Coughing, sneezing, talking

Travels 3 ft. or less

Enters nose / mouth

Mumps, pertusis, influenza

Private room

Staff regular mask for 3 ft.

Client mask for transport

Contact Dry skin to dry skin = Direct Dry skin to object = Indirect Impetigo, herpes zoster, scabies Gloves – for direct care or touching anything in the room Private room or semi if cohort has same diagnosis

Dry skin to dry skin = Direct

Dry skin to object = Indirect

Impetigo, herpes zoster, scabies

Gloves – for direct care or touching anything in the room

Private room or semi if cohort has same diagnosis

Remove gloves prior to exiting and wash hands Gown for patient contact Changing linen Handling objects in the room

Remove gloves prior to exiting and wash hands

Gown for

patient contact

Changing linen

Handling objects in the room

Remove gown prior to exiting Wash hands Careful clothing does not touch room surfaces

Remove gown prior to exiting

Wash hands

Careful clothing does not touch room surfaces

Protective Isolation / Reverse isolation Compromised or suppressed immune system Highly susceptible to infections Protection from environmental pathogens

Compromised or suppressed immune system

Highly susceptible to infections

Protection from environmental pathogens

Protective Isolation / Reverse isolation What do you need ? Private room – door closed Gown, mask, gloves if direct contact Wash hands No plants / flowers

What do you need ?

Private room – door closed

Gown, mask, gloves if direct contact

Wash hands

No plants / flowers

Procedure Before instituting EXPLAIN to client & family Disease Purpose of isolation Steps to follow Time frame

Before instituting

EXPLAIN to client & family

Disease

Purpose of isolation

Steps to follow

Time frame

Room Preparation Private with BR facilities Sign on door Isolation cart outside door Laundry hamper in room Waste basket with plastic bag Thermometer, B/P cuff, stethoscope in room Sharps receptacle

Private with BR facilities

Sign on door

Isolation cart outside door

Laundry hamper in room

Waste basket with plastic bag

Thermometer, B/P cuff, stethoscope in room

Sharps receptacle

Be organized Gather equipment prior to entering room Remove rings and wash hands Don PPE Gown usually disposable Gloves up over cuff of gown

Be organized

Gather equipment prior to entering room

Remove rings and wash hands

Don PPE

Gown usually disposable

Gloves up over cuff of gown

Put your watch in a plastic bag if no clock in room Linen is placed in a water soluble bag & then cream/yellow bag No special treatment for dishes / trays

Put your watch in a plastic bag if no clock in room

Linen is placed in a water soluble bag & then cream/yellow bag

No special treatment for dishes / trays

Exiting Room Untie gown at waist Remove gloves properly Remove mask Untie gown at neck, drop over shoulders, don’t touch outside, fold inwards, and discard

Untie gown at waist

Remove gloves properly

Remove mask

Untie gown at neck, drop over shoulders, don’t touch outside, fold inwards, and discard

Exiting Room Wash hands Use paper towel on door handle Wash hands again outside room Important to do as much client care as you can while you are in the room….CLUSTER ACTIVITY.

Wash hands

Use paper towel on door handle

Wash hands again outside room

Important to do as much client care as you can while you are in the room….CLUSTER ACTIVITY.

Basic Principles Wash hands prior to entering & exiting room Careful disposal of contaminated materials Knowledge of disease and mode of transmission Protection of client and public during transport

Wash hands prior to entering & exiting room

Careful disposal of contaminated materials

Knowledge of disease and mode of transmission

Protection of client and public during transport

Client Consideration Isolation Loneliness Self – esteem, body image Boredom

Isolation

Loneliness

Self – esteem, body image

Boredom

Sterile Technique / Surgical Asepsis Purpose – to eliminate all microorganisms from objects that come into contact with the tissues of the body that are normally sterile.

Purpose – to eliminate all microorganisms from objects that come into contact with the tissues of the body that are normally sterile.

Practice Areas Operating room Labor and delivery Major diagnostic area At the bedside in 3 main situations Procedures requiring intentional perforation of the skin

Operating room

Labor and delivery

Major diagnostic area

At the bedside in 3 main situations

Procedures requiring intentional perforation of the skin

When the skin’s integrity is broken due to surgery or burns During procedures involving insertion of devices into normally sterile body cavities

When the skin’s integrity is broken due to surgery or burns

During procedures involving insertion of devices into normally sterile body cavities

Any break in technique could result in contamination increasing clients risk for infection.

Any break in technique could result in contamination increasing clients risk for infection.

Methods of Sterilization Steam – most common Dry heat Ethylene oxide gas Chemicals Indicator of sterility – tape on pkg. turns color or forms lines Expiration Date

Steam – most common

Dry heat

Ethylene oxide gas

Chemicals

Indicator of sterility –

tape on pkg. turns color or forms lines

Expiration Date

Examples of sterilization processes Moist heat /steam Radiation Autoclave- instruments, parental solutions, dressings Drugs, foods, heat sensitive items

Moist heat /steam

Radiation

Autoclave- instruments, parental solutions, dressings

Drugs, foods, heat sensitive items

Examples of sterilization processes Chemicals All types microorganisms Rapid action Work with water Stable in heat & light Inexpensive Not harmful to body tissue Instruments Glass thermometers Ex. Chlorine – used to disinfect water & for housekeeping purposes

Chemicals

All types microorganisms

Rapid action

Work with water

Stable in heat & light

Inexpensive

Not harmful to body tissue

Instruments

Glass thermometers

Ex. Chlorine – used to disinfect water & for housekeeping purposes

Examples of sterilization processes Ethylene oxide gas Destroys microorganisms by altering cells’ metabolic processes. Rubber Plastic

Ethylene oxide gas

Destroys microorganisms by altering cells’ metabolic processes.

Rubber

Plastic

Examples of sterilization processes Boiling water Cheap Imp. – bacterial spores andsome viruses resist boiling. Not used in hospitals! Items should be boiled for at least 15 min.

Boiling water

Cheap

Imp. – bacterial spores andsome viruses resist boiling. Not used in hospitals!

Items should be boiled for at least 15 min.

Practical Exam Prepare a sterile field Add an item Add a liquid Don sterile gloves

Prepare a sterile field

Add an item

Add a liquid

Don sterile gloves

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