งานนำเสนอกำลังจะดาวน์โหลด โปรดรอ

งานนำเสนอกำลังจะดาวน์โหลด โปรดรอ

This involves YOU The interaction between the 6 elements of the chain determine whether an infection will result.

งานนำเสนอที่คล้ายกัน


งานนำเสนอเรื่อง: "This involves YOU The interaction between the 6 elements of the chain determine whether an infection will result."— ใบสำเนางานนำเสนอ:

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5 This involves YOU

6 The interaction between the 6 elements of the chain determine whether an infection will result.

7 6 Links to the Chain of Infection Portal of Entry Susceptible Host Causative Agent Reservoir Portal of Exit Mode of Transmission

8 # 1 Causative Agent Bacteria (includes Richettsia, Chlamydia, and Mycoplasm Viruses Fungi Protozoa Helminths

9 Characteristics of causative agents Infective dose Pathogenicity Virulence Invasiveness

10 Characteristics of Causative Agents (Continued……. Host Specificity Viability Antigenic Variation Resistance

11 #2 Reservoir Humans:  Patients  Healthcare Workers

12 Reservoirs Animals Insects Rodents Shell Fish

13 Reservoirs Environment  Patient Care Equipment  Environmental Surfaces  Food

14 # 3 Portal of Exit The path by which the infectious organism (agent) leaves the reservoir

15 Respiratory Tract:  Coughing  Sneezing  Talking  Suctioning

16 Genitourinary Tract:  Foley Catheters  Sexually transmitted diseases Gastrointestinal Tract:  Feces  Vomitus

17 Skin/Mucous Membranes  Wounds  Skin breaks Transplacental Blood:  Needle stick  Blood Transfusion

18 #4 Mode of Transmission The mechanism for transfer of an infectious agent from the reservoir to a susceptible host.

19 4 Modes of Transmission Contact (Direct and Indirect) Airborne Vector-Borne Common Vehicle

20 CONTACT DIRECT: immediate transmission Person-to-person Actual physical contact between source and patient

21 INDIRECT CONTACT: Patient to contaminated indirect object (contaminated endoscope) Droplets spread (large particles that rapidly settle out on horizontal surfaces – usually within 3 feet of source)

22 AIRBORNE Organisms contained within droplet nuclei or dust particles (i.e. droplet nuclei of tuberculosis Suspended in air for extended periods, may be spread through ventilation systems

23 VECTOR-BORN External vector-born transmission; mechanical transfer of microbes on external appendages (feet of flies)

24 Harbored by Vector Harbored by vector, but no biological interaction between vector and agent (i.e. yellow fever virus

25 #5 PORTAL OF ENTRY The path by which an infectious agent enters the suceptible host

26 Respiratory Tract Genitourinary Tract Gastrointestinal Tract Skin/Mucous Membrane Trasplacental (fetus from mother) Parenteral (percutaneous, via blood

27 #6 SUSCEPTIBLE HOST A person or animal lacking effective resistance to a particular pathogenic agent

28 NOSOCOMIAL INFECTIONS CAUSES AND SITES

29 SITES Surgical Sites Surgical Sites Respiratory Respiratory Bone and Joint Infection Bone and Joint Infection Central Nervous System Central Nervous System Gastrointestinal System Gastrointestinal System Skin and Soft Tissue Skin and Soft Tissue Blood Stream Blood Stream Urinary System (UTI) Urinary System (UTI) Cardiovascular Cardiovascular Eye/Ear/Throat Mouth Infection Eye/Ear/Throat Mouth Infection Reproductive System Reproductive System

30 Compromised Patients Immunocompromised patients vary in their susceptibility to nosocomial infections, depending on the severity and duration of immunosuppression. Use of the two tiered system essential to break the “Chain of Infection”.

31 3 Major Modes of Transmission in the Healthcare Setting Puncture Wounds Skin Contact Mucous Membranes (eye/mouth/nose)

32 Bloodborne Pathogens Hepatitis B Virus Hepatitis C Virus Human Immunodeficiency Virus

33 Role of the Infection Control Nurse/Practioner Surveillance Track/Trend types of infections Education of staff

34 Infection Control Methods and Personal Protective Equipment

35 Hand Washing Method Wet hands with clean (not hot) water Wet hands with clean (not hot) water Apply soap Apply soap Rub hands together for about 20 seconds Rub hands together for about 20 seconds Rinse with clean water Rinse with clean water Dry with disposable towel or air dry Dry with disposable towel or air dry Use towel to turn off faucet Use towel to turn off faucet

36 Alcohol-based Hand Rubs Effective if hands not visibly soiled Effective if hands not visibly soiled More costly than soap & water More costly than soap & waterMethod Apply appropriate (3ml) amount to palms Apply appropriate (3ml) amount to palms Rub hands together, covering all surfaces until dry Rub hands together, covering all surfaces until dry

37 Personal Protective Equipment (PPE) When used properly can protect you from exposure to infectious agents When used properly can protect you from exposure to infectious agents Know what type of PPE is necessary for the duties you perform and use it correctly Know what type of PPE is necessary for the duties you perform and use it correctly

38 Types of PPE Gloves Gloves Gowns Gowns Masks Masks Boots (for agricultural settings, not used for human healthcare) Boots (for agricultural settings, not used for human healthcare) Eye protection Eye protection

39 Types of PPE Gloves Different kinds of gloves Different kinds of gloves Housekeeper gloves Housekeeper gloves Clean gloves Clean gloves Sterile glove Sterile glove Work from clean to dirty Work from clean to dirty Avoid “touch contamination” Avoid “touch contamination” Eyes, mouth, nose, surfaces Eyes, mouth, nose, surfaces Change gloves between patients Change gloves between patients

40 Types of PPE Gowns Fully cover torso Fully cover torso Have long sleeves Have long sleeves Fit snuggly at the wrist Fit snuggly at the wrist

41 Types of PPE Surgical masks Surgical masks Cotton, paper Cotton, paper Protect against body fluids and large particles Protect against body fluids and large particles Particulate respirators (N95) Particulate respirators (N95) Fit testing essential Fit testing essential Protect against small droplets and other airborne particles Protect against small droplets and other airborne particles Alternative materials (barrier) Alternative materials (barrier) Tissues, cloth Tissues, cloth Masks and Respirators: Barriers and Filtration

42 Types of PPE Particulate Respirators Three types: disposable, reusable, powered air purifying respirators Three types: disposable, reusable, powered air purifying respirators Disposable Particulate Respirators Disposable Particulate Respirators Classified N95, N99, N100, R95, R99, R100, P95, P99, P100 Classified N95, N99, N100, R95, R99, R100, P95, P99, P100 Letter indicates oil resistance: N = not resistant, R = somewhat resistant, P = strongly resistant Letter indicates oil resistance: N = not resistant, R = somewhat resistant, P = strongly resistant Number is percent of airborne particles filtered (e.g. N95 filters 95% of particles) Number is percent of airborne particles filtered (e.g. N95 filters 95% of particles)

43 Types of PPE Boots Boots (non-hospital settings) (non-hospital settings) Eye Protection Face shields Face shields Goggles Goggles

44 PPE Supplies Maintain adequate, accessible supplies Maintain adequate, accessible supplies Creative alternatives (studies not done to asses effectiveness) Creative alternatives (studies not done to asses effectiveness) Mask: tissue, scarf Mask: tissue, scarf Gown: laboratory coat, scrubs Gown: laboratory coat, scrubs

45 Working with Limited Resources Avoid reuse of disposable PPE items Avoid reuse of disposable PPE items Consider reuse of some disposable items only as an urgent, temporary solution Consider reuse of some disposable items only as an urgent, temporary solution Reuse only if no obvious soiling or damage Reuse only if no obvious soiling or damage When prioritizing PPE purchase When prioritizing PPE purchase Masks Masks Gloves Gloves Eye protection Eye protection

46 Infection Control Precautions

47 STANDARD PRECAUTIONS for all patient careกิจกรรมการพยาบาลล้างมือถุงมือเสื้อคลุม ผ้าปิดปากและ จมูก แว่นตา พูดคุยกับผู้ป่วย ปรับอัตราการไหลของสารน้ำทางหลอดเลือดดำ หรือการใช้ เครื่องมือที่ไม่ได้สอดใส่เข้าร่างกาย การตรวจ/ประเมินสภาพผู้ป่วยโดยไม่ได้สัมผัสเลือด สารในร่างกาย หรือเยื่อบุต่างฯของร่างกาย  การตรวจ/ประเมินสภาพผู้ป่วยโดยสัมผัสเลือด สารในร่างกาย หรือ เยื่อบุต่างฯของร่างกาย  การเจาะเลือด  การแทงน้ำเกลือ หรือสอดใส่ Catheter เข้าหลอดเลือดดำ  การดูดเสมหะ  ใส่เสื้อคลุม ผ้าปิดปากและจมูก และแว่นตา ถ้ามีการกระเด็น ของสารในร่างกาย การสอดใส่ Catheter เข้าไปในร่างกายหรือใบหน้า  ใส่เสื้อคลุม ผ้าปิดปากและจมูก และแว่นตา ถ้ามีการกระเด็น ของสารในร่างกาย การถือของใช้ที่สกปรก/เปื้อน/Contaminated เสื้อผ้าหรือสิ่งอื่นฯ ของผู้ป่วยที่ Contaminated  ใส่เสื้อคลุม ผ้าปิดปากและจมูก และแว่นตา เฉพาะในกรณี ที่ของใช้หรือเสื้อผ้าเปื้อนมากฯ และอาจมีการกระเด็น ของสารในร่างกายได้ ใส่ท่อช่วยหายใจ  การส่องกล้อง (Endoscopy)  การสอดใส่ Catheter เข้าในหลอดเลือดแดง  การผ่าตัดหรือกิจกรรมอื่น ซึ่งมีการกระเด็นของเลือดหรือสารใน ร่างกายอย่างมาก 

48 Precaution Levels All levels require hand hygiene Standard Standard Transmission based precautions: Contact Contact Droplet Droplet Airborne Airborne

49 Standard Precautions Prevent the transmission of common infectious agents Prevent the transmission of common infectious agents Hand washing key Hand washing key Assume infectious agent could be present in the patient’s Assume infectious agent could be present in the patient’s Blood Blood Body fluids, secretions, excretions Body fluids, secretions, excretions Non-intact skin Non-intact skin Mucous membranes Mucous membranes

50 PPE for Standard Precautions Wear: Gloves Gloves Gowns Gowns Eye Protection and / or Mask Eye Protection and / or Mask If: Touching Touching Respiratory secretions Respiratory secretions Contaminated items or surfaces Contaminated items or surfaces Blood & body fluids Blood & body fluids Soiling clothes with patient body fluids, secretions, or excretions Soiling clothes with patient body fluids, secretions, or excretions Procedures are likely to generate splashes / sprays of blood, body fluids, secretions, excretions Procedures are likely to generate splashes / sprays of blood, body fluids, secretions, excretions

51 Contact Precautions Taken in addition to Standard Precautions Limit patient movement Limit patient movement Isolate or cohort patients Isolate or cohort patients Gown + gloves for patient / room contact Gown + gloves for patient / room contact Remove immediately after contact Remove immediately after contact Do not touch eyes, nose, mouth with hands Do not touch eyes, nose, mouth with hands Avoid contaminating environmental surfaces Avoid contaminating environmental surfaces

52 Contact Precautions Wash hands immediately after patient contact Wash hands immediately after patient contact Use dedicated equipment if possible Use dedicated equipment if possible If not, clean and disinfect between uses If not, clean and disinfect between uses Clean, then disinfect patient room daily Clean, then disinfect patient room daily Bed rails Bed rails Bedside tables Bedside tables Lavatory surfaces Lavatory surfaces Blood pressure cuff, equipment surfaces Blood pressure cuff, equipment surfaces

53 Cleaning and Disinfection for Contact Precautions Detergents Detergents Remove dirt, soiling Remove dirt, soiling Mechanical force essential Mechanical force essential Flush with clean water Flush with clean water Disinfectants Disinfectants Kill viruses, bacteria Kill viruses, bacteria Decontaminate surfaces Decontaminate surfaces Type depends on infectious agent Type depends on infectious agent Use after detergent Use after detergent


ดาวน์โหลด ppt This involves YOU The interaction between the 6 elements of the chain determine whether an infection will result.

งานนำเสนอที่คล้ายกัน


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