barrier nsg.pptx

I YR BBSC NURSING

1. NURSING FOUNDATION UNIT XI INFECTION CONTROL IN CLINICL SETTING TOPIC:ISOLATION PRECAUTIONS [ BARRIER NURSING ] Presented By: Mrs Bemina JA Assistant Professor ESIC College of Nursing Kalaburagi

2. Isolation refers to techniques used to prevent or limit the spread of infection. Some forms of isolation has been used for centuries, whether to protect a high-risk person from exposure to pathogens or to prevent the transmission of pathogens from an infected person to others. Barrier nursing or isolation technique is intended to confine the micro-organisms within a given and recognized area. There are a number of isolation techniques and precautions used to prevent the spread of infection. INTRODUCTION

3. Barrier nursing  is a largely archaic term for a set of stringent infection control  techniques used in nursing It is sometimes called "bedside isolation." The nursing technique by which a patient with an infectious disease is prevented from infecting other people is called barrier nursing Definition

4. The aim of barrier nursing Is to protect medical staff against infection by patients To protect patients with highly infectious diseases from spreading their pathogens to other non-infected people. Purposes

5. Contact Precautions Airborne Precautions Droplet Precautions Protective Isolation Three more elements have been added to standard precautions. Respiratory hygiene/cough etiquette Safe injection practices Use of masks for insertion of catheters or injection into spinal or epidural areas Types of Transmission Based Precautions

6. Clean, non-sterile gloves are usually adequate for routine care of the patients Use gloves before providing care to patient Change gloves after contact with infective material. After providing care, remove gloves and wash hands Follow proper use of protective gown in case of direct contact with patient with potentially contaminated environmental surfaces and observe hand hygiene Limit the movement or transport of the patient from the room. Make sure any infected or colonized areas are contained or covered. Ensure that patient care items, bedside equipment and frequently touched surfaces receive daily cleaning.  Contact Precautions

7. Used to prevent or reduce the transmission of micro-organisms that are airborne in small droplet nuclei (5 or smaller in size) or dust particles containing the infectious agent. Place the patient in private room that has negative air pressure, with 6-12 air changes/per hour. If not available, cohort with patient with active infection with same microorganism Use of respiratory protection Limit movement and transport of the patient. Use a mask on the patient if they need to be moved Keep patient room door closed.   Airborne Precautions

8. Used to reduce the risk of transmission of microorganisms transmitted by large particle droplets (larger than 5 in size). Droplets usually travel 3 feet or less within the air and thus special air handling is not required, however newer recommendations suggest a distance of 6 feet be used for safety. Place the patient in a private room Use of respiratory protection such as a mask when entering the room recommended and definitely if within 3 feet of patient Limit movement and transport of the patient Use a mask on the patient if they need to be moved and follow respiratory hygiene/cough etiquette Keep patient at least 3 feet apart between infected patient and visitors Room door may remain open Droplet Precautions

9. Informing personnel if they have any symptoms of respiratory infection• Health educate patients and visitors to cover their mouth/nose while coughing and sneezing • Proper disposal of used materials, during coughing and sneezing • Use of surgical masks on coughing person when appropriate • Providing alcohol-based hand-rubbing dispensers and supplies for hand hygiene and educating patients and staff in their use, • Encouraging hand hygiene after coughing or sneezing. • Separating coughing persons at least 3 feet away from others in a waiting room or have separate locality. • Instructing patients and providers not to touch eyes, nose, or mouth. • Health care workers should use standard precautions with all patients. Respiratory Hygiene/Cough Etiquette

10. Correct disposal in appropriate container Avoid re-sheathing needle Avoid removing needle Discard syringes as single unit Avoid over-filling sharps container Use of masks for insertion of catheters or injection into spinal or epidural areas  Safe injection practices

11. 1. Aseptic technique[Hand Washing] 2. Isolation 3.Personal protective equipments 4. Decontamination of equipments and unit[Safer Handling of Sharps, Linen handling and disposal] 5. Waste disposal 6. Transportation of infected patients [Handling Biological Spills 7. Standard safety precautions[Universal precautions] 7. Environmental cleaning 8. Risk assessment 9. Staff health Barrier Techniques Infection Control

12. ASEPTIC TECHNIQUE • Sepsis - harmful infection by bacteria • Asepsis - prevention of sepsis • Minimise risk of introducing pathogenic micro- organisms into susceptible sites • Prevent transfer of potential pathogens from contaminated site to other sites, patients or staff • Follow local policy of your hospital • Disinfect clean skin with an appropriate antiseptic before insertion and at the time of dressing changes. • A 2% chlorhexidine is preferred. Hand hygiene is the single most important measure for control of nosocomial infections Aseptic technique[Hand Washing]

13. Introduction Hand washing is the single most effective way to prevent the spread of germs/micro-organism which prevent communicable diseases.It’s easy to learn how to wash your hands and how to stop the spread of infection by washing the germs away. Good hand washing can prevent diseases such as: Shigellosis,E . Coli, Streptococcal Disease, Influenza and the Common Cold. We can pick-up germs from doorknobs, stair railings or anything that has been touched by others who aren’t good hand washers Hand washing

14. Hand washing or hand hygiene is the act of cleaning one's hands with or without the use of water or another liquid, or with the use of soap for the purpose of removing soil, dirt, and/or micro organisms. Who should  practice hand  hygiene Hand hygiene practicing is not important only for health care Providers, everyone needs to practicing appropriate & effective hand hygiene to prevent spread of micro organisms. Definition of hand washing

15. MANY PERSONNEL DON’T REALIZE WHEN THEY HAVE MICROBES ON THEIR HANDS • Healthcare workers can get 100s to 1000s of bacteria on their hands by doing simple tasks like: • pulling patients up in bed • taking a blood pressure or pulse • touching a patient’s hand • rolling patients over in bed • touching the patient’s gown or bed sheets • touching equipment like bedside rails, overbed tables, IV pumps WHY WE ARE NOT WASHING HANDS ??? • Working in high-risk areas • Lack of hand hygiene promotion • Lack of role model • Lack of institutional priority • Lack of sanction of non-compliers

16.   1. Busy health care providers need access to hand hygiene products where patient or patient environment contact is taking place. 2 . Hand hygiene is important in all work settings, including Acute Care, Long Term Care Facilities, Community and Corporate sites. 3 . Providing alcohol-based hand rub at the point of care (within arm’s reach) is an important system support to improve hand hygiene Where should you perform hand hygiene

17. Hand hygiene is essential : • 1-When hands are visible soiled • 2-Before and after caring for a patient • 3-After contact with organic material ,such as feces ,wound drainage ,and mucus • 4-In preparation for an invasive procedure ,such as suction catheterization ,or injections • 5-Before changing a dressing or having contact with open wounds • 6-Befor preparing and administrating medications • 7-After removing disposable gloves • 8-Before and after using the toilet • 9-Before and after eating • 10-At the beginning and end of the shift . 11-Before initial patient or patient environment contact When do you perform hand hygiene/ Indications

18. 1 . Hand hygiene is the most important way to prevent the spread of germs. 2 . Hand hygiene helps keep you healthy by reducing the number of germs on your hands and helps reduce the spread of germs to your family, friends, co-workers, patients, residents or clients. 3 . Using appropriate hand hygiene prevents contamination of the patient’s, client’s, or resident’s environment. Why do we need to learn about Hand Hygiene

19. 1- Routine Hand washing 10-15 seconds • Washing hands with plain soap and water 2- Antiseptic hand wash 1 minute • Washing hands with water and soap or other antiseptic agent 3- Alcohol-based hand rub • Rubbing hands with an alcohol-containing preparation (used after hand washing) 4- Surgical antisepsis 3-5 minutes • Hand washing with antiseptic soap or alcohol- based hand rub before operations by surgical personnel HAND HYGIENE TECHNIQUES

20. Proper technique is important when it comes to effective hand hygiene. Without proper hand hygiene technique, we can still spread many micro-organisms with our hands. This section will cover the proper techniques for the following procedures 1. Wet hands under running water 2. Apply soap and distribute over hands 3. Rub hands together vigorously for 15 seconds to create a good lather: Palm to palm 4. Rub fingertips of each hand in opposite palm 5. Between and around fingers 6. Rub each thumb clasped in opposite hand 7. Rub back of each hand with opposite palm 8. Rinse hands thoroughly under running water. How to perform hand hygiene

21. • Nails • Rings • Hand creams • Cuts & abrasions • “Chapping” • Skin Problems Rings and Jewelry Studies have demonstrated that skin underneath rings is more heavily colonized than comparable areas of skin on fingers without rings. Keep fingernails SHORT! Not excesses • 1/4 inch – Avoid artificial nails – Avoid nail polish Fingernails HAND CARE

22. Designed to prevent transmission of microorganisms by common routes in hospitals. Because agent and host factors are more difficult to control, interruption of transfer of microorganisms is directed primarily at transmission. Single room or group Source or protective Source - isolation of infected patient • mainly to prevent airborne transmission via respiratory droplets • respiratory MRSA, pulmonary tuberculosis Protective - isolation of immune-suppressed patient • Significant psychological effects   ISOLATION

23. PPE is a precautionary step to protect yourself and the people around you. PPE is specialized clothing or equipment worn for protection against dangerous or infectious materials. PPE prevents contact with an infectious agent by creating a barrier between the potentially infectious material and the public health practitioner. Purpose of PPE Public health practitioners should wear PPE to:  Stop the spread of illness/infection  Protect their health  Protect their client's health  Protect their family's health  Protect the community's health Personal Protective Equipment (PPE)

24. PPE when contamination or splashing with blood or body fluids is anticipated Disposable gloves Gowns, aprons, coveralls Respirators/Masks Goggles or Face shields Plastic aprons Face masks Safety glasses, goggles, visors Head protection / Hair covers Foot protection/ Shoe covers PERSONAL PROTECTIVE EQUIPMENT

25. Masks There are several types of masks to prevent the spread of infectious disease. They vary in shape (rectangular, round) and method of securing (elastic, ties Note that masks are not respirators. They do not protect you from airborne transmitted diseases, just droplet transmitted disease. PPE Gadgets

26. Goggles Goggles or face shields protect the mucous membranes of the eyes, nose and mouth during situations where blood, body fluid, secretions, or excretions may splash or spray. Eye glasses do not provide an adequate level of protection. Goggles cover the top, front and sides of the eye area, providing the proper protection from splashes and sprays that eyeglasses do not. Some brands of goggles can be decontaminated and reused

27. GLOVES It is important to select the right size gloves to provide proper protection from infectious agents. Remember to change gloves if they become torn or heavily contaminated during use. Gloves are not a substitute for hand hygiene!

28. RESPIRATORS Several types of respirators can be worn to control the spread of infectious disease. Respirators vary in size, shape (oval or round), and level of respiratory protection offered (N95 versus N100). Unlike masks, respirators must be fit-tested before use to ensure they fit properly. Respirators must have a mask-to-face seal and must be checked annually to make sure they are providing adequate protection. Fit-testing is the procedure used to check for a correct mask-to-face seal and involves testing to ensure there is no air leakage between the mask and the face. Using a respirator that has not been fit-tested for your face provides only droplet based transmission protection, which only reduces the risk of transmission via large particle droplets generated by coughing, sneezing or talking. It will not protect you from airborne transmitted diseases.

29. Per CDC guidance, PPE should be donned in the following order:  Gown (or apron/coverall)  Shoe and/or hair covers (if worn)  Mask/respirator  Goggles (or face shield in lieu of mask and goggles)  Gloves (if you are wearing a gown, tuck the gown cuffs securely under each glove) Donning PPE

30. To Undo ! Recommended sequence of removal of PPE Since gloves are considered the most contaminated (compared to masks and gowns) remove first. The gown can then be removed by handling the portion of the gown that the gloves were on top of (i.e. the most distal portion of the sleeves) as this portion would be considered clean. This is the reason for the order recommended by the CDC. After removing PPE, discard immediately and properly to prevent contamination of the clean area. Always remember to perform hand hygiene immediately after removing PPE. Remove PPE in an area where you are not in danger of exposure to the infectious agent, such as a separate room, a porch, a garage, or entryway. Then identify the clean areas and contaminated areas of the PPE. Clean areas: have not been in contact with infectious agent Contaminated areas: have been in contact with infectious agent TO LIMIT SELF-CONTAMINATION, REMOVE PPE IN THE FOLLOWING ORDER:  1. Gloves  2. Goggles (or face shield)  3. Gown (or apron/coverall)  4. Shoe and/or hair covers (if worn )  5. Mask/ respirator Removing PPE

31. Provide supplies for hand hygiene. All rest rooms must have hot water, soap, and paper towels for proper hand washing. Hand sanitizer should be available to all visitors and staff; placed at entrances, desks, hallways, staff lounge and waiting areas. Post visual alerts Place signs and posters at the entrances and in strategic places (e.g., restrooms, elevators, cafeterias) to provide staff and visitors with instructions (in appropriate languages) about respiratory hygiene and cough etiquette. Provide PPE in the Workplace Inform staff of the types of PPE that are available in the workplace and where they are located. PPE should be stored in a secure location, but should be easily accessible by staff when needed. A policy should be devised to track PPE use, when to replace PPE supply, and how to properly dispose of used PPE Keys to Workplace Safety

32. Psychological effects of being separated from healthcare personnel, family, and friends may occur when isolation precautions are used. Patients may mistakenly feel dirty or untouchable, especially if they have diseases that are considered socially unacceptable. Lack of social interaction can be psychologically injurious. Maintaining the patient’s social support before, during, and after care by being present, listening to the patient’s concerns and answering questions while adhering to infection control practices is crucial for the patient’s well-being and healing. Answering call lights promptly to alleviate feelings of abandonment is also important. Conclusion