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 Infection Control

استعرض الموضوع السابق استعرض الموضوع التالي اذهب الى الأسفل 
كاتب الموضوعرسالة
THE SPIDER
رئيس مجلس الادارة
رئيس مجلس الادارة
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عدد المساهمات : 1453
تاريخ التسجيل : 15/08/2010
العمر : 26
الموقع : Elmansoura


مُساهمةموضوع: Infection Control   الأربعاء نوفمبر 24, 2010 6:55 pm

Infection Control
Every year, many lives are lost because of the spread of infections in hospitals. Health care workers can take steps to prevent the spread of infectious diseases. These steps are part of infection control.
Proper hand washing is the most effective way to prevent the spread of infections in hospitals. If you are a patient, don't be afraid to remind friends, family and health care providers to wash their hands before getting close to you.
Other steps health care workers can take include:


  • Covering coughs and sneezes

  • Staying up-to-date with immunizations

  • Using gloves, masks and protective clothing

  • Making tissues and hand cleaners available

  • Following hospital guidelines when dealing with blood or contaminated items

Infection Control Measures
In addition to influenza vaccination, the following infection control measures are recommended to prevent person-to-person transmission of influenza and to control influenza outbreaks in acute-care facilities:
1. Surveillance
Conduct active surveillance for respiratory illness and use rapid influenza testing to identify outbreaks early so that infection control measures can be promptly initiated to prevent the spread of influenza in the facility.
2. Education
Educate personnel about the signs and symptoms of influenza, control measures and indications for obtaining influenza testing.
3. Influenza Testing
Develop a plan for collecting respiratory specimens and performing influenza testing (e.g., rapid diagnostic test, immunofluorescence) and viral cultures for influenza when clusters of respiratory illness occur or when influenza is suspected in a patient or health-care provider.
4. Respiratory Hygiene/Cough Etiquette
Respiratory hygiene/cough etiquette should be implemented beginning at the first point of contact with a potentially infected person to prevent the transmission of all respiratory tract infections in acute-care settings. Respiratory Hygiene/Cough Etiquette include:
1. Posting visual alerts instructing patients and persons who accompany them to inform health-care personnel if they have symptoms of respiratory infection
2. Providing tissues or masks to patients and visitors who are coughing or sneezing so that they can cover their nose and mouth
3. Ensuring that supplies for hand washing are available where sinks are located; providing dispensers of alcohol-based hand rubs in other locations
4. Providing space for coughing persons to sit at least 3 feet away from others, if tolerated
5. Standard Precautions
During the care of any patient with symptoms of a respiratory infection, health-care personnel should adhere to Standard Precautions:
· Wear gloves if hand contact with respiratory secretions or potentially contaminated surfaces is anticipated.
· Wear a gown if soiling of clothes with a patient's respiratory secretions is anticipated.
· Change gloves and gowns after each patient encounter and perform hand hygiene.
· Decontaminate hands before and after touching the patient and after touching the patient's environment or the patient's respiratory secretions, whether or not gloves are worn.
· When hands are visibly soiled or contaminated with respiratory secretions, wash hands with soap (either plain or antimicrobial) and water.
· If hands are not visibly soiled, use an alcohol-based hand rub.
6. Droplet Precautions
In addition to Standard Precautions, health-care workers should adhere to Droplet Precautionsduring the care of a patient with suspected or confirmed influenza for 5 days after the onset of illness:
· Place patient in a private room. If a private room is not available, place (cohort) suspected influenza patients with other patients suspected of having influenza; cohort confirmed influenza patients with other patients confirmed to have influenza.
· Wear a surgical or procedure mask when entering the patient’s room or when working within 3 feet of the patient. Remove the mask when leaving the patient’s room and dispose of the mask in a waste container.
· If patient movement or transport is necessary, have the patient wear a surgical or procedure mask, if possible.
7. Antiviral Prophylaxis
Antiviral prophylaxis may be given to patients and health-care personnel in accordance with current recommendations. On the basis of antiviral testing results conducted at CDC and in Canada indicating high levels of resistance of influenza A virus to some antiviral medications, CDC and ACIP recommend that neither amantadine nor rimantadine be used for the treatment or chemoprophylaxis of influenza A in the United States until susceptibility to these antiviral medications has been re-established among circulating influenza A viruses. Oseltamivir and zanamivir are antiviral medications with activity against both influenza A and B.
8. Restrictions for Ill Visitors and Ill Health-care Personnel
If there is no or only sporadic influenza activity occurring in the surrounding community:
· Discourage persons with symptoms of a respiratory infection from visiting patients. Post notices to inform the public about visitation restrictions.
· Monitor health-care personnel for influenza-like symptoms and consider removing them from duties that involve direct patient contact, especially those who work in specific patient care areas (e.g., intensive care units [ICUs], nurseries, organ-transplant units). If excluded from duty, they should not provide patient care for 5 days after the onset of symptoms.
If widespread influenza activity is in the surrounding community:
· Notify visitors (e.g., via posted notices) that adults with respiratory symptoms should not visit the facility for 5 days and children with symptoms should not visit for 10 days following the onset of illness.
· Evaluate health-care personnel, especially those in high risk areas (e.g., ICUs, nurseries, and organ transplant units) for symptoms of respiratory infection; perform rapid influenza tests to confirm that the causative agent is influenza and to determine whether they should be removed from duties that involve direct patient contact. If excluded, they should not provide patient care for 5 days following the onset of symptoms. The influenza antiviral agents oseltamivir and zanamivir can be used for treatment of influenza.
Transmission
Influenza is primarily transmitted from person-to-person via large virus-laden droplets (particles >5 µm in diameter) that are generated when infected persons cough or sneeze; these large droplets can then settle on the mucosal surfaces of the upper respiratory tracts of susceptible persons who are near (e.g., within 3 feet) infected persons. Transmission may also occur through direct contact or indirect contact with respiratory secretions such as when touching surfaces contaminated with influenza virus and then touching the eyes, nose or mouth. Adults may be infectious and able to spread influenza to others from the day before getting symptoms to approximately 5 days after symptoms start. Children may be infectious and able to spread influenza to others for 10 or more days after symptoms begin.
Prevention and Control Measures
Strategies for the prevention and control of influenza in acute-care facilities include the following: annual influenza vaccination of all eligible patients and health-care personnel, implementation of Standard and Droplet Precautions for infected individuals, active surveillance and influenza testing for new illness cases, restriction of ill visitors and personnel, administration of prophylactic antiviral medications, and Respiratory Hygiene/Cough Etiquette.
All health-care personnel and persons at high risk for complications of influenza should receive annual influenza vaccination according to current national recommendations current national recommendations.
· Vaccination is the primary measure to prevent infection or development of illness from influenza, and thereby limits transmission of influenza and prevents complications from influenza.
· Inactivated influenza vaccine or live attenuated influenza vaccine may be used to vaccinate most health-care personnel.
· Inactivated influenza vaccine may be used for all health-care personnel and is preferred for vaccinating health-care personnel who have close contact with severely immunosuppressed persons (e.g., patients with hematopoietic stem cell transplants) during those periods in which the immunosuppressed person requires care in a protective environment.
The following persons should not receive inactivated influenza vaccine:

· Persons known to have anaphylactic hypersensitivity to eggs or to other components of the influenza vaccine without first consulting a physician.
· Persons with moderate-to-severe acute febrile illness usually should not be vaccinated until their symptoms have abated. However, minor illnesses with or without fever do not contraindicate use of influenza vaccine, particularly among children with mild upper-respiratory tract infection or allergic rhinitis.
· Avoiding vaccination of persons who are not at high risk for severe influenza complications and who are known to have experienced GBS within 6 weeks after a previous influenza vaccination is prudent.
· Live, attenuated vaccine (LAIV) may be given to health-care personnel younger than 50 years of age who do not have contraindications to receiving the nasal vaccine. Health-care personnel who may receive LAIV include those taking care of immunocompromised patients who do not require care in a protective environment. If health-care personnel who care for severely immunocompromised patients in protected environments receive LAIV, then they should not care for these patients for 7 days following immunization.
The following persons should not receive LAIV:

· Persons <5 years of age or those 50 years of age and older.
· Persons with asthma, reactive airways disease or other chronic disorders of the pulmonary or cardiovascular systems; persons with other underlying medical conditions, including such metabolic diseases as diabetes, renal dysfunction and hemoglobinopathies; or persons with known or suspected immunodeficiency diseases or who are receiving immunosuppressive therapies.
· Children or adolescents receiving aspirin or other salicylates (because of the association of Reye’s syndrome with wild-type influenza infection).
· Persons with a history of Guillain-Barré syndrome.
· Pregnant women.
· Persons with a history of hypersensitivity, including anaphylaxis, to any of the components of LAIV or to eggs.





The heart hides what you can’t say but the eyes say what you try to hide


علمنى ازاى احبه ومعه اعيش بس ازاى اعيش من غيره ده اللى معلمنيش





آلمعآنآإة آلگبرى هي :حين يسقط من
عينيگ إنسآإن مآ ..! لگنّہ لـآ يسقط من قلبگ ..! ۆ يظلُّ معلقاً بين مرآآحل
سقوط آلقلب ۆ سقوط آلعين ۆ تبقى ۆحدگ آلضحية لأحآسيس مُزعجہ ..!تحبّہ ..
لگنّك بينگ ۆ بين نفسگ تحتقره
...
الرجوع الى أعلى الصفحة اذهب الى الأسفل
ضى القمر lolo
قمر المنتدى ومشرفة الفرقة الثانية
قمر المنتدى ومشرفة الفرقة الثانية
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عدد المساهمات : 1974
تاريخ التسجيل : 20/08/2010
العمر : 25
الموقع : المنصوره




مُساهمةموضوع: رد: Infection Control   الأربعاء نوفمبر 24, 2010 11:37 pm

وده
chain of infection control







A model used to understand the infection process is the chain of infection, a circle of links, each representing a component in the cycle. Each link must be present and in sequential order for an infection to occur. The links are: infectious agent, reservoir, portal of exit from the reservoir, mode of transmission, and portal of entry into a susceptible host.Understanding the characteristics of each link provides the nurse with methods to support vulnerable patients and to prevent the spread of infection. An awareness of this cycle also provides the nurse with knowledge of methods of self-protection
PREVENTION AND CONTROL OF INFECTION:
Breaking the Chain

Nurses maintain the immediate health care environment. Because they provide care for a variety of patients, the risk of contamination from pathogenic microorganisms is increased. The practice of medical asepsis and standard precautions provides the nurse with techniques for destroying or containing pathogens and for preventing contamination to other people or to bedside materials and equipment.
Medical Asepsis
The practice of medical asepsis helps to contain infectious organisms and to maintain an environment free from contamination. The techniques used to maintain medical asepsis include hand washing, gowning and wearing facial masks when appropriate, as well as separating clean from contaminated or potentially contaminated materials and providing information to patients about basic hygienic practices. Appropriate hand washing by the nurse and the patient remains the most important factor in preventing the spread of microorganisms.

One common example of medical asepsis involves the steps taken by the nurse to ensure that only clean linen is applied to each patient's bed. Clean linen remains in the clean linen cabinet until taken to the patient's room. The hands of the health care worker are washed before handling the clean linen. Unused bed linen from one patient's room cannot be returned to the clean linen cabinet and cannot be used for any other patient. This linen is considered soiled and placed in the soiled linen bag.
Standard Precautions
Standard precautions combine the major features of universal precautions and body substance isolation. These standard precautions alert the health care worker to patient situations that require special barrier techniques. These barrier techniques are used when working with any patient where potential or actualized contact with blood or body fluid exists.

Universal Precautions
Universal precautions help control contamination from bloodborne viruses such as human immunodeficiency virus (HIV) and hepatitis viruses. When in contact with a patient's blood or any body secretion that may be contaminated with blood, protective measures such as wearing gloves, gown, facial mask, and/or goggles must be followed.

Body Substance Isolation
Body substance isolation protects against bacterial organisms that may exist in body substances. Body substance isolation applies in all patient encounters regardless of the diagnosis. The application of gloves for contact with moist body surfaces and areas of nonintact skin, gowns when in contact with body secretions, and facial mask when in danger of contact with respiratory droplet secretions, prevents the contamination of both health care worker and patient.

Psychosocial Effect
Strict adherence to basic techniques such as hand washing, wearing barrier gloves and protective isolation provides the foundation for life saving measures. However, the physical protection gained from barrier isolation may have a negative psychological impact on the patient.

Many principles of infection control limit contact between the nurse and patient. Wearing barrier gloves for example, prevents direct physical contact through touch and may cause an individual to feel dirty or contaminated. Protective isolation, one form of isolation, limits contact with health care workers and visits from family and friends. Protective isolation often results in feelings of loneliness and interferes in needed emotional support.
The knowledgeable nurse balances the principles of asepsis, standard precautions and psychological support. Knowledge of the infectious agent allows the nurse to use protective measures without isolating the patient beyond what is necessary. The nurse recognizes the importance of interaction in maintaining psychological health and therefore provides appropriate contact within safe limits. For example, nurses wear barrier gloves when handling moist body secretions. However, holding a hand without the barrier glove to provide psychological comfort is, in most situations, an acceptable and important intervention as well. Psychological support for the patient in isolation comes in many forms, such as allowing an individual to express feelings about the constraints of isolation and providing information about the purpose of barrier techniques. The nurse provides psychological support through the development and maintenance of an effective nurse-patient relationship.
Guidelines for Specific Institutions
Methods to control the spread of infections are standardized in recommendations from the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA). These prevention standards are applied in all health care settings and modified according to the needs of each health care facility. The health care worker must practice within the guidelines of the specific institution.























Patient Situation: 1
The Spread of Infection
An elderly patient, hospitalized with a gastrointestinal disorder, was on bed rest and required assistance for activities of daily living. The patient had frequent uncontrolled diarrhea stools and the nurse provided excellent care to maintain cleanliness and comfort. Following one episode of cleaning the patient and changing the bed linen, the nurse immediately went to a second patient to provide care. The nurse's hands were not washed before assisting the second patient.
Let's examine the chain of infection as it applies to this situation.

Escherichia coli

Large intestine
E. coli, bacteria in the large intestine of humans forms the greater part of the normal intestinal flora.

E. coli exited the body in feces.

The nurse removed the contaminated linen from the bed. The E. coli organism contaminated the hands of the nurse who then provided morning care to another patient.

The second patient receiving care had a Foley catheter. The nurse manipulated the tubing attached to the catheter. The E. coli organism on the nurse's hands contaminated the catheter tubing and ascended to the patient's meatus and then into the urinary bladder.

The second patient with a Foley catheter. This patient was elderly and had a chronic illness necessitating complete bed rest. The Foley catheter contaminated by the E. coli organism provided a direct route into the urinary bladder






































Patient Situation: 2
The Nurse Breaks the Chain
A patient assigned for morning care has an open wound on her left lower leg. The wound is draining and when last cultured, the microorganism MRSA was identified.
In preparation for bedmaking, hands of the nurse were washed. Clean linen and a bag for soiled linen were gathered from the linen room and placed on the patient's clean bedside stand.
To remove the soiled linen from the bed, the following procedure was followed:


    1. Hands washed
    2. Gloves worn
    3. Each side of the soiled linen ends folded towards the middle of the bed
    4. Soiled linen held away from the nurse's clean uniform
    5. Soiled linen placed in the linen bag for later discard
    6. Protective gloves removed
    7. Hands washed

The nurse applied principles of medical asepsis and standard precautions with the use of body substance isolation to contain the infectious organism at many points in the chain of infection.

MRSA (Methicillin-resistant organism)

Patient's infected wound

Draining from the open wound


BREAK IN THE CHAIN
Nurse used proper hand washing techniques, wore protective gloves and properly handled the linen.

MRSA commonly transferred on hands of the nurse by indirect contact
BREAK IN THE CHAIN
Proper hand washing, gloving and handling of linen
BREAK IN THE CHAIN
Organisms isolated with use of medical asepsis and body substance isolation

PROTECTED




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تقبل مرورى




اللهم إنى أسألك الثبات فى الأمر

والعزيمة على الرشد

وأسألك موجبات رحمتك ، وعزائم مغفرتك
......
وأسألك شكر نعمتك ، وحسن عبادتك

وأسألك قلبا سليما ، ولسانا صادقا

وأسألك من خير ما تعلم ، وأعوذ بك من شر ما تعلم
واستغفرك لما تعلم

إنك أنت علام الغيوب


الرجوع الى أعلى الصفحة اذهب الى الأسفل
شمس

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عدد المساهمات : 273
تاريخ التسجيل : 09/11/2010



مُساهمةموضوع: رد: Infection Control   السبت نوفمبر 27, 2010 12:32 am




شغل جامد ياسبيدر انت ولولو


وبجد ربنا يجزيكوا كل خير


دمتم على خير


الرجوع الى أعلى الصفحة اذهب الى الأسفل
 
Infection Control
استعرض الموضوع السابق استعرض الموضوع التالي الرجوع الى أعلى الصفحة 
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