Basic Nursing Skills and Procedures | Hand Hygiene | Principles of Infection Control | Microorganisms and Modes of Transmission | Donning and Doffing PPE

 

Basic Nursing Skills and Procedures:

Infection Control and Asepsis:

1. Introduction to Infection Control

Infection control refers to the practices and procedures used to prevent and control the spread of infections within healthcare settings. Effective infection control protects patients, healthcare workers, and visitors from acquiring infections. In healthcare facilities, infections can spread from person to person, contaminated surfaces, or through the air. The importance of infection control has increased significantly, especially during outbreaks of infectious diseases such as COVID-19. Adhering to infection control protocols reduces the risk of healthcare-associated infections (HAIs) and ensures patient safety.

Objectives of Infection Control

  • To protect patients, healthcare workers, and visitors from infectious agents.
  • To reduce the risk of cross-contamination in healthcare settings.
  • To promote a safe and healthy environment for healthcare delivery.

Principles of Infection Control

  • Breaking the Chain of Infection: Identify and address each link in the chain (infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host).
  • Standard Precautions: Apply standard precautions for all patients, regardless of infection status.
  • Transmission-Based Precautions: Implement additional measures for infections spread by airborne, droplet, or contact routes.

2. Microorganisms and Modes of Transmission

Microorganisms are microscopic living organisms that can cause disease. They include bacteria, viruses, fungi, and parasites. Understanding the modes of transmission of these microorganisms is essential for effective infection control.

Types of Microorganisms

  • Bacteria: Single-celled organisms that can cause diseases like tuberculosis, pneumonia, and wound infections.
  • Viruses: Infectious agents that require a host cell to multiply, such as influenza, HIV, and COVID-19.
  • Fungi: Organisms like molds and yeasts that can cause infections like candidiasis and ringworm.
  • Parasites: Organisms that live on or inside a host, such as protozoa and helminths, causing diseases like malaria.

Modes of Transmission

  1. Contact Transmission

o    Direct Contact: Physical contact with an infected person (e.g., touching wounds, patient care).

o    Indirect Contact: Contact with contaminated objects (e.g., medical equipment, door handles).

  1. Droplet Transmission

o    Large respiratory droplets from coughing, sneezing, or talking can transfer pathogens to a susceptible host within a short distance (usually within 6 feet).

  1. Airborne Transmission

o    Pathogens are carried on small respiratory particles that remain suspended in the air and can be inhaled by others (e.g., tuberculosis, measles, chickenpox).

  1. Vector-Borne Transmission

o    Infections are transmitted through vectors like mosquitoes, ticks, and fleas (e.g., malaria, dengue, Lyme disease).

  1. Fomite Transmission

o    Infections spread through inanimate objects such as medical instruments, linens, and doorknobs.

3. Hand Hygiene and Personal Protective Equipment (PPE)

Hand Hygiene and PPE are the most crucial elements of infection prevention and control.

Hand Hygiene:

Hand hygiene is the single most effective measure to prevent the spread of infections. It involves cleaning hands to remove dirt, germs, and microorganisms.

When to Wash Hands:

  • Before and after patient contact
  • Before performing aseptic procedures
  • After exposure to bodily fluids
  • After touching contaminated surfaces or objects

Methods of Hand Hygiene:

  • Handwashing with Soap and Water: Use when hands are visibly soiled.
  • Hand Sanitization with Alcohol-Based Hand Rub (ABHR): Use when hands are not visibly soiled, as it effectively kills most pathogens.

Personal Protective Equipment (PPE)

PPE refers to equipment worn to protect healthcare workers from exposure to infectious agents. It also prevents the spread of infections from one patient to another.

Types of PPE:

  • Gloves: Worn to protect hands from exposure to body fluids and contaminants.
  • Gowns/Aprons: Worn to protect the body from splashes and sprays of fluids.
  • Face Masks: Protects the nose and mouth from respiratory droplets.
  • Respirators (N95, FFP2, FFP3): Used for airborne precautions (e.g., for tuberculosis, COVID-19).
  • Face Shields/Goggles: Protects eyes from splashes or sprays of bodily fluids.

Donning and Doffing PPE:

  • Donning (Putting On): Wash hands ➔ Gown ➔ Mask ➔ Goggles/Face Shield ➔ Gloves
  • Doffing (Taking Off): Gloves ➔ Goggles/Face Shield ➔ Gown ➔ Mask ➔ Wash hands

4. Disinfection, Sterilization, and Waste Disposal

To maintain a clean and safe environment in healthcare settings, it is essential to disinfect and sterilize medical equipment and dispose of waste properly.

Disinfection

Disinfection is the process of eliminating or reducing harmful microorganisms from inanimate objects and surfaces. It does not destroy bacterial spores.

Methods of Disinfection:

  • Chemical Disinfection: Use of disinfectants like chlorine, alcohol, and hydrogen peroxide.
  • Thermal Disinfection: Using heat to kill microorganisms (e.g., boiling or using hot water).

Levels of Disinfection:

  • Low-Level Disinfection: Kills most bacteria and some viruses and fungi.
  • Intermediate-Level Disinfection: Kills bacteria, mycobacteria, most viruses, and most fungi.
  • High-Level Disinfection: Destroys all microorganisms except bacterial spores.

Sterilization

Sterilization is the process of killing or removing all forms of microorganisms, including bacterial spores. It is necessary for instruments used in surgical and invasive procedures.

Methods of Sterilization:

  • Steam Sterilization (Autoclaving): Uses pressurized steam to kill all microorganisms.
  • Dry Heat Sterilization: Uses high temperatures to sterilize heat-resistant items.
  • Chemical Sterilization: Uses gases like ethylene oxide (ETO) or liquid chemicals.
  • Radiation Sterilization: Uses gamma rays to sterilize single-use medical products.

Waste Disposal

Proper waste disposal prevents the spread of infections and protects the environment. Different types of healthcare waste require specific disposal methods.

Types of Healthcare Waste:

  • Infectious Waste: Items contaminated with blood, body fluids, or infectious agents.
  • Pathological Waste: Tissues, organs, and body parts.
  • Sharps Waste: Needles, syringes, scalpels, and other sharp instruments.
  • Pharmaceutical Waste: Expired, unused, or contaminated medications.
  • Chemical Waste: Disinfectants, solvents, and laboratory chemicals.

Waste Segregation:

  • Use color-coded bins for waste disposal:

o    Red: Infectious waste

o    Yellow: Pathological waste

o    Blue/White: Pharmaceutical waste

o    Black: General waste



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