Bài giảng Medical Assisting - Chapter 19: Principles of Asepsis

ChapterPowerPoint® to accompany Second EditionRamutkowski  Booth  Pugh  Thompson  WhickerCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.Medical AssistingChapter 191Objectives19-1 Explain the historical background of infectious disease prevention.19-2 Identify the types of microorganisms that cause disease.19-3 Explain the disease process.19-4 Explain how the body’s defenses protect against infection.19-5 Describe the cycle of infection.Principles of Asepsis2Objectives (cont.)19-6 Identify and describe the various methods of disease transmission.19-7 Explain how you can break the cycle of infection.19-8 Compare and contrast medical and surgical asepsis.19-9 Describe how to perform aseptic hand washing.Principles of Asepsis3Objectives (cont.)19-10 Define Bloodborne Pathogens Standards and Universal Precautions as described by the rules and regulations of the Occupational Safety and Health Administration (OSHA)19-11 Explain the role of Universal Precautions in the duties of the medical assistant.Principles of Asepsis4Objectives (cont.)19-12 List the procedures and legal requirements for disposing of hazardous waste.19-13 Explain how to educate patients in preventing disease transmission.Principles of Asepsis5Introduction Our bodies are amazing structures that defend us against infections under normal circumstances.You will learn:About disease causing microorganisms.How the body fights against disease.Ways infections occur You can be instrumental in helping to break the cycle of infection by practicing asepsis in the office and educating patients in the prevention of disease transmission.6History of Infectious Disease PreventionHippocrates – first attempt to prevent infection. He believed:Environment and natural forces play an important part in role of disease and healthSimple treatments, using strong drugs and surgery only as a last resort.7Joseph Lister Discovered how to use chemical antiseptics to control surgery related infections Used antiseptics to disinfect surgical equipment and supplies Microorganisms are simple forms of life commonly made up of a single cell only seen with a microscope.8Holmes and Semmelweis HolmesDemonstrated that puerperal fever was carried from patient to patient by doctors.SemmelweisAlso concluded puerperal fever was a communicable disease.9Microorganisms Microorganisms live all around us.Viruses – smallest infectious agentBacteria – single celled reproduced quicklyProtozoans – single celled found in soil (most do not cause disease)Fungi – complex cell structure (most do not cause disease)Parasites – cause disease10Disease ProcessBegins with microorganisms finding hostGrows with specific requirementsProper temperature, pH, and moisture levelDamage is caused by:Depleting nutrientsReproducing themselvesMaking body cells the target of body’s own defensesProduce toxins11Body’s DefensesImmunity – resistant to pathogens and the disease they causeIf defenses are not functioning properly, person will become susceptible to invasion and infection.Lines of DefenseSkin Normal floraStaying healthy12Defenses Against DiseaseInfection is the presence of a pathogen in or on the body Nonspecific defenses - mechanisms to protect us against pathogens in general Nonspecific DefensesSpecies resistance Mechanical barriers Chemical barriers Fever Inflammation Phagocytosis 13Specific Defenses Against DiseaseImmunityProtects the body against very specific pathogens Lymphocytes and macrophages are the major cells Antibodies and complement are the major proteins involved in specific defenses 14Apply Your KnowledgeWhat are three lines of defense against microorganisms?15Apply Your Knowledge -AnswerLines of DefenseSkin Normal floraStaying healthyWhat are three lines of defense against microorganisms?16Types of ImmunityNaturally acquired active – naturally exposed to an antigen (usually long lasting)Artificially acquired – being injected with a pathogen (immunizations or vaccines) Naturally acquired passive – immunity through his mother (short-lived)Artificially acquired passive – immunity when person is injected with antibodies (short-lived) 17T CellsHelper T cells increase antibody formation, memory cell formation, B cell formation, and phagocytosis Memory T cells memory cells “remember” the pathogen that activated the original T cell person is later exposed to the same pathogen, memory cells trigger an immune response that is more effective than the first immune response 18Cell-Mediated ImmunityTwo major types of lymphocytesB Cells and T CellsRecognize antigens in the bodyT Cells:Cell-mediated bind to antigens on cells and attack them directly B cells:Respond to antigens by becoming plasma cell -make antibodies against the specific antigen 19Cycle of InfectionA reservoir host –animal, insect or human body where pathogen is growing (carrier, unaware of presence of pathogen)Means of exit – pathogen must exit the hostNose, mouth, eyes or earsFeces or urineSemen, vaginal fluid or other reproductive dischargeBlood or blood productsClick for Cycle of Infection20Cycle of Infection (cont.)Means of transportation – must spread to another host by some means of transmissionVectors – living organisms, insects or personFomites – inanimate objects such as clothing, water, foodAirborne transmissionBlood-borne transmissionIngested transmissionTouching During pregnancy or birthClick for Cycle of Infection21Means of EntranceEnter through any cavity lined with mucous membraneMouth, nose, vagina, rectumThrough ears, eyes, intestinal tract, urinary tract, reproductive tract, breaks in the skinCycle of Infection (cont.)Click for Cycle of Infection22Susceptible Host determined by:AgeGenetic predispositionNutritional statusDisease processStress levelsHygiene habitsCycle of Infection (cont.)Click for Cycle of Infection23Cycle of Infection (cont.)Back24Apply Your KnowledgeWhat are fomites?25Apply Your Knowledge -AnswerFomites are inanimate objects such as clothing, water, food that serve as a means of transportation for microorganisms.What are fomites?26Break the CycleAsepsis – condition in which pathogens are absent or controlledMaintain strict housekeeping standardsAdhering to government guidelines to protect against disease Educating patients in hygiene, health promotion and disease prevention 27Medical AsepsisClean technique - based on maintaining cleanliness to prevent spread of microorganismsKeep office clean:Reception room clean, well lit, and ventilatedKeep furniture in good repairStrict “no food or drink” policy28Medical Asepsis (cont.)HandwashingBeginning of dayAfter breaksBefore and after each patientBefore and after handling equipment or specimensAfter blowing your nose or coughing29Sanitization – reduction of the number of microorganismsDisinfection – destruction of infectious agents on an objectSterilization – removal of all microorganisms Medical Asepsis (cont.)30Surgical AsepsisKeep the surgical environment completely free of all microorganisms.Sterile technique used for even minor operation or injections.Object is either sterile or not sterile; if unsure then it is not sterile.31OSHA Bloodborne Pathogens StandardsWritten OSHA Exposure Control Plan must be created and updated annuallyTraining must be provided to all employees as mandated by the standard that includes use of PPE.Employees must take hepatitis B vaccine or decline in writing.32Hazardous Waste Operation & Emergency Response Final RuleHazardous waste products include:Blood and blood productsBody fluids and tissueCultures VaccinesSharpsGlovesSpeculaInoculating loopsPaper product contaminated with body fluids33Universal Precautions Use universal blood and body fluid precautions for:Blood and blood productsHuman tissueSemen and vaginal secretionsSaliva from dental proceduresCerebrospinal, synovial, pleural and other body fluids34Standard PrecautionsCombination of Universal Precautions and rules to reduce the risk of disease transmission.Applies to:BloodAll body fluids, secretions, and excretions except sweatNonintact skinMucous membrane35OSHA Routine Safeguards Category I Tasks: Those that expose a worker to blood, body fluids, or tissue or those that have a chance of spills or splashes. (Always were specific protective measures)Category II Tasks: Do not usually involve risk of exposureCategory III Tasks: Do not require special protection36Personal Protective EquipmentEmployers must provide personal protective equipment (PPE) at no charge to the employee.Disposable, sterile, exam & utility glovesMasks and protective eyewear or face shieldsProtective clothing37Postprocedure CleanupDecontaminate all exposed surfacesReplace protective coverings on surfaces or equipmentDecontaminate receptaclesPick up any broken glass with tongsDiscard all potentially infectious waste materialsOSHA required steps:38Apply Your KnowledgeThe physician is going to remove a small growth from your patient’s back. In order to prepare for this procedure what steps would you take to prevent the spread of infection?39Apply Your Knowledge -AnswerUse medical asepsis while preparing the patient and then use surgical asepsis during the procedure. Follow all CDC and OSHA rules for the prevention of infection and disease.The physician is going to remove a small growth from your patient’s back. In order to prepare for this procedure what steps would you take to prevent the spread of infection?40Exposure IncidentsA worker has reason to believe that he has come in contact with a substance that may transmit infectionNotify physician or employerEmployer must offer free medical evaluationTesting for HBV if not immunizedPostexposure evaluation with written report41Educating PatientsStress basic principles of hygiene and disease preventionHandwashingDaily hygieneUse tissues when coughing or sneezingRoutinely disinfect rooms at home42Educating Patients (cont.)You will teach patient about: Nutrition and dietExercise and weight controlPrevention of sexually transmitted diseaseSmoking cessationProper use of medicationsStress reduction techniques43Your Role in Patient EducationRemember the following factors when providing education:Psychological and lifestyle factorsPatient’s age and family circumstancesDisease and disorders Patient’s psychological conditionRemind patient to eat healthfully44Apply Your KnowledgeWhat is the first step to take after you have been stuck with a blood-tinged needle?45Apply Your Knowledge -Answer Notify the physician or employer.What is the first step to take after you have been stuck with a blood-tinged needle?46Summary Medical Assistant You must follow federal regulations related to infection control and asepsis. You need to know the how pathogens cause disease, how disease is transmitted and how to prevent the spread of infection.47End of ChapterEnd of Chapter48