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HYGIENIC AND PREVENTIVE PROCEDURES. Dragica Kopić, MD Department Of Anesthesiology and Intensive Treatment, University Hospital Split, Croatia. The principal task of health care institution. To provide a good health care service To prevent hospital infection; and
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HYGIENIC AND PREVENTIVE PROCEDURES Dragica Kopić, MD Department Of Anesthesiology and Intensive Treatment, University Hospital Split, Croatia
The principal task of health care institution • To provide a good health care service • To prevent hospital infection; and • To prevent hospital infection transmission and spreading
Transmission of infection from patient to health care workers, and the other way around, occurs: • By direct contact and touch • By fecal - oral transmission (food and drink) • By air (inhalation) • By blood
The infections are caused by: • bacteria, • viruses, • fungi … • They are present in: • water, • air, • patient’s environment, and • Patient can be a source of infection, too.
Asepsis • Method we use to control microbes transmission • from one place to another, • from one patient to the other one, or • from patient to health care workers. • To achieve asepsis we use: • disinfection • sterilization
Disinfection • The process of destroying majority of microorganisms • Bacterial spores may survive and contaminate • Highly effective disinfectants, acting in prolonged time (6-10 h) can eliminate bacterial spores.
Disinfection techniques are applied on: • Health care providers’ hands • Patients’ skin and mucous membranes • Instruments and equipment • Working surfaces, floors, walls • Air in rooms • All patients’ requisites and equipment • Patients’ clothes, health care workers clothes and footwear.
Self protection measures • Regular and proper hand cleaning • Appropriate use of protective clothing and footwear • Appropriate use of masks and gloves • Appropriate handling of sterile materials
Hand cleaning • This is the most important and the most effective preventive method against spreading microbes between health care workers and patients in the hospital. • The basic condition for proper hand hygiene is that nails do not overgrow finger cushion. • Jewelry and long artificial nails are strictly prohibited
Hand cleaning • There are three levels of hand cleaning: • – standard, • – hygienic disinfection , • – surgical disinfection.
Standard hand washing • Hands have to be cleaned: • Before handling food • Before meal • Before feeding patient • After use of bathroom Swab taken of unwashed hands
Standard cleaning • Hands are washed in hot water and with soap over one minute period. Swab from washed hands
Hygienic hand disinfection or antisepsis • Before and after dealing with patient • Before performing invasive procedure • Before and after wound dressing, handling urinary catheters, tubes, iv lines etc. • Before and after gloves usage • After contact with blood and other patient secretions and excretions • After contact with patient with know hospital bacterial colonization
Hand disinfection is made in two steps • Hygienic hand washing with antiseptic soap over one minute period • Hygienic scrubbing with alcohol based antiseptic lasting one minute. Swab after hand desinfection
Surgical hand antisepsis • Goal of surgical disinfection or antisepsis is to eradicate microbes. • Procedure of surgical hand cleaning is in principle the same as hygienic disinfection • The difference is in duration of hand washing, surgical one lasts longer, 2-3 minutes, and • The are to be washed is larger, includes wrists and forearm • Common antiseptic substances are chlorinebased antiseptics - chlorhexidine; iodine based and alcohol based ones.
Proper hand washing algoritam Apply alcohol antiseptic to the palm Scrub palm to palm
Proper hand washing algoritam Scrub palm to palm with crosed fingers Scrub right palm to left forearm and vice versa
Proper hand washing algoritam Hook the fingers of apposite hands with flexed fingers Dry for 20-30 seconds
Hand disinfection sequence and duration 3 minutes 2 minutes 1 minutes
Medical protective clothing and footwear • Protective clothing and footwear consist of: • caps, • masks, • protective goggles • gloves • coats, • gowns and operating theatre footwear.