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Valera
Procedure/Techniques on Patient Safety DATE: Sept. 30, 2013
Community-acquired Infections
• Infections that are acquired outside of hospitals or other
health care facilities
High-Risk Patients
1. Elderly patients
2. Women in labor and delivery
3. Premature infants and newborns
4. Surgical (especially transplant) and burn patients
5. Diabetic and cancer patients
6. Patients receiving treatment with steroids, anticancer drugs, anti-
lymphocyte serum, and radiation
7. Immunosuppressed, paralyzed, dialyzed and catheterized patients
Contributing Factors
3 Major factors: Most Effective Infection Control Technique
- Increased number of drug-resistant pathogens • Handwashing
- Failure of healthcare personnel to follow infection control – Single most important measure to reduce the risks of
guidelines transmitting pathogens from one patient to another
- Increased number of immunocompromised patients – (cross-infection) or from one anatomic site to another
Other factors: on the same patient (cross-contamination)
- Indiscriminate use of antimicrobials
Results in drug-resistant / mulitdrug-resistant pathogens Disinfectant
- Neglect in aseptic techniques & infection control procedures
Due to false sense of security about antimicrobial agents Disinfectant Mode of Action and Spectrum Uses
- Lengthy & Complicated surgeries
- Overcrowded healthcare facilites & shortage of staff
- Undertrained healthcare providers Hydrogen Produces destructive free Limited clinical
Unaware of infection control procedures peroxide radicals that are destructive to use; Disinfection
- Increased used of anti-inflammatory & immunosuppressive agents essential cellular bacterial of inanimate
Radiation, steroids, anticancer chemotherapy, components; same a chlorine surfaces
antilymphocyte serum
Iodine (betadine) Disrupts protein & nucleic Antiseptic
12 steps to prevent antimicrobial resistance acids structure & synthesis;
• Prevent Infection Same spectrum as chlorine
– Step 1: Vaccinate at-risk patients before discharge and
healthcare workers annually. Phenols Disrupts cell walls & Decontamination
– Step 2: Use catheters only when essential. Observe &Phenolics (Lysol) inactivates essential enzyme of noncritical
proper insertion and removal protocols. systems; same spectrum as medical and
• Diagnose and Treat Infection Effectively alcohol surgical items
– Step 3: Target definitive therapy against pathogens by
using culture, hospital antibiogram; empiric and
definitive therapy
– Step 4: Consult infectious disease experts to patients
with serious infections
Group 3 |Lofranco, Lopez, Lopez, Lu, Luspo, Page 2 of 4
MICROBIOLOGY 3.11
– Droplet
Disinfectant Mode of Action and Uses – Vehicular
Spectrum
– Vectors
• Three types of Transmission-based Precautions
Alcohols (60-90% Denaturation of proteins; Disinfection of
A. Airborne Precautions
ethyl, isopropyl, bactericidal, tuiberculocidal, instruments,
Airborne droplet nuclei or dust particle containing
benzyl) fungicial, virucidal BUT NOT hands, skin prep
pathogens
sporocidal
Small-particle residues (≤5µm) of evaporated droplets
Chlorine compounds Denaturation of proteins & Disinfectant of containing microorganisms
(chlorox, zonrox) nucleic acids; Same floors, blood Isolation rooms
spectrum as alcohols but spills, water May share room with other pxs with same disease
sporocidal treatment Visitors must wear protective masks; or they’re immune
to disease
Formaldehyde Alters protein structures & Limited to Ex. Mycobacterium tuberculosis, rubeola, varicella
(formalin) purine bases; Same preserving
spectrum as chlorine specimens due to B. Droplet Precautions
fumes Form of contact transmission
Droplets (≥5µm) produced via coughing, sneezing, talking,
Gluteraldehyde Interferes with DNA, RNA, Disinfection of
(cydex) and proteins synthesis; Same instruments suctioning, bronchoscopy propelled in short distances
spectrum as formaldehyde deposited in person’s conjunctiva, nasal mucosa or mouth
but slow tuberculocidal Ex: adenovirus, Haemophilus influenzae, German measles,
activity Group A Streptococci, Neisseria meningitidis, mumps,
pertussis, diphtheriae, pneumonia
C. Contact Precautions
Direct (body surface-to-body surface)
Standard Precautions Indirect (contaminated intermediate object)
- Used for all patients regardless of diagnosis or presumed infection May share room with other pxs with same disease; use
status exclusive equipments
- Designed to reduce the risk of transmission of bloodborne Visitors must wear protective masks, gloves, gown; or they’re
pathogens & pathogens from moist body substances immune to disease
Ex: Clostridium-difficile associated diseases, RSV, scabies,
impetigo, chickenpox, shingles, viral hemorrhagic fever
Isolation
Source Isolation
Handling Fomites
• Fomites
– Any non-living or inanimate objects that may harbor and
transmit microbes
• Examples: gowns, beddings,gloves, ECG
electrodes, etc
• Preventive measures vs. Fomites
– Proper disposal of equipments, supplies
– Use disinfectants
– Avoid re-using equipments
– Sterilization processes