Contact transmission

Direct-contact transmission Indirect-contact transmission

Direct-contact transmission a direct body surface-to-body surface

contact and physical transfer of microorganisms between a susceptible host and an infected or colonized person, such as occurs when a person turns a patient, gives a patient a bath, or performs other patient-care activities that require direct personal contact.

Direct-contact transmission also can occur between two patients, with one serving as the source of the infectious microorganisms and the other as a susceptible host.

Indirect-contact transmission

contact of a susceptible host with a contaminated intermediate object, usually inanimate, such as contaminated instruments, needles, or dressings, or contaminated gloves that are not changed between patients.

The Nursing Process Assessment

includes the collection and organization of data, validation, and documentation of the data. A nursing assessment may include biographic data, the patient's chief complaint, the history of the present illness, the patient's past medical history, a family history of illness, a lifestyle assessment, social and psychological data, as well as vital signs, signs and symptoms of illness, and a physical examination.

The Nursing Process Diagnosing includes

analyzing the data, identifying health problems, health risks, and formulating nursing diagnoses that take all of the above factors into account.

Planning includes prioritizing the patient's

problems and diagnoses, formulating goals and desired outcomes for the patient to meet, selecting nursing interventions to enable the patient to meet those goals, and writing the nursing orders. Goals and outcomes must be measurable. A generalized goal is acceptable if it is followed by specific desired outcomes.

Implementation

includes reassessing the client (to make sure the client's needs have not changed), determining the nurse's need for assistance, implementing the nursing orders (directly or through supervision), and documentation of nursing actions. When implementing nursing orders, it is important to explain to the patient what is being done.

Documentation

is very important, not only legally "If it isn't written down, you didn't do

it." If there is no documentation that a treatment was performed or a

medication given, it is possible that the patient may receive another

treatment or dose of medication.

Evaluation includes collecting data related to

the desired outcomes, comparing the data to see if the patient's goals or outcomes desired were met, relating the nursing actions to the goals and outcomes, evaluating the status of the problem, and continuing, modifying or terminating the patient care plan.

Patient risk factors

Severity of illness

Weak immunity

Length of hospital stay..

Prevention and Control of Hospital Acquired Infections

* Emphasis on hand-washing, use of aseptic techniques in invasive

procedures, care of catheters, intravenous sites, surgical wounds and improvement of disinfection and sterilization procedures in respective areas.

Handwashing

Handwashing

80% of common infections spread by hands

Most effective way to prevent the spread of respiratory tract infections

Bad Germs

Usually survive less than 24 hours

Easily removed by handwashing

Can be either bacteria or viruses

Cause disease

How dirty are things?

Contamination (%)Playground 44Public Restrooms 25Pens (shared) 16Vending Machines 14Public phones* 13

*home phones more contaminated

How easy is it to transmit germs?

1,000 – 100,000 bacteria to hands

Touching patient shoulder

Measuring blood pressure

Observational handwashing survey

September 2000 / 8000 people

• 95% say they wash their hands

• 67% actually do

• 75% women / 58% men

Do people really wash?

American Society for Microbiology

Hand Drying

Removes 42% more germs than washing alone

Use towels and avoid sharing towels

Hot air dryers promote bacterial growth because hands are left warm and moist

انديكاسيونهاي شستن دست :

ـ قبل و بعد از تماس با هر بيمار يا انجام اعمالي1

مثل جمع آوري پانسمان مستعمل و ظروفي كه خلط،

ده را در آن اژ ـش واد درـن ا ـم واد دفعي ـي ون و ـم ترـشحات، ـخ

جمع آوري كردهاند.

ـ قـبل و بـعد از دـست زدن ـبه وـسائلي ـكه آـلوده ـشدهاند ـيا 2

احتمال آلودگي آنها ميرود.

ـ قبل و بعد از جمع آوري نمونهها3

ار 4 ه وـسايل ـمورد مـصرف بيـم د از دـست زدن ـب ـ قـبل و بـع

مثل كاتتر وريدي،

ــيزات ــع آوري ادرار و تجه ــه جم ــوند ادراري، كيس س

تنفسي

انديكاسيونهاي شستن دست :

وده و 5 ل رويت آـل ه صـورت قاـب ه وضـوح و ـب ر دسـتها ـب ـ اـگ

كثيف شدهاند.

ـ قبل و بعد از خوردن غذا يا دست زدن به آن6

ا 7 ني ـي ردن بـي اك ـك د از ـپ ويي و بـع ه دستـش د از رفتن ـب ـ بـع

تخليه آن

ـ هنگام شروع كار، ترك كردن بخش و پايان كار روزانه8

مراحــل شســتن دســت بــه روش

روتين :

براي شستن دست به سينك، آب جاري و گرم )شير آب(، 1

تمال ذي )دـس ه كاـغ ده و حوـل وني كنـن اده ـضد عـف ا ـم ابون ـي ـص

كاغذي( نياز است.

ــاال ميزنيم. 2 ــا قســمت فوقــاني مچ ب ـ آســتينهاي روپــوش را ت

جواهرات  )بجزء حلقه ساده (

و ساعت مچي را از دستها و انگشتان در ميآوريم.

اخن3 ا الك ـن اخن ـي رق ـن د از ـب اه باـشند و نباـي د كوـت ا باـي ا ـ ناخنـه ـی

مصنوعي استفاده شده باشد.ناخن

مراحل شستن دست به روش روتين :

ســطح انگشــتان و دســتها بايــد از نظــر بريــدگي و خــراش كنــترل ـ 4

شوند.

ا سـطح سـينگ 5 د ـب وش نباـي وي سـينگ ايسـتاد. دسـتها و روـپ د جـل ـ باـي

تماس داشته باشند.

ا دسـتها و 6 ا دسـت( ـت و ـي ا زاـن ائي ـي دال ـپ ا ـپ رده )ـب از ـك ـ شـير آب را ـب

ر ايين ـت د دـستها و ـساعد ـپ اني ـساعد خيس ـشوند. باـي قـسمتهاي تحـت

از ـبازو ـقرار گيرـند. آب باـيد ـبه اـندازه ـكافي ـگرم باـشد )ـنه ـجوش و

داغ(. از پاشيده شدن آب به روپوش بايد اجتناب كرد.

ـ ـصابون را باـيد در مـيان دـستهاي خيس گذاـشت. اـگر ـبه ـجاي ـصابون 7

د از آن ـمورد cc 3ـقالبي )جاـمد( از ـصابون ـمايع اـستفاده ميـشود باـي

استفاده قرار گيرد. بايد كف فراوان ايجاد شود.

اليم. شـستن ـهر ـيك از نـقاط ـ 8 ه يـكديگر ميـم ا دقت ـب دـستها را ـب

انگشتان،

بار انجام شود.5 كف و پشت دست بايد حداقل

باـيد توـجه ـشود ـتا ـنوك انگـشتان، ناخنـها و البالي انگـشتان و ـنيز

شست خوب پاك شوند.

يز ر تـم اي دـست ديـگ اخن ـه ا ـن د ـب ثيف اـست باـي ا ـك ر ناخنـه ر زـي اـگ

ـشوند )زـير ناخنـها، ـنوك انگـشتان و اـطراف شـست آـلوده ـترين

قســمتهاي دســت بعــد از شستشــو گــزارش شــدهاند(. مــدت

ثانيه ميباشد.10-15زمان اين مرحله

ـ

د ــ9 ير آب را نباـي يد ولي ـش ل آب كـش ور كاـم تها را بـط د دـس ا باـي در انتـه

بست.

بايد دقت شود تا صابون روي دستها باقي نماند.

بايـد بـا حولـه كاغـذي )دسـتمال كاغـذي( بـه آرامي و بطـور كامـل 10

دستها را خشك نمود.

اين عمل بايد از سمت انگشتان به طرف مچ و ساعد انجام شود.

ه رار دارد، دـستها ـب ه )دـستمال( در دـستن ـفرد ـق ه حوـل ان ـك ر همزـم اـگ

يكــديگر ماليــده شــوند بــه حــذف باكتريهــاي باقيمانــده كمــك ميشــود.

دستمال بايد به طريقه صحيح دفع شود.

ا 11 ا آرنج ـب ا ـب د ـشير آب را بـست )ـي يز باـي ه كاـغذي خـشك و تـم ا حوـل ـ ـب

پدال پائي(.