role nursing admn

8/8/2019 Role Nursing Admn

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Role of NursingRole of NursingAdministration inAdministration inInfection ControlInfection Control

Role of NursingRole of NursingAdministration inAdministration inInfection ControlInfection Control

Bhagavathi KrishnaBhagavathi KrishnaNursing SuperintendentNursing Superintendent


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Tenets of infection

Control are Vigilance

Vigilance

Vigilance


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Role of Nursing

Administration Planning

Organizing

Implementation

Coordination

Control

Evaluation

Team work is essential


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Characteristics of

Successful leaders Adopting Specific behaviors

Challenging the process

Inspired and shared vision

Enabling others to act

Modeling the way

Encouragement


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Desirable characteristics

of leaders Attitudes: Sensitivity and commitment tothe cause Knowledge: Expertise and credibility and

the application of problem solving Communication: both with in outside

nursing

Skills: directing and helping others Personal Attributes: attract, Influence

and evoke confidence


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Purposes Hepatitis B virus (HBV), Human

Immunodeficiency Virus, (HIV) and

other blood-borne pathogens cannotbe reliably identified by medicalhistory and examination. Therefore,

certain precautions must be takenwith all patients and patientspecimens encountered


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Employee Health

Reduce risks of Endemic & epidemic

Nosocomial Infections Ongoing surveillance of infection

Orient new employees to infection

control policies


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Employee Health Promote a Safe working environment Address in terms of injury and illness

Care is provided by competent medicaland supporting staff

Minimizing injury or exposure

Follow up exposure to communicablediseases


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Concepts of Isolation They are as follows:

Universal Precautions .

Patients requiring Strict,Respiratory,enteric, BMTIsolation must beadmitted or transferred to an isolation room.

Drainage/Secretion Precautions should bemanaged in standard rooms.

. Protective Isolation is rarely indicated


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General Infection

Control Principles Hand Washing

Hand Care

Use of Gloves, Masks,

Instruments

Needles & Syringes

Dressings


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General Infection

Control Principles Laboratory Specimens

Thermometers

Linen

Patient Food types

Transportation of patients


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General Infection

Control Principles Drinking water

Books, magazines and letters

Toys and personal effects

Patients Chart

Elevators

Take equipment which are neededonly


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Engineering and Work PracticeControls:

1. Hand washing facilities shall bereadily accessible. When provision of

hand washing facilities is notfeasible, the employer shall provideeither an appropriate antiseptic handcleanser in conjunction with papertowels


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Universal Precautions 2. Supervisors shall ensure that

employees wash their hands

immediately or as soon as feasibleafter removal of gloves or otherpersonal protective equipment..


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Universal Precautions Supervisors shall ensure that

employees wash hands and any other

skin surface with soap and water, orflush mucous membranes with water.

The eyes must be flushed with water

at an eyewash station for fifteen(15) minutes following contamination.


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Wash Hands Coming on duty

when soiled

between handling of patients

immediately before contact withpatient

after contamination with blood/bodyfluids

After personal use of toilet

After handling dressings


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Wash Hands After blowing or wiping the nose

After handling sputum containers

After removing gloves

Before eating

on Completion of duty


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Universal Precautions Contaminated needles and other

contaminated sharps shall not be

bent, recapped, or removed fromdisposable syringes except asrequired for medical or dental

procedure. Shearing or breaking ofcontaminated needles is prohibited.


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Universal Precautions . Immediately or as soon after

use as possible contaminateddisposable sharps shall bediscarded in containers that are:

a. Puncture resistant; b.Yellow in color or labeled with a

biohazard label; and

c. Leakproof on the sides and bottom.


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Reusable sharps that arecontaminated with blood or other

potentially infectious materials shallnot be stored or processed

Eating, drinking, smoking, applying

cosmetics or lip balm, and handlingcontact lenses are prohibited in workareas.


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Food and drink shall not be kept inrefrigerators, freezers, shelves,

cabinets or on countertops orbenchtops where blood or otherpotentially infectious materials are

present. All procedures involving blood orother potentially infectious materialsshall be performed in such a manneras to minimize s lashin , s ra in ,


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. Mouth pipetting/suctioning of bloodor other potentially infectious

materials is prohibited. Specimens of blood or other

potentially infectious materials shall

be placed in a container whichprevents leakage during collection,handling, processing, storage,transport or shipping. Specimensmust be sealed in a trans arent


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A readily observable tag containingthe universal biohazard symbol shall

be attached to the equipment statingwhich portions remain contaminated.Supervisors shall ensure that this

information is conveyed to allaffected employees,


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PersonalProtective Equipment:

1. Provision:

Equipment such as, but not limited to,gloves, gowns, laboratory coats, faceshields or masks and eye protection,and mouthpieces, resuscitation bags,pocket masks, or other ventilation

devices will be provided. Personalprotective equipment will beconsidered "appropriate" only if itdoes not permit blood or otherotentiall infectious materials to


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2. Use:Supervisors shall ensure that theemployee uses appropriate personalprotective equipment unless they canshow that they can otherwiseprotected

3. Accessibility:

Supervisors shall ensure thatappropriate personal protectiveequipment in the appropriate sizes is

readily accessible at the worksite


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Universal Precautions 4. Cleaning, Laundering, and Disposal:

5. Repair and Replacement:

6. Garment Penetration:

7. All personal protective equipmentshall be removed prior to leaving the

work area.


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When personal protective equipmentis removed it shall be placed in an

appropriately designated area orcontainer for storage, washing,decontamination or disposal.

9. Gloves: 10. Masks, Goggles and Face Shields:

.


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Universal Precautions 11. Gowns, Aprons, and Other

Protective Body Clothing:

12. Surgical Hoods or caps and orshoe covers must be worn


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Cleaning and

Decontamination All equipments

Contaminated work surfaces

Protective coverings forenviornmental surfaces

Reusable bins and pails

Broken glassware must not be pickedup by bare hands


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Labels Wherever required biohazard labels

are to be used

Individual containers are sparedfrom labeling

Secondary containers are labeled


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Waste Disposal Waste liquids /blood /infectious

materials can be poured into the

drain after treating with bleach solid waste may be discarded as

trash if contaminated must be placed

in yellow bags Pathological wasted are incinerated

Exposure Reporting


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Hospital Unit for

Inpatients Background Design - The Theme is tomaintain the microbial population at a lowlevel and below the infective dose

a. Room air control-air handling, filtered airentry of air, isolation rooms

b. Surface Residues - surfaces are used with

detergents, beds are without springs, use ofdisposable materials


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Avoidance of person to persontransmission of infection- isolation of

patients, proper hand washingfacilities, Doors with forwardpressure are used

Avoidance of contamination ofequipment, supplies and medication -Disposable Supplies are useddirectly, IV fluids to be prepared

under laminar flow, Refrigeration


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Some general rules for

Inpatient Keep all doors closed

Staff may not eat or drink oninpatient floors

Take only necessary supplies into theroom


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Continued All wastebaskets must be emptied

frequently

charts to be decontaminated Report of non compliance

Nursing supervisors are responsible

for surveillance and enforcement ofall policies


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Standard Room Care Patient Categories:- No evidence of

infection,

Hiv Infection, Infections with low probability of

transmission,

minor infections , with chronic carriers, Hep-B/C,

Fever, Streptococcal pharyngitis


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Specifications Private Room

Hand washing

Cleaning daily and removal of wastes Only washable toys are provided

Urine and Feces

Lab Specimens

Needles and syringes and HouseKeeping


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Conclusions Goals and strategies

Team work

Training Policies and procedures

Perseverance

Research

High Quality -Low cost


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Role of Nursing

Administration Planning

Organizing

Implementation Coordination

Control

Evaluation

Team work is essential


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PLANNING Depts. Structured separately

O.Tand ICU

Space in wards Isolation rooms

Adequate staffing


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ORGANISATION Infection control team

Physician, Infection control officer

and Infection control nurse

Infection control committee

Representatives from various depts.E.g. catering, cleaning facilities/building and management


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OCCUPATIONAL HEALTH

RISKS FOR HCWs Elements

- Assess infection risks & prioritisepreventive measures- Ongoing education programm regardingsafety and infection prevention- Appropriate immunisation programme

-R

eview of exposure analysis and postexposure mgt. analysis- Surveillance of occupational bloodexposures & preventive strategies for highrisk practices


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GENERAL MEASURES Accurate occupational health records

Screening of new employees for

communicable diseases Record of needlestick injuries in an

accident log

Covering of exposed skin lesions withwater proof dressing


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supervision Infection control practices

Provision of protective devices

Making sure that protective devicesare used

Accessibility


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TEACHING Orientation of new employees

Universal precautions

Cleaning, disinfection andsterilisation

Isolation

Waste disposal Infection control manual

Infection control policy


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ECONOMIC EVALUATION

OF INFECTION CONTROL Rationale- Scarce resources

Types of economic analysis

- Cost minimisation- Cost effectiveness

- Cost benefit


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SURVEILLANCE FOR

HAI Plan

- How infection to be defined

- What data to be collected, stored,retrieved, summerised andinterpreted

- Feeding of results to clinicians- How to use info. To bring aboutchange


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Requirements for

surveillance Monitor inf. Pattern ( sites,

pathogens, risk factors, location,

etc.) Detect changes in the pattern that

may include infection problem

Direct implementation of controlmeasures

Monitor antibiotic use and resistance

Provide staff with adequate


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INFECTION CONTROL

AUDIT Auditing infection control practices,

results and communicating them


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RESEARCH


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Conclusion Goals and strategies

Team work

Training Policies and procedures

Perseverance

Research

High Quality -Low cost


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Thank You

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