PCC CNA Unit 5

1. Unit 5 Infection Prevention and Control
HandWashing

2. Microorganisms
 Microorganisms are always present in
the environment. Some of these
microorganisms cause disease
(pathogens)
 Some pathogens have developed
resistance to antibiotics, making them
especially difficult to control.

3. Microorganisms
 Small living plants or animals seen only with a
microscope
 Requirements of microbes
 Food-most need organic material for
nourishment
 Moisture and light-most grow well in moist
locations and in darkness.
 Oxygen-particularly bacteria need O2 to live
 Temperature-most thrive at body temp

4. Microorganisms
 Elderly people and individuals with
chronic diseases often have immune
systems that are not as active or
responsive, making them more
susceptible to pathogens.

5. Infection
 Different types of Infection
 Local infection-one certain area
 Systemic infection-entire body
 Focus on changes in an older person
-confusion
-redness, warmth, swelling or drainage
-foul smelling or dark urine

6. Types of Microorganisms
 Bacteria
 Viruses
 Fungi
 Parasites
 Normal flora is
bacteria that is
suppose to be on
your body as part
of a defense
mechanism to fight
microorganisms
trying to enter your
body.

7. How pathogens are
transmitted
 Direct Contact
 Touching the source of
infection, then touching
a susceptible body
location.
 EX: Touching feces or
secretion from a res.
then touching a break
in the skin or mucous
membrane.
HANDWASHING !!!!!!!!
 Indirect Contact
 Infection is picked up
on an object and
carried to the person.
 EX: Feces contaminates
the floor and visible
residue is cleaned up,
then a drinking straw of
another res falls to the
floor and is picked up
for another resident to
use.

8. How pathogens are
transmitted
 Droplet
 Pathogens are
transmitted by
droplets given off
by coughing,
sneezing, or
coughing.
Didn’t your mother
tell you to COVER
YOUR MOUTH!!
 Vehicle spread
 Pathogens are
carried by
contaminated food,
water, blood.
(Bloodborne
pathogens)
Any food or drink
must be covered
when going down
the hall.

9. Chain of Infection
Transparency 2-8

10. Disease Prevention
The number ONE defense
against the spread of infection
and disease prevention is…
Proper Hand Hygiene

11. Hand Hygiene
 Hands are a primary means for
spreading disease by direct contact.
 Jewelry, watches and rings provide a
place for microorganisms to hide.
 ARTIFICIAL NAILS-and chipped polish
provide a place for microorganisms to
hide.
 Around and under nails is another
location where microorganisms may
hide.

12. Hand Hygiene continued
 Intact skin provides a protective
barrier.
 Hand washing is the single most
important measure in infection
prevention and control.
 A waterless cleaner is also effective
for routine hand care, but should not
substitute for washing when hands
are visibly soiled.

13. Hand Hygiene 101
 Wash hands when visibly soiled, when
gloves have been removed, after suing the
restroom, before eating, before res
contact, after contact with a res skin after
contact with bodily fluids or excretions, and
any time hands have touched
contaminated material.
 Use warm, running water, keeping hands
lower than elbows allowing water to flow
toward fingertips

14. Handwashing 101 continued
 Use firm rubbing motion to clean all
surfaces of wrists, hands, fingers and nails.
Liquid soap is usually provided form a
dispenser.
 Wash for an adequate length of time (15-
30) seconds.
 Dry hands with paper towels, using dry
towel to turn off faucet.
 Avoid touching sink with clothing or body.

15. Waterless Hand Cleaner
 Follow facility policies regarding use.
 Rub adequate amount of cleaner onto all
surfaces of wrists, hand sand fingers. Rub
until the cleaner dries, at least 15 seconds
or as described in facility policy.
 If hands are visibly soiled, use soap and
water.
 Waterless hand cleaner is not to be used in
food preparation areas.

16. Clean Environment
 All areas of the facility
 Operating Practices
 Housekeeping
 Food Preparation

17. Infection Control should…
 Prevent cross- infection, protect
residents, visitors and staff from
acquiring an infection. It also
prevents staff from carrying infection
home to family members.
 Nosocomial infection is the term used for
an infection that is acquired within the
facility.

18. Infection Control
should…continued
 Prevent infection-protect a resident
who has had an infection from being
infected again.
 Provide a safe environment that is as
free from pathogens as possible.
Reducing the # of pathogens and
hindering their transfer decreases the
opportunity for spread of infection.

19. Who is Responsible?
 Nurses
 Doctors
 Nurse Assistants
 Dietary Personnel
 Housekeeping
 Patients
 Visitors

20. Monitoring
 Staff practices
 Environmental
Controls
 Safety
 Epidemiology
 Preventive
measures

21. Potential Sources of
Infection
 Blood
 All body fluids, secretions and
excretions, except sweat , regardless
of whether they contain visible blood.
 Non intact skin
 Mucous membranes

22. Bloodborne Pathogen Standard
 The human immunodeficiency (HIV)
and hepatitis B (HBV) viruses are
major health concerns.
 The Bloodborne Pathogen Standard is
intended to protect the health team
from exposure.
 Exposure control plan
 Training requirements

23. Standard Precautions
 These are standard care precautions that
are to be used for the care of ALL residents
whether or not they have been diagnosed
with an infectious disease. These
precautions are designed to reduce
transmission of pathogen from both
recognized and unrecognized sources. The
CNA or other staff can never be certain
who may be a carrier of infection.

24. PPE Personal
Protective Equipment
Gloves
Gowns
Masks
Eye Protection
Common Sense

25. Clean Gloves
 Gloves may be made of different materials to
protect individuals who have latex allergy.
 Gloves are to be used when hands have contact
with blood, body fluids, broken skin or mucous
membrane.
 Gloves may be used to protect CNAs hands if skin
is not intact.
 Hands should be clean before putting on gloves.
Hands should be washed after gloves are
removed.

26. Removing Gloves
 Remove and discard soiled gloves
immediately after completion of task.
 Remove gloves without contaminating
hands. Gloves are NOT reused.

27. Overview of Standard
precautions
 Wash hands after touching potential sources of
infection. (Wash hands before and after contact
with res. And any time hands are soiled.
 Use personal protective equipment also called
barrier equip. when touching potential sources of
infection.
 Wear gloves changing frequently after contact with
infected material. Proper use of gloves provides a
protective barrier.
 Wear face and eye protection or face shield if body
substance could splash or spray.
 Wear fluid resistant gown to protect skin and clothing if
body substance could splash or spray.

28. Overview continued
 Handle res. care equip. with caution,
particularly when equip. has contacted
potential sources of infection.PPE may
be needed.
 Handle linen with care. Assume that
linen has touched potential sources of
infection.
 Avoid contact with one’s clothing
 Handle so that microorganisms are not
transferred to other res. or the environment

29. Overview continued
 Use approved environmental control
measures when cleaning up a spill,
disposing of trash, or cleaning the res
unit. Label bio-hazardous waste.
 Prevent injuries from needles and other
sharp devices. The nurse will dispose of
needles in a “sharps” container that is
puncture resistant.

30. Needs of Res in isolation
 Meeting basic needs for safety and
security, belonging and caring.
 Remember to care for the person as
well as disease process.
 Personal care needs are the same as
if the resident were not in isolation.
 Resident and family need to be
educated about isolation purpose and
procedure.

31. Types of transmission based
precautions
 Contact
 Droplet
 Airborne
 Then nurse will identify the type of
isolation or precautions required for a
res infection. The facility will have
written descriptions of the isolation
procedure.

32. Transmission Based
Precautions or Isolation
 These are infection control
precautions based on the way a
particular disease is spread.
 They are used in addition to standard
precautions for a res who has an
identified infection.

33. Transmission Based
Precautions or Isolation
 Isolation precautions
 Protective measures
 Gloves
 Masks and respiratory protection
 Protective apparel
 Eyewear and face shields
 Bagging items
 Collecting specimens
 Transporting persons

34. Reverse or Protective
Isolation
 Purpose is to protect the res with a
weakened immune system from
pathogens in the environment.
 Less commonly seen in long-term
care facilities. Mostly in hospitals.

35. Correcting breaks in
infection control procedures
 If CNA catches a break in procedure,
he or she can use the hint
”stop , correct, resume”
as a reminder for the action to take
place.

36. Examples of correcting
breaks in procedure
 When providing
incontinent care, the
CNA forgets to apply
gloves. Corrective
actions are to stop,
leave the res. In a
safe condition, wash
hands, apply gloves,
and resume
incontinent care.
 While changing linens
on res bed, the CNA
places soiled linen on
the bedside table.
Corrective actions are
to stop, remove linens
to a hamper or plastic
bag, clean top of table
with disinfectant, then
complete res care.

37. Medical Asepsis
 Medical asepsis (clean technique)
 Surgical asepsis (sterile technique)
 Common aseptic practices
 Hand washing
 Preventing the spread of microbes
 Focus on home care
 Focus on older persons
 Hand hygiene
 Supplies and equipment
 Cleaning
 Disinfection
 Sterilization
 Other aseptic measures