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Universal precautions provide the basic guidelines by which all blood, body fluids, and wastes are considered "infected" in any client regardless of condition. There are two levels, one general for all individuals, and one specific to known infections at specific sites in the body, for example, the intestines. Gloves and appropriate protective apparel are then used to reduce the transmission of organisms in either direction, that is, from patient to caregiver and from caregiver to patient. Guidelines have been established for the disposal of such potentially dangerous items as needles, tissue, and waste materials. The Centers for Disease Control and Prevention (CDC) can be consulted for advice.
In order to break the cycle and minimize the risk of infection:
• The reservoir or sources of infection must be located and removed. Sources and contacts must be identified in some situations, especially when asymptomatic carriers maybe involved, or when travelers maybe infected.
• Contaminated water or food or carrier food handlers should be identified to prevent continued transmission of epidemics of infectious disease. As a precaution some institutions test stool specimens from food handlers in order to identify carriers. Some intestinal pathogens can survive in feces outside the body for long periods of time and increase the risk of contaminating food or water;
• In some cases, an infection can be transmitted before clinical signs are evident in the infected person, and this permits widespread contamination if the incubation period is prolonged. For example, there is a prolonged " window" of time before hepatitis or human immunodeficiency virus (HIV) infection can be identified in persons. In institutions, the infection can spread very rapidly, particularly when the patient's health status is already compromised;
• Infected travelers should refrain from travel to prevent spreading infectious diseases into many areas;
Block the portal of exit (secretions, e.g., blood, saliva, urine) of microbes from the reservoir. This includes minimizing the effects of coughing and sneezing when the infected person is in close contact with other people. However, it is now evident that contaminated oral and nasal secretions are more dangerous when they are on hands or on tissues than when they are airborne, so proper disposal of contaminated items is essential. It is advisable for anyone with or without an infection to use general precaution to prevent transmission by body fluids; and
• Know the mode (droplet, oral-fecal) or modes of transmission of specific infections in order to block this route. Precautions must be undertaken in a prescribed manner; for example, the appropriate condoms with the recommended guidelines is essential to prevent the spread of sexually transmitted disease.
Using disposable equipment, proper sterilization and cleaning, good ventilation, and frequent handwashing are some ways to reduce transmission:
• Block portals of entry and exit, by covering mouth and nose with a mask. provide barriers over breaks in the skin or mucous membrane. Also, the number of organisms transmitted at any one time can be an important factor in the establishment of infection, and therefore of the risk; and
• Reduce host susceptibility (increase host resistance) by maintaining immunizations and ensuring boosters. there is currently concern about the increasing evidence of pertussis (whooping cough), related to the declining effectiveness of the original immunization. Work is proceeding on providing a suitable booster for adults.
Other precautions include avoiding injury to the skin, maintaining nutrition and rest, frequent effective handwashing, and using barriers or other methods to reduce contact with infected persons.
Additional techniques to reduce transmission include:
1. Adequate cleaning of surroundings and clothing.
2. Sterilization destroys microorganisms by exposing them to heat using several methods, such as autoclaving. Time, packaging, and temperature are critical to success. Moist heat is preferable since it penetrates more efficiently and can destroy microbes at lower temperatures. Incineration (burning) and autoclaving are effective methods of destroying microbes.
3. Disinfectants are chemical solutions that are known to destroy microorganisms or their toxins on inanimate objects. The literature on these solutions must be carefully checked to determine the limitations of the specific chemicals as well as the instructions for use. For example, few chemicals destroy spores. Adequate exposure time and concentration of the chemical are required to kill some viruses such as hepatitis B. Other potential problems include inactivation of some chemicals by soap or protein (mucus, blood) or damage to metals or latex materials on instruments by the disinfectant. One of the more effective disinfectants at present is glutaraldehyde. Flushing certain equipment and tubing (e.g., in a dental office), with disinfectant and water, is a recommended daily activity.
4. Antiseptics are chemicals applied to the skin that do not usually cause tissue damage, such as isopropyl alcohol-70%. The chemical affects only surface organisms and does not penetrate crevices. Antiseptics reduce the number of organisms in an area but do not destroy all of them. Also, they may be diluted or removed quickly by body secretions. Some antiseptics, such as iodine compounds, cause allergic reactions in some individuals.
Universal precautions provide the basic guidelines by which all blood, body fluids, and wastes are considered "infected" in any client regardless of condition. There are two levels, one general for all individuals, and one specific to known infections at specific sites in the body, for example, the intestines. Gloves and appropriate protective apparel are then used to reduce the transmission of organisms in either direction, that is, from patient to caregiver and from caregiver to patient. Guidelines have been established for the disposal of such potentially dangerous items as needles, tissue, and waste materials. The Centers for Disease Control and Prevention (CDC) can be consulted for advice.
In order to break the cycle and minimize the risk of infection:
• The reservoir or sources of infection must be located and removed. Sources and contacts must be identified in some situations, especially when asymptomatic carriers maybe involved, or when travelers maybe infected.
• Contaminated water or food or carrier food handlers should be identified to prevent continued transmission of epidemics of infectious disease. As a precaution some institutions test stool specimens from food handlers in order to identify carriers. Some intestinal pathogens can survive in feces outside the body for long periods of time and increase the risk of contaminating food or water;
• In some cases, an infection can be transmitted before clinical signs are evident in the infected person, and this permits widespread contamination if the incubation period is prolonged. For example, there is a prolonged " window" of time before hepatitis or human immunodeficiency virus (HIV) infection can be identified in persons. In institutions, the infection can spread very rapidly, particularly when the patient's health status is already compromised;
• Infected travelers should refrain from travel to prevent spreading infectious diseases into many areas;
Block the portal of exit (secretions, e.g., blood, saliva, urine) of microbes from the reservoir. This includes minimizing the effects of coughing and sneezing when the infected person is in close contact with other people. However, it is now evident that contaminated oral and nasal secretions are more dangerous when they are on hands or on tissues than when they are airborne, so proper disposal of contaminated items is essential. It is advisable for anyone with or without an infection to use general precaution to prevent transmission by body fluids; and
• Know the mode (droplet, oral-fecal) or modes of transmission of specific infections in order to block this route. Precautions must be undertaken in a prescribed manner; for example, the appropriate condoms with the recommended guidelines is essential to prevent the spread of sexually transmitted disease.
Using disposable equipment, proper sterilization and cleaning, good ventilation, and frequent handwashing are some ways to reduce transmission:
• Block portals of entry and exit, by covering mouth and nose with a mask. provide barriers over breaks in the skin or mucous membrane. Also, the number of organisms transmitted at any one time can be an important factor in the establishment of infection, and therefore of the risk; and
• Reduce host susceptibility (increase host resistance) by maintaining immunizations and ensuring boosters. there is currently concern about the increasing evidence of pertussis (whooping cough), related to the declining effectiveness of the original immunization. Work is proceeding on providing a suitable booster for adults.
Other precautions include avoiding injury to the skin, maintaining nutrition and rest, frequent effective handwashing, and using barriers or other methods to reduce contact with infected persons.
Additional techniques to reduce transmission include:
1. Adequate cleaning of surroundings and clothing.
2. Sterilization destroys microorganisms by exposing them to heat using several methods, such as autoclaving. Time, packaging, and temperature are critical to success. Moist heat is preferable since it penetrates more efficiently and can destroy microbes at lower temperatures. Incineration (burning) and autoclaving are effective methods of destroying microbes.
3. Disinfectants are chemical solutions that are known to destroy microorganisms or their toxins on inanimate objects. The literature on these solutions must be carefully checked to determine the limitations of the specific chemicals as well as the instructions for use. For example, few chemicals destroy spores. Adequate exposure time and concentration of the chemical are required to kill some viruses such as hepatitis B. Other potential problems include inactivation of some chemicals by soap or protein (mucus, blood) or damage to metals or latex materials on instruments by the disinfectant. One of the more effective disinfectants at present is glutaraldehyde. Flushing certain equipment and tubing (e.g., in a dental office), with disinfectant and water, is a recommended daily activity.
4. Antiseptics are chemicals applied to the skin that do not usually cause tissue damage, such as isopropyl alcohol-70%. The chemical affects only surface organisms and does not penetrate crevices. Antiseptics reduce the number of organisms in an area but do not destroy all of them. Also, they may be diluted or removed quickly by body secretions. Some antiseptics, such as iodine compounds, cause allergic reactions in some individuals.
