护理临床见习带教英文2013.10

Fang Kong,Department of infection 2013.10.10,Disinfection and Isolation,Nosocomial Infection Cleaning,Disinfection and Sterilization,Isolation,03,02,01,Standard Precautions,04,Operation Demonstration,05,Infectious diseases are caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi; the diseases can be spread, directly or indirectly, from one person to another.,Infectious diseases,Law of the PRC on the Prevention and Treatment of Infectious Diseases,A Class infectious diseases shall include plague and cholera. B Class infectious diseases shall include 26 kinds of disease. C Class infectious diseases shall include11 kinds of disease.,Reporting on and Announcing,When medical care and health personnel or anti-epidemic personnel on duty find patients, pathogen carriers or suspected patients of A Class or B Class infectious diseases, or if they find in a monitored area patients, pathogen carriers or suspected patients of C Class infectious disease, they must report the epidemic situation to the local health and anti-epidemic agency within the time limit prescribed by the health administration department under the State Council.,When a health and anti-epidemic agency finds the prevalence of infectious diseases or receives a report on the epidemic situation of A Class infectious diseases or of SARS, pulmonary anthrax as a type of anthrax, human avian influenza or H1N1influenza among B Class infectious diseases, it shall immediately report to the local health administration department within 2 hours in urban and 6 hours in rural areas.,For patients of B Class infectious diseases other than SARS, pulmonary anthrax as a type of anthrax, human avian influenza or H1N1influenza, it shall immediately report to the local health administration department within 6 hours in urban and 12 hours in rural areas.,For patients of C Class infectious diseases, it shall immediately report to the local health administration department within 24 hours.,Cleaning, Disinfection and Sterilization,Cleaning refers to the removal of dirt and part of microorganisms on the outer surface of objects by using detergent and clean water.Disinfection is the elimination or killing of pathogens and other harmful microorganisms in the environments to make the number of them decreases to a harmless degree.Sterilization is a process that destroys all the microorganisms, including spores and propagules. The sterilized objects are called aseptic supplies.,Common Methods of Disinfection and Sterilization,Physical methodsHeatBurning methodToastingBoiling waterSteam under pressureMicrowave disinfection and sterilization,01,IrradiationUltraviolet light radiation Ionizing radiationSunshine disinfection,Chemical disinfection and sterilizationImmersionFumigationNebulizationScrubbing,02,Disinfection measures in our hospital,I will show you later in the department!,Isolation,Isolation is the practices placing infectious clients and highly susceptible people in a certain area to separate them from the others for the time being. The isolation fr the infected clients is called infection source isolation. The isolation for the susceptible people is called protective isolation.,Clean area refers to such areas not contaminated by pathogens as office, treatment room, changeroom and the areas other than wards, like canteen and pharmacy.,Clean Area,Half-contaminated area,Half-contaminated area refers to the area that are potentially contaminated by pathogens, like laboratory and disinfection room.,Contaminated area,Contaminated area refers to the area in contact with clients directly and indirectly, such as ward, lavatory and bathroom.,1、Strict isolation 2、Respiratory isolation 3、Enteric isolation4、Contact isolation5、Blood-fluid isolation,Types of Isolation and Practices,Strict isolation,Contagious disease with strong infectivity and high mortality needs strict isolation to cut its transmission route. Strict isolation is applicable for fulminating contagious diseases which are directly or indirectly transmitted by droplets, secretion or elimination, such as cholera, plague et al.,Respiratory isolation,It is mainly used to prevent infectious disease transmitted by droplets nuclei in short distance, such as influenza, epidemic encephalitis B and measles.,Enteric isolation,It is used for diseases which are caused directly or indirectly by contaminated food or water by the clients stool, such as typhoid, bacillary dysentery, hepatitis A.,Contact isolation,It is suitable for diseases directly or indirectly infected through skin or wound contact, such as tetanus, gas gangrene.,Blood-body fluid isolation,It is used to prevent the infectious diseases caused by the direct or indirect contact with the contagious blood or body fluid, such as hepatitis B, AIDS, and syphilis.,Which type of isolation you should use if you care for a SARS patient?,Standard Precautions,Standard Precautions are work practices required to achieve a minimal level of infection control for the treatment of all clients. They are designed to protect both the health care worker and client. Precautions (such as use of personal protective equipment) to prevent skin and mucous membrane exposure when contact with any blood or other body fluids is anticipated. Standard precaution guidelines are based on the principle that all blood, body fluids, secretions, non-intact skin, mucous membranes, and excretions except sweat may contain transmissible infectious agents.,Normal prevention,Primary prevention,Secondary Prevention,Tertiary Prevention,Three levels of Prevention,Primary PreventionFever clinicWorking clothes and working shoesHand washingIsolation hatsIsolation gown,Secondary Prevention,Isolation observation room, special wardsWorking clothes Hand washingIsolation hatsProtective maskIsolation gownGlovesIsolation shoes,Tertiary Prevention,Sputum aspiration TracheotomyTracheal intubation Respiratory Protection,Operation Demonstration,Don and remove isolation gownWear mask and cap and remove wrist watch, roll sleeves above elbows;Take a gown by grasping the collar with clean inner side toward wearer. Fold the two sides of the collar and expose the armholes of the sleeves;Grasp collar with right hand, slip left hand into sleeve. Pull up the collar with right hand and let the left hand out of the sleeve;Grasp the collar with left hand and slip right hand into the sleeve, and make the right hand out of the sleeve. Hold up both hands to make both wrists out of sleeve;,Grasp the collar with both hands. Tie the neck bounds from the center to the back. Button up the buttons;(6) Unite the knot of girdle, gradually pull one side of gown forward and hold it when reaches the edge. Hold another edge of the gown in the same way. Make parallel of the gown edges and overlap the gown at one side. Press the folded part with one hand and pull the girdle to back with another hand, cross the girdle on the back and turn it to the front and make a free tie. Fasten the back button of the gown.,Unite the girdle and make a free tie in front;Unfasten the buttons of shoulder and sleeve. Tuck part of the sleeves on elbow sleeve and disinfect hands;Unfasten the neck button. Stretch right hand into the inside of left sleeve at wrist to pull the cuff down. Hold the outer surface of right sleeve with gown-covered left hand and pull the right sleeve down. Withdraw both hands from sleeves gradually, hold the shoulders of the gown with right hand to withdraw left hand. Hold the outer side of the collar with left hand to withdraw right hand;,(4)Hold the collar with both hands, make parallel of th