SAFE AND HEALTHY

ENVIRONMENT
PART 2

DARWIN M. PANGANIBAN, PTRP

ISOLATION PRECAUTIONS
• Refers to measures designed to prevent the spread of infections or
potentially infectious microorganisms to health personnel, clients &
visitors.

• CENTERS FOR DISEASE CONTROL PREVENTION (CDC) established

isolation guidelines SUCH AS:
UNIVERSAL PRECAUTIONS (UP)-
BODY SUBSTANCE ISOLATION PRECAUTIONS (BSI)
• UNIVERSAL PRECAUTIONS (UP)- refers to the practice in medicine, of
avoiding contact with patient’s bodily fluids, by means of wearing non
porous articles such as medical gloves, goggles, and face shields.

• BODY SUBSTANCE ISOLATION PRECAUTIONS (BSI) - a system of

isolation in which barrier techniques are used for specific patient
rather than for a specific diagnosis. BSI requires use of hand hygiene
and barrier precautions for ALL persons whether or not they have a
diagnosed or suspected infection.
Types of Body Substance Isolation included:
• Hospital gowns
• Medical gloves
• Shoe covers
• Surgical mask or N95 respirator.
• Safety glasses
CDC ISOLATION PRECAUTIONS, these guidelines designate two tiers of
precautions:

• TIER 1: STANDARD PRECAUTIONS

• Practices used to prevent transmission of diseases that can be acquired by
contact with blood, body fluids, non-intact skin (including rashes, and mucous
membranes.

• TIER 2: TRANSMISSION – BASED PRECAUTIONS

> types: contact, droplets, and airborne, the type used depends on the mode of
transmission of a specific disease
PERSONAL PROTECTIVE EQUIPMENT (PPE)

1. mask
2. gloves
3. goggles
4. gown (laboratory)
Why do we need to wear gloves?

Gloves are worn for three reasons:

• Protect the hands when personnel is likely to handle any substances
• Reduce transmission of endogenous microorganisms
• Lessen the spread of microorganisms from one client to another
When to wear face masks?

The CDC recommends that masks be worn under the following

conditions:
• Those close to the patient if the infection is transmitted by close
contact & travel short distances. (1 m. or 3 ft.) like measles, mumps
• All persons entering the room if the infection is transmitted by small
particle aerosols such as SARS.
• What kind of protective eyewear?

• Goggles
• Glasses
• Face shields
DISPOSAL OF SOILED EQUIPMENT &
SUPPLIES
• Appropriate handling of soiled equipment & supplies is
essential for these reasons:
1. To prevent exposure of Health Care Workers (HCW) to articles
contaminated with body substances
2. To prevent contamination of environment
BAGGING
• Most articles do not need to be placed in bags
unless they are contaminated or likely to have
been contaminated with infective material.
• Contaminated articles need to be enclosed in a
sturdy bag impervious to microorganism before
they are removed from the room of client.
• Some agencies use labels or bags of particular
color that designates them as infective wastes.
DISPOSAL OF SOILED EQUIPMENT & SUPPLIES
LINENS
• Handle soiled linen as little as possible & with least agitation before placing it in the laundry
hamper.
• Close the bag before sending it to laundry.

LABORATORY SPECIMENS
• Put in a leak proof container with proper label
• Use care when collecting specimens
• Containers that are contaminated outside should be placed in a sealed plastic bag

DISPOSABLE NEEDLES, SYRINGES & SHARPS

• Place it into puncture resistant container
• To avoid puncture wounds, use approved safety or needless systems & do not detach
needles from syringe or recap the needle before disposal
HANDWASHING

Most important measure for controlling and preventing the spread of

infection
HW is a brief, vigorous rubbing together of all surfaces of hands, lathered
by soap, ff. by rinsing under a stream of water.

RATIONALE:
1. to reduce no. of microorganism on the hands
2. to reduce risk of transmission of microorganism
3. to reduce risk of cross contamination among clients
4. to reduce number of transmission of infectious organisms to one self
GUIDELINES FOR HAND HYGIENE
BASED ON DEGREE OF ANTISEPSIS
TYPE OF HAND CARE PURPOSE METHOD
hand wash Remove soil & Soap or detergent for at
transient least 10 – 15 seconds
microorganisms
hand antisepsis Remove or destroy Antimicrobial soap or
transient detergent or alcohol
microorganisms based hand rub for at
least 10 – 15 seconds
surgical hand scrub Remove or destroy Antimicrobial soap or
transient detergent & brushing to
microorganisms & create friction for at least
reduce resident flora 120 seconds or alcohol
based preparation for at
least 120 seconds
 Handwashing
STEPS RATIONALE
1. Assess the hands.
a. nails should be kept short Short, natural nails are less likely to harbor microorganisms
b. remove all jewelry Microorganisms can lodge in the settings of jewelry & under rings. Removal
facilitates proper cleaning
2. Do hand washing(HW) in front of the pt as much as possible, explain to This will educate the client of the importance of hand washing & encourage
the client what you are going to do & why it is necessary him/her to practice it correctly
3. Stand in front of the sink, keeping hands & uniform away from the sink Proper body mechanics & it will avoid you to touch the sink
surface ( If hands touch sink during HW, repeat)
4. Turn on the water & adjust the flow so that water is warm. Turn on the Warm water removes less of the protective oil of the skin, microorganisms
faucet using paper towel. Avoid splashing water on uniform. travel & grow in moisture
5. Wet the hands thoroughly by holding them under the running water. Keep The water should flow from the least contaminated to the most
hands & forearm lower than elbow washing. contaminated area, hands generally considered more contaminated than the
lower arms.
6. Apply 2 – 4 mL of liquid soap. If it is bar or granules or sheets rub them To ensure that all surfaces of hands & fingers are covered & cleansed.
firmly between the hands.
7. Perform hand hygiene using plenty of lather & friction for at least 15 Friction & rubbing mechanically loosen & remove dirt & transient bacteria.
seconds. Adequate time is needed to expose the skin surfaces to antimicrobial agent.
a. Use firm, rubbing & circular movements to wash the palm, back & wrist
of each hand.
b. Interlace the fingers & thumbs, move & rub palms & back of hands for 10
seconds or 10 times.
c. rub the finger tips against the palm of opposite hand.
8. Rinse the hands & wrists thoroughly, keeping hands down & elbows up. Rinsing mechanically washes away dirt & microorganisms

10. Dry hands thoroughly, keeping hands down & elbows up. Discard paper Drying from cleanest to least clean area avoids contamination. Drying hands
towel in the appropriate container. prevents chapping & roughened skin.
11. Use towel to turn off hand faucet. Avoiding touching handles with Prevent transfer of pathogen from faucet to hands
hands.
 DONNING & REMOVING PPE
STEPS RATIONALE
Preparation: Done after HW
1. Explain to the client what you are going to do & why it is necessary For pt’ awareness, cooperation &
education.
2. HW See the rationale on page 5
3. Don a clean gown Avoid the spread of pathogen to
a. Pick up a clean gown & allow it to unfold in front of you without allowing to
other person & it will protect you
touch any area soiled with body substances. from being contaminated.
b. Slide arms & the hands through the sleeves.
c. Fasten the ties at the neck to keep the gown in place.
d. Overlap the gown at the back as much as possible & fasten the waist ties or
belt.
4.Don the face mask Protection from any airborne
a. locate the top edge of the mask. The narrow metal strip. disease.
b. Hold the mask by the top two strings or loops
c. Place the upper edge of the mask on the bridge of the nose & tie the upper
ties at the back of the head or secure it on ears.
d. Secure the lower edge of the mask under the chin & tie the lower ties at the
nape of the neck.
e. if mask has metal strip adjust it firmly over the bridge of the nose.
f. Wear the mask only once & if it is wet discard the mask.
g. Do not leave it hanging on your neck
5. Don protective eyewear if it is not combined with face mask. Avoid any substances to enter the
eyes.
6. Don clean disposable gloves.
REMOVING PPE
7. To remove soiled PPE, remove the gloves first. Most contaminated PPE
a. If wearing a gown that is tied at the waist, undo the ties before removing gloves.
b. Remove the first glove by grasping it on palmar surface just below the cuff, taking care to
touch only glove to glove.
c. Pull the first glove completely off by inverting or rolling the glove inside out.
d. Continue to hold the inverted removed glove by the fingers of the remaining gloved hand.
Place the first two fingers of the bare hand inside the cuff of the second hand.
e. Pull the 2nd glove off the fingers by turning it inside out.
f. using bare hand, continue to remove the gloves, which are now inside out & dispose of them.
8. HW
9. Remove the mask
a. if using a mask with strings, first untie the lower strings of the mask.
b. Untie the top strings & while holding the ties securely, remove the mask from the face.
c. Discard in waste container
10. Remove the gown
a. avoid touching the soiled parts on the outside of the gown
b. Grasp the gown along the inside of the neck & pull down over the shoulders.
c. Roll up the gown with the soiled part inside & discard it in appropriate container.
11. Remove the protective eyewear & dispose it properly
12.HW