Antibiotic Resistance Prevention

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Transmission of bacteria from one patient to another is an easy way to ensure that a resistant bacteria from the ICU can migrate to the Pediatric ward. Here are some examples of ways to minimize the risk of spreading antibiotic resistance from a patient that has an illness to one who does not.

Hand Hygiene

Proper hand washing is a good technique to utilize when avoiding the spread of contaminants. Hands should be washed under warm water vigorously with soap for about 20 seconds, or the time it takes to sing the "Happy Birthday" song to yourself twice. Once rinsed, do not turn off the faucet handle with your clean hands; use a paper towel to dry your hands first and then use that towel to turn off the tap. Also, use a paper towel to open the door out of the bathroom.[1]

Hands should be washed after coming in contact with any contaminated surface, like the desk, a patient, your face/hair, or after you sneeze/cough. Hands should also be washed before and after wearing gloves, and before touching a patient.



Personal Protective Equipment (PPE)

PPE should be donned when there is an increased chance of spreading infectious organisms between highly susceptible patients and the health care worker.

1. Hair/Head Caps

Some microorganisms can be spread by shedding skin or hair. Using a hair/head cap protects the patient from acquiring any organism that the health care worker may be carrying. The cap should be changed between patients and should be large enough to conceal the workers hair, yet still be snug to the skin to prevent particles from escaping.[2]

2. Eye/Face Shield

Protective eye wear, when worn correctly, can aid the hospital personnel by preventing foreign objects or bacteria from entering the body. Goggles or glasses should be clean and fitted[3] to the person wearing them so that they fit comfortably while offering maximum protection. Prescription lenses and contact lenses do not offer adequate protection and should not be used in place of goggles.[4]

A face shield maximizes protection by covering the eyes, nose, and mouth to prevent fluid[4] or airborne substance penetration, thereby minimizing modes of transmission for bacterial entry.

3. Respiratory Mask

Respiratory masks filter the air for particles before it is inhaled by the medical worker. It has the ability to filter particles that are less that 5 microns.[4] This is useful to prevent acquiring an airborne transmitted microorganism or inhaling dangerous chemicals. Choose masks that are comfortable yet snug, and offer adjustable nose pieces to provide optimal performance. Make sure that it is fitted to your size and provides a proper seal.[4]

4. Gown

Gowns protect the torso, arms, and clothing from contamination and microorganisms. Gowns should fit snug and comfortably while also providing coverage down the length of the arm.[4] Using a gown (and changing it) between patients with severe complications or infections can reduce the spread of infectious microorganisms to compromised individuals or to other locations. Disposable gowns should be discarded in appropriate waste containers and reusable ones should be sent to the facility's laundering service. Do not bring home to launder, as this increases the risk of spreading microorganisms to your home.

5. Gloves

Wearing gloves prevent hands from coming in contact with dangerous chemicals or contaminated surfaces and passing the contaminant to patients or yourself. Choose gloves that are nitrile or latex, fit snug to the skin, and are devoid of tears or holes.[4] Always change gloves between patients! Gloves should be changed after use on each patient and discarded. Do not wash patient care gloves for re-use, as it will not remove all contaminants or bacteria and could lead to tears.[4]

6. Protective Clothing

Scrubs are used mainly to cover the health care worker's body and to prevent contamination of "street clothes".[2] Scrubs protect the skin of the health care worker from accidental splashes and bodily fluids. In the event of contamination, scrubs should be removed and sent to the facility's laundering service for disinfection. Do not bring scrub suits home that are contaminated with bodily fluids, as you may transfer infectious organisms from the hospital to your home.

7. Shoe Covers

Wearing protective footwear prevents contamination of the health care worker by accidental sharps exposure or spills.[2] Footwear should be clean to decrease the spread of contaminants that could be picked up from either the hospital or outside environment. Shoe covers are then used if footwear could be a possible form of contamination if entering an isolated clean environment (such as a surgical ward) and should always be removed by a gloved hand.[2]

Sterilizing Equipment

Indwelling medical devices need to be fully cleaned between use if they are to be reused with other patients in order to remove any residing microbial life and prevent cross-contamination. Typically, it is recommended that devices coming in contact with bodily fluids be sterilized, done either by steam under pressure, dry heat, or by chemical sterilizers.[5] The type of sterilization used depends on the type of equipment, the organism, and available methods at the health care facility.[5]

References

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  1. Mayo Foundation for Medical Education and Research, (2007, Oct 16). Hand washing: An easy way to prevent infection. Retrieved November 12, 2008, from MayoClinic.com Web site: http://www.mayoclinic.com/health/hand-washing/HQ00407#
  2. 2.0 2.1 2.2 2.3 Tietjen, L, Bossemeyer D, McIntosh N. (2003, March). Personal protective equipment and drapes. Infection Prevention: Guidelines for Healthcare Facilities with Limited Resources, Retrieved Nov 12, 2008, from www.reproline.jhu.edu/English/4morerh/4ip/IP_manual/05_PPE.pdf
  3. Centers for Disease Control and Prevention, (2002). PSA radio script: Eye protection . Retrieved November 12, 2008, from National Ag Safety Database Web site: http://www.cdc.gov/nasd/docs/d001101-d001200/d001120/d001120.html
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Centers for Disease Control and Prevention, (2004, June 29). Guidance for the selection and use of personal protective equipment (PPE) in healthcare settings. Retrieved November 12, 2008, Web site: http://www.cdc.gov/ncidod/dhqp/ppe.html
  5. 5.0 5.1 Manivannan, G, (2007). Disinfection and Decontamination: Principles, Applications and Related Issues. St. Louis, MO: CRC Press.


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