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INFECTION CONTROL NURSING - Agents of Nosocomial Infection - Modes of Transmission - Infection Control Principles
ANATOMICAL LOCATION PREDOMINANT BACTERIA
Skin staphylococci and corynebacteria
Conjunctiva Gram-positive cocci and Gram-negative rods
Teeth streptococci, lactobacilli
Mucous membranes streptococci and lactic acid bacteria
Nares (nasal membranes) staphylococci and corynebacteria
pharynx (throat) streptococci, neisseria, Gram-negative rods and cocci
stomach Helicobacter pylori (up to 50%)
small intestine lactics, enterics, enterococci, bifidobacteria
colon bacteroides, lactics, enterics, enterococci, clostridia,
anterior urethra staphylococci, corynebacteria, enterics
vagina lactic acid bacteria during child-bearing years; otherwise
THE SKIN Is the main source of bacteria responsible for IV infections.
Bacteria sticking on to the skin like Staphylococcus albus may enter the IV site.
CANNULA contamination can occur from skin during insertion of the cannula.
AIRBORNE BACTERIA enter into unprotected IV solutions (e.g. while pricking
needles in IV bags for airflow) which hang during IV infusion.
CONTAMINATION OF IV SOLUTION CAN OCCUR:
By allowing IV bag to hang near bedside for prolonged periods more than 24 hrs.
By leaving IV solution bag open on the shelf.
During handling IV bags if small punctures occur to the bag.
By solutions which got expired (nutrient-rich solutions such as TPN and blood
get expired quicker)
BLOOD may also contain microorganisms such as Hepatitis B and HIV which are
dangerous to the health care worker.
GENERAL MEASURES TO REDUCE INFECTIONS
Use of strict aseptic technique at all times.
Use clean gloves while handling blood and body fluids.
Examine equipment for quality and expiry date.
Careful cannula site preparation in aseptic manner.
Avoid reinsertion of the same cannula to prevent infection.
All insertion equipment are to be single patient use (i.e. IV Sets, Cannulas)
Use of filter needle for IV medications.
Needles should not be recapped, but disposed in a sharps disposal container.
Correct storage and handling of blood products.
Avoid pricking needles in IV bags which hang during infusion.
On-going assessment to find signs of infection early.
INFECTION CONTROL GUIDELINES/ POLICIES
Routine safe Practices like hand hygiene, personal protective equipment, safe disposal of
wastes, and blood and body fluid spills clean-up should be followed.
All IV insertion sites should be cleansed with a scrub using 2% Chlorhexidine with 70%
alcohol solution, and allowed to dry prior to insertion.
Cleanse an area larger than the intended dressing and allow solution to air-dry completely
prior to applying dressing.
All needleless connectors should be cleansed with 70% alcohol for 30 seconds and
allowed to dry completely before accessing.
It is strongly recommended that all IV insertion sites should be covered with a
transparent semi-permeable membrane dressing.
An intact dressing must be used to stabilize the IV cannula in site and reuse of IV sets
should be avoided.
Label the date of IV Insertion over the site and change the IV cannula every 7 days.
A minimum of IV supplies should be taken to the patient’s bedside and unsealed
solutions, cannulas and IV sets should not be used.
Use sterile articles at all times, any unused supplies(IV Bags, Cannulas, IV sets) that
have been in contact with the patient or their bed side can be wiped with a disinfectant
wipe provided there is no blood or body fluid contamination.
If they are contaminated they should be discarded before leaving the patient bedside or
The use of “IV trays” is strongly discouraged as there is a potential for cross-
contamination between patients.
Do not hang the IV solutions for more than 24hours.
Perform Hand Hygiene and maintain strict aseptic technique during tubing and needle
Your Hands can be Dangerous…
Wash them with antiseptic hand wash
to keep bacteria away