Professional Documents
Culture Documents
OF NURSING
MA.CRISTINA TAMPINCO-REYES, RN
NLE INSTRUCTOR, ICSEC-KAPLAN
History of
Nursing in the
Philippines
EARLIEST HOSPITALS
1. Hospital Real de Manila – for Spanish
King’s soldiers
2. San Lazaro Hospital – for patients with
leprosy
3. Hospital de Indio – supported by alms 7
contributions from charitable persons
4. Hospital de Aguas Santas –near
medicinal spring
5. San Juan de Dios Hospital – supported
by alms & rents for gen.health of public
IMPORTANT PERSONS
JOSEPHINE BRACKEN
ROSA SEVILLA DE ALVERO
DOÑA HILARIA DE AGUINALDO – organized
Filipino Red Cross
DOÑA MARIA AGONCILLO DE AGUINALDO –
president of Filipino Red Cross in Batangas
MELCHORA AQUINO
FILIPINO RED CROSS – provided nursing care to wounded
Filipino soldiers by collecting war funds & materials thru
concerts, charity bazaar & contributions
HOSPITALS & SCHOOLS OF NURSING
1. Iloilo Mission Hospital School of Nursing
(1906)
2. St. Paul’s Hospital School of Nursing
(1907) – general hospital services with
free dispensary & dental clinic
3. Philippine General Hospital School of
Nursing (1907) – opened first dormitory
for enrollees of Philippine Normal Hall &
University of the Philippines
- Anastacia Giron-Tupas – 1st Filipino chief nurse
& superintendent
4. St. Luke’s Hospital School of Nursing
(1907) – started with 3 enrollees merged
with St.Paul & PGH for the 1st year (Central
School Idea)
-Helen Hicks – 1st principal
-Vitaliana Beltran – 1st Filipino
superintendent of nurses
-Dr. Jose Fores – 1st Filipino medical
director
5. Mary Johnston Hospital & School of
Nursing – called”Bethany Dispensary” for
suffering women & children
6. Philippine Christian Mission Institute
School of Nursing –
-Sallie Long Read Memorial School of Nursing
(Laoag)
-Mary Chiles Hospital School of Nursing
(Manila)
-Frank Dunn Memorial Hospital (Ilocos)
7. San Juan de Dios Hospital School of
Nursing
8. Emmanuel Hospital School of Nursing –
offered a 3-year training course with P100
annual fee
9. Southern Islands Hospital School of
Nursing – established under Bureau of
Health
FIRST COLLEGES OF NURSING
1. University of Santo Tomas College of
Nursing
2. Manila Central University College of
Nursing
3. University of the Philippines College of
Nursing
NURSING LEADERS IN THE PHILIPPINES
1. Anastacia Giron-Tupas – 1st Chief Nurse
Superintendent, founder of PNA
2. Cesaria Tan –1st to receive Masters degree
3. Socorro Sirilan- pioneered Hospital Social
Service in San Lazaro
4. Rosa Militar – pioneer in school health
education
5. Sor Ricarda Mendoza – pioneer in nursing
education
6. Socorro Diaz – 1st editor of PNA magazine
“The Message”
7. Conchita Ruiz – 1st editor of newly named
PNA magazine “The Filipino Nurse”
8. Loreto Tupaz –Dean of Philippine Nursing
- Florence Nightingale of Iloilo
PROFESSIONAL ORGANIZATIONS OF
NURSING
1. Philippine Nurses Association – national
organization of Filipino nurses
2. National League of Nurses – association
of nurses employed in DOH
3. Catholic Nurses Guild of the Philippines
4. ORNAP
5. MCNAP
6. ANSAP
EVOLUTION OF NURSING
1. PERIOD OF INTUITIVE NURSING- since
prehistoric times through eraly Christian era
-Nursing was untaught & instinctive,
performed out of compassion for others
2. PERIOD OF APPRENTICE NURSING –
extends from founding or religious nursing
orders and ended in 1836 when
KAISERWERTH INSTITUTE for the training of
DEACONESSES in Germany was established
- Called Period of “On-the-Job” training
3. DARK PERIOD OF NURSING – extends from
period of reformation until US Civil War
(17th to 19th century)
-Unity of Christian faith destroyed by Martin
Luther
-No provisions for the sick
-Nursing became work of least desirable
women
4. PERIOD OF EDUCATED NURSING – bagan
when Florence Nightingale School of
nursing opened
-Strongly influenced by the war, social
consciousness, emancipation of women &
increased educational opportunities
offered to women
5. PERIOD OF CONTEMPORARY NURSING –
covers after WWII to present.
- Scientific & technological developments
& social changes mark this period.
Man and
His Basic
Human Needs
THE 4 MAJOR ATTRIBUTES OF
HUMAN BEINGS
1. Capacity to think or conceptualize
2. Family formation
3. Tendency to seek and maintain territory
4. Ability to use verbal symbols as
language, means of developing &
maintaining culture
THE NURSING CONCEPTS OF MAN
ROY – “Man is a biopsychosocial & spiritual
being who is in constant contact with the
environment”
•As biologic being – man is LIKE ALL OTHER
MEN
•As psychologic being – man is LIKE NO
OTHER MAN.
•As social being – man is LIKE SOME OTHER
MEN
•As spiritual being – man is LIKE ALL OTHER
ROY – “Man is an Open system in constant
interaction with a changing environment”
SELF
ACTUALIZATION
SELF ESTEEM
PHYSIOLOGIC
MASLOW’S HIERARCHY OF NEEDS:
1. Physiologic Needs are as follows:
- Oxygen
- Fluids
- Nutrition
- Body temperature
- Elimination
- Rest & sleep
- Sex
** Sex is not necessary for individual survival but
rather for survival of mankind
2. Safety & security needs
-Physical safety
-Psychological safety
-The need for shelter & freedom from harm &
danger
3. Love & belongingness needs
-Need to love & be loved
-Need to care & be cared for
-Need for affection, to associate or to belong
-Need to establish fruitful & meaningful
relationships w/ people,institution or organization
4. Self-Esteem needs
-Self-worth
-Self-identity * Need to be well-thought of
by oneself as well as by
-Self-respect others
-Body image
5. Self-actualization needs
-Need to learn, create & understand or comprehend
- need for harmonious relationship
-Need for beauty or aesthetics
-Need to be self-fulfilled
CHARACTERISTICS OF HUMAN NEEDS
ILLNESS HEALTH
5. RECOVERY / REHABILITATION
-Gives up sick role & returns to former roles/functions
RISK FACTORS
1. Information Dissemination
2. Health Appraisal and Wellness Assessment Programs
3. Lifestyle & Behavior Change Programs
4. Worksite wellness Programs
5. Environment Control Programs
The Professional
Nurse
CHARACTERISTICS OF A PROFESSION
1. Education
2. Theory
3. Service
4. Autonomy
5. Code of Ethics
6. Caring
QUALIFICATIONS & ABILITIES OF A
PROFESSIONAL NURSE
1. Has faith in fundamental values
underlying democratic way of life
2. Has sense of responsibility for
understanding those with whom she
works
3. Has faith in the reality of spiritual &
aesthetic values
4. Has basic KSA to address present-day
problems, realistic & well-organized
5. Has skill both in spoken and written
language
6. Appreciates & understands importance of
good health
7. Has emotional balance
8. Likes hard work & possesses capacity for it
9. Appreciates high standards of workmanship
10. Accepts & tries to understands people of
all sorts
11. Knows nursing thoroughly
ROLES & FUNCTIONS OF A NURSE
1. Care provider
2. Communicator / Helper
3. Teacher
4. Counselor
5. Client Advocate
6. Change Agent
7. Leader
8. Manager
9. Researcher
10. Case Manager
11. Collaborator
TYPES OF NURSING INTERVENTIONS
1. Independent or Nurse-Initiated
2. Dependent or Physician-Initiated
3. Interdependent or Collaborative
NURSING CARE DELIVERY MODELS
Total Patient Care
Functional Nursing
Team Nursing
Primary Nursing
Case Management
Selected
Nursing
Theories
FLORENCE NIGHTINGALE
DECLINE OF FEVER
Methods Ranges
Oral 36.5-37.5 C
(97.6-99.6 F)
Axillary 35.8-37 C
(96.6 – 98.6 F)
Rectal 37.0 – 38.1 C
(98.6 – 100.6 F)
Tympanic 36.8 – 37.9 C
(98.2 – 100.2 F)
PULSE RATE
- Wave of blood created by contraction of
the LV of the heart, regulated by ANS
FACTORS AFFECTING PULSE RATE
1. Age
2. Sex/gender
3. Exercise
4. Fever
5. Medications
6. Hemorrhage
7. Stress
8. Position changes
PULSE SITES
1. Temporal
2. Carotid
3. Apical
4. Brachial
5. Radial
6. Femoral
7. Posterior tibial
8. Popliteal
9. Pedal
ASSESSMENT OF THE PULSE
RATE – Normal Pulse Rate are as follows:
Newborn - 1 month 80 – 180 bpm
1 year 80- 140 bpm
2 years 80 – 130 bpm
6 years 75 – 120 bpm
10 years 60 – 90 bpm
adult 60 – 100 bpm
CLASSIFICATIONS:
1. Admission from Emergency Room
2. Direct Admission
ADMISSION THRU EMERGENCY DEPARTMENT
PURPOSES:
1. Give immediate care
2. Prompt and proper evaluation of patient’s
management & placement
WORKFLOW:
1. Assist in examining table & accomplishing
forms
2. Assess vital signs
3. Inform AMD stat, prepare materials & assist as
needed
4. Carry out stat orders
ADMISSION TO GENERAL UNIT
PURPOSES:
1. Ensure patient & relatives a courteous
welcome
2. Assist patient & family to hospital setup
3. Provide immediate care of patients upon
admission
CHECK FOLLOWING FROM E.R.
DOS, patient’s data & PIN, name tag, adm. Kit,
Kardex, ready made chart, chart cover
WORKFLOW:
1. Receive from Admission Office/ER:
- receive preliminary telephone
endorsement
2. Prepare room for completeness
3. Receives patient : ht., wt., allergies,
DOS, patient data, name tag, PIN
4. Usher to room
5. Render preliminary nursing care
6. Retrieve old chart & document care
TRANSFER TO ANOTHER UNIT
PURPOSES: transfer patient with all possible
safety
WORKFLOW:
1. Receive written transfer order from the
doctor
2. Prepare client transfer
3. Document procedure
4. Transfer patient
TRANSFER TO ANOTHER HOSPITAL
WORKFLOW:
1. Receive written transfer out orders
2. Prepare patient for transfer
3. Arrange transportation system
Patient Discharge
DISCHARGE PLANNING: systematic process
of preparing patient to leave the healthcare
agency & continuity of care
® Discharge planning starts upon admission.
PATIENT DISCHARGE WORKFLOW
1. Ensure that patient has discharge order
2. If leaving against medical advice, ensure
proper forms are filled up
3. Ensure discharge instructions are given
& understood both by the patient &
family
4. Check if all needed equipment/supplies
are ready for the patient
5. financial statements should be
counterchecked
6. Assist patient in dressing up & packing
7. Help transport patient & belongings
8. Document all pertinent events & data
before closing the charting ensuring that
the date & time & status/condition of the
patient upon discharge is clearly written.
Medication
Administration
Definition of Terms
Medications – substance administered for
diagnosis, cure, treatment, relief or
prevention of disease. AKA as drug
Prescription Name – name given to a drug
before it becomes official
Official Name – name after which the drug is
listed in one of the official publications
Chemical Name- name that describes
precisely the constituents of drugs
Brand name- name given to a drug by the
manufacturer. AKA trademark.
Pharmacology – study of effects of drugs on
living organisms
Posology – study of dosage or amount of
drugs given in the treatment of diseases
Types of Doctor’s Orders
Standing Order – carried out until the
specified period of time or until
discontinued by an order
Single Order – carried out for only once
STAT Order –carried out at once
PRN Order – only as patient requires or
needed
Parts of A Legal Doctor’s Order
1. Name of Patient
2. Date and Time
3. Name of Drug
4. Dose of Drug
5. Route of Administration
6. Time or Frequency
7. Signature of Physician
Effects of Drug
Therapeutic Effect – intended primary
effect. AKA desired effect.
Side Effect – Unintended effect of the drug.
AKA secondary effect.
Drug Allergy – immunologic reaction to the
drug
Anaphylactic Reaction – severe allergic
reaction
Drug Tolerance – decreased physiologic
response to repeated administration of a
drug
Cumulative Effect – increased response to
repeated doses of drug that occurs when
the rate of administration exceeds the rate
of metabolism or excretion
Idiosyncratic Effect- unexpected peculiar
response to the drug
Drug Abuse – inappropriate intake of a
substance, either continually or
periodically
Drug Dependence – person’s reliance to
take a drug/substance which will produce
an intense reaction upon withdrawal
Addiction – due to biochemical changes in
body tissues esp. of the nervous system.
Tissues come to require the substance to
function normally. AKA physical
dependence.
Habituation – emotional reliance on a drug
to maintain sense of well being. AKA
psychological dependence.
Drug Interaction – effects of one drug are
modified by the prior or concurrent
administration of another drug, thereby
increasing or decreasing the
pharmacological action
Drug Antagonism – conjoint effect of two
drugs is less that the drugs acting
separately
Summation – combined effect of two drugs
produces result that equals the sum of the
individual effects of each agent
Synergism – combined effects of drugs is
greater than the sum of each individual
agent acting independently
Potentiation – concurrent administration of
two drugs in which one drug increases the
effect of the other drug
Therapeutic Actions of Drugs
Palliative – relieves symptoms of disease but
does not affect the disease itself
Curative – treats the disease condition
Supportive – sustains body functions until other
treatment of the body’s response can take over
Substitutive – replaces body fluids / substances
Chemotherapeutic – destroys malignant cells
Restorative – returns/repairs body to health
General Properties of Drugs
1. Drugs do not confer any new function on
a tissue or organ. They only modify
existing functions.
2. Drugs in general exert multiple actions
rather than single effect.
3. Drug interaction results from
physiochemical interaction between drug
& a functionally important molecule in
the body
Pharmacokinetic Factors in Drug
I. ABSORPTION
Therapy
Is the process by which a drug passes from its site
of administration to bloodstream
Factors Affecting Drug Absorption:
1. Blood Flow 7. Solubility of Drug
2. Pain 8. pH
3. Stress 9. Drug Concentration
4. Foods 10. Dosage Form
5. Exercise
6. Nature of absorbing surface
II. DISTRIBUTION
Is the transport of drug from its site of absorption
to site of action
Factors Affecting Drug Distribution
1. Plasma-Protein Binding
2. Volume Distribution
3. Barriers to Drug Distribution
A. Blood Brain Barrier – drug must be lipid soluble &
loosely attached to plasma proteins
B. Placental Barrier- shields from possibility of adverse
drug effects
4. Obesity
5. Receptor Combination
III. METABOLISM or BIOTRANSFORMATION
- Sequence of chemical events that change a drug
to less active form after entering the body. AKA
detoxification.
- LIVER – principal site of drug metabolism
Factors Affecting Drug Metabolism
1. Age
2. Nutrition
3. Insufficient amounts of major body hormones
IV. EXCRETION
- Process by which drugs are eliminated from the
body
- KIDNEYS – most important route of excretion of
drugs
Factors Affecting Drug Excretion
1. Renal Excretion
2. Drugs can affect elimination of other drugs
3. Blood concentration levels
4. Half life
Principles of Drug Administration
1. Observe the “7 Rights” of drug
administration.
-RIGHT drug,dose,time,route,patient,
recording, approach
2. Practice asepsis.
3. Nurses administering medications are
responsible for their own actions.
4. Be knowledgeable about the meds you
administer.
5. Keep narcotics locked.
6. Use only medications that are clearly
labeled.
7. Return liquid that are cloudy in color.
8. Identify patient correctly before
administering medications.
9. Do not leave medications at the bedside.
10. The nurse who prepares the drug must
be the one to administer it.
11. If patient vomits, report to nurse in
charge or physician.
12. Preoperative meds are usually
discontinued during postop unless ordered
to be continued.
13. When meds is omitted for any reason,
record the fact & the reason.
14. When med error is made, report ASAP.
Routes of Drug Administration
I. ORAL
ADVANTAGES: most convenient, less
expensive, safe & does not break the skin
barrier
DISADVANTAGES: inappropriate for those
with nausea & vomiting, dysphagia,
reduced GIT motility, seriously ill
May give unpleasant odor/taste, discolor
teeth, irritate gastric mucosa
Oral Drug Forms
1. SOLID – tablet, capsule, pill, powder
2. LIQUID – syrup, suspension, emulsion,
elixir, milk, other alkaline substance
SYRUP-sugar-based
SUSPENSION-water-based
EMULSION- oil-based
ELIXIR- alcohol-based
** Never crush enteric-coated or sustained-
release medication
II. SUBLINGUAL
NURSING MANAGEMENT
1.Proper Refrigeration
250 cc packed of RBC, refrigerate 3-5 days
1 platelet bag refrigerate 5-6 days
2. Proper blood typing & cross matching
Type O universal donor
AB- universal recipient
85% of people is RH RH (+)
3. Aseptical assemble all materials
needed for BT
4. With filter (BT set)
5. Gauge 18 of needle
6. Check for name of the client
7. Check for expiration date
8. Check for serial number
9. Use RED ballpen when charting
10. Check blood unit for presence of bubbles,
cloudiness, and dark color
11. Never warm the BLOOD
- It may destroy vital product of the blood
- Let the room temperature warm the blood
@ 30minutes
12. Avoid mixing the drugs at BT line
13. Regulate @ KVO or 100 cc/hr to prevent
circulatory overload for first 30 minutes
Start at slow rate (10 gtts/min)& remain at
bedside for 15-30 mins
14. BT should be done less than 4hrs
for WB & PRBC and 20 minutes for
plasma, platelets, cryoprecipitate
15. Monitor VS before. During & after
BT 10 especially q15minns. For 1st hour
- Majority of BT reaction occurs within
1hr.
16. Administer 0.9% NaCl before,
during or after BT. Never administer
IV with dextrose
17. Observe for Complication
BT REACTION
H- emolytic
A- llergic
P- yrogenic
C- irculatory overload
A- ir embolism
T- hrombo cytophenia
C- itrate intoxication
H- yperkalemia
Hemolytic REACTION
S & Sx
Dizziness
Headache
Dyspnea
Hypotension
Flushed skin
Palpitation
lumbar/ sterna / flank pain
Red port wine urine
Nsg. Management
1. Stop BT
2. Notify doctor
3. Flush with PNSS to prevent hemolysis
4. Administer isotonic solution to counter
act shock and prevent tubular necrosis
5. Never dispose the blood unit and send
and send it to the blood bank for
reexamination
6. Obtain urine and and blood sample of the
client and send it to the laboratory for
reexamination
7. Monitor VS and allergic reaction
ALLERGIC REACTION
SIGN AND SYMPTOMS
1. Fever
2. Chills
3. Dyspnea
4. Larygospasm
5. Bronchial wheezing
6. Urticaria
Nsg. Management
Stop
Notify
Flush
Antihistamine and paracetamol as ordered
If positive to hypotension and shock
adminester corticosteroid and epinephrine
Pyrogenic Reaction
Fever producing agent
Sign and Symptoms
1. Fever
Nsg. Management
1. Stop
2. Notify
3. Flush
4. Antipyretic as ordred
Circulatory Overload
Sign and Symptoms
1) Dyspnea
2) Orthopnea
3) Rales and Crackles sound on chest
upon auscultation
NSG. MANAGEMENT
Stop
Notify
Administer diuretis as ordered
CITRATE INTOXICATION
Sign and Symptoms
Hypocalcemia
Tetani
Nsg. Management
Stop
Notify
Flush
Hypercalcemia indicates if the blood is
expired
Priority cases
1st
Hemolytic Rxn.- attend to
destruction of Hgb – O2 brain
barrier
And Anaphylactic shock
2nd
Circulatory
3rd
Allergic reaction
4rth
Pyrogenic
Asepsis
& Infection
Control
TERMINOLOGIES:
INFECTION – invasion of body tissue by
microorganisms
ASEPSIS – absence of disease-producing
microorganisms; being free from infection
MEDICAL ASEPSIS – practices designed to
reduce number & transfer of microorganisms
SURGICAL ASEPSIS – practices that render &
keep objects/areas free from microorganisms;
sterile technique
SEPSIS – presence of infection
SEPTICEMIA – transport of infection
throughout the body or blood
CARRIER – person / animal, with or without
signs of illness but who harbors pathogens within
his body that can be transferred to another
CONTACT – person / animal known or believed
to have been exposed to a disease
RESERVOIR – natural habitat for growth &
multiplication of microorganisms
TRANSIENT FLORA – microorganisms picked
up as a result of normal activities & can be removed
easily.
RESIDENT FLORA – microorganisms that
normally live on a person’s skin
STERILIZATION – process by which all
microorganisms including spores are destroyed
DISINFECTANT – substance that destroys
pathogens but generally not including spores
ANTISEPTIC – substance that inhibits growth of
pathogens but does not necessarily destroy them
BACTERICIDAL – chemical that kills
microorganisms
BACTERIOSTATIC – agent that prevents bacterial
multiplication but does not kill all forms of
organisms
CONTAMINATION – process by which something
is rendered unclean / unsterile
DISINFECTION – process by which pathogens but
not their spores are destroyed
COMMUNICABLE DISEASE – results if
infectious agent can be transmitted to another by
direct/indirect contact thru vector/vehicle
INFECTIOUS DISEASE – results from
invasion & multiplication of microorganisms in a
host
PATHOGEN – disease-producing
microorganism
PATHOGENICITY – ability to produce a
disease
VIRULENCE – vigor with which the organism
can grow & multiply
SPECIFICITY – organism’s attraction to a
specific host
OPPORTUNISTIC PATHOGEN – causes
disease only in susceptible individuals
NOSOCOMIAL INFECTION – hospital-
acquired infection
ISOLATION – separation of persons with
communicable disease from another so that
transmission is prevented
ISOLATION TECHNIQUES – practices
designed to prevent transfer of specific
microorganisms
ETIOLOGY – study of causes
STAGES OF INFECTIOUS PROCESS
Incubation Period – from entry of
microorganism to the body to onset of S/S
Prodromal Period – from onset of non-specific
S/S to appearance of specific S/S
Illness Period – specific S/S develop & become
evident
Convalescent Period – S/S start to abate until
client returns to normal state of health
THE CHAIN OF INFECTION
ETIOLOGIC/INFECTIOUS AGENT
(MICROORGANISMS)
RESERVOIR
SUSCEPTIBLE HOST
(SOURCE)
CHILDREN/ELDERLY/ILL, WITH
TRAUMA/INJURY
MODES OF TRANSMISSION
(CONTACT,VEHICLE,AIRBORNE,
VECTOR)
ETIOLOGIC AGENT – may be bacteria, virus,
fungi or parasites
RESERVOIR – humans, animals, plants,
environment
PORTAL OF EXIT – (from reservoir)
-Respiratory Tract- droplet,sputum
-GIT- vomitus, feces, saliva, drainage tubes
-Urinary Tract – urine, urethral catheter
-Reproductive Tract- semen, vaginal discharge
-Blood – needle puncture, open wound
MODES OF TRANSMISSION
CONTACT TRANSMISSION – direct/indirect
DROPLET TRANSMISSION – when MM are
exposed to secretions of an infected personwho is
coughing, sneezing, laughing within 3 feet
VEHICLE TRANSMISSION – transfer by way of
vehicles or contaminated items (food, water, milk,
utensils, pillows, mattress)
AIRBORNE TRANSMISSION – when fine
particles are suspended in the air for a long time &
dispersed by air current then inhaled/deposited to a
host
VECTOBORNE TRANSMISSION – vectors
can be biologic or mechanical
Biologic – animals (rats, snails, mosquitoes)
Mechanical – infected inanimate objects
(contaminated needles/syringes)
PORTAL OF ENTRY – permits organism to
enter host
- Through body orifice such as mouth, nose,
vagina, rectum OR breaks in the skin or MM
SUSCEPTIBLE HOST – host is a person who
is at risk for infection, whose body defense
mechanism are unable to withstand the invasion
of the pathogen
TYPES OF IMMUNIZATION
ACTIVE IMMUNIZATION- antibodies are
produced by the body in response to infection
NATURAL – antibodies formed in presence of
active infection in the body. It is lifelong.
ARTIFICIAL – antigens (vaccines/toxoid) are
administered to stimulate Ab production
PASSIVE IMMUNIZATION – antibodies are
produced by another source (animal/human)
NATURAL – Ab from mother to baby
ARTIFICIAL – Immune serum (antibody) from an
animal or another human is injected
ASEPTIC PRACTICES
1. HANDWASHING
Handwashing is the single most important
infection control practice.
Handwashing for medical asepsis is done by
holding hands lower than the elbows
Use running water, soap & friction for 15-30
seconds each hand
Wash hands before and after client contact
2. CLEANING, DISINFECTION &
STERILIZATION
-Cleaning – physical removal of dirt & debris by
washing, dusting or mopping
-Disinfection – chemical or physical process to
reduce number of potential pathogens on a
surface but not necessarily the spores
-Sterilization – complete destruction of all
microorganisms including spores
METHODS OF STERILIZATION
STEAM STERILIZATION – autoclaving uses
supersaturated steam under pressure
-non-toxic , inexpensive, sporicidal & penetrates
fabric
-Color indicator strips change color to indicate
sterilization
GAS STERILIZATION – ethylene oxide is
colorless gas that can penetrate plastic, rubber,
cotton or other subs. Used for oxygen, suction
gauges, BP apparatus, stethoscope, catheter
-Expensive & requires 2-5 hours
-Ethylene oxide is toxic to humans
RADIATION – ionizing radiation penetrates deeply
to objects
-Used for drugs, food & other heat-sensitive items
CHEMICALS – are effective disinfectants
-Attacks all types of microorganisms rapidly,
inexpensive & stable in light & heat. Chlorine is
used.
BOILING WATER – least expensive, at least 15
minutes
TYPES OF DISINFECTION
Concurrent – during
Terminal - after CATEGORIES OF WASTES:
3. USE OF BARRIERS Infectious
a. Masks Injurious
Hazardous
b. Gowns
c. Caps & shoe covers
* Most agencies use color
d. Gloves coding
e. Private rooms
f. Equipment & refuse handling
4. ISOLATION SYSTEMS
CLASSIFICATIONS:
A. Standard Precautions
- Universal Precaution & Body-Substance
Isolation
- Prevent transmission of bloodborne & moist
body substance pathogens
1. Wear clean gloves
2. Perform handwashing
3. Wear masks, goggles, face shield if sprays/splashes
are expected
4. Wear gown if soiling & splashes are expected
5. Remove soiled protective items immediately
6. Clean & reprocess all equipment
7. Discard all single-used items
8. Prevent injuries
9. Use private room or consult with Infection Control
Department
B. Transmission-Based Precautions
1. AIRBORNE PREC – for small-particle droplet
that may remain suspended in the air & dispersed
by air current (varicella, TB, measles
- Private room, negative airflow, wear masks
2. DROPLET PREC – for large-particle droplet &
dispersed by air current (H. influenza, diphtheria,
rubella, mycoplasma pneumoniae)
- Private room, wear masks within 3 ft.
3. CONTACT PREC – for those transferred by
hand-or skin-to-skin contact (clostridium
difficile, shigella, impetigo)
- Private room, use gloves, gowns & other
protective barriers when exposure to infected
material is likely
C. Protective Isolation – prevent infection for
people with compromised resistance
(leukopenia, undergoing chemoRx, extensive
burns)
- Private room, restrict visitors, no fresh
fruits/flowers, raw foods, potted plants allowed,
only cooked/canned foods allowed
5. SURGICAL ASEPSIS
PRINCIPLES:
a. Moisture causes contamination.
b. Never assume that an object is sterile.
c. Always face the sterile field.
d. Sterile articles may touch only sterile
surface/articles to maintain sterility.
e. Sterile equipment/areas must be kept above
the waist & on top of the sterile field.
f. Prevent unnecessary traffic & air currents
around sterile area
g. open, unused sterile articles are no longer
sterile after the procedure
h. A person who is considered sterile who
becomes contaminated must reestablish sterility
i. Surgical technique is team effort.
Wound Care
TYPES OF WOUNDS: accdg. to
contamination
1. Clean Wounds – uninfected, minimal inflammation,
closed
- respiratory, GIT & urinary tract are not entered
2. Clean-contaminated Wounds – also surgical
wounds, no infection
- respiratory, GIT & urinary tract entered
3. Contaminated Wounds- open, fresh, accidental
wounds, with evidence of inflammation
4. Dirty/Infected Wounds – with dead tissue &
evidence of infection
TYPES OF WOUND: accdg to cause
1. Incision
2. Contusion
3. Abrasion
4. Puncture
5. Laceration
6. Penetrating wound
TYPES OF WOUND HEALING
1. Primary Intention healing
2. Secondary Intention healing
PHASES OF WOUND HEALING
1. Inflammatory Phase – immediate, 3-6 days
2. Proliferative Phase – 3rd to 21 days
3. Maturation Phase – 21 days to 2 years
STAGES OF PRESSURE ULCER
Stage 1 – non-blanchable erythema signaling
FORMATION
potential ulceration
Stage 2 – partial-thickness skin loss (abrasion,
blister or shallow crater) involving epidermis &
dermis
Stage 3 – full-thickness skin loss involving
damage or necrosis of subcutaneous tissue that
may extend down but not thru fascia. Deep crater.
Stage 4 – full-thickness skin loss with necrosis or
damage to muscle, bone, structures, tendon, joints
KINDS OF WOUND DRAINAGE
EXUDATE – material that escapes from blood
vessels during the inflammatory process
1. SEROUS EXUDATE – blister from burns
2. PURULENT EXUDATE
3. SANGUINEOUS (Hemorrhagic)
EXUDATE
COMPLICATIONS OF WOUND HEALING
OXYGEN TENT
HIGH FLOW ADMINISTRATION
DEVICES