Inessa Borovskiy

1) For nurses and health care providers, it is important to use infection control precautions.

Applying infection control precautions decreases or eliminates sources and transmission of

infection that help to protect patients and health care providers from disease (Perry, Potter, &

Elkin, 2016, p. 74). Nurses and health care providers can apply different types of infection

control precautions to limit and prevent the spread of microorganisms. According to Perry,

Potter, & Elkin (2016), "The two types of aseptic techniques that a nurse practices are medical

and surgical asepsis" (p.74). Medical asepsis also called clean technique, is a method applied to

reduce the number and prevent the spread of microorganisms. The medical asepsis procedure

includes hand hygiene, barrier techniques such as gloves, mask, and gown, and routine

environmental cleaning. The second type of aseptic technique is called surgical asepsis also

known as the sterile technique, and this procedure is used to kill all microorganisms from an

area. This method is used among nurses in the operating room, labor and delivery, and

procedural areas (Perry, Potter, & Elkin, 2016, p. 74).

The U.S. Centers for Disease Control and Prevention (CDC) established guidelines called

Standard Precautions, nurses and health care providers use these guidelines to limit susceptibility

to infectious organisms that a patient may carry (Perry, Potter, & Elkin, 2016, p. 74). One main

component of Standard Precautions is the use of barrier protection. The barrier protection

includes the use of personal protection equipment or PPE. According to Phillips (2013),

Personal Protection Equipment (PPE) consists of items such as gloves, masks, eyewear, and

gowns all of which prevent nurses and health care providers from coming into contact with

patient's bodily substances (as cited in Perry, Potter, & Elkin, 2016, p. 75). However, the type of

Personal Protection Equipment required is dependent on several factors such as the kind of

procedure performed, whether the patient has an infection that can be transmitted to others, and

the health status of the nurse or physician themselves (Perry, Potter, & Elkin, 2016, p. 80).
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Nurses are always required to wear gloves despite the procedure performed. Nurses

"wear clean gloves before coming in contact with mucous membranes, nonintact skin, blood,

body fluids, or other potentially infectious materials" (Perry, Potter, & Elkin, 2016, p. 79).

Whereas, "Masks are worn when nurses work over sterile areas or with equipment, such as

changing a central line dressing" (Perry, Potter, & Elkin, 2016, p. 79). Additionally, "Protective

eyewear is important when there is a risk of exposure of the eyes to splattering of blood or other

body fluids" (Perry, Potter, & Elkin, 2016, p. 79). A gown on the other hand "Prevents

transmission of infection when patient has excessive drainage or discharges" (Perry, Potter, &

Elkin, 2016, p. 80). And a surgical cap is often worn " to secure loose hair that might

contaminate a sterile field" (Perry, Potter, & Elkin, 2016, p. 80).

Due to the increasing number of microorganisms within health care facilities, nurses,

staff, and patients are at risk for exposure to such pathogens. Particularly, patients are at higher

risk of contracting nosocomial infections which can potentially lead to death. Therefore, to

reduce the possibility of nosocomial infections among patients, and prevent the transfer of

pathogens onto nurses and staff it is important to follow infection control guidelines (Perry,

Potter, & Elkin, 2016, p. 74-75).

References

Perry, A. G., Potter, P. A., & Elkin, M. K. (2016). Nursing interventions & clinical skills

th
(6 ed.). St. Louis, MO : Mosby Elsevier.
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2) As a nurse, our top priority is to ensure the safety of our patients. And one way to ensure

the safety of our patients is to prevent the patient from contracting an infection through the

process of hand hygiene (Potter, Perry, Stockert, & Hall, 2017, p.458). Therefore, to prevent and

remove any microorganisms from being passed on to our patients, nurses, and staff must

understand that "Hand hygiene is not an option." (Perry, Potter, & Elkin, 2016, p. 76). Hand

hygiene includes four techniques, including handwashing, antiseptic hand wash, antiseptic hand

rub, and surgical hand antisepsis (Perry, Potter, & Elkin, 2016, p. 76). Each hand hygiene

procedure follows specific guidelines based on visible or not visible dirt on one's hands.

Nurses or staff members whose hands are visibly dirty containing blood or other body

fluids must wash hands using either plain soap and water or an antimicrobial soap and water

(Perry, Potter, & Elkin, 2016, p. 76). Additionally, individuals whose hands were exposed to

spore-forming organisms wash their hands with soap and water (Perry, Potter, & Elkin, 2016, p.

76). It is imperative that the following steps be followed when performing the hand hygiene

procedure using regular or antimicrobial soap and water. Step one, the person must stand in front

of the sink, and their hands and uniform must be kept away from the sink surface. If the

individual's hands touch the sink during hand washing, the step must be repeated. Step two, turn

on the water, the temperature of the water and flow must be regulated before washing hands.

Step three, do not splash water against oneself, specifically against one's uniform. Step four, the

temperature of the water should be warm. Step five, wet the hands and wrists completely under

the running water. The hands and forearms must remain under the elbows during washing. Step

six, the individual must apply three to five milliliters of soap and rub the hands together

forcefully, scrubbing thoroughly. The person may use soap granules and leaflet preparations.

Step seven, while performing hand hygiene it is important to use plenty of lather and friction for

at least 15 seconds. Additionally, the fingers must be interlaced while rubbing palms and backs
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of hands with circular motion at least five times each time. The fingertips must be faced down,

ensuring the removal of microorganisms. Step eight, the areas underlying fingernails must be

cleaned with the fingernails of the other and additional soap. Step nine, once the individual has

thoroughly washed his or her hands, they should rinse their hands and wrists completely, while

keeping hands down and elbows up. Step ten, the individual must dry their hands thoroughly

from fingers to wrists followed by the forearms with a paper towel or warm air dryer. Step

eleven, if a paper towel was used to dry one's hands, the paper towel must be discarded in the

proper container. And step twelve, using a clean, dry paper towel, turn off the water faucet,

without touching the handles with one's hands, or shut down the water with knee paddles if

available (Perry, Potter, & Elkin, 2016, p. 77-78).

Another hand hygiene method is the use of alcohol-based hand rub. The alcohol-based

hand rub is used on hands that do not contain human excrement. First, the individuals must

dispense sufficient amount of product into the palm of one hand. Second, they must rub their

hands together, and while rubbing the hands together, it is important to cover all surfaces of the

hands and fingers with antiseptic. And lastly, the person should continue to rub their hands

together until the antiseptic is dry. Once the hands are dry completely, then the individual can

then apply the gloves (Perry, Potter, & Elkin, 2016, p. 77). Using the and hygiene method will

help prevent the spread of bacteria to or from the patient reducing the likeliness of contracting

any disease.

References

Perry, A. G., Potter, P. A., & Elkin, M. K. (2016). Nursing interventions & clinical skills

th
(6 ed.). St. Louis, MO : Mosby Elsevier.

Potter, P.A., Perry, A.G., Stockert, P. A., & Hall, A. M. (2017). Fundamentals of nursing
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(9th ed.). St. Louis, MO : Mosby Elsevier.

3) Within a health care facility, nurses and staff support perform patient handling such as

transferring, positioning, and lifting patients, all of these which can result in overexertion injuries

in health care workers.

The greatest risk factor for overexertion injuries in health care workers is the manual lifting,

moving, and repositioning of patients (Perry, Potter, & Elkin, 2016, p. 399). According to BLS

(2012), "More recent data show that within the health care industry, workers in these occupations

suffered the most lost-time cases of general musculoskeletal pain and back pain (13,000)" (as

cited in Perry, Potter, & Elkin, 2016, p. 400). Therefore, when turning/positioning a patient or

transferring them from the bed to a chair/wheelchair, there are certain principles of body

mechanics that are important to keep in mind. According to Krill, et al., (2012), Pelczarski

(2012), and Waters et al., (2011a), "Using principles of body mechanics during routine activities

helps to prevent injury. However, body mechanics alone are insufficient to prevent

musculoskeletal injuries when positioning or transferring patients. Teaching the use of patient-

handling equipment in combination with proper body mechanics is more effective than either

one in isolation" (Perry, Potter, & Elkin, 2016, p. 400).

In order to prevent physical injuries, nurses should use safe patient-handling equipment in

combination with facility lift teams resulting in a risk reduction of injury to both the patient and

the members of the health care team (Perry, Potter, & Elkin, 2016, p. 401). Some of the patient-

handling equipment and devices include height-adjustable beds, ceiling-mounted lifts, friction-

reducing slide sheets, and air assisted devices. For example, when transferring a patient onto a

stretcher or bed, the nurse may use a slide board; this involves sliding the patient toward yourself

using a pull sheet or slide board. However, if the patient-handling equipment and tools are not
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available, and the nurse decides to lift the patient manually, then the nurse must only apply this

method if it does not involve lifting most or all of a patient's weight. (Perry, Potter, & Elkin,

2016, p. 401). However, because half of all back pain is linked to manual lifting tasks, it is

crucial that manual lifting is only used when it is the last resort and when it does not involve

lifting most or all of the patient's weight. (Perry, Potter, & Elkin, 2016, p. 401).

Transferring is a nursing skill that helps a dependent patient or a patient with restricted

mobility to accomplish positions to regain optimal independence as quickly and safely as

possible (Perry, Potter, & Elkin, 2016, p. 401). However, upon transfer, the nurse must "prevent

self-injury by using correct posture, minimal muscle strength, and effective body mechanics and

lifting techniques" (Perry, Potter, & Elkin, 2016, p. 401). Additionally, nurses can use a transfer

belt and get assistance during the transferring process (Perry, Potter, & Elkin, 2016, p. 401).

While, as a nurse, it is important to help your patients it is also important that to use proper body

mechanics and avoid injury to oneself and the patient.

References

Perry, A. G., Potter, P. A., & Elkin, M. K. (2016). Nursing interventions & clinical skills

th
(6 ed.). St. Louis, MO : Mosby Elsevier.

4) Open simulation practice sessions are sessions for students to practice skills that were learned

during their on and off campus clinical. Some of the skills that can be practiced include health

assessment, dressing changes, and medication administration. Students are required to attend and

complete at least 5 hours for the semester.

5) There are several interventions we can put in place to prevent falls. One intervention we can

put into place to prevent falls is the removal of small area rugs within the home. However, if the
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person persists in using the small area rug then, it would be best to secure the mat to a nonslip

pad or skid-resistant adhesive strips (Potter, Perry, Stockert, & Hall, 2017, p.389). Another

intervention used to prevent falls, "Be sure that adults know how to use assist devices (e.g.,

walkers and canes) correctly. Consult with a physical therapy staff member" (Potter, Perry,

Stockert, & Hall, 2017, p.387). Additionally, "Encourage supervised exercise classes for older

adults and teach them to seek assistance with household tasks as needed. Safety features such as

grab bars in the bathroom are often necessary" (Potter, Perry, Stockert, & Hall, 2017, p.387).

Implementing some of these interventions can prevent falls within older adults.

References

Potter, P.A., Perry, A.G., Stockert, P. A., & Hall, A. M. (2017). Fundamentals of nursing

(9th ed.). St. Louis, MO : Mosby Elsevier.