National Nurses United

CE:8 page 2/8/08 2:25 PM Page 22 recover without treatment. However, in some persons the diarrhea professionals and workers) likely to be exposed to all potential infecmay be so severe that the patient needs to be hospitalized. In these tious materials, such as: 1. The use of personal protective equipment (gown, gloves, N95 or patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death equivalent respirators, mask, and eye protection). 2. Proper handling and disposal of sharps (sharps containers). unless the person is treated promptly with antibiotics. The elderly, 3. Safe personnel health practice (protect staff from acquiring disinfants, and those with impaired immune systems are more likely to have a severe illness. It is usually contracted by ingesting contami- ease from patients – tuberculosis, blood-borne infections, etc.) Infecnated food or water. Hand washing after using the bathroom or tion prevention and control standards to protect the health, welfare, changing a diaper is essential in preventing the spread of Salmonel- and safety of the public include: Transmission-based precautions (airborne, droplet, and contact la. It is important for the public health department to know about transmission). cases of salmonellosis. Prevention of the development of antibiotic-resistant organisms, Infections spread by droplet (coughing, laughing, sneezing, and talking) include Hantaviruses, SARS, bacterial and viral pneumonias, such as methicillin-resistant Staphylococcus aureus/MRSA or vaninfluenza, measles, tuberculosis, meningitis, mumps, Pertussis comycin-resistant enterococcus/VRE. Keeping a clean environment (disinfecting surfaces, spot cleaning (whooping cough), rubella, diphtheria, and Varicella (chickenpox). Many of these can be prevented by vaccines. They can be deadly for of body fluid spills). Safe equipment and material maintenance practice (refrigeration children, the elderly, and immunosuppressed individuals. of certain medications and vaccination, no multi-dose vials, continuCommunity-Associated MRSA (CA-MRSA) Nationwide, there has been an increase in the number of commu- ous check of expiration dates of medications and solutions). Waste disposal practice that avoids transmission of potential nity-associated methicillin-resistant Staphylococcus aureus (CAMRSA) infections among persons of all ages who previously were infections (biomedical waste, anatomical or non-anatomical, sharps, considered to be at low risk for this infection. CA-MRSA infections needles). Effective cleaning, disinfection, and sterilization of medical are predominantly skin and soft tissue infections (SSTIs). The infection is often described as a "spider bite" or appears as reddened areas instruments according to prevailing standards of practice. on the skin. Staphylococcus aureus (S. aureus) is a gram-positive bacterium TRIAGE: PRIOR ASSESSMENT OF POSSIBLE CONTAGIOUS INFECTIONS that can be found on the skin and in the nose of approximately 20 currently, physician offices or outpatient clinics exercise a stanpercent to 30 percent of healthy individuals. It is one of the most dard of care where every patient attending the office or the clinic is common causes for skin and soft tissue infections (SSTIs) in the Unit- triaged for the possibility of contagious infections prior to coming in ed States and may also cause invasive disease, including surgical wound infections, bacteremia, pneumonia, necrotizing fasciitis, and toxic shock syndrome. During the past 50 years, treatment of S. CENTERS FOR DISEASE CONTROL aureus infections has become more difficult due to AND PREVENTION increasing antibiotic resistance. (See Addendum III) INFECTION CONTROL INFRASTRUCTURE i n f e c t i o n c o n t r o l i s a n integral part of any practice setting, whether a physician office, clinic, or hospital setting. It has long been recognized as an important means of preventing transmission of infectious agents. Office or clinic waiting areas often present opportunities for transmission. Multiple outbreaks of measles, tuberculosis, and other infectious diseases have been traced to physician offices or clinics. Most outbreaks associated in outpatient settings were associated with noncompliance with infection control procedures. Fomites, such as toys and office equipment, have been implicated in the transmission of some pathogens. A key principle of infection control is separation of infected, contagious children from uninfected children. The prevailing standards of practice of physician offices and outpatient clinics focus on protecting personnel/staff and the public.Employers are required by the Occupational Safety and Health Administration (OSHA) to take precautions to protect staff (health 22 REGISTERED NURSE Diarrhea People can become infected with germs that cause diarrhea by: Eating food or drinking liquids contaminated with diarrhea-causing germs, Touching surfaces or objects contaminated with diarrhea-causing germs and then touching their own mouth, nose, or eyes. Sharing personal items such as towels and toothbrushes. Having contact with an infected person, for example, by: Being present while someone is vomiting Sharing food or eating from the same utensils Caring for a sick person Shaking hands with a person who did not wash hands after using the bathroom or changing a diaper Not washing hands after changing diapers or before eating or preparing food. Examples of diseases commonly spread this way are campylobacteriosis , cryptosporidiosis, cytomegalovirus (CMV) infection, diarrhea, giardiasis, hand, foot, and mouth disease, hepatitis A, non-polio enterovirus infections, rotavirus infection, shigellosis. W W W. C A L N U R S E S . O R G JANUARY | FEBRUARY 2008

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