Expanded program of immunization

•Launched in july 1976

•Objective was to reduce the morbidity and mortality among infants and children
caused by the six childhood immunizable diseases.
•Principles :
1. based on epidemiological situation; schedules are drawn on the
basis of the occurrence and characteristics epidemiological
features of dse.
2. whole community rather than individual is to be protected ,thus
mass approach is utilized

3. immunization is a basic health service and such it is integrated in

to the health services being provided for by the rural health unit
Routine immunization schedules for infants

Routine immunization schedules for infants

vaccine min. age at Number of Min. reasons

1st dose doses interval bet
doses

1. bcg Birth or 1 Bcg given at the earliest possible

anytime age protects against the
after birth possibility of infection from
other family member

2. DPT 6 weeks 3 4 weeks An early start with DPT

reduces the chance of severe
pertussis

3. OPV 6 weeks 3 4 weeks The extent of protection against

polio is increased the earlier the
opv is given
 4.hepatitis 6 weeks 3 4 weeks An early start of hepatitis B
B reduce the chance of being
infected and becoming carrier

5. measles 9 months 1 At least 80% of measles can be

prevented by immunization at
this age

School entrants
BCG immunization shall be given to all school entrants both in public and
private school regardless of the presence of BCG scar

Tetanus toxoid immunization for woman

vaccine Minimum age Percent protected Duration of
interval protection
1. TT1 As early as possible 80%
during pregnancy
2. TT2 At least 4 weeks 80% Infants born to
later mother will be
protected from
neonatal tetanus
Gives 3 years
protection for the
mother
3. TT3 At least 6 months 90% Same as above
Gives 5 years
protection for the
mother
4. TT4 At least 1 year later 99% Same as above
Gives 10 years
protection to the
mother
5. TT5 At least 1 year later 99% Gives lifetime
protection for the
mother
All infant born to
that mother will be
 protected

ISOLATION TECHNIQUE
 separation of seriously ill patients from others to prevents spraed of an
infection or protect patient from irritating environmental factors

purposes/ objectives :
1. prevents transmission of infection
2. protect patient
3. protect environment

Double Bagging :
 used for contaminated items from an isolation room (except protective
isolation)
 one nurse inside the room , one nurse outside carry out this procedure
 use for wet linen
 for item that are being sent for contamination

Procedure:
1. outside nurse placed used items in Full bags are difficult to double bag
appropriate container linen in the linen
hamper, glass, bottle , and jars to brown
paper bag .do not fill bag to full ,carefully
close and secure the bag
2. outside nurse: form an another bag Protects your hands from contact to
spreading , to received the bag from the contaminated items inside the bag
nurse inside
3. inside nurse: place bag holding
contaminated items directly to the bag hold
by outside nurse( careful to touch only
inside of bag)
4. Outside nurse: hold over and carefully
secure top of outside bag
5. mark the bag according to the policy of So that proper sterilization or destruction
the institution .Indicates content of the bag process can be carried out
6. dispose the bag in proper place
Nursing consideration:
 dont put lids or cups or glass jars or bottles being sent to be sterilized because
it will explode , might injury to the staff.
CARING FOR LINEN:
1. Handled solied linen with glove hands
2. touch only inside of laundry bag with
soiled linen
3. use double bagging
Types of isolation
1. strict isolation
2. respiratory isolation
3. tuberculosis/AFB
isolation
4. contact isolation
5. enteric precaution
6. drainage secretion
precaution
For self protection
Maintain outside as clean as possible
Proper decontamination can be carried out
Indications Requirements
Highly transmissible -private room
disease by direct contact -gowns mask gloves
and airborne routes of -handwashing
transmission -double bagged technique
for soiled linen
Droplets transmission -private room
-pt. with the same organism
generally may share aroom
-handwashing
-labelled plastic bag are
used for soiled particles
Suspected or active TB -private room with negative
pressure ventilation
-mask
-handwashing
-procedure are not done
unless pt had 2 weeks
duration of tx.
Infectious dse. Or multiple -private rm.
resistant microorganism that -mask, gown ,gloves
are spread by close or
direct contact
Infectious dse,transmitted -private rm.handwashing,
through direct or indirect -gloves
contact with infected feces Gowns shld. Be wear only
if handling object with
contaminated feces
Pt. with infected wounds Gloves
Gown are indicated only if
clothing is likely to be
contaminated
7. universal blood and body Blood borne ,body fluids -gloves
fluids precaution pathogens -mask and protected eye
gear
-gown

COMMON DSE CONDITION AND ITS APPROPRIATE PRECAUTION

Disease Isolation precaution Duration of precaution
1.AIDS Blood/body fluids Duration of illness
2. burns with infection Drainage DOI
3. diarrhea infectious Enteric DOI
4. diphtheria cutaneous Contact Until 2 lesion cultures are
Diphtheria pharyngeal Strict negative
5. gastroenteritis Enteric DOI
6. hepatitis A Enteric For 7 days after onset of
B Blood and body fluids jaundice
C Blood/body fluids
7. herpes simplex Contact DOI
8. herpes zoster Strict DOI, until lesion are crusted
9. Measles respiratory For 4 days after onset of
rash DOI in
immunocompromised pt.
10. methicillin resistant Contact Until antimicrobials are
staphylococcus aureus discontinued and culture
are negative
11. meningitis H. influenza Respiratory For 24 hrs after start of
effective therapy
12. mumps respiratory For 9 days bafter onset of
swelling
13. pediculosis Contact For 24 hrs after start of
effective therapy
14. pneumonia Strict -for 48hrs after start of
S. Aureus effective therapy
Streptococcus Strict - for 24hrs after start of
Grp. A effective therapy

15. scabies Contact For 24 hrs after starting

16. syphilis
17. tuberculosis pulmonary
18. typhoid fever
19. varicella
effective therapy
Contact For 24hrs after starting
effective therapy
Tuberculosis (AFB) Usually 2-3 weeks after
chemotherapy has been
started
Enteric DOI
Strict Until all lesion are crusted
SUMMARY
Strict isolation Respiratory isolation Contact isolation
-diphtheria pharyngeal -H influenza -diphtheria cutaneuos
-herpes zoster -measles -herpes simplex
- pneumonia -mumps -MRSA
-varicella -N.Meningitidis -pediculosis
-scabies
-syphllis
Enteric isolation Blood /body fluids Tuberculosis AFB
-aseptic meningitis precaution isolation
-diarrhea - AIDS - tuberculosis
-gastroenteritis - hepatitis B
-hepatitis A -hepatitisC
-typhoid fever