Infection Control

Communicable diseases

Illness spread from one person to another, from animal to person, from surface, or from a food

Examples of communicable diseases

Varicella, viral meningitis, bacterial meningitis, conjunctivitis, rhinovirus, strep throat, pertussis, influenza

Disease-causing micro organism forms

virus, parasites, fungi, bacteria

Parasite classifications

rickettsia, ectoparasite, helminths, protozoa

Cycle of infection

Infectious agent —> Reservoir/source —> Portal of exit —> Mode of transmission —> Portal of entry to host —> Susceptible host

Signs

visible manifestations

Symptoms

manifestations felt by patient

Nonpathogens

do not cause disease

Normal flora

micr-organisms that live in body without causing disease

Universal precautions

Precautions when someone might come into contact with secretions, bodily fluids, blood, or tissue regardless of if patient is infected

Standard precautions

Minimum infection prevention practices in all patient care regardless of knowing infection status

Category I potential for pathogen exposure

Chance of body fluids or blood splashing, or tasks with minor exposure to fluids or bloods like minor surgical procedure

Category II potential for pathogen exposure

Not usually involve chance of exposure, like CPR, but still have precautions

Category III potential for exposure

no PPE required, like taking VS

How often does exposure control plan need to be updated

annually

Exposure control plan should include

engineering controls, workplace controls, PPE, Hepatitis B vaccinations, post-exposure followup, labels and signs for hazards, information and training to employees, documented employee medical training records

Engineering controls

Safety, needles, sharps containers, needle-less systems

Workplace controls

Handwashing, sharps disposal, specimen packaging

Rule for Hepatitis B vaccinations in employment

Employees must be given within 10 days of employment for no cost

Types of transmission based precautions

Droplet, contact, airborne

Medical asepsis

technique for cleanliness: hand hygiene, gloves, cleaning/sterilizing medical equipment, sanitizing surfaces

Asepsis is the state of

being free from disease causing organisms

Disinfection

process of destroying or rendering pathogens inactive on a surface

Surgical asepsis

removal of all micr-organisms; used in invasive procedures

Time for handwashing

15-20 seconds

What minimum percentage of alcohol should the alcohol-based sanitizers used have

60%

Sanitization

cleaning process reducing micro-organisms to a safe level; wear gloves

Ultrasonic sanitization is used for

delicate equipment

Alternative to Glutaraldehyde disinfectant

1:10 bleach solution

Low level disinfectants

chlorine, iodophores, phenols, quaternary ammonium

Intermediate level disinfectants

alcohol, chlorine, phenols, quaternary ammonium

Low level disinfection

kills most vegetative bacteria & some viruses and fungi ; ex: hydrogen peroxide

Low level disinfection is used for (Examples)

exam tables, countertops

Intermediate-level disinfection

kills vegetative bacteria & most viruses and fungi, but not spores; ex: isopropyl alcohol

Intermediate level disinfection is used for (Examples)

stethoscopes, hammers, BP cuffs

High level disinfection

kills all micro-organisms except for some bacterial spores; ex: cidex OPA

High level disinfection is used for (Examples)

mucous membrane containing items

Mandatory info on an SDS

identification, hazard identification, composition, first-aid measures, fire-fighting measures, accidental release measures, handling and storage, exposure controls/PPE, physical and chemical properties, stability and reactivity, toxicological info

What needs to occur before sterilization

sanitizing and disinfecting

Primary method to sterilize medical equipment

autoclaves

Autoclave recommended temp. to reach

250 degrees F to 270 degrees F

Unwrapped items are sterilized for ___ mins, and wrapped items are sterilized for __ mins

20 mins; 30 mins

How many layers of autoclave paper used for wrapping

two

Chemical sterilization is used for

instruments that cannot undergo autoclave because of the high temp

How often should eyewash stations be inspected

monthly

Biohazard waste bag

for items contaminated with blood or body fluids, like dressings, gauze, or gloves

Biohazard waste box

For items contaminated with blood or body fluids, like disposable gowns or table covers

Biohazard sharps container

for sharp objects, lancets, and needles

Should needles be recapped

no; place in sharps container

When is sharps container disposed

when it is two-thirds full

What should you do if waste contaminates the outside of the bag

double bag it

What to do after an exposure

wash area, report to supervisor, undergo medical evaluation (info documented for employment + 30 years), do incident exposure form, vaccination offered for Hepatitis B, health care gives copy of written opinion after 15 days of evaluation, get health counseling

Stages of infection

Incubation, prodromal, acute, declining, convalescent

Incubation stage of infection

pathogen gains entry to host

Prodromal stage of infection

pathogen reproduces in body, manifestations appear

Acute stage of infection

highest part, severe manifestations

Declining stage of infection

Manifestations lessen, infection still there

Convalescent stage of infection

manifestations resolved

Five signs of inflammation

pain, redness, swelling, heat, loss of function

Regulated medical waste

any item contaminated by or could release body fluids, blood, or infectious things

What is considered sterile area in surgical asepsis

Everything above waist

What is considered a contaminated area in surgical asepsis

Everything below the waist

What to write on autoclave wrap

date, time, initials of who’s preparing it, what item package contains

Ergonomics

efficiency of working environment

Body mechanics

how a person uses body to move

Order of donning PPE

hand hygiene, gown, mask, goggles, gloves

Order of removing PPE

gloves, goggles, gown, mask

When to use aseptic handwashing or sanitizer

Before/after handling specimen, before/after eating, after removing gloves, after using restroom, between patients

Why should artificial nails be avoided

can harbor micro-organisms

Where to hold hands/forearms during handwashing

below elbows

Should liquid or bar soap be used

liquid; bar soap could be contaminated

How far above wrist should you wash

1 inch (2.54 cm)

Why is it bad if water is too hot or cold when handwashing

could make skin crack from dryness, and pathogens may infect

Should you use hand sanitizer if you have cuts or abrasions on hands

No; use water and soap

Best temperature for removing organic substances in sanitization

warm

Why should you not use hot water on organic materials in sanitization

can cause coagulation and make removal harder

Purpose of separating sharps instruments from others

avoids self injury, and the instruments from dulling

When should three pairs of disposal gloves be used when sanitizing instruments

before disinfection of countertop, before separating sharps from other instruments, and when transporting dirty instruments to cleaning area

What to do before instrument sanitization

review SDS

Issues with leaving instrument closed in sterilization

may not be fully cleaned, weak parts might crack

Purpose of covering sharp tips of instruments in sterilization

Prevent penetration through paper

Purpose of using distilled water in autoclave

prevents corrosion

Varicella

chicken pox — direct/indirect contact and airborne secretions

Meningitis

swelling around lining of brain and spine, viral or bacterial, spreads quick; direct contact, droplets, respiratory secretions, oral-fecal

Conjunctivitis

pink eye; direct or indirect contact with eye or upper respiratory discharge

Rhinovirus, flu, pertussis, strep (how it spreads)

respiratory droplets and/or direct contact with infected persons or secretions

pertussis

whooping cough; droplet precaution

Examples of viruses

rhinovirus, varicella, HIV/AIDS, hepatitis, coronavirus

influenza

flu; respiratory droplets and contact

rhinovirus

usually cause the common cold; droplets in the air

HIV / AIDS

human immunodeficiency virus ; spreads by direct contact with body fluids

COVID-19

coronavirus ; airborne and droplets

Examples of bacteria

e-coli, vibrio cholerae, bordetella pertussis

E-coli

escherichia coli; usually live in gut, but some strains can give diarrhea

vibrio chollerae

Causes cholera diarrhea infection

bordetella pertussis

causes whooping cough

Examples of fungi

tinea pedis, Candida albicans, histoplasmosis

tidia pedis

athlete’s foot; skin infection caused by fungi; spreads easily

Candida albicans

yeast, usually part of normal microbiome, can be infectious if growing out of control

histoplasmosis

in bird and bat droppings, usually from inhaling fungal spores