Infection Prevention and Control

microorganisms

living organisms too small to be seen with the naked eye

• mouth

• upper respiratory tract

• intestines

Specific permanent flora are found in:

Pathogenic microorganisms

microorganisms that are capable of causing/producing infection or disease by destroying cells or tissues, or secreting toxins.

• can be transmitted from one host to another

antisepsis

is a practice that inhibit the growth of pathogenic microorganisms

medical asepsis

reduces the likelihood of transferring pathogenic microorganisms to a vulnerable individual

• destruction of bacteria through the use of disinfectants/antiseptics

disinfection

The destruction of pathogens through the use of chemical materials

• hydrogen peroxide

• chlorine

• iodine

• chlorhexidine

• formaldehyde

Examples of disinfectants:

Surgical asepsis (sterilization)

refers to the REMOVAL of ALL microorganisms and their spores (reproductive cells) and is practiced in the SURGICAL SUITE

lower than the elbows

When washing hands, the hands and forearms should always be kept _____

proper and timely hand washing

The single, most effective means of controlling the spread of infectious microorganisms.

Hand lotion

What can be used to prevent hands from chapping?

hard surfaces

Disinfectants and germicides are often used for ______

antiseptics

are generally used for tissue

• Wear clean uniforms

• Limit jewelry as microorganisms can find safe harbor in jewelry especially in rings with stones and crevices

• Artificial nails may be prohibited for they can harbor

Some items to consider for personal care:

Gram-negative pathogens on their fingertips

Staff that wear artificial nails are more likely to harbor what?

sterile corridor

the area between the draped patient and the instrument table.

• Only the surgeon and the instrument nurse occupy this area.

Factors in Infection Transmission/Cycle of Infection

1. An infectious organism/pathogen

2. A reservoir of infection and environment for pathogen to live and multiply

3. A portal of exit from the reservoir

4. A means of transmission

5. A susceptible host

6. A portal of entry into the susceptible new host

Pathogens

are causative agents — microorganisms capable of producing disease.

Pathogens opportunistic

Pathogens that are usually harmless, but can be harmful

• a part of the body where they do not normally reside

• an immunocompromised host

The pathogens opportunistic can be harmful if introduced to:

Blood-borne pathogens

pathogens that reside in blood and can be transmitted to an individual exposed to the blood or body fluids of the exposed individual.

• hepatitis C virus (HCV)

• hepatitis B virus (HBV)

• human immunodeficiency virus (HIV)

Blood-borne pathogens include the following:

Reservoir (source)

a chain of infection: in any environment where pathogens can survive and reproduce, and ultimately pose a risk of transmission to a susceptible host.

• an appropriate temperature

• moisture

• nutrients

The reservoir environment must afford the following:

• a patient w/ active TB

• a visitor with an upper respiratory infection

• a health care professional with conjunctivitis

Examples of reservoirs of infection include:

A portal of exit from the reservoir

a chain of infection: can be any pathway by which pathogens are able to leave the reservoir

• Urine

• feces

• blood

• respiratory droplets

• contaminated solutions

examples of portals of exit:

The most susceptible hosts

a chain of infection: are all who have a diminished natural resistance to infection

Health care-associated infections (HAIs) or nosocomial infections

are infections acquired by patients (susceptible hosts) while they are in the hospital, unrelated to the condition for which the patients were hospitalized.

remain

Microorganisms can ______ infectious while awaiting transmission to another host

portal of entry

a chain of infection: the pathway by which infectious organisms gain entry to the body

• breaks in the skin

• GI tract

• mucous membranes of eyes, nose, or mouth

• respiratory tract

• urinary tract

Potential portals of entry include:

• ingestion

• injection

• inhalation

• across mucous membrane

entry can be accomplished by:

placenta

serves as a portal entry between the mother and the fetus

• droplet

• airborne

• contact (direct/indirect)

three modes of transmission:

• Vector

• Vehicle

Other sources of infection:

droplets

pathogenic microorganisms expelled from the respiratory tract through the mouth or nose through the air

• can be carried as evaporated.

• LARGE droplets

fomite

a contaminated inanimate object

• ex. food utensil, doorknob, IV pole

indirect contact

fomite can be transmission via

vector

an insect or animal carrier of infectious organism

• rabid animal

• mosquito that carries malaria

• tick that carries Lyme disease

vehicle

transmission includes anything that transmits infectious microorganisms

• ex. contaminated blood, water, food, and drugs

disinfectants (germicides)

what are used in hand-washing liquids to kill microorganisms

HIV-infected individuals

individuals may be symptomless and go undiagnosed for 10 years or more, yet they are carriers of the infection and have the potential to spread the disease.

intimate contact with blood or body fluids of a infected individual

• sharing contaminated needles

• sexual contact

• between mother to baby at childbirth

• transfusion of contaminated blood

how is HIV infection can be transmitted?

cannot

Inanimate objects, such as water fountains, telephones surfaces, or toilet seats ______ transmit HIV

Hepatitis B

a blood-borne infection that affects the liver and can transmit the disease to others

standard precautions

the rationale that treats all body fluids and substances as infectious and serves to prevent the spread of microorganisms to other patients by the radiographer from contamination

iatrogenic

infection resulting from physician intervention

urinary tract infection

the most common HAI is the ________

• sepsis

• wound infection

• respiratory tract infection

other types of HAIs:

way of hands

microorganisms are most commonly spread by:

Transmission-Based Precautions

• tubercle bacillus (TB)

• chickenpox (varicella)

• measles (rubeola)

examples of airborne precautions

air-purifying respirator (PAPR)

Those who cannot be fitted for an N95 mask may need to wear what instead?

negative-pressure room

Patients infected with airborne disease require a private, specially ventilated, what pressure room?

• rubella (German measles)

• mumps

• influenza

examples of droplet contact:

• dons a gown, gloves, and a mask

For contact isolation, the first radiographer (or “dirty) does what?

disinfectant

The mobile unit must be thoroughly cleaned w/ a _____

grasp the UNCOVERED IP

the second radiographer (clean) should ___________

• remove by folding the gown FORWARD (with the dirty surfaces touching)

• pull the sleeves inside out

• roll the gown into a ball with the clean side now on the outside of the rolled gown.

How do you remove a donned gown?

• lab waste

• pathology waste

• used bandages and dressings

• discarded gloves

• all sharp objects

• liquid waste from suction

• bladder catheters

• chest tubes

• IV tubes

• drainage containers

What are included in the disposal of biomedical waste?

special, easily identifiable, impermeable bags and removed from the premised by an approved biomedical waste hauler

Biomedical waste must be packaged in ______

neutropenic (protective or reverse) isolation

this isolation is used to keep the susceptible patient whose immune system is compromised from becoming infected

1. Transplant recipient

2. Chemotherapy recipient

3. Leukemia

4. Burned skin

In which of the following conditions is protective, or reverse, isolation indicated?