Nursing Unit 6 --- Prevention and Control

1st step in the chain of infection

infectious agent

2nd step in the chain of infection

reservoir

3rd step in the chain of infection

portal of exit

4th step in the chain of infection

mode of transmission

5th step in the chain of infection

portal of entry

6th step in the chain of infection

susceptible host

What is an infectious agent?

bacteria, viruses, fungi, parasites

What is a reservoir?

where the germs live (people, animals, food, water, soil, etc)

What is the portal of exit?

how the germs get out (mouth, open cuts in the skin, etc)

What is the mode of transmission?

how the germs get around (contact, droplets)

What is the portal of entry?

how germs get in (mouth, cuts in the skin, eyes)

What is the susceptible host?

the person who is most likely to get sick from this pathogen (elderly, children, babies, people with weak immune systems)

Infection prevention

set of methods to prevent and control spread of disease

Microorganisms/Microbes

organisms that are too small to be seen with the naked eye

Pathogens

harmful microbes that cause infections

Healthcare-associated infection (HAI)

an infection acquired within a healthcare setting during the delivery of medical care

Localized infection

an infection that is limited to a specific location in the body

Systemic infection

an infection spreads to several sites and tissue fluids usually in the bloodstream

Community-aquired infection

an infection caused by microorganisms that originated in a setting outside of a health care facility

Redness is a sign/symptom of a...

localized infection

Swelling is a sign/symptom of a...

localized infection

Pain is a sign/symptom of a...

localized infection

Heat is a sign/symptom of a...

localized infection

Drainage is a sign/symptom of a...

localized infection

A fever is a sign/symptom of a...

systemic infection

Chills are a sign/symptom of a...

systemic infection

A headache is a sign/symptom of a...

systemic infection

A change in v/s are signs/symptoms of a...

systemic infection

N/V/D are signs/symptoms of a...

systemic infection

What does N/V/D stand for?

nausea, vomiting, diarrhea

Mental confusion is a sign/symptom of a...

systemic infection

What is an infectious disease?

a disease caused by pathogens

What is a communicable disease?

a disease that is spread from one host to another (person to person, animal to person)

What is a noncommunicable disease?

a disease that is not transmitted from one host to another

Where do pathogens grow best?

warm, dark, moist places

What do pathogens look for?

food and a host with a low resistance

Infection prevention helps prevent...

cross contamination and reinfection.

What is cross contamination?

when pathogens are transferred from one surface or food to another

What is reinfection?

when a person becomes infected again with the same pathogen

What is considered dirty in health care?

a condition in which an object has been contaminated with pathogens

What is an example of something dirty in health care?

a vital sign machine is used on a Resident to take blood pressure

What is considered clean in health care?

a condition in which an object is not contaminated with pathogens

What is an example of something clean in health care?

a vital sign machine is wiped down after it is used on a Resident

What is transmission?

the spread of a disease or infection from person to person

What is medical asepsis?

practices that kill some microorganisms to prevent them from spreading

What is surgical asepsis?

practices that completely kill and eliminate microorganisms

What is disinfection?

a process that reduces the number of microorganisms where they do not present a risk to patients

What is sterilization?

a process of complete elimination or destruction of all forms of microbial life

How to break the first link in the chain of infection...

seek prompt treatment if you are ill and use the correct cleaning solution to disinfect the pathogens you have identified.

How to break the second link in the chain of infection...

washing your hands, keeping a clean environment, and disinfecting surfaces

How to break the third link in the chain of infection...

washing hands, using proper PPE, properly disposing of trash, and covering your cough or sneeze

How to break the fourth link in the chain of infection...

washing hands, controlling airflow in negative pressure rooms, disinfecting surfaces, handling food properly, and observing isolation precautions

How to break the fifth link in the chain of infection...

practicing aseptic technique (using practices and procedures to prevent contamination from pathogens) during procedures, taking proper care of wounds, washing your hands, and properly caring for catheters

How to break the sixth link in the chain of infection...

treating primary disease and identifying those that are at higher risk for infection

Why are elderly people at a higher risk of infection?

they are hospitalized more often (higher chance of HAI), their skin is dry and thin (more at a risk of pressure injuries and skin infections), their bones are more brittle, their circulation is decreased, and they are most at risk for dehydration and malnutrition

Can tubes in the body cause infection?

yes

Center for Disease Control and Prevention (CDC)

a federal agency that issues guidelines to protect and improve health

What is a standard precaution?

something that treats "all blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes may contain transmissible infectious agents"

What is a transmission-based precaution?

treats patients with known or suspected infectious agents that require additional control measures to prevent transmission

What are some examples of standard precautions?

hand hygiene, wear gloves- if in contact with body fluids, etc, remove gloves- when finished, wash hands and all skin surfaces, wear mask, protective gloves, face shield, etc., wear gloves when handling sharps, DO NOT recap needles, bag all disposable contaminated supplies, and clean all surfaces

What are some examples of transmission-based precautions?

gloves, gown, all reusable items must be cleaned and disinfected, and disposable items should be discarded after use

When do you have to wash your hands instead of hand sanitizer?

when your hands are visibly dirty and when caring for certain disease processes

How long should you lather for?

at least 20 seconds

What is the single most important thing a nursing assistant can do?

hand hygiene

PPE in Facilities

gown (sterile vs non sterile), gloves, masks (surgical mask vs respirator), goggles, and face shield

When should gloves be worn?

when in contact with blood, bodily fluids, open wounds, mucous membranes, disposing of soiled items, when CNA has sores or cuts, touching contaminated surfaces

When should gloves be changed?

if gloves become wet, worn, soiled, or torn and before contact with mucous membranes or broken skin

When should the CNA remove gloves?

after care is given and before leaving the room

Types of transmission-based precautions

Airborne precautions, droplet precautions, and contact precautions

How are airborne diseases spread?

they spread throughout the air

Airborne precautions...

place in Airborne Infection Isolation Room (AIIR)/or HEPA filter, doors & windows closed, personnel wears N-95 or respirator, Resident must wear surgical mask if they leave the room

How are droplet diseases transmitted?

spread droplets in the air which usually don't travel more than 6 feet

True/False - -airborne diseases stay suspended in the air.

True

What is an example of an airborne disease?

Tuberculosis

Droplet precautions...

wear a surgical mask and the Resident must wear a surgical mask if they leave the room

What can spread droplets?

talking, laughing, and sneezing

How are contact diseases transmitted?

by direct contact with another person or object (blood, object, body, bodily fluids)

What is an example of a droplet disease?

Influenza

Contact precautions...

Put on a gown before entering a Resident's room, put on gloves before entering the room, change gloves if they become contaminated, remove gloves before leaving the room, do not share Residents' equipment with other residents, Resident will be placed in a private room.

What are examples of contact diseases?

MRSA, Conjuctivis, and C-Diff

What is OSHA?

Occupational Safety and Health Administration;

a federal agency

All transmission-based precautions must include ____________ precautions.

standard

What does OSHA do?

sets standards for a safe and healthy workplace

What does bloodborne pathogen standard mean?

protects employees from bloodborne health hazards)

What does OSHA's bloodborne pathogen standard do?

provide in-service training on risk of Bloodborne pathogens and any updates on hire and annually; exposure Control Plan; provide PPE to staff and visitors; biohazard containers available; biohazard bags available; log for all injuries from contaminated sharps; provide a free hep b vaccine to all employees upon hire

What are bloodborne pathogens?

pathogens found in human blood, body fluids, draining wounds, and mucous membranes

How are bloodborne pathogens transmitted?

infected blood entering the bloodstream and/or

infected semen or vaginal secretions contact with mucous membranes

Types of waste that are considered infectious....

blood, body fluids and human tissue

What are incidents of exposure?

needle stick, mucous membrane contact, cut from object with body fluid (including human bites), and contact with non intact skin

What is an exposure incident?

When an employee is exposed to blood or other infectious material

Exposure Control Plan

Follow facility policy regarding spill, splash, or cut

Report exposure incident to supervisor

Fill out exposure report form

Go to employer's health service department for any needed tests

Examples of bloodborne diseases:

Hepatitis and HIV

What is hepatitis?

inflammation of the liver

What is an HIV?

a virus that can lead to acquired immune deficiency syndrome (AIDS)

What is hepatitis caused by?

certain viruses and other factors, such as alcohol abuse, some medications, and trauma