Infection Prevention and Control (IPAC)

Chain Transmission

Process by which microorganisms transfer from one host to another to cause an infection

1. Infectious agent

2. Reservoirs

3. Portals of exit

4. Modes of transmission

5. Portals of entry

6. Susceptible host

Infectious agent

Microorganisms that causes the infection

Ex. Bacteria, fungi, viruses, parasites

Reservoirs

Place where the microorganism lives, grows, and multiplies before infecting

Ex. People, water, food

Portals of exit

Pathway the microorganism uses to leave the reservoir to spread to another host

Ex. Blood, secretions, excretions, skin

Modes of transmission

How the microorganism transfer from the portal of exit to the next host

Ex. Contact, droplet, airborne

Portals of entry

Route where the microorganism uses to get into the new host

Ex. Mucous membrane, respiratory, GI, broken skin

Susceptible host

Person vulnerable to the infection, their body is unable to effectively fight off the microorganism

Ex. Immunosuppression, diabetes, burs, surgery, age

How is the chain of transmission broken?

When the transmission is interrupted:

1. The agent is eliminated or inactivated or cannot exit the reservoir

2. Portals of exit are eliminated through safe practices

3. Transmission between object or people does not occur due to barriers and/or safe practices

4. Portals of entry are protected

5. Hosts are not susceptible

Preventing infectious agent examples

1. Antimicrobial therapy

2. Disinfection

3. Sterilization

Preventing reservoir transmission examples

1. Engineering controls

2. Environmental cleaning/disinfection

3. Proper food storage

4. Water treatment

Preventing portals of exit examples

1. hand hygiene

2. disposal of waste and contaminated lien

3. control of excretions and secretions

Preventing modes of transmission examples

1. spatial separation

2. engineering controls

3. hand hygiene

4. environmental sanitation

5. equipment disinfection/sterilization

6. PPE

Preventing portals of entry from transmission examples

1. had hygiene

2. aseptic technique

3. wound care, catheter care

4. PPE

Preventing susceptible host from transmission examples

1. immunization

2. nutrition

3. recognition of high-risk patients

4. treatment

Organizational risk assessment

put engineering and administrative controls in place and PPE if required

→ ex: evaluating ventilation system or sharps disposal procedures, establishing protocols for cleaning and disinfection

Personal risk assessment

identify controls already in place and use additional measures if needed

→ ex. wearing gloves and mask gown, avoiding tasks if immunocompromised or not trained, personal exposure risk when performing aerosol-generating procedures

Routine Practice

• standard level of care used by health care workers during all care to prevent and control transmission of microorganisms

• premise: all clients, patients, residents are potentially infectious, even when they have no symptoms

Routine practices examples

1. risk assessment

2. hand hygiene

3. environmental controls

Environmental controls examples

1. appropriate placement and bed spacing

2. cleaning of equipment/health care environment

3. engineering controls (heating, ventilation, air conditioning)

4. point of care sharps containers, hand hygiene product dispensers, hand washing sinks

Administrative controls

• additional policies, procedures, and practices introduced for higher-risk exposure to infectious agents

Administrative controls examples

1. appropriate PPE

2. staff education

3. healthy workplace policies

4. immunization programs

5. respiratory etiquette

6. monitoring of compliance with feedback

7. sufficient staff levels

5 moments for hand hygiene at a placement

1. before touching patient

2. before cleaning/aseptic procedure

3. after body fluid exposure

4. after touching a patient

5. after touching patient surroundings