Chapter 5: Infection Prevention & Control

infection prevention

the set of methods practiced in healthcare facilities to prevent and control the spread of disease through effective hygiene, sterilization, and isolation practices

infection

the state resulting from pathogens invading the body and multiplying

pathogen

a microorganism capable of causing infection and disease

localized infection

an infection that is limited to a specific location in the body and has local symptoms

systemic infection

an infection that travels through the bloodstream and is spread throughout the body causing general symptoms

healthcare-associated infection (HAI)

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

signs and symptoms of a localized infection

pain; redness; swelling; pus; drainage; heat

drainage

fluid from a wound or cavity

signs and symptoms of a systemic infection

fever; body aches; chills; nausea and vomiting; weakness; headache; mental confusion; drop in blood pressure

chain of infection

a way of describing how disease is transmitted from one human being to another

causative agent

a pathogenic microorganism that causes disease

reservoir

a place where a pathogen lives and multiplies

portal of exit

any body opening on an infected person that allows pathogens to leave

mode of transmission

the method of describing how a pathogen travels

direct contact

a way of transmitting pathogens through toucching the infected person or their secretionsi

indirect contact

a way of transmitting pathogens through touching an object contaminated by the infected person

portal of entry

any body opening on an uninfected person that allows pathogens to enter

mucous membranes

the membranes that line body cavities that open to the outside of the body, such as the linings of the mouth, nose, eyes, rectum, and genitals

susceptible host

an uninfected person who could become sick

transmission

passage or transfer

infections

contagious

medical asepsis

measures used to reduce and prevent the spread of pathogens

surgical asepsis

the state of being completely free of all microorganisms; aka sterile technique

When the chain of infection is broken

When is the spread of infection stopped?

Occupational Safety and Health Administration (OSHA)

a federal government agency that makes rules to protect workers from hazards on the job

Standard Precautions

a method of infection prevention in which all blood, body fluids, non-intact skin, and mucous membranes are treated as if they were infected with an infectious disease

lancet

a sharp instrument used to make small incisions, as in capillary puncture procedures

sharps

a collective term for needles and other sharp objects

body fluids

blood, tears, saliva, sputum, urine, feces, semen, vaginal secretions, pus or other wound drainage, vomit

sputum

mucus coughed up

measures for Standard Precautions

wash hands; wear gloves; remove gloves immediately when finished with a procedure; immediately wash skin surfaces; wear a disposable gown; wear a mask and goggles and/or face shield; wear gloves when handling sharp objects; never attempt to recap needles or sharps; carefully bag all contaminated supplies; clearly label body fluids being saved for a specimen; dispose of contaminated waste properly

hand hygiene

washing hands with soap and water or using alcohol-based hand rubs

times when MAs should wash their hands

when first arriving at work; anytime when they are visibly soiled; before, between, and after all patient contact; before putting on gloves and after removing gloves; after contact with body fluids, mucous membranes, non-intact skin, and wound dressings; after handling contaminated items; after contact with any object in a patient’s care environment (inpatient setting); before and after using the toilet; after touching garbage or trash; after picking up anything from the floor; after blowing or wiping nose or coughing or sneezing into hands; before and after eating; after smoking; after touching areas on the body (including face and hair); before and after applying makeup; after any contact with pets; before leaving facility

personal protective equipment (PPE)

equipment that helps protect employees from serious workplace injuries or illnesses resulting from contact with workplace hazards

invasive procedure

a procedure that involves inserting a foreign object into a patient’s body

don

to put on

don

to remove

When should MAs wear gowns, masks, goggles, and face shields?

when splashing or spraying of body fluids or blood could occur

What should be worn if there is a chance of contact with body fluids, mucous membranes, or open wounds?

PPE

What kind of PPE should be removed after exiting the room and closing the door?

respirators/masks

Who provides PPE?

employers

Who’s responsibility is it to know where PPE is kept and how to use it?

Medical assistants

When putting on a gown, what should not be done?

shaking the gown and letting it touch the floor

steps for donning a full set of PPE

gown, mask/respirator, goggles/face shield, put on gloves

steps for doffing a full set of PPE

gloves, goggles/face shield, gown, mask

transmission-based precautions

a method of infection prevention used when caring for persons who are infected or may be infected with certain infectious diseases

multi-drug resistant organisms (MDROs)

microorganisms, mostly bacteria, that are resistant to one or more anti-microbrial agents that are commonly used for treatment

isolate

to keep something separate, or by itself

infectious diseases that transmission-based precautions are used for

MDROs, C. diff, scabies, lice, influenza, COVID-19

scabies

skin disease that causes itching

airborne precautions

precautions include wearing special masks, gowns, handwashing, and proper ventilation

airborne precautions are used when

pathogens can be transmitted through the air after being expelled and can remain floating for some time

airborne infection isolation room (AIIR)

rooms to hold patients with airborne infections

AIIRs should be opened and closed

slowly

droplet precautions

precautions include wearing a face mask, covering the nose and mouth when sneezing or coughing, and handwashing

droplet precautions are used when

precautions are used for diseases spread by droplets in the air

droplets do not travel more than

6 feet

ways droplets can spread

talking, coughing, sneezing, laughing, singing, or suctioning

example of a droplet disease

influenza

example of airborne disease

tuberculosis

contact precautions

precautions include wearing gloves and gown, patient isolation, hand washing, avoiding touching infected surfaces without gloves, and avoiding touching uninfected surfaces with contaminated gloves

contact precautions are used

when resident is at risk of spreading a disease by direct or indirect contact

examples of contact diseases

conjunctivitis and C. diff

contact precautions

wearing gloves and gown; patient isolation; washing hands; avoiding touching infected surfaces without gloves; and avoiding touching uninfected surfaces with contaminated gloves

guidelines for isolation

transmission-based precautions are always used in addition to standard precautions; MAs may set up the isolation unit; use PPE as instructed (do not use it outside of patient’s room and perform hand hygene after removing it); use handwashing areas inside the patient’s room or wall-mounted hand rub dispensers near the exit; wear proper PPE required to take speciments; do not rush through care tasks for a person who is in isolation

bloodborne pathogens

a microorganism found in human blood that can cause infection and disease in humans

acquired immunodeficiency syndrome (AIDS)

the final stage of HIV infection, in which infections, tumors, and central nervous system symptoms appear due to a weakened immune system that is unable to fight infection

human immunodeficiency virus (HIV)

a virus that attacks the body’s immune system and gradually disables it; eventually can cause AIDS

hepatitis

inflammation of the liver caused by certain viruses and other factors such as alcohol abuse, some medications, and trauma

ways for bloodborne disease are transmitted

1. infected blood entering the bloodsteam

2. infected semen or vaginal secretions contacting mucous membranes

3. sexual contact'

4. sharing infected drug needles

5. infected pregnant women

6. in healthcare, contact with infected blood, certain other body fluids, or needles or other sharp objects

Hepatitis A

results from fecal-oral contamination

Hepatitis B

transmitted through sexual contact, sharing infected needles, from mother to baby during delivery, and by exposure at work from accidental contact with sharps; has a vaccine

Hepatitis C

transmitted through blood or body fluids; can result in serious illness or death; no vaccine

Hepatitis D

transmitted by blood and is only found in people who carry hepatitis B; no vaccine

Hepatitis E

rare in the US and is transmitted by the fecal-oral route; no vaccine

bloodborne pathogens standard

federal law that requires that healthcare facilities protect employees from bloodborne health hazards

engineering controls

features incorporated in medical devices to make their use less hazardous

exposure control pain

a plan designed to eliminate or reduce employee exposure to infectious material

significant expoures

needle stick, mucous membrane contact, cur from an object containing potentially infectious body fluid, having non-intact skin

employer responsibilities

1. have written exposure control plan

2. provide proper PPE

3. make sure biohazard containers are available

4. provide hepatitis B vaccine free to employees

5. place warning labels where potentially infectious material is present

6. keep a log of injuries from contaminated sharps

7. provide in-service training

8. provide in-service education

disinfection

a process that destroys most, but not all, pathogens; it reduces the pathogen count to a level that is considered not infectious

sterilization

a cleaning measure used to decrease the spread of pathogens and disease by destroying all microorganisms, including those that form spores

guidelines for handling patient specimens

Don clean gloves for every patient interaction; replace wet, torn, or soiled gloves; check specimen containers/tubes for leaks; place specimens in biohazard bags for transport; follow facility policy regarding method of transport'; do not place needles or sharps ina transport bag/specimen container; follow any specific instructions regarding patients under transmission-based precautions; clean and disinfect all surfaces in care areas between patients using facility-approved antimicrobial agent

employee responsibilities

follow standard precautions; follow all facility policies and procedures; follow patient care plans and assignments; use PPE; take advantage of free hepatitis B vaccine; immediately report any exposure to infection, blood, or bodily fluids; participate in education programs