[Copy] Infection Ctrl - Introduction

Disease

• disorder or an abnormal condition which negatively affects the structure or function of body parts that produces specific signs and symptoms.

Infection

 invasion of an organism's body tissues by disease-causing agents, their multiplication, and the reaction of host tissues to the infectious agents and the toxins they produce.

NORMAL FLORA

• It prevents the bacteria from invading a normal community. 

• EX. Skin: Staphylococcus aureus

Protaglandins

• Once our body is invaded by certain microorganisms, ______ is released by the body which increases our body temperature.

Exogenous infection

• pathogen entering the patient's body comes from the environment (e.g. contaminated device, healthcare worker, surface, or other vector); persons at risk include patients with open incisions, in-dwelling devices, immunocompromised

Endogenous infection

• pathogen comes from the body of the patient (own microflora) that grows unchecked due to a compromised immune system [Ex. Nagpipigil ng wiwi and mahina uminom ng water, prone to urinary infection].

• Infection Control

• Prevention of the spread of pathogenic microorganisms that have the potential to cause infectious disease

Infection Control

• Encompasses policies and procedures exercised to reduce the risk of spreading infections to humans, animals, and health care facilities

1550 BC EGYPTIANS

used honey, lard and inttor dressing wounds. Honey actually contains substantial amounts of hydrogen peroxide which can kill bacteria

Honey

This contains hydrogen peroxide which is one of the main ingredients of aseptic techniques.

pitch,

tar,

Egyptians

The use of antiseptics such as ____or ____, resins and aromatics was widely employed by _____in embalming bodies.

Molds

____ in bread were believed to produce raw forms of antibiotics to treat some disease conditions, particularly infected wounds used in ancient civilizations.

• Early Infection Control

• Personal cleanliness

• Isolation practices

• Food hygiene

• Diagnosis and treatment of infections

Happenings in 1000BC

THE LATE 1800s - EARLY 1900s

• Quarantine regulations enacted consistently 

• Immunization era begins 

• Soap produced on a large commercial scale 

• Pasteurization, water treatment, sewer systems and boards of health 

• Hospitals practice aseptic technique

1665, Robert Hooke

 invented microscope and discovered a tiny hollow rooms which he called "cells" that exist in plants & fungi

1850, Ignaz Semmelweis

saved lives with three words: wash your hands

1867, Doctor Joseph Lister

 a surgeon at the Royal Infirmary in Glasgow, Scotland. Introduced antiseptics (carbolic acid which is now known as phenol to clean his surgical tools.

1887, Louis Pasteur

one of the fathers of microbiology created vaccines for anthrax and rabies. Pasteur is most known today for inventing the process of pasteurization, which is widely used to treat liquids like milk. Also introduced the process of sterilization

Antonie van Leeuwenhoek

 used the microscope and first described microorganisms

Robert Koch

 Regarded as a pioneer of public health, aided legislation, and helped change prevailing attitudes about hygiene to prevent the spread of infectious diseases. Discovered bacteria such as anthrax bacilli, tubercle bacilli, and cholera bacilli. Invented the hot air oven and steam sterilizer, and also introduced new laboratory methods.

anthrax bacilli

tubercle bacilli

cholera bacilli

Robert Kooch discovered bacteria such as (3)

Florence Nightingale

Founder of modern nursing and organized care for wounded soldiers

universal precautions

standard precautions

transmission-based precautions

• contact precautions

• droplet precautions

• airborne precautions

types of precautions

Universal Guidelines

• Standard set of guidelines that aim to prevent bloodborne pathogen transmission through exposure to blood and other potentially infectious materials

• Treat all bodily fluids and fecal matter as infectious

• Body substance Isolation - avoidance of direct physical contact with "all moist and potentially infectious body substances"

1. Use Barrier Protection: cover up any open wounds or sores before proceeding.

2. Wear gloves when handling bodily fluids or contaminated materials or other wastes.

3. Wear a Face Mask/Gown.

4. Use Caution when handling sharp objects, needles and wastes.

5. Discard Contaminated Materials: follow biohazard procedures for disposal.

6. Clean Area Thoroughly with a disinfectant.

7. Wash hands thoroughly with soap and water for at least 20 seconds.

8. Wash Clothing in hot water.

8 Universal Precautions

DISENFECTANT

Clean Area Thoroughly with a ___

20 seconds

Wash hands thoroughly with soap and water for at least ______

hot water

Wash Clothing in ____

Bloodborne transmission

disease is spread when the blood of an infected person reaches the bloodstream of another person

Blood-borne pathogens

HIV, hepatitis B virus (HBV), hepatitis C virus (HCV)

Brain or spinal cord

cerebrospinal fluid (Blood and Body Fluid Transmission)

Joint space

synovial fluid (Blood and Body Fluid Transmission)

Lungs

pleúral fluid (Blood and Body Fluid Transmission)

Lining of the belly and pelvis

peritoneal fluid (Blood and Body Fluid Transmission)

Heart

 pericardial fluid (Blood and Body Fluid Transmission)

Fetus

amniotic fluid (Blood and Body Fluid Transmission)

1996

In ____, the CDC Guideline for Isolation Precautions in Hospitals, prepared by the Healthcare Infection Control Practices Advisory Committee (HICPAC), combined the major features for Universal Precaution and Body Substance Isolation into what is now referred to as Standard Precautions

Standard precautions

basic, minimum infection prevention practices that apply to all patient care regardless of suspected or confirmed infection status of the patient, in any setting where health care is delivered

Practices under Standard Precautions include:

• Hand Hygiene.

• Use of Personal Protective Equipment (e.g., gloves, masks, eyewear, head covering).

• Respiratory Hygiene/cough etiquette.

• Sharps Safety (Engineering and Work Practice Controls).

• Safe Injection Practices (i.e., aseptic technique for parenteral medications)

• Sterile Instruments and Devices.

• Clean and Disinfect Environmental Surfaces.

Practices under Standard Precautions include:

Transmission-Based Precautions

• For patients known or suspected to be infected or colonized with infectious agents which require additional control measures to effectively prevent transmission

• Second tier of basic infection control in addition to standard precaution

• Contact transmission

• Droplet transmission

• Airborne transmission

Three categories: Transmission-Based Precautions

Direct contact transmission

 requires physical contact between an infected person and a susceptible person 

• Touching an infected individual

• Kissing

• Sexual contact

• Contact with oral secretions

• Contact with body lesions

EXAMPLES OF Direct contact transmission

Indirect contact transmission

contact with a contaminated surface

Frequently touched surfaces (fomites)

• Door knobs, door handles, handrails

• Tables, beds, chairs Washroom surfaces

• Cups, dishes, cutlery, trays

• Medical instruments

• Computer keyboards, mouse

• Pens, pencils, phones, office supplies

• Children's toys

Indirect contact transmission - contact with a contaminated surface

Frequently touched surfaces (fomites) include:

respiratory tract, susceptible mucosal surfaces

Transmission-Based Precautions (Droplet) - Droplets carrying infectious pathogens transmit infection when they travel directly from the ______ of an infectious individual to ____ of the recipient.

Droplets, ≥ 5 um

• Produced when a person coughs, sneezes, or speaks and during procedures _____ are considered to be _____ in size, droplet nuclei (particles from desiccation of suspended droplets) are defined as < 5 um and have been associated with airborne transmission

Transmission-Based Precautions (Airborne)

Infectious agent spread by airborne transmission can travel across a room or even farther (e.g., influenza, tuberculosis, measles, chicken pox, shingles, SARS, MERS, and COVID-19)

Aerosols, ≤ 5 um

_____ are the dissemination of airborne droplet nuclei or small particles in the respirable size range _____

aerosols, irrigation

In Dentistry, _____ are generated during ____ of operating field in the mouth using syringes, drilling of the tooth using rotatory instruments, the use of electronic scalers and polishing after scaling

• Standard Precautions

• Observe 6 feet distancing

• All re-usable items taken into an exam room or home should be cleaned and disinfected before removed.

• Disposable items should be discarded at point of use.

• Frequent disinfection of surfaces commonly touched

Contact Precautions:

• Standard Precautions with physical distancing

• Patient placed in a single room.

• Patient wears a mask when outside of the room

• Providers follow the standard precautions

• Special air handling ventilation is not required

• Respirators are not required – for the reason that if a patient is infected no treatment procedures will be done, instead advice patient to go on self-quarantine

Droplet Precautions:

• Standard precautions with physical distancing

• Use Respirators

• AIIR – Airborne infection isolation room consisting of the following requirements:

a. 6 air exchanges/hour in the room

b. the room must have negative air pressure

c. exhaust via HEPA filter

d. materials for walls and floors must be cleaned 2x daily 

e. proper signage to the door

• Administrative, engineering and work practice controls

• Patients should be referred to an appropriate facility.

Airborne Precautions: