IP&C

Healthcare-Associated Infection (HAI)

Infection acquired during healthcare; also called a nosocomial infection.

Purpose of IP&C

Prevent HAIs in patients, healthcare workers, and visitors.

Localized Infection

Infection limited to one body area; causes local symptoms.

Localized Infection Symptoms

Redness, heat, swelling, pain, loss of function.

Systemic Infection

Infection affecting multiple body areas or systems.

Systemic Infection Symptoms

Fever, fatigue, loss of appetite, symptoms in multiple body systems.

Pathogen

Organism capable of causing infection.

Colonization

Presence of microorganisms without causing disease.

Carrier

Person who carries microorganisms without symptoms.

Normal Flora (Microbiome)

Microorganisms that normally live on or in the body.

Endogenous Infection

Infection caused by alteration or overgrowth of a person's normal flora.

Exogenous Infection

Infection caused by microorganisms from an external source.

Chain of Infection Six Links

Infectious agent, reservoir, portal of exit, transmission, portal of entry, susceptible host.

Most Common Transmission Route

Contact transmission.

Direct Contact Transmission

Physical person-to-person contact spreads microorganisms.

Indirect Contact Transmission

Spread through contaminated objects or surfaces.

Reservoir

Place where microorganisms survive and multiply.

Portal of Exit

Path used by microorganisms to leave a reservoir.

Portal of Entry

Path used by microorganisms to enter a host.

Susceptible Host

Person lacking immunity to an infectious agent.

How to Break the Chain of Infection

Hand hygiene, proper PPE, safe sharps handling, proper equipment and linen handling.

Asepsis

Absence of disease-causing microorganisms.

Medical Asepsis

Clean technique used to reduce microorganisms and prevent transmission.

Surgical Asepsis

Sterile technique used to eliminate all microorganisms.

Sterile

Free of all microorganisms.

PCRA

Point of Care Risk Assessment performed before every patient interaction.

Purpose of PCRA

Determine infection risks and appropriate precautions.

Factors Considered in PCRA

Interaction/task, environment, client, healthcare worker.

Routine Practices

IP&C measures used with every client in every healthcare setting.

Purpose of Routine Practices

Prevent transmission of infection in all healthcare settings.

Most Important Infection Prevention Measure

Hand hygiene.

Two Methods of Hand Hygiene

Alcohol-based hand rub (ABHR) and soap and water.

When to Use Soap and Water

Hands visibly soiled or client has suspected/confirmed C. difficile.

When to Use ABHR

When hands are not visibly soiled.

4 Moments of Hand Hygiene

Before client contact; before aseptic procedure; after body fluid exposure risk; after client/environment contact.

Medical Gloves Purpose

Additional barrier protection; not a substitute for hand hygiene.

When to Wear Gloves

Contact with blood, body fluids, mucous membranes, non-intact skin, contaminated surfaces.

Hand Hygiene and Gloves

Perform before putting gloves on and after removing them.

Additional Precautions (Tier 2)

Contact, Droplet, and Airborne precautions.

Routine vs Additional Precautions

Routine applies to all clients; additional precautions are added for specific infections.

Contact Precautions Room

Single room preferred; door may remain open.

Contact Precautions Hand Hygiene

Soap and water during outbreaks, C. difficile, or anthrax exposure.

Contact Precautions PPE

Gloves required; gown when contact with client/environment is likely.

Contact Precautions Examples

MRSA, VRE, CPO, C. difficile, impetigo, scabies, pediculosis.

Droplet Precautions Room

Single room preferred; clients separated by 2 m if cohorting.

Droplet Precautions PPE

Mask and facial protection within 2 m of coughing client.

Droplet Precautions Examples

Influenza, rubella, SARS, pertussis, mumps, pneumonia.

Airborne Precautions Room

Airborne Infection Isolation Room (AIIR) with door closed.

Airborne Precautions PPE

N95 respirator required.

Airborne Precautions Examples

Tuberculosis, measles, varicella zoster, disseminated shingles.

AGMP

Aerosol-Generating Medical Procedure.

Examples of AGMP

Intubation, CPR, bronchoscopy, endotracheal suctioning, nebulized therapy, CPAP/BiPAP.

PPE for AGMP

N95 respirator and eye protection.

Respiratory Hygiene

Measures taken to reduce spread of respiratory pathogens.

Respiratory Hygiene Measures

Cough into sleeve, use tissues, discard tissues, wear mask, maintain distance.

Recommended Distance for Respiratory Symptoms

2 metres (6 feet).

Common Antibiotic-Resistant Pathogens

MRSA, VRE, CPO.

Bare Below the Elbows

No long sleeves, watches, or jewelry during patient care.

Items That Can Become Contaminated

Stethoscopes, uniforms, cell phones, badges, name tags.

Uniform Care

Launder daily and change before going home.