Infection Control

Why is Infection Control Important?

Hospitals are concentration centers of disease, patients are at a higher risk

Hospital Acquired Infections (HAI)

Nosocomial infections. Infection due to being in a health care facility.

Infections and Diseases

Seasonal colds/flus, COVID, Disease carried by insect, Foodborne Illness, Natural disasters, STDs, TB

CDC

Center of Disease Control

WHO

World Health Organization (track Asia to predict flu)

Pathogens

microscopic organisms that cause disease, may lie dormant for long periods of time and then become active when the environment modifies and becomes ideal for fostering growth.

Bacteria

single cell organism with simple cellular structure and no nucleus. Colonies. classified on shape. Strep throat, pneumonia, c-diff, food poisoning.

Viruses

obligate intracellular parasites, cannot survive for long outside of living cell. cannot replicate on their own. replicates itself in a cell until it explodes the cell. Examples: common cold, COVID-19, mono, and warts

Fungi

Eukaryotic organisms with membrane bound nucleus. Macroscopic. Travel via dispersal. Infect skin, nails, hair, circulatory/lymph systems. Athletes foot, ringworm, valley fever.

Protozoan Parasites

Unicellular Organisms, neither plant nor animal, larger than bacteria no cell wall, mobile, malaria

Infectious Agents

micro-organisms capable of causing disease or illness

Infectious Agents Examples

Bacteria, Fungi, Parasites, Prions

Reservoirs

Place in which infectious agents live, grow, and reproduce

Reservoir Examples

Peopel, Water, Food

Portals of exit

Ways in which infectious agent leaves the reservoir

Portals of Exit Examples

Blood, Secretions, Excretions, Skin, Cough/air droplets

Modes of Transmission

Ways in which the infectious agent is spread from the reservoir to the susceptible host

Modes of Transmission Examples

Physical contact (direct and indirect), Droplets, Airborne

Portals of Entry

Ways in which the infectious agent enters the susceptible host

Portals of Entry Examples

Mucous Membrane, Respiratory System, Digestive System, Broken Skin

Susceptible Host

Individuals may have traits that affect their susceptibility and severity of disease

Susceptible Host Examples

Immune Deficiency, Diabetes, Burns, Surgery, Age,

Breaking chain of infection - Infectious Agent

Sterilization

Breaking chain of infection - Reservoirs

Sanitizing environment and Antimicrobial drugs

Breaking chain of infection - Portals of Exit

Hand Washing, Covering Secretions, Trash Disposal

Breaking chain of infection - Means of Transmission

Isolation, Food Handling, Airflow Control, Universal Precautions, Sterilizations, Hand Washing

Breaking chain of infection - Portal of Entry

Covering Potential Entry Points

Breaking chain of infection - Susceptible Host

Recognitions of High-Risk Patients, Treatment of Underlying Disease

Most Effective means of stopping the spread of disease:

Hand Washing, always perform hand hygiene before and after wearing gloves!

When to Perform Hand Hygiene in a Health Care Setting

Before and after every patient, donning and removing gloves, eating, going to the restroom, Before beginning any aseptic task (biopsy/invasive procedure), Before and after touching any part of the patient's environment (ex: bedrail), After contact with blood, body fluids and contaminated surfaces

Alcohol-Based Sanitizer

Before touching patient, performing a aseptic task, moving from a soiled work environment to a clean environment, After touching a patient or the patient's immediate environment, After contact with blood, body fluids, or contaminated surfaces, Immediately after removing gloves

Soap and Water

When hands are visibly soiled, After caring for a person with known or suspected infectious diarrhea (possible C. Diff) , After known or suspected exposure to spores, Before and after eating, After using restroom

Health Care Worker Infection Control through dress

Appropriate Clothing, Appropriate Hairstyle, Fingernail Care, Jewelry

Also Most Important: Disinfection (Medical Asepsis)

Commonly refers to destruction of pathogens on inanimate objects by chemical means, Chemical disinfection is not always effective against spores, Read the labels, Use gloves (can damage liver), Be careful and ask before using disinfectant on image receptors, Specialized Wipes Based on Type of Infection, Purple and Orange (bleach)

Linen Use and Disposal in Hospitals

Wash hands before handling clean linen, Keep clean linen stored under cover or in cabinet, In Radiology Department- one time use, the deposit in linen receptacle (we will use hundreds of sheets everyday)

Disposal of Items

Soiled with body fluids (blood, etc.) - red biohazard bag, Patient information - shred box, Sharps - sharps container, Non-soiled material - regular trash (tissues)

Surgical Asepsis (disinfection → reduction)

Prevents contamination of pathogens before, during, and after surgery through the use of sterile technique, Scrubbing for surgery, Radiology examples: biopsy, arteriogram, cardiac catheterization

Sterilization (destroy everything)

Process of steam, dry, or moist heat, gas, chemicals, or radiation to destroy ALL pathogens and spores, Material is then packaged in a manner to indicate sterility

Sterile Field / What is considered Sterile?

The table area (air) above the sterile field, The area of the sterile person's sleeves of the gown from about 2-in above the elbows to the cuff, Sterile person's chest to the level of the field

What is considered Contaminated?

"Sterile" persons back, neckline, below the waist, The outer border of the sterile field (about 1 inch), Below the level of the patient and the field

Sterile Fields - Operating Rom

Sterile field must be continuously monitored, Doubts about sterility - assume object is unsterile, Any sterile object or field touched by an unsterile object or person becomes contaminated, Sterile objects/materials must remain dry, Never reach across a sterile field, Do not pass between a patient and the sterile field - sterile corridor, Sterile persons pass each other back-to-back

Sterile Field - Specialized Imaging Procedures

Have everything out and within reach before beginning, Be sure others recognize the sterile field, Do not reach over field when opening packages, and do not turn away from field, "All-or-nothing"; doubt=contamination, Discard suspicious items (damp, broken seal, unclear sterilization indicator tape, expired date, etc.), Never leave the sterile field unattended

Sterile Technique - Opening a Sterile Tray

Keep clothing away, Specific order of opening sterile trays, May drop sterile items onto field, but do not reach over

OR Dress Protocol

Booties, Cap, Mask (with hair pulled back), Surgical Handwashing ("scrubbing"), Gown (with/without assistance), Gloves (surgical method)

Standard Precautions

Refers to ALL contact with ALL body substances, All patients are considered potentially infectious, Wear gloves to avoid unanticipated contact, Wear gloves to clean spills or work with specimens, Personal Protective Equipment includes gloves (NOT STERILE), gowns, masks, goggles, shoe covers, hats

Patients with Isolation

Understand each isolation patient's pathology, Patients may feel rejected and untouchable, Be empathetic and friendly, and safe

Contact Precautions

Spread through direct contact, Handwashing, gloves, gown, and mask as necessary, Ex: MRSA

Droplet Precautions

DROPLET = particles > 5 microns in size (larger), Handwashing, gloves, mask

Airborne Precautions: TB (Covid)

spread through respiratory contact, Respirator mask (aka "N-95" mask), Fit - testing, Gown as necessary, Students are not fit-tested; DO NOT interact with patients in airborne precaution rooms

Protective Precautions (Reverse Isolation)

Immunocompromised patients with low resistance to pathogens in the environment, Ex: organ transplant, immunosuppressed, drug therapy patients, burn patients, neonates, AIDS, etc. , DO early in the day, if possible, use two-person team, clean equipment before procedures, Ex. entering bone marrow unit or burn unit

Performing Procedures on Patients in Isolation

Remember radiation protection even with complicated cases, Have RN assist with neonatal, nursery and ICU cases, Move mobile radiography units while processing images in case of emergency., Clean equipment after each isolation case, Do non-emergency/portable isolation cases when the department is most empty, Follow protocols

Performing Procedure on Patients in Isolation (two-person)

Two-person team approach works well, especially on portables, One RT operates the equipments and works indirectly with patient, DOES NOT come into direct contact with patient, The other RT works directly with and comes into direct contact with the patient

Remember- YOU are also at risk

Follow proper procedures/precautions, Utilize available devices/products, Wash Hands!, Get immunized! Stay immunized with boosters, Be aware and prudent, In the event of an exposure, follow post-exposure protocols