PTH 121: Infection Control

What is the 1st requirement for Spread of Infection?

A source: patient, employee, visitor, or contaminated object

True or False: Germs can survive for DAYS on bed rails, walkers, etc?

True

True or False: You DONT need to wash your hands even if you didn’t touch the patient, but you touched surfaces in the patients environment?

False: wash your hands EVEN IF YOU DIDNT touch the the patient, but you touched surfaces in the patient’s environment

True or False: Can there be a risk of contamination from the environment occupied by a patient?

True: “HCW’s were nearly as likely to have contaminated their hands or gloves after touching the environment in a room by a patient…”

What is the 2nd requirement for spread of infection?

A host: person exposed to the bacteria or virus

What is the 3rd requirement for spread of infection?

Means of TRANSMISSION: blood, air, mucous membranes

How were the standard precautions for blood borne pathogens originally developed?

They were created by the Centers for Disease Prevention & Control originally for HIV/AIDS

What was a result of the creation of Standard Precautions for Blood Borne Pathogens?

Everyone were to treat ALL BODY FLUIDS, NONINTACT SKIN, and MUCOUS MEMBRANES as though they were infected

When are Hand Hygiene and Personal Protective Equipment (PPE) used with?

Any body fluid (except sweat), Non intact skin (yours or the patient), Mucus membrane

What are some types of Blood Borne diseases?

HIV/AIDS and Hepatitis A, B, C

How long should you wash your hands for?

20 seconds

When your hands are visibly dirty or contaminated with proteinaceous material or visibly soiled with blood or other body fluids, what should you wash your hands with?

Wash hands with either a nonantimicrobial or antimicrobial soap and water (2002 CDC Hand Washing Guidelines)

If your hands are not visibly soiled, what should you use to disinfect your hands?

Use an alcohol based hand rub for routinely decontaminating hands in all other clinical situations (2002 CDC Guidelines)

WHO has the authority on Hand Hygiene in Health Care?

the World Health Organization (WHO)

Who are at risk for poor adherence to recommended Hand Hygiene?

Physician or CNA status, Male, working in an ICU, working weekday, wearing gowns/gloves, high # of opportunities for hand hygiene/hr of patient care

When should you perform hand hygiene? (Part 1)

When first arriving at work and just before leaving

When should you perform hand hygiene? (Part 2)

Before and after treating each patient

When should you perform hand hygiene? (Part 3)

After removing gloves or other personal protective equipment (PPE)

When should you perform hand hygiene? (Part 4)

Before and after eating, drinking, smoking or using restroom

When should you wash your hands? (Part 1)

After touching blood, body fluids or substances, nonintact skin or mucous membranes

When should you wash your hands? (Part 2)

After possible contact with patient with Clostridium Difficile

True or false: should you wash your **hands** with non-antimicrobial soap and water or with antimicrobial soap and water if contact with spores (e.g., *C. difficile or Bacillus anthracis)?*

True

Why do we need to wash **hands** with non-antimicrobial soap and water or with antimicrobial soap and water if contact with spores?

*because* __***alcohols, chlorhexidine, iodophors, and other antiseptic agents have poor activity against spores***__

What are some types of Personal Protective Equipment (PPE)?

Gloves, gowns, lab coats, face shields, masks, eye protection, resuscitation bags, and pocket masks

When is PPE worn?

When you ANTICIPATE contact with Blood or body fluids, Excretions or Secretions (*except sweat*), mucous membranes, non intact skin, and contaminated surfaces

How is HIV transmitted?

transmitted via blood, semen, rectal fluids, vaginal fluids, and breast milk

Blood Borne Pathogens (BBP) including HIV are ***NOT*** transmitted through…?

saliva, tears, sputum, nasal secretions, vomit, urine or feces **unless they contain visible blood**

If you have a cut, what should you do before putting on gloves?

Cover any cuts

True or false: you should avoid touching with contaminated gloves

True

True or false: you should remove contaminated gloves and perform hand hygiene ASAP?

True

What are some sharp safety precautions to have? (Part 1)

Never bend or break needles

What are some sharp safety precautions to have? (Part 2)

Never set a sharp down

What are some sharp safety precautions to have? (Part 3)

Always use sharps container

What are some sharp safety precautions to have? (Part 4)

Never reach into sharps container

What are some sharp safety precautions to have? (Part 5)

Have container emptied when 2/3 full

What should you know when dealing with an infected person’s dirty laundry? (Part 1)

Wear gloves or wash your hands afterward

What should you know when dealing with an infected person’s dirty laundry? (Part 2)

Don’t shake the dirty laundry

What should you know when dealing with an infected person’s dirty laundry? (Part 3)

Wash on the warmest recommended setting

What should you know when dealing with an infected person’s dirty laundry? (Part 4)

CAN wash with others’ laundry

What should you know when dealing with an infected person’s dirty laundry? (Part 5)

Clean and disinfect the hamper or use a liner

True or false: you should avoid eating/drinking, smoking or personal grooming in areas where you may be exposed to infectious materials?

True

What are transmission precautions used for to protect?

to protect against diseases which are transmitted **through the air, through droplets, or by contact**

What are the 3 categories of Transmission Precautions?

Airborne, droplet, and contact

True or false: a disease may be spread in all THREE WAYS?

True

What is an airborne disease?

Infections spread through the air in small particles (

What are some things you should know about airborne diseases? (Part 1)

May stay in the air a long time

What are some things you should know about airborne diseases? (Part 2)

May travel long distances on air currents

What are some types of airborne diseases? (Part 1)

Tuberculosis

What are some types of airborne diseases? (Part 2)

Varicella (chicken pox)

What are some types of airborne diseases? (Part 3)

Shingles

What are some types of airborne diseases? (Part 4)

Legionella

What are some types of airborne diseases? (Part 5)

Measles

What are some types of airborne diseases? (Part 6)

SARS

What are some types of airborne diseases? (Part 7)

Bird flu

What are some types of airborne diseases? (Part 8)

Small pox

What are some types of airborne diseases? (Part 9)

Plague

What are some Airborne precautions to take? (Part 1)

Hospital policy may require a negative pressure room

What are some Airborne precautions to take? (Part 2)

Donning a respirator (special filter mask, typically N95 which filters out 95% of airborne pathogens) before entering the patient’s room is required

What are some Airborne precautions to take? (Part 3)

Keep the patient’s door closed

What are some Airborne precautions to take? (Part 4)

**If the patient must leave the room, the patient must wear a** __***mask***__ ***(not a respirator)***

What is a mask used for?

Droplet Borne disease

What can a mask stop?

**droplets** (larger particles), splashes and sprays

What is a respirator used for?

Airborne diseases

What does a respirator filter?

Small particles

What type of filter is a respirator?

An N95 or higher filter

What are some TB precautions to take?

Negative pressure room and Respirator rechecked for fit yearly

What is a Droplet Borne Disease?

Larger particles (>5 microns) which can be propelled **up to 3 feet** when an infected person coughs, sneezes, talks, sings, etc

Is Covid-19 an Airborne Disease?

It has been shown to be primarily transmitted by ***respiratory droplets*****, but people within less than 6 feet** of the infected person are most likely to be infected

How are Droplet Borne Disease spread?

Spread through close respiratory or mucous membrane contact with an infected person’s respiratory secretions

How are Droplet Borne Disease transmitted?

Transmission occurs via contact with mucous membranes of mouth, nose or eyes

What are some types of Droplet Borne diseases? (Part 1)

Covid-19

What are some types of Droplet Borne diseases? (Part 2)

Meningitis

What are some types of Droplet Borne diseases? (Part 3)

Pneumonias

What are some types of Droplet Borne diseases? (Part 4)

Rhinovirus (colds)

What are some types of Droplet Borne diseases? (Part 5)

Influenza (flu)

What are some types of Droplet Borne diseases? (Part 6)

Rubella (German measles)

What are some types of Droplet Borne diseases? (Part 7)

Diphtheria

What are some types of Droplet Borne diseases? (Part 8)

Pertussis (whooping cough)

What are some types of Droplet Borne diseases? (Part 9)

Strep (sore throat & scarlet fever)

What are some types of Droplet Borne diseases? (Part 10)

mumps

What are some types of Droplet Borne diseases? (Part 11)

Streptococcal invasive disease

What are some Droplet precautions? (Part 1)

Don gloves

What are some Droplet precautions? (Part 2)

Don a mask upon entering the patient’s room if you’ll be within 3-6 feet

What are some Droplet precautions? (Part 3)

Remove PPE before leaving the room

What are some Droplet precautions? (Part 4)

**CDC** makes no recommendation for ***routinely*** wearing eye protection (unless it’s COVID)

What are some Droplet precautions? (Part 5)

Place patient in a private room

What are some Droplet precautions? (Part 6)

Patient must wear mask to leave room

What are some Droplet precautions? (Part 7)

Don’t share patient equipment- stethoscope, walker, etc

What is contact Transmission?

Germs spread by direct contact, usually hands

What is the main mode of disease spread by contact?

Health care worker’s hands

What disease is spread by direct contact? (Part 1)

VRE: Vancomysin Resistant Enterococcus

Where is VRE normally found in?

Bacteria normally present in intestinal and female genital tract

What disease is spread by direct contact? (Part 2)

MRSA: Methicillin Resistant Staph Aureus

What does MRSA infect?

Infects skin, bones, joints, surgical wounds, the bloodstream, heart valves and lungs

How is MRSA spread by?

Spread by contact with infected area, but also by sharing towels and razors

What are some MRSA precautions to take? (Part 1)

Put on gloves when entering the room

What are some MRSA precautions to take? (Part 2)

Put on gown if you will contact the patient or surfaces

What are some MRSA precautions to take? (Part 3)

Remove PPE before exiting room

What are some MRSA precautions to take? (Part 4)

Do not share patient equipment

What are some MRSA precautions to take? (Part 5)

If you must transport patient, change his gown and have him perform hand hygiene