Infection control summary

Sterile Technique and Asepsis

Sterility

• Sterile: Absence of all microbes (pathogens and non-pathogens).

• Sterilization: Process of destroying microbes.

• Contamination: Process of becoming unclean; requires re-sterilization to regain sterility.

Medical Asepsis

• Clean: Free of pathogens, but other non-harmful microbes may be present.

• Contamination: Occurs when any pathogens or non-pathogens are present on a sterile item or area.

• Medical asepsis focuses on eliminating pathogens, while sterility means the absence of all microbes.

Aseptic Practices

• Breaks the chain of infection by eliminating the mode of transport.

• Hand hygiene is crucial before and after patient care.

• Use hand sanitizer or wash hands before and after touching a person or their belongings.

• Be mindful of what you touch after providing care to avoid cross-contamination.

Supplies and Equipment

• Disposable items: Intended for single-use to prevent infection spread.

• Discard single-use items immediately after use, even on the same person, to prevent microbial growth and multiplication.

• Multi-use items: Can be used multiple times by the same person but should never be borrowed.

• If borrowing is necessary, disinfect thoroughly before and after use.

• Non-disposable items: Cleaned, disinfected, and sterilized to eliminate all types of microbes.

Cleaning, Disinfection, and Sterilization

• Cleaning: Reduces the number of microbes and removes organic matter (e.g., skin flakes, blood).

• Disinfection: Destroys pathogens but may not eliminate spores.

• Spores: Resistant and require specific methods like bleach for removal.

• Clostridium difficile (C. Diff): Example of bacteria that forms spores; requires bleach or thorough handwashing with soap and water for removal.

• Sterilizing: Destroys all pathogens, non-pathogens, and spores; achieved through high temperatures, UV light, or chemical sterilants.

• Home Sterilization: Can be done by boiling items for 5-10 minutes or using a vinegar solution (3 cups water, 1 cup vinegar).

• Autoclave: Lab equipment that uses very high temperature and UV light to sterilize.

Isolation Precautions

• Based on the mode of transmission (airborne, droplet, bloodborne, contact).

• Blood, body fluids, secretions, and excretions can transmit pathogens.

• Barriers (PPE) needed to contain pathogens within a specific area or person.

• Guideline: CDC's "Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings" (updated frequently).

CDC Guidelines

• Followed by hospitals, nursing homes, and rehabilitation centers to prevent disease spread.

• Prevent the spread of communicable (contagious) diseases, not non-contagious conditions.

• Isolation precautions based on clean vs. dirty and how the pathogen spreads.

• Clean areas/objects: Free of pathogens.

• Dirty areas/objects: Contaminated with pathogens.

Two Tiers of Precautions

• Standard precautions: Basic measures like hand hygiene and bloodborne pathogen protocols for all interactions.

• Transmission-based precautions: Additional measures based on the specific communicable disease.

• Droplet precautions: For diseases spread through saliva or respiratory droplets (e.g., flu).

Standard Precautions Details

• Reduce the risk of spreading known and unknown infections.

• Hand hygiene: Before and after patient care.

• Gloves: Wear when touching anything "wet and yucky" that isn't yours.

• Prevent spread of infection from blood, body fluids, secretions, excretions, and non-intact skin.

• Mucous membranes (nose, mouth, eyes): Easy entry points for bacteria.

Protective Measures

• Involve PPE, proper removal of linens, trash, and equipment from the room.

• Double bagging: Required if items are visibly soiled, leaking, or dripping.

• Agency procedures: Follow when collecting specimens and transporting people.

• PPE: Put on before entering the room, remove before exiting, and dispose of properly inside the room.

PPE Usage

• Gloves: Wear when contact with blood, body fluids, secretions, excretions, mucous membranes, or non-intact skin is likely.

• Gowns: Protect clothes and body from splashes or sprays; cover from neck to knees; disposable and used only once; change if wet.

• Masks: Protect from infectious materials carried in the air, splashes, or sprays; tuberculosis respirators (N95 masks) used for TB and require fitting.

• Goggles and Face Shields: Protect eyes, mouth, and nose from splashes or sprays; front is considered contaminated; clean reusable eyewear between uses.

Handling Contaminated Items

• Bag contaminated items before removing them from the room.

• Use leak-proof plastic bags with biohazard symbol.

• Biohazardous waste: Items contaminated with blood, body fluids, secretions, or excretions.

• Special measures for discarding regulated waste: Use closable, puncture-resistant, leak-proof, color-coded containers with the biohazard symbol.

• Double bagging: Needed if the outside of the first bag is wet, soiled, or potentially contaminated.

Transporting Procedures

• Vary among agencies; ensure the person being transported is protected from transmitting the infection to others.

Meeting Basic Needs

• Isolation precautions can affect love, belonging, and self-esteem needs.

• People may feel lonely, unwanted, or rejected.

• Treat individuals with respect, kindness, and dignity, and explain why precautions are necessary.
  *Remind them that you are making sure that you don't transport any of the germs that may be in the room to another person.

Bloodborne Pathogen Standard

• Protects healthcare team from exposure to HIV and HBV.

• Found in blood and other potentially infectious materials (OPIM).

• Spread through blood and OPIM.

Exposure Control Plan

• Every agency required to have one.

• Identifies staff at risk for exposure to blood or OPIM.

• Outlines steps to take in case of an exposure incident.

• Staff at risk receive free training upon employment and annually.

Preventative Measures

• Hepatitis B vaccination recommended.

• Engineering and work practice controls: Reduce employee exposure in the workplace.
  *Make sure to use/wear your PPE.

Contaminated Equipment and Agency Maintenance

• Contaminated Equipment: Clean and decontaminate with the proper disinfectant.

• Accidental Spills: Clean those immediately.

• Contaminated Laundry: Follow special measures to ensure it does not come in contact with other items.

Exposure Incidents with Blood

• Eye, mouth, or other mucous membrane, non-intact skin, or parenteral contact with blood or OPIM.

• Parenteral: Piercing the mucous membranes or the skin.

• Always, always report exposure incidencts at once, immediately.

• Confidentiality is very important, so you do need to report what you were doing and if you were in contact with somebody, where as you have to follow confidentiality, but it is imparative that one does report the incidents.

Surgical Asepsis

• Keep equipment and supplies free of all microbes.
  *Sterile is all non-pathogens as well as pathogens/spores.

• 
  Surgery, punture, etc when sking/steril tissues are entered.