Infection Control

%%Infection Control%%

  • Infection control
    • Prevent spread of infectious diseases
  • Pathogens
    • Disease-causing microorganisms (germs)
  • Infectious disease
    • Caused by growth of pathogens
  • Epidemic
    • Widespread occurrence of infectious disease
  • Pandemic
    • Disease spread over a wide area, even worldwide

%%Types of Infections%%

  • Generalized or systemic
    • Affecting whole body
    • May include headache, fever, vomiting, fatigue
  • Localized
    • Affecting one area of body
    • Red, swollen, warm, and painful

%%Scope of the Problem%%

  • Health care facilities have high concentrations of germs
  • Nosocomial infection (HAI or health care- associated infection)
    • Occurs while patient is receiving health care
    • 36% increase over past 25 years
  • Industrial illness
  • Sharps injuries
    • Continuing cause of illness and death

Needlestick injuries

  • High number of injuries
  • Safety devices being developed

%%Regulatory Agencies%%

  • Centers for Disease Control and Prevention (CDC)
    • Federal agency
    • Studies causes and distribution of diseases
  • Occupational Safety and health Administration (OSHA)
    • Establish workplace health and safety standards
    • Enforce the standards

%%Microorganisms%%

  • Very small, usually one-celled living plants and animals
  • Not all are harmful
    • Normal flora
    • Some necessary for body function
  • Immune response
    • Body’s defense against infection
  • Antibodies
    • Proteins that fight pathogens
  • Opportunistic infection
    • Infection due to body’s weakened condition
  • Aerobic
    • Need oxygen to live
  • Anaerobic
    • Don’t require oxygen to live
  • Environment
    • Human body provides moisture, darkness, and food supply
  • Food supply
    • Hosts
    • Living organisms that supply food
    • Neutralism: microorganism does not cause harm
    • Parasitic: microorganism causes damage to host

%%Microbes%%

  • Pathogenic microorganisms
    • Cause diseases
  • Five types
    • Bacteria
    • Viruses
    • Fungi
    • Rickettsia
    • Protozoa

%%Bacteria%%

  • Can be pathogenic or nonpathogenic
  • One-celled organisms
  • Many produce toxins

%%Bacterial Infections%%

  • Most can be treated with antibiotics
    • Destroy bacteria or inhibit growth
    • Drugs attack specific types of bacteria
  • Identifying the type
    • Gram staining
    • Cultures

%%Spores%%

  • Protective coating on bacteria cells
  • Bacteria can be dormant for years
  • Killed by very high temperatures

%%Viruses%%

  • Smallest type of microbes
  • Incomplete cells
    • Depend on living cells for nutrients and reproduction
  • Cause common cold, influenza, hepatitis B, AIDS, many others
  • Multiply quickly
  • Difficult to treat
    • Resistant to disinfectants
    • No drugs available that destroy them
    • 3 FDA approved drugs inhibit their growth

%%Fungi%%

  • Neither plant nor animal
    • Unique organisms
  • Two types
    • Yeasts: one-celled
    • Molds: multi-celled
  • Some are nonpathogenic
    • penicillin
  • Some cause chronic, recurrent infections
    • Ringworm, athlete’s foot
    • Systemic infections
    • Very difficult to treat

%%Rickettsia%%

  • Smaller than bacteria
  • Parasitic
    • Must live inside another organism
  • Cause typhus and Rocky Mountain spotted fever

%%Protozoa%%

  • Classified as animals
  • Consist of one cell
  • More than 50,000 types identified
  • Found in decayed materials, contaminated water, sewage waste
  • Cause dysentery, trichomoniasis, malaria

%%Body’s Defense Mechanisms%%

  • Cilia in respiratory tract
  • Cough and sneeze
  • Tears
  • Hydrochloric acid in stomach
  • Mucous membranes
  • Rise in body temperature
  • Increase in leukocytes (white blood cells)

%%Chain of Infection%%

  • Links in the chain

    • Infectious agent
    • Reservoir host
    • Portal of exit
    • Route of transmission
    • Portal of entry
    • Susceptible host

  • Breaking any link prevents infection

    Chain of Infection

%%Infection Control%%

  • Decrease source of microorganisms

    • Wash hands
    • Practice aseptic techniques
    • Avoid contact when contagious

    5 moments of hand hygiene

%%Handwashing%%

  • “Single most important procedure for preventing health-care acquired \n infections” (CDC)
  • Use proper technique
  • Any time you might transfer microbes
    • Examples: when coming on duty, between patients, after touching contaminated \n object

%%Aseptic Techniques%%

  • Methods for making environment as pathogen free as possible
  • Bacteriostatic
    • Inhibits growth of microorganisms
  • Bacteriocidal
    • Kills microorganisms
  • As microbes mutate, harder to kill them

%%Medical Asepsis%%

  • Decrease number of pathogens
  • Handwashing, clean rooms, use gloves

%%Surgical Asepsis%%

  • Completely eliminate pathogens
  • Sterile technique
    • Wear sterile caps, gowns, gloves
    • Sterilize instruments
    • Maintain sterile field

%%Sterile Field%%

  • Area designated as free of microorganisms
  • Procedures
    • Sterile object cannot touch nonsterile one
    • Cannot be wet
    • Constantly observe
    • Do not reach over
    • Keep hands above waist
    • Do not talk or cough over sterile field

%%Preventing Infections Chemical and Physical Methods%%

  • Antiseptics
    • Chemical agents that inhibit growth of pathogens
    • Can be used on skin
    • Example: 70% isopropyl alcohol
  • Disinfectants
    • Chemical agents that destroy most bacteria and viruses
    • Nonpenetrating instruments and environment
    • Example: 10% bleach solution
    • Boiling water to clean instruments (rarely used today)
  • Sterilization
    • Agents or methods that completely destroy microorganisms
    • Examples: steam, gas, radiation
    • Autoclave, steam from pressure, commonly used

%%Preventing Infections Standard Precautions%%

  • Procedures to prevent spread of infection
  • Potentially infectious fluids
    • All body fluids, including blood
    • Nonintact skin
    • Mucous membranes
  • Use with every patient

%%Standard Precautions Environmental Control%%

  • Clean and disinfect surfaces, furniture, objects
  • Handle and clean linens properly
  • Dispose of infectious waste properly
  • Place patients with contagious infections in private rooms, if possible

%%Standard Precautions Blood-Borne Pathogens%%

  • Spread through contact with blood
  • Common means of infection is from injury using needles and sharp \n instruments
  • Do not recap needles
  • Use puncture-proof containers for disposal
  • Use protection when performing resuscitation

%%Preventing Transmission of Microorganisms%%

  • Wear personal protective equipment (PPE)
  • Follow transmission precautions

%%Preventing Transmission of Pathogens Personal Protective Equipment%%

  • Gloves, masks, eyewear, gowns, caps
  • OSHA requires use when infection possible
  • Must be put on and removed correctly to be effective
  • Available in sterile and nonsterile forms

%%Preventing Transmission of Pathogens Transmission Precautions%%

  • Types of infection transmission
    • Airborne
    • Droplet
    • Contact
  • Patient placed in private room
  • Contact with others limited
  • Each type of transmission requires special handling
  • Consequences to patient, staff, and visitors
  • Impact on facility
  • Neutropenic precautions
    • Used to protect patients highly susceptible to infections
    • includes isolation

%%Preventing Infection Maximize Resistance%%

  • Provide good hygiene
  • Ensure proper nutrition and fluid intake
  • Decrease stressors that weaken immune response