Chapter 31: Infection Control - Precautions and Standards Notes

Infection Control Precautions and Standards

  • Universal Precautions (1985)

    • Established by the CDC to protect against HIV, HBV, and bloodborne pathogens.

    • Treat all blood and bodily fluids as if contaminated.

    • Later revised to consider all moist body secretions as contaminated (except sweat).

    • Essential practices:

    • Proper hand hygiene.

    • Use of gloves during invasive procedures (e.g., venipuncture).

  • Hepatitis and HIV/AIDS Overview

    • Hepatitis A (HAV)

    • Transmission: Fecal/oral, sexually transmitted.

    • Symptoms: Fever, loss of appetite, jaundice, nausea, dark urine, light-colored stools.

    • Hepatitis B (HBV)

    • Transmission: Contact with contaminated body fluids (blood, saliva, breast milk).

    • Symptoms: Similar to HAV; 30% have no symptoms, but can lead to serious long-term effects.

    • Hepatitis C (HCV)

    • Transmission: Predominantly through sharing needles; mother to baby during birth.

    • Symptoms: 80% are asymptomatic; mimic HAV/HBV if symptoms occur.

    • HIV/AIDS

    • Transmission: Sexual contact, mother to child, contact with contaminated blood.

    • Symptoms of HIV: Fatigue, weight loss, night sweats can lead to AIDS.

  • Standard Precautions

    • Established by the CDC for all patients, irrespective of infection status.

    • Focuses on reducing transmission risk.

    • Essential components:

    • Hand washing and use of PPE (gloves, gowns, masks).

COVID-19 Pandemic Impact on Infection Control

  • Emergence of a new coronavirus led to widespread infectious disease prevention initiatives.

    • First confirmed U.S. case on January 21, 2020.

    • Asymptomatic individuals can transmit the virus.

    • CDC guidelines:

    • Wear masks and face coverings.

    • Avoid touching face.

    • Regular cleaning and disinfection of surfaces.

    • Hand hygiene with soap and alcohol-based sanitizers.

Transmission-Based Precautions

  • Implemented for patients with known or suspected infections, divided into:

    • Airborne Precautions: For diseases like TB; require isolation and use of masks/gowns by healthcare personnel.

    • Droplet Precautions: Used with conditions spread via droplets; masks required for healthcare staff.

    • Contact Precautions: Conditions spread via skin-to-skin contact or contaminated surfaces (e.g., hepatitis, scabies).

Bloodborne Pathogen Standards (1991)

  • OSHA Standards

    • Regulations to protect healthcare workers from exposure to bloodborne pathogens.

    • Key components:

    • Establish exposure control plans and universal precautions.

    • Use engineering controls and PPE (gloves, gowns).

    • Provide training and medical evaluations for employees.

    • Maintain worker medical and training records.

Hand Hygiene Practices

  • Frequent and thorough hand hygiene is critical in infection control, performed as follows:

    • Handwashing: Use soap and warm water for at least 20 seconds or alcohol-based rubs. Important to wash hands before eating, after the restroom, and when visibly soiled.

    • Glove Use: Apply and remove gloves without contamination, ensuring proper disposal in biohazard containers when applicable.

Personal Protective Equipment (PPE)

  • PPE is essential to prevent infection transmission and should include:

    • Gloves, masks, gowns, and face shields as per the situational risk.

    • Procedures for correctly donning and doffing PPE help maintain asepsis.

  • Medical Asepsis: Involves practices to reduce the risk and spread of pathogens post-body exit, including proper waste handling and disinfecting surfaces.

Conclusion

  • Understanding infection control protocols is vital in ensuring safety for patients and healthcare workers. This includes adhering to standards, practicing proper hygiene, using PPE, and recognizing types of infections and their transmission methods..