infection control

Infection Control

Micro-organisms

  • Micro-organisms are defined as any organism of microscopic size that can cause disease or illness.

Infectious Agents

  • Types of infectious agents include:

    • Bacteria:

    • Transmitted through air, food, water, soil, vectors, or bodily fluids.

    • Viruses:

    • Smaller than bacteria and require a host for replication.

    • Fungi:

    • Includes both beneficial and harmful types.

    • Example: Candida is a beneficial fungus that can overgrow and cause issues under certain conditions.

    • Parasites:

    • Organisms that live off others without providing benefit.

    • Thrive in water environments.

    • Prions:

    • Cause neurodegenerative diseases and are untreatable and fatal; e.g., mad-cow disease.

    • Multi-drug-resistant organisms:

    • Microbes evolve over time to survive and create resistance to treatments.

Reservoirs

  • Reservoirs are environments in which infectious agents live, grow, and reproduce. Types of reservoirs include:

    • People

    • Water

    • Food

Susceptible Hosts

  • Individuals may exhibit certain traits that affect their susceptibility and the severity of disease, including:

    • Immune Deficiency

    • Diabetes

    • Burns

    • Surgery

    • Age

Chain of Infection

  • The chain of infection describes how infections are transmitted, which includes:

    • Portals of Entry: The ways in which the infectious agent enters the susceptible host.

    • Examples of Portals of Entry:

      • Mucous membranes, respiratory system, digestive system, broken skin.

    • Modes of Transmission: The methods by which the infectious agent is spread from the reservoir to the susceptible host.

    • Examples of Modes of Transmission:

      • Physical contact, droplets, airborne.

    • Portals of Exit: The pathways through which the infectious agent leaves the reservoir.

    • Examples of Portals of Exit:

      • Blood, secretions, excretions, skin.

Multi-Drug Resistant Organisms

  • Common multi-drug resistant organisms include:

    • MRSA: Methicillin-resistant Staphylococcus aureus; can be acquired through the community or hospital.

    • VRE: Vancomycin-resistant Enterococcus.

    • PRSP: Penicillin-resistant Streptococcus pneumoniae.

    • CDAD: Clostridium difficile associated diarrhea (C-diff).

Aseptic Practices

  • Medical Asepsis:

    • Measures taken to control and reduce the number of pathogens present.

    • Known as “clean technique”.

    • Includes practices to prevent the spread of disease/illness, such as handwashing and disinfecting.

  • Surgical Asepsis:

    • Known as “sterile technique”.

    • Requires being free of ALL organisms.

    • Used for procedures involving entry into sterile body cavities, such as IM injection and Foley catheter insertion.

Personal Protective Equipment (PPE)

  • Essential PPE in a healthcare setting includes:

    • Masks and Respirators

    • Gowns

    • Caps and Shoe Coverings

    • Gloves

    • Goggles or Face Shields

    • Private Rooms

Healthcare-associated Infections (HAI)

  • Also known as nosocomial infections, these are infections that clients contract while in the healthcare setting.

  • The longer a client is in a facility, the greater the risk of infection.

  • Factors contributing to HAIs include:

    • Environmental contaminants (contaminated items).

    • Therapeutic regimens (e.g., Foley catheters, IVs, etc.).

Standard Precautions

  • General guidelines that everyone must follow, which include:

    • Clean hands when entering and leaving a room.

    • Cover mouth and nose with arm or tissue when coughing or sneezing.

    • Wear gown, glove, and face protection for any risk of body fluid contact.

  • Specific actions for doctors and staff:

    • Wear appropriate masks, eye cover, gown, and gloves if contact with body fluids is likely.

Standard Precautions Equipment

  • Designed to prevent skin and mucous membrane exposure and cross-contamination.

  • Ensure cleaning and processing of reusable equipment.

  • Special precautions must be taken when handling spills.

  • Soiled linen should be handled to prevent contamination of skin, mucous membranes, and clothing.

  • Sharps:

    • Do not recap, bend, or break needles.

    • Place immediately in sharps containers.

Isolation Precautions

  • Airborne Precautions:

    • For small particle droplets that can remain suspended and widely dispersed in the air.

    • Requires the use of a negative pressure room and an N95 mask for healthcare workers.

    • Surgical masks are required for patients when leaving the room.

  • Droplet Precautions:

    • For large particle droplets that require disposal within 3-6 feet.

    • Masks must be used within the patient’s room, with the patient wearing a mask when leaving.

  • Contact Precautions:

    • Pathogens transmitted by hands or skin-to-skin contact.

    • Gloves and gowns must be used when in the room.

  • Protective/Reverse Isolation:

    • Used for immunocompromised patients to protect them from contamination.

    • Fresh fruits/vegetables and flowers are prohibited in the room.

    • Staff and patients must wear masks while in the room and when the patient leaves the room.