infection FC

Definition of Infection

Infection is the invasion and multiplication of harmful microorganisms (such as bacteria, viruses, fungi, and parasites) in the body, leading to disease or tissue damage.

• Not all microorganisms cause infection—some are harmless or even beneficial (e.g., normal flora).

• Infections can be localized (limited to one area) or systemic (spread throughout the body).

Infectious Diseases

These are diseases caused by pathogenic microorganisms that can spread from one person to another.

Types of Infectious Agents

1. Bacteria

• Single-celled microorganisms that reproduce rapidly.

• Some bacteria are beneficial (e.g., gut bacteria), while others cause disease (e.g., Mycobacterium tuberculosis causes TB).

• Treated with antibiotics, but misuse can lead to antibiotic resistance.

2. Viruses

• Smaller than bacteria and need a host cell to reproduce.

• Examples:

• HIV (causes AIDS)

• Influenza virus (causes flu)

• Hepatitis B virus (affects the liver)

• Cannot be treated with antibiotics—require antiviral medications or vaccines.

3. Fungi

• Can be yeasts (unicellular) or molds (multicellular).

• Some are harmless, while others cause diseases like athlete’s foot or ringworm.

• Treated with antifungal medications.

4. Parasites

• Organisms that live on or inside a host and get their nutrients from the host.

• Examples:

• Plasmodium (causes malaria)

• Ascaris lumbricoides (causes worm infections)

• Treated with antiparasitic medications.

Types of Infections

Infections can be classified based on their cause, location, or duration.

1. Primary Infection

• The initial infection caused by a pathogen in a previously healthy person.

• Example: A person getting influenza (flu) for the first time.

2. Secondary Infection

• An infection that occurs after or because of a primary infection, often due to a weakened immune system.

• Example: A person with influenza developing pneumonia due to a weakened respiratory system.

3. Local Infection

• Infection is limited to a specific area of the body.

• Symptoms include redness, swelling, pain, and pus at the infection site.

• Example: A wound infection or a boil on the skin.

4. Systemic Infection

• Infection spreads throughout the entire body via the bloodstream or lymphatic system.

• Symptoms include fever, chills, body aches, and fatigue.

• Example: Septicemia (blood infection).

5. Acute Infection

• Short-term infection that develops quickly and resolves within days or weeks.

• Symptoms are severe but do not last long.

• Example: Common cold, cholera.

6. Chronic Infection

• Long-lasting infection that may persist for months or years.

• Symptoms may be mild or intermittent but can cause long-term damage.

• Example: Tuberculosis (TB), Hepatitis B.

7. Iatrogenic Infection

• Infection that occurs as a result of a medical procedure or treatment.

• Example:

• Surgical wound infection after an operation.

• Infection from poorly sterilized medical instruments.

8. Healthcare-Associated Infection (HAI)

• Also known as nosocomial infections, these occur in a hospital or healthcare setting.

• Patients with weak immune systems are at higher risk.

• Example:

• Urinary tract infections (UTIs) from catheters.

• Methicillin-resistant Staphylococcus aureus (MRSA) infections.

Normal Flora of the Human Body

The normal microbial flora consists of microorganisms that live on or inside the human body without causing disease under normal conditions. These microorganisms play a role in protecting the body and maintaining health.

1. Types of Normal Flora

a) Resident Flora

• Microorganisms that permanently live on the body in specific locations.

• They help with digestion, immune function, and preventing harmful infections.

• Example: Lactobacillus in the vagina, Staphylococcus epidermidis on the skin.

b) Transient Flora

• Microorganisms that temporarily exist on the skin or mucous membranes but do not permanently stay.

• They can cause infection if the immune system is weak or if they enter sterile body areas.

• Example: Escherichia coli (E. coli) on hands after using the toilet.

2. Role of Resident Flora

✅ Protection against pathogens – Prevents harmful bacteria from colonizing.

✅ Vitamin production – Some bacteria, like those in the gut, produce Vitamin K and B-complex vitamins.

✅ Immune system stimulation – Helps develop immunity by exposing the body to small amounts of microbes.

3. Advantages of Normal Flora

• Prevents the growth of harmful bacteria by competing for nutrients and space.

• Aids in digestion and vitamin production.

• Helps maintain a healthy immune system.

4. Disadvantages of Normal Flora

❌ Can cause opportunistic infections if the immune system is weak.

❌ Overgrowth in certain areas can lead to infections (e.g., yeast infection caused by Candida albicans).

❌ If normal flora enters sterile body sites, it can cause disease (e.g., E. coli from the gut entering the urinary tract and causing UTI).

5. Normal Flora in Different Body Parts

Body Part Examples of Normal Flora

Skin Staphylococcus epidermidis, Staphylococcus aureus

Conjunctiva (eyes) Staphylococcus spp., Corynebacterium spp.

Nose & Nasopharynx Staphylococcus aureus, Streptococcus pneumoniae

Mouth & Upper Respiratory Tract Streptococcus mutans, Candida albicans

Gastrointestinal Tract. Escherichia coli, Bacteroides spp., Lactobacillus

Genitourinary Tract Lactobacillus (in females), Corynebacterium spp.

Healthcare-Associated Infections (HAIs)

Healthcare-Associated Infections (HAIs) are infections that patients acquire during healthcare delivery in hospitals, clinics, or other medical facilities. These infections were not present at the time of admission and usually occur after 48 hours of hospitalization.

1. Effects and Examples of HAIs

HAIs can cause:

❌ Prolonged hospital stays – leading to increased healthcare costs.

❌ Serious complications – such as sepsis, pneumonia, or organ failure.

❌ Increased mortality rates – especially in immunocompromised patients.

❌ Spread of antibiotic-resistant bacteria – making treatment more difficult.

Examples of HAIs:

1. Urinary Tract Infections (UTIs) – Often caused by E. coli due to prolonged catheter use.

2. Surgical Site Infections (SSIs) – Caused by Staphylococcus aureus after surgeries.

3. Pneumonia – Ventilator-Associated Pneumonia (VAP) occurs in patients on ventilators.

4. Bloodstream Infections (BSIs) – Catheter-Related Bloodstream Infections (CRBSIs) occur due to IV catheters.

2. Contributing Factors for HAIs

Several factors increase the risk of HAIs:

🔴 Poor hand hygiene – Failure of healthcare workers to wash hands properly.

🔴 Contaminated medical equipment – Improper sterilization of surgical instruments and catheters.

🔴 Prolonged hospital stays – The longer a patient stays, the higher the risk.

🔴 Weakened immune system – Elderly, newborns, and immunocompromised patients are more vulnerable.

🔴 Overuse of antibiotics – Leads to antibiotic-resistant bacteria like MRSA (Methicillin-Resistant Staphylococcus aureus).

3. Interventions to Prevent HAIs

✅ Proper Hand Hygiene – Frequent and effective handwashing with soap and alcohol-based sanitizers.

✅ Use of Personal Protective Equipment (PPE) – Gloves, masks, gowns, and face shields.

✅ Sterilization & Disinfection – Proper cleaning of surgical tools, catheters, and hospital surfaces.

✅ Isolation of Infected Patients – To prevent the spread of contagious infections.

✅ Safe Injection Practices – Using sterile needles, syringes, and aseptic techniques.

✅ Proper Waste Disposal – Handling medical waste safely to prevent contamination.

4. Importance of Infection Prevention and Control

🛑 Reduces the spread of infections – Protects both patients and healthcare workers.

🛑 Decreases hospital costs – Prevents prolonged hospital stays and expensive treatments.

🛑 Prevents antimicrobial resistance – Reduces unnecessary antibiotic use.

🛑 Improves patient safety and healthcare quality – Reduces morbidity and mortality rates.

Colonization

Colonization occurs when microorganisms (bacteria, viruses, fungi, or parasites) live and multiply on a host’s skin or mucous membranes without causing disease. The host does not show any symptoms, but the microorganisms can still spread to others.

🦠 Example:

• Methicillin-Resistant Staphylococcus aureus (MRSA) can colonize the skin, nose, or throat without causing infection. However, it can spread to open wounds and cause serious infections.

🔴 Difference Between Colonization and Infection

Colonization. Infection

Microorganisms are present but do not cause disease Microorganisms invade tissues and cause symptoms

No signs or symptoms. Signs and symptoms like fever, pain, inflammation

Host may carry and spread the bacteria Requires medical treatment (antibiotics, antifungals, etc.)

The Chain of Infection

The chain of infection describes how infections spread from one person to another. Breaking any link in this chain helps prevent infections.

1. Infectious Agents (Pathogens)

These are disease-causing microorganisms such as:

• Bacteria (e.g., Staphylococcus aureus, E. coli)

• Viruses (e.g., HIV, Influenza, Hepatitis B)

• Fungi (e.g., Candida, Aspergillus)

• Parasites (e.g., Plasmodium (Malaria), Giardia)

➡ Prevention: Proper sterilization, disinfection, and antibiotics for bacterial infections.

2. Reservoir (Source of Infection)

The place where pathogens live and multiply, such as:

• Humans (patients, healthcare workers, carriers)

• Animals (rats, dogs, mosquitoes)

• Environment (contaminated water, soil, food, medical equipment)

➡ Prevention: Proper sanitation, food safety, and infection control in hospitals.

3. Portal of Exit (How Pathogens Leave the Reservoir)

Microorganisms leave the body through:

• Respiratory droplets (coughing, sneezing – e.g., COVID-19, Tuberculosis)

• Blood and body fluids (HIV, Hepatitis B, Ebola)

• Feces and urine (Cholera, Typhoid)

• Skin wounds and secretions (MRSA, Streptococcus infections)

➡ Prevention: Proper wound care, cough etiquette, safe handling of bodily fluids.

4. Mode & Routes of Transmission (How Pathogens Spread)

Person-to-Person Transmission

• Direct Contact (e.g., touching infected wounds, kissing)

• Indirect Contact (e.g., touching contaminated surfaces, medical equipment)

Other Transmission Routes

• Animal-to-Person (e.g., Rabies, Zoonotic diseases)

• Mother-to-Unborn Child (e.g., HIV, Syphilis)

• Food Contamination (e.g., Salmonella, Listeria)

• Airborne Transmission (e.g., Tuberculosis, COVID-19, Chickenpox)

• Droplet Transmission (e.g., Influenza, Meningitis)

➡ Prevention: Hand hygiene, wearing masks, proper food handling, vector control (e.g., mosquito nets).

5. Portal of Entry (How Pathogens Enter a New Host)

Pathogens can enter through:

• Mucous membranes (eyes, nose, mouth – e.g., COVID-19)

• Respiratory tract (inhalation of airborne pathogens)

• Gastrointestinal tract (contaminated food/water)

• Broken skin or wounds (HIV, Hepatitis B)

• Medical devices (catheters, IV lines)

➡ Prevention: PPE, proper wound care, avoiding contaminated food and water.

6. Susceptible Host (Who is at Risk?)

People who have weakened immune systems are at a higher risk, including:

• Newborns and elderly

• Patients with chronic diseases (diabetes, cancer, HIV/AIDS)

• People undergoing surgery or chemotherapy

• Malnourished individuals

➡ Prevention: Vaccination, good nutrition, managing underlying conditions.

Breaking the Chain of Infection

To prevent infections, healthcare workers should:

✅ Practice proper hand hygiene (handwashing, alcohol rubs)

✅ Use PPE (Personal Protective Equipment) (gloves, masks, gowns)

✅ Follow safe injection and sharps disposal practices

✅ Ensure proper sterilization and disinfection of medical tools

✅ Isolate infectious patients when necessary

✅ Encourage vaccination to boost immunity

Standard & Transmission-Based Precautions

1. Standard Precautions

Standard precautions are basic infection control measures that apply to all patients, regardless of diagnosis or infection status. These precautions help prevent the spread of infections in healthcare settings.

Key Components of Standard Precautions

1⃣ Hand Hygiene

• Wash hands with soap and water or use an alcohol-based hand rub before and after patient contact.

• Follow proper handwashing techniques (20–30 seconds, covering all areas of the hands).

2⃣ Use of Personal Protective Equipment (PPE)

• Gloves: Wear when touching blood, body fluids, non-intact skin, or contaminated surfaces.

• Masks, Goggles, or Face Shields: Use when there is a risk of splashes or sprays of blood, body fluids, secretions, or excretions.

• Gowns/Aprons: Wear if clothing is likely to be exposed to infectious material.

3⃣ Respiratory Hygiene & Cough Etiquette

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

• Dispose of tissues properly and perform hand hygiene immediately.

• Use masks for patients with respiratory symptoms when possible.

4⃣ Safe Injection Practices

• Use a new, sterile needle and syringe for each injection.

• Do not reuse single-dose vials.

• Disinfect the skin before giving an injection.

5⃣ Environmental Cleaning & Disinfection

• Regular cleaning of patient care areas and equipment.

• Use appropriate disinfectants for different surfaces (e.g., chlorine solution for high-touch surfaces).

6⃣ Handling of Soiled Linen & Waste Disposal

• Handle soiled linen with minimal agitation to avoid the spread of microorganisms.

• Dispose of medical waste (e.g., sharps, contaminated items) properly.

2. Transmission-Based Precautions

These precautions are used in addition to standard precautions when dealing with highly contagious infections. They are classified into three categories:

A. Contact Precautions

Used for infections spread by direct or indirect contact (e.g., MRSA, C. difficile).

• Wear gloves and gowns before entering the patient’s room.

• Use dedicated patient equipment (e.g., thermometers, stethoscopes).

• Perform hand hygiene before and after contact with the patient.

• Place the patient in a single room if possible.

B. Droplet Precautions

Used for infections transmitted by large respiratory droplets (e.g., influenza, COVID-19, meningitis).

• Wear a surgical mask when within 1 meter (3 feet) of the patient.

• The patient should wear a mask when being transported.

• Perform hand hygiene after touching respiratory secretions.

C. Airborne Precautions

Used for infections spread by small airborne particles (e.g., tuberculosis, measles, chickenpox).

• Place the patient in a negative-pressure isolation room.

• Wear an N95 respirator or equivalent before entering the room.

• Limit patient movement; if necessary, the patient should wear a surgical mask.

3. Isolation of Patients

Isolation is the practice of separating infected patients from others to prevent the spread of infection. There are two main types:

A. Source Isolation (Infectious Isolation)

This is used to prevent the spread of infections from a patient to others. It is applied when a patient has a highly contagious disease (e.g., tuberculosis, COVID-19, Ebola).

• Patient Placement: The patient should be in a single room or a negative pressure room (for airborne infections).

• PPE Requirements: Healthcare workers should wear gloves, gowns, masks, and sometimes face shields.

• Restricted Movement: The patient should stay in their room and wear a mask if they must leave.

• Proper Waste Disposal: Contaminated items should be disposed of safely to prevent the spread of infection.

B. Protective Isolation (Reverse Isolation)

This is used to protect immunocompromised patients from infections (e.g., patients with leukemia, organ transplants, or HIV/AIDS).

• Patient Placement: The patient is placed in a sterile, well-ventilated, and filtered environment.

• Strict Hand Hygiene: Anyone entering the room must perform thorough hand washing.

• PPE Requirements: Healthcare workers and visitors may wear masks, gowns, and gloves to prevent introducing infections.

• Limit Visitors: Only healthy visitors should be allowed, and they must follow strict infection control measures.

4. Hand Hygiene

Hand hygiene is the most effective way to prevent infections. It involves various methods:

A. Principles of Hand Hygiene

• Always perform hand hygiene before and after patient contact.

• Use the correct technique to ensure thorough cleaning.

• Avoid wearing artificial nails or jewelry, which can harbor bacteria.

B. Effective Hand Hygiene Mechanisms

1. Routine/Social Hand Washing

• Indication: Before and after patient contact, after using the toilet, before eating.

• Procedure:

1. Wet hands with clean running water.

2. Apply soap and rub hands together for at least 20 seconds.

3. Cover all areas, including fingers, thumbs, and wrists.

4. Rinse thoroughly under running water.

5. Dry hands with a disposable towel or air dryer.

2. Surgical Hand Wash/Scrub

• Indication: Before performing surgical procedures.

• Steps/Procedure:

1. Remove all jewelry.

2. Wet hands and apply antiseptic soap.

3. Scrub hands, wrists, and forearms with a sterile brush for 5 minutes.

4. Rinse with sterile water and dry with a sterile towel.

5. Keep hands raised and avoid touching non-sterile surfaces.

3. Alcohol-Based Hand Scrub

• Advantages:

• Kills more bacteria than soap.

• Quick and convenient (no need for water).

• Reduces skin irritation compared to frequent washing.

• Procedure: Apply 3-5 mL of alcohol-based hand rub, rub hands together for 20-30 seconds, and allow to air dry.

C. Skin Care in Hand Hygiene

• Use hand creams to prevent skin dryness.

• Avoid hand hygiene barriers such as skin lesions, cuts, and abrasions, as they can harbor bacteria.

5. Personal Protective Equipment (PPE)

PPE refers to protective clothing and equipment used by healthcare workers to prevent exposure to infectious agents.

A. Types of PPE and Their Uses

1. Gloves

• Types of Gloves:

• Sterile Surgical Gloves – Used for surgical procedures.

• Non-Sterile (Examination) Gloves – Used for routine patient care.

• Utility/Heavy-Duty Gloves – Used for cleaning and handling contaminated equipment.

• Proper Use of Gloves:

• Change gloves between patients and between different tasks on the same patient.

• Perform hand hygiene before and after using gloves.

2. Aprons and Gowns

• Types:

• Disposable Plastic Aprons/Gowns – Used during general patient care.

• Overalls or Coveralls – Used in high-risk environments (e.g., handling infectious diseases like Ebola).

• Purpose: Protects clothing from contamination.

3. Masks and Respirators

• Surgical Masks – Protect against large droplets and splashes.

• N95 Respirators – Provide a tight seal and filter airborne particles (used for tuberculosis, COVID-19, etc.).

• Proper Mask Removal: Avoid touching the front of the mask when removing it.

4. Eye and Face Protection

• Goggles and Face Shields – Protect eyes from splashes of blood and body fluids.

5. Headgear and Leg Protection

• Caps and Hoods – Used in operating rooms to prevent hair from contaminating sterile fields.

• Shoe Covers – Used in highly sterile environments (e.g., surgery).

B. Correct Sequence for Putting On and Removing PPE

1. Putting On PPE (Donning)

1. Perform hand hygiene.

2. Put on gown or apron.

3. Put on mask or respirator.

4. Put on goggles or face shield.

5. Put on gloves (ensure they cover the cuffs of the gown).

2. Removing PPE (Doffing)

1. Remove gloves (inside-out technique).

2. Remove gown and fold it inward.

3. Remove goggles or face shield.

4. Remove mask or respirator (touch only the straps).

5. Perform hand hygiene.

C. Incorrect Use of PPE

• Reusing disposable PPE.

• Touching contaminated areas of used PPE.

• Not wearing PPE properly (e.g., loose-fitting mask).

• Removing PPE in the wrong order, leading to contamination.

D. Storage of PPE

• PPE should be stored in a clean and dry area.

• Check expiration dates before use.

6. Respiratory Hygiene and Cough Etiquette

Respiratory hygiene and cough etiquette are infection prevention measures that help reduce the spread of respiratory infections like tuberculosis, influenza, COVID-19, and pneumonia.

A. Key Principles of Respiratory Hygiene

1. Covering the Mouth and Nose

• Use a tissue, handkerchief, or the elbow when coughing or sneezing.

• If using a tissue, dispose of it immediately in a covered waste bin.

2. Hand Hygiene After Coughing/Sneezing

• Wash hands with soap and water for at least 20 seconds OR

• Use an alcohol-based hand sanitizer if soap and water are unavailable.

3. Wearing a Mask When Sick

• Patients with respiratory infections should wear a surgical mask when in shared spaces (e.g., hospital waiting rooms).

4. Maintaining Physical Distance

• Stay at least 1 meter (3 feet) away from others when coughing or sneezing.

5. Environmental Hygiene

• Frequently disinfect commonly touched surfaces (e.g., doorknobs, bed rails, medical equipment).

• Ensure good ventilation in healthcare and public settings.

B. Implementation in Healthcare Settings

1. Healthcare Workers Should:

• Educate patients about respiratory hygiene.

• Provide tissues, masks, and hand sanitizers in waiting areas.

• Separate patients with respiratory symptoms from others.

2. Visitors and Patients Should:

• Follow proper cough etiquette.

• Report symptoms of respiratory infections early.

• Avoid unnecessary visits to healthcare facilities if they are sick.

C. Importance of Respiratory Hygiene

• Reduces the transmission of respiratory infections.

• Protects healthcare workers, patients, and the community.

• Minimizes outbreaks in hospitals, schools, and workplaces.

7. Safe Injection Practices & Sharp Disposal

Safe injection practices and proper disposal of sharps help prevent infections, protect healthcare workers, and reduce the risk of needlestick injuries.

A. Safe Injection Practices

1. Use Sterile Equipment

• Always use a new, sterile syringe and needle for each patient.

• Do not reuse syringes or needles, even for the same patient.

• Use single-dose vials whenever possible.

2. Skin Disinfection Before Injection

• Clean the injection site with 70% alcohol or chlorhexidine solution.

• Allow the area to air dry before injecting.

3. Use of Single-Dose & Multi-Dose Vials

• Single-dose vials: Use once and discard immediately.

• Multi-dose vials:

• Always use a new sterile needle and syringe when drawing medication.

• Store as per manufacturer guidelines.

• Label with opening date and discard after the recommended period.

4. Aseptic Technique

• Do not touch needle tips, syringe nozzles, or medication ports.

• Do not mix medications in the same syringe unless medically necessary.

• Always inspect medication vials for contamination, discoloration, or floating particles before use.

5. Infusion and Administration Sets

• Change IV infusion sets as per hospital guidelines (e.g., every 24–72 hours).

• Use closed-system transfer devices to reduce contamination risks.

6. Injection Preparation Area

• Prepare injections in a clean, dedicated area.

• Do not place used and unused syringes together.

• Dispose of contaminated materials properly.

B. Sharp Disposal & Needlestick Injury Prevention

1. Safe Handling of Needles & Syringes

• Do not recap needles after use (unless using the one-hand scoop method).

• Use safety-engineered needles to prevent injuries.

• Immediately dispose of used needles into a puncture-proof sharps container.

2. Proper Sharp Disposal

• Use color-coded sharps disposal containers (typically yellow).

• Containers should be leak-proof, puncture-resistant, and labeled.

• Do not overfill containers—dispose of them when three-quarters full.

3. Managing Needlestick Injuries & Exposure

• Do not squeeze or rub the wound.

• Wash the site with soap and running water immediately.

• Report the incident to a supervisor or infection control team.

• Follow post-exposure prophylaxis (PEP) protocols if needed (e.g., for HIV or Hepatitis B exposure).

C. Importance of Safe Injection Practices

• Prevents transmission of bloodborne infections like HIV, Hepatitis B, and Hepatitis C.

• Reduces hospital-acquired infections (HAIs).

• Protects patients, healthcare workers, and the environment.

8. Managing Injuries & Exposure

Healthcare workers are at risk of injuries and exposure to infectious agents through needlestick injuries, body fluid splashes, and direct contact with contaminated materials. Proper management is crucial to reduce infection risks and protect healthcare staff.

A. Common Types of Injuries & Exposure Risks

1. Needlestick and Sharp Injuries

• Occurs when a used needle or sharp object punctures the skin.

• Risks include exposure to HIV, Hepatitis B, and Hepatitis C.

2. Blood & Body Fluid Exposure

• Contact with blood, saliva, urine, or other fluids through cuts, splashes, or mucous membranes (eyes, mouth, nose).

• Can lead to infections if the fluid contains harmful pathogens.

3. Mucosal Exposure

• Happens when infectious fluids enter the eyes, nose, or mouth.

4. Non-Intact Skin Exposure

• Occurs when infectious fluids contact broken skin (wounds, cuts, abrasions).

B. Immediate First Aid Measures After Exposure

1. For Needlestick & Sharp Injuries

• Do not squeeze or rub the wound.

• Wash the area with soap and running water.

• Do not use bleach, alcohol, or disinfectants on the wound.

2. For Blood & Body Fluid Exposure to Mucous Membranes

• Flush the affected area with clean water or saline solution for at least 10–15 minutes.

• If exposed to the eyes, use eye wash stations or sterile saline.

3. For Skin Exposure to Infectious Fluids

• Wash the affected area with soap and water immediately.

C. Reporting & Documentation

• Report all exposures and injuries to a supervisor or infection control officer.

• Fill out an incident report form, stating:

• Type of exposure (e.g., needlestick, fluid splash).

• Type of fluid involved (blood, saliva, urine, etc.).

• Source of infection risk (if known).

D. Post-Exposure Prophylaxis (PEP)

1. HIV Exposure

• PEP should be started within 1–2 hours after exposure (ideally within 72 hours).

• A 28-day course of antiretroviral (ARV) drugs is recommended.

• Follow-up HIV testing at 6 weeks, 3 months, and 6 months.

2. Hepatitis B Exposure

• If the exposed person is not vaccinated, Hepatitis B Immune Globulin (HBIG) and a Hepatitis B vaccine should be given.

• If already vaccinated, test for antibodies (anti-HBs) and follow guidelines.

3. Hepatitis C Exposure

• No immediate post-exposure treatment, but close monitoring of HCV antibodies is required.

E. Preventive Measures to Reduce Exposure Risks

1. Use Personal Protective Equipment (PPE)

• Wear gloves, masks, gowns, and eye protection when handling body fluids.

2. Follow Safe Injection Practices

• Use safety-engineered needles.

• Dispose of sharps in puncture-resistant sharps containers.

3. Hand Hygiene & Disinfection

• Wash hands frequently with soap and water or alcohol-based hand sanitizer.

• Disinfect contaminated surfaces and equipment properly.

4. Proper Handling & Disposal of Infectious Waste

• Dispose of contaminated materials in biohazard waste containers.

F. Importance of Managing Injuries & Exposure

• Prevents the spread of infections to healthcare workers and patients.

• Reduces hospital-acquired infections (HAIs).

• Protects healthcare professionals from long-term health risks.

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9. Sterilization, Disinfection & Decontamination

Infection control in healthcare settings requires proper cleaning and decontamination of instruments, equipment, and surfaces to prevent the spread of infections. This is achieved through sterilization, disinfection, and decontamination.

A. Definitions

1. Decontamination

• The process of removing, inactivating, or destroying microorganisms to make an object or environment safe.

• Includes cleaning, disinfection, and sterilization.

2. Sterilization

• The process of destroying or removing all microorganisms, including bacteria, viruses, fungi, and spores.

• Used for surgical instruments, needles, and catheters.

3. Disinfection

• The process of eliminating most microorganisms, except bacterial spores.

• Used for hospital surfaces, patient care equipment, and some instruments.

B. Steps in Decontaminating Instruments

1. Pre-Cleaning

• Remove visible dirt, blood, and body fluids immediately after use.

• Use water and enzymatic detergent.

2. Cleaning

• Use warm water and detergent.

• Scrub using soft brushes to remove organic material.

3. Disinfection or Sterilization

• Choose an appropriate method based on the type of instrument.

4. Drying & Storage

• Dry properly to prevent contamination.

• Store in sterile containers or packages.

C. Methods of Sterilization

1. Heat Sterilization

• Autoclaving (Steam Sterilization):

• Uses high-pressure steam at 121°C–134°C.

• Kills all microorganisms, including spores.

• Used for metal instruments, surgical tools, and dressings.

• Dry Heat Sterilization (Hot Air Oven):

• Uses 160°C–180°C dry heat.

• Suitable for glassware and heat-resistant materials.

2. Chemical Sterilization

• Uses ethylene oxide gas, hydrogen peroxide, or glutaraldehyde.

• Used for plastic instruments, endoscopes, and delicate materials.

3. Radiation Sterilization

• Uses gamma rays or UV light.

• Mostly used in industrial settings for disposable medical products.

D. Methods of Disinfection

1. High-Level Disinfection (HLD)

• Kills bacteria, viruses, fungi, and some spores.

• Used for endoscopes, respiratory therapy equipment, and anesthesia tools.

• Example: Glutaraldehyde solution.

2. Intermediate-Level Disinfection

• Kills bacteria, most viruses, and fungi, but not spores.

• Used for thermometers and some patient care equipment.

• Example: Alcohol, chlorine compounds.

3. Low-Level Disinfection

• Kills some bacteria and viruses, but not spores or stronger pathogens.

• Used for hospital furniture, floors, and walls.

• Example: Phenolic and quaternary ammonium compounds.

E. Decontamination Products & Their Uses

Product Use

Chlorine Solution (Bleach) Disinfects surfaces, floors, and contaminated instruments

Alcohol (70%) Disinfects skin, thermometers, and medical equipment

Glutaraldehyde High-level disinfectant for endoscopes and surgical instruments

Hydrogen Peroxide Sterilizes and disinfects medical tools and wounds

Phenolic Compounds Disinfects hospital furniture, floors, and walls

F. Preparation of 0.5% & 0.05% Chlorine Solution

Chlorine solution is widely used in hospitals for disinfection. It is prepared using bleach (sodium hypochlorite, NaOCl) and water.

1. Preparation of 0.5% Chlorine Solution

Used for disinfecting contaminated instruments, surfaces, and spills.

• Formula:



• Example: If using 5% bleach stock solution to prepare 1 liter (1000ml) of 0.5% solution:



• Steps:

1. Take 100ml of 5% bleach.

2. Add 900ml of clean water.

3. Mix well and use immediately.

2. Preparation of 0.05% Chlorine Solution

Used for hand hygiene and wound disinfection.

• Formula:



• Steps:

1. Take 10ml of 5% bleach.

2. Add 990ml of clean water.

3. Mix well and use immediately.

G. Importance of Sterilization & Disinfection

• Prevents the spread of infections in hospitals.

• Reduces healthcare-associated infections (HAIs).

• Ensures patient safety and protects healthcare workers.

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10. Safe Injection Practices & Sharp Disposal

Safe injection practices are essential for preventing infections, protecting healthcare workers, and ensuring patient safety. Proper sharp disposal is also necessary to prevent needle-stick injuries and the spread of infectious diseases.

A. Safe Injection Practices

Safe injection practices ensure that injections do not harm the patient, healthcare provider, or community. These practices prevent bloodborne infections like HIV, Hepatitis B, and Hepatitis C.

1. Needles & Syringes

• Use a new, sterile needle and syringe for each injection.

• Do not reuse or share syringes between patients.

• Dispose of used needles immediately in a puncture-resistant sharps container.

2. Skin Disinfection

• Clean the injection site with alcohol (70%) before giving an injection.

• Allow the alcohol to air dry completely before injecting.

• Do not touch the cleaned area with your fingers.

3. Single-Dose vs. Multi-Dose Vials

• Use single-dose vials whenever possible to prevent cross-contamination.

• If using multi-dose vials:

• Use a new, sterile needle and syringe for each withdrawal.

• Store vials properly and check for expiration or contamination.

• Never combine leftover medication from different vials.

4. Aseptic Technique

• Wash hands before preparing injections.

• Use sterile gloves if needed.

• Avoid touching the needle or tip of the syringe.

5. Infusion & Administration Sets

• Change intravenous (IV) administration sets every 24–72 hours depending on hospital policy.

• Use disposable infusion sets to reduce infection risks.

• Ensure IV fluids and medications are free from contamination before administration.

6. Injection Preparation Area

• Prepare injections in a clean, designated area.

• Avoid placing injection supplies on contaminated surfaces.

• Keep medication vials covered and stored properly.

B. Sharp Disposal

Proper disposal of needles, syringes, and sharp objects prevents injuries and infections.

1. Safe Handling of Sharps

• Do not bend, break, or recap used needles.

• Always dispose of used needles immediately after use.

• Handle sharps carefully to avoid needle-stick injuries.

2. Sharp Disposal Containers

• Use a puncture-resistant sharps container that is labeled and color-coded.

• Do not overfill sharps containers (fill up to ¾ full).

• Keep sharps containers in easily accessible locations.

3. Steps for Safe Sharp Disposal

1. Immediately place used sharps into a sharps container.

2. Ensure the container is securely closed when full.

3. Dispose of the full sharps container according to hospital waste management guidelines.

4. Never throw needles into regular waste bins.

4. Managing Needle-Stick Injuries

• Wash the injured area with soap and water immediately.

• Do not squeeze or rub the wound.

• Report the injury immediately to a supervisor.

• Follow hospital protocol for post-exposure prophylaxis (PEP) if needed.

C. Importance of Safe Injection Practices & Sharp Disposal

• Prevents infections like HIV, Hepatitis B, and Hepatitis C.

• Reduces needle-stick injuries among healthcare workers.

• Protects patients and staff from cross-contamination.

• Ensures a safe healthcare environment.

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11. Managing Injuries & Exposure

Healthcare workers are at risk of injuries and exposure to infectious agents through needle-stick injuries, splashes, and contact with infected body fluids. Proper management of these incidents reduces the risk of infections like HIV, Hepatitis B, and Hepatitis C.

A. Common Types of Exposure in Healthcare Settings

1. Needle-Stick & Sharp Injuries

• Occurs when a needle or sharp object accidentally pierces the skin.

• Can transmit bloodborne infections (e.g., HIV, Hepatitis B, Hepatitis C).

2. Splash or Contact Exposure

• Blood or body fluids enter the eyes, nose, mouth, or broken skin.

• Can happen during procedures, suctioning, or cleaning spills.

3. Cuts & Open Wounds

• Contact with contaminated instruments or patient secretions.

• Increases the risk of bacterial and viral infections.

4. Inhalation Exposure

• Breathing in infectious droplets (e.g., TB, COVID-19).

• Can occur when dealing with patients in airborne isolation.

B. Immediate Steps After Exposure

1. Needle-Stick or Sharp Injury

• Do NOT squeeze the wound.

• Wash immediately with soap and running water.

• Do not apply disinfectants, bleach, or alcohol to the wound.

• Cover with a clean, dry dressing.

• Report the incident to a supervisor or infection control officer.

2. Splash to Eyes, Nose, or Mouth

• Flush the affected area immediately with clean water or saline for at least 10 minutes.

• Do not rub the eyes.

• Seek medical evaluation for post-exposure prophylaxis (PEP).

3. Skin Exposure

• Wash affected skin with soap and water.

• Do not use strong disinfectants on the skin.

C. Post-Exposure Prophylaxis (PEP)

PEP is a treatment given after exposure to infectious materials to reduce the risk of infection.

1. PEP for HIV Exposure

• Must be started within 1–2 hours (best within 72 hours).

• Involves a 28-day course of antiretroviral (ARV) drugs.

• Requires HIV testing at the time of exposure, after 6 weeks, 3 months, and 6 months.

2. PEP for Hepatitis B Exposure

• If not vaccinated, get the Hepatitis B vaccine & Hepatitis B immune globulin (HBIG) within 24 hours.

• If vaccinated, check for antibody levels.

3. PEP for Hepatitis C Exposure

• No specific PEP, but early detection & monitoring is essential.

D. Reporting & Documentation of Exposure

• Report the incident immediately to the supervisor.

• Fill out an exposure incident report form.

• Follow hospital protocols for monitoring and follow-up.

E. Preventive Measures to Reduce Exposure Risks

1. Follow Standard Precautions (gloves, masks, eye protection).

2. Dispose of sharps properly (no recapping of needles).

3. Practice proper hand hygiene before and after patient care.

4. Wear PPE when handling body fluids.

5. Use safety-engineered devices (needle-free systems, retractable syringes).

F. Importance of Proper Management of Injuries & Exposure

• Reduces the risk of infectious disease transmission.

• Ensures early intervention and treatment.

• Improves safety for healthcare workers.

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