Communicable Disease and Infection Control Study Guide

Communicable Disease and Infection Control

Objectives

• Review Key Terms and Abbreviations
• Microbes
• Defense Against Communicable Disease
• MRSA/VRE/C-Diff
• Chain of Infection
• Infection Control in the Health Care Setting
• Medical Asepsis
• Hand Hygiene Practices
• Barrier Methods – PPE
• Standard Precautions
• Transmission Based Precautions
• Videos: Handwashing, Hand Sanitizer, PPE

LEQ (Learning Essential Question) Statement

• How does the Health Care provider prevent the transmission of disease in the clinical setting?

Key Terminology

• Communicable Disease: A disease that can be spread from one person to another.
• Microbe: A microorganism, a living thing not visible to the naked eye.
• Pathogens: Microbes that cause illness.
• Non-Pathogens: Harmless microbes that help the body function; normal (resident) flora.
• Colonization: The presence of microbes in a specific location.
• Antibiotics: Drugs that kill bacteria or make it difficult to reproduce.
• Antiseptic: A substance that prevents the growth of disease-causing microorganisms.
• Disinfection: Using stronger chemicals to kill pathogens, but too strong for use on skin.
• Sterilization: The strongest method to completely remove microbes.
• Sanitization: Physically removing pathogens; basic cleanliness.
• Fomites: Objects or materials that can carry infection, such as clothes, utensils, and furniture.
• Vector: An organism, typically a biting insect or tick, that transmits a disease or parasite from one animal or plant to another.
• Nosocomial Infection: An infection acquired in a healthcare facility; also known as a Health Care-Associated Infection (HAI).
• Contact: Transmission of an infectious agent by physical contact.
• Droplet: Transmission via droplets expelled during coughing, sneezing, or talking.
• PPE: Personal Protective Equipment, such as gloves, masks, eye protection, and gowns.
• Standard Precautions: Safety measures taken with all patients to prevent transmission of pathogens through blood and body fluids.
• Medical Asepsis: Practices aimed at physically removing or killing pathogens.
• Chain of Infection: The sequence of elements required for infection to spread.
• MRSA: Methicillin-resistant Staphylococcus aureus, a type of bacteria resistant to many antibiotics.
• VRE: Vancomycin-resistant Enterococcus, another type of bacteria resistant to antibiotics.
• Aerobic: Needing oxygen to live.
• Anaerobic: Dies if oxygen is present.
• MDRO: Multi-drug resistant organism

What is a Microbe?

• Microorganism; Living thing that cannot be seen with the naked eye.
• Normal (resident) Flora or Non-Pathogens:
  • Harmless microbes help the body function.
  • Normally live in some parts of the body.
• Pathogens:
  • Cause illness.
  • Normal flora in one part of the body can be pathogens in another (e.g., E. coli in intestines vs. bladder causing UTI).

Microbe Survival

• Environment for Survival:
  • Warm
  • Dark
  • Moist
  • Nutrition Source
• Aerobic Bacteria:
  • Need oxygen to live.
• Anaerobic Bacteria:
  • Die if oxygen is present.
• Endospores Characteristics:
  • Hard Shell
  • Inactive until growing conditions become available
  • Difficult to kill

Types of Microbes

• Bacteria
  • Defined: One cell and reproduce by dividing in half.
  • Group together to form colonies.
  • Classifications:
    • By shape
    • Arrangement in Colonies
    • How they react to the stain
  • Cell Shapes:
    • Cocci - round
    • Corkscrew - Curved and Spiral Shaped
    • Bacilli - oblong shape

Common Bacteria

• Cocci:
  • Diplococci.
  • Streptococci.
  • Staphylococci.
  • Tetrad
  • Sarcina
• Bacilli:
  • Chain of bacilli
  • Flagellate rode
  • Spore-former
• Others
  • Vibrios
  • Spirilla
  • Spirochaetes

Types of Microbes

• Bacteria:
  • Strep Throat, UTI, Tuberculosis, Lyme Disease, Meningitis, Rocky Mountain Spotted Fever, Syphilis
• Virus
  • HIV/AIDS, Hepatitis, Fever Blister, Common Cold, COVID
• Fungi
  • Ringworm, Athlete’s Foot, Vaginal Yeast Infection (Candidiasis), Oral Yeast Infection (Thrush)
• Parasites
  • Live on a host for food and protection
• Helminths
  • Parasite, worm like organisms that live in the human body. Pinworms, Tapeworms, roundworms. Transmitted by eating or inhaling worm eggs which grow inside the digestive tract.
• Protozoa
  • Malaria, Amebic Dysentery
• Insects
  • Scabies, Pediculosis (Lice)

How are Microbes Transmitted?

• Blood, body fluids, secretions, excretions
• Coughing, sneezing, talking, laughing, singing
• Animals
• Air
• Insects
• Food
• Water
• Dressings
• Direct contact
• Eating and drinking utensils
• Personal care items

Immune System Defined

• A defense system that protects us from infection
• Non-Specific Defense Mechanisms:
  • Help to protect us from all pathogens
  • Healthy Intact Skin/Mucous Membranes

Defense Mechanism

• Specific Defense Mechanism
  • Physical Barriers and general Immune Response to prevent and ward off infections
  • Antibodies: Specialized proteins used to fight off certain microbes
  • Develops antibodies when exposed to the microbe
  • Exposure or Vaccinations

Immune System: Defense System

• Pathogen passes through 1st line of defense, and an infection results, the body activates a general response to help fight off infection.
• Blood Vessels around the site dilate:
  • Increase ${O_2}$ and Nutrients
  • Causes area to become red, swollen, warm, painful
• White Blood Cells (Leukocytes) destroy bacteria
• Fever is normal response to infection- kills the pathogens.

Antibiotics

• Defined: Drug that can kill off bacteria or make it difficult for it to reproduce and grow.
• MDRO- Multi drug-resistant organism- some bacteria have used their ability to change to develop resistance to the antibiotics used to fight them.
• Resistant to Antibiotics
  • MRSA
  • VRE
  • C-Diff- infectious diarrhea caused by antibiotics killing off good bacteria in bowel. Putrid smelling diarrhea

Tell the Nurse

• Fever
• Rapid Pulse
• Pain with breathing or Dyspnea
• Redness, swelling or pain at site
• Foul smelling or cloudy urine
• Pain with urination
• Diarrhea or foul smelling feces
• Nausea or Vomiting
• Skin Rash
• Fatigue
• Increased confusion or disorientation
• Discharge or drainage from body

Chain of Infection

• 6 links:
  • Pathogen
  • Reservoir
  • Portal of Exit
  • Mode of Transmission
  • Portal of Entry
  • Susceptible Host

Chain of Infection: Links Explained

• Infectious Agents
  • Micro-organisms capable of causing disease or illness
  • Bacteria, Fungi, Parasites, Prions
• Reservoirs
  • Place in which infectious agents live, grow and reproduce
  • People, water, food
• Portals of Exit
  • Ways in which infectious agent leaves the reservoir
  • Blood, Secretions, Excretions, Skin
• Modes of Transmission
  • Ways in which the infectious agent is spread from the reservoir to the susceptible host
  • Physical Contact, Droplets, Airborne
• Portals of Entry
  • Ways in which the infectious agent enters the susceptible host
  • Mucous Membrane, Respiratory System, Digestive System, Broken Skin
• Susceptible Host
  • Individuals may have traits that affect their susceptibility and severity of disease
  • Immune Deficiency, Diabetes, Burns, Surgery, Age

Video: Chain of Infection

• How do you break the Chain?

Medical Asepsis

• Physically Removing or Killing Pathogens
• Use of Soap, Water, Antiseptics, Disinfectants or Heat.
• Goal: to remove Pathogens from surfaces, equipment, and hands of workers

Medical Asepsis

• HAI: Health Care Associated Infection /Nosocomial Infection
• Infections acquired while in a Health Care Facility
• 4 Major Methods of Infection Control
  • Medical Asepsis
  • Surgical Asepsis
  • Barrier Methods
  • Isolation Precautions

Sanitization and Antisepsis

• Sanitization
  • Physically remove pathogens
  • Basic Cleanliness
  • Handwashing
  • Cleansing Surface with Soap and Water
  • Provide Clean Linens and clothes
• Antisepsis
  • Takes sanitization one step further by killing microbes/growing
  • Chemical capable of killing pathogen or prevent from growing.
  • Alcohol Hand Cleanser

Disinfection and Sterilization

• Disinfection
  • Stronger Chemicals to kill pathogens
  • Too strong for skin
  • Used to clean non-living objects that encounter exposure to body fluids; Bedpan, urinal, overbed table
• Sterilization
  • Strongest method to completely remove microbes from surgical instrument, or other equipment used to enter the body.
  • Equipment cleansed with chemical then placed in high intensity heat autoclave

Surgical Asepsis & Barrier Methods

• Surgical Asepsis
  • All equipment must be sterile, and free of microbes for surgical procedures and equipment.
• Barrier Methods
  • PPE or Personal Protective Equipment
    • Gloves
    • Mask
    • Eye Protection
    • Gown

What are Standard Precautions?

• Precautions that health care workers take with every patient or resident to protect themselves and others from pathogens that are transmitted through blood and other body fluids.
• Use of barrier methods as well as certain Environmental control methods to protect the health care worker.
  • Respiratory Hygiene Cough Etiquette
  • Safe Injection Practices
  • Infection Control practices for Special Lumbar Puncture Procedures

Video: Standard Precautions

• Standard Precautions

Video: Standard Precaution and Transmission of Pathogens

• Isolation Precautions MADE EASY
• Contact
• Droplet
• Airborne
• Mnemonics for Nursing, NCLEX, USMLE

Video: Handwashing

• Handwashing

Video: PPE- Donning

• PPE Donning

Video: PPE-Doffing

• PPE Doffing