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Infection Control For the Healthcare Worker Microorganism • Small living organism that cannot be seen with the naked eye • Have to have microscope in order to view microorganisms • They are found everywhere, in the environment, including on & • In the Human body Pathogens • Microorganisms that cause infection and disease. • There are many different classes of microorganisms, we will discuss a few that affect humans Nonpathogen • Microorganisms that are part of the normal flora and are beneficial to certain body processes. Bacteria • Simple one-celled • Multiply rapidly • Classified by shape and arrangement • Cocci, Bacilli, & Spirilla Cocci • • • • • • • Round in shape They can occur in pairs, chains or groups They cause diseases such as: Gonorrhea Meningitis Pneumonia Strep throat or Staph infections Bacilli • • • • • • Rod shaped bacteria Some diseases caused by bacilli are: TB Tetanus Pertussis (Whooping cough) Botulism Spirilla • Spiral or corkscrew in shape • Some diseases caused by spirilla bacteria: • Syphilis Other Microorganisms • Protozoa: Cause malaria, trichomonas, • These are one-celled animal-like organisms • Found in decayed materials and contaminated water • Fungi: Cause ringworm, athlete’s foot, yeast vaginitis and thrush • Plant-like organisms that live on dead organic material Rickettsiae: These are parasitic microorganisms, which means They cannot live outside the cells of another living organism. They are commonly found in fleas, lice, ticks and mites. They are transmitted to human by bites of these insects. Causes diseases such as Rocky Mountain spotted fever. Viruses • Smallest microorganisms • Visible only using an electron microscope • Cannot reproduce unless they are inside another living cell. • Spread from human to human via blood and other body fluids • There is no cure for viruses!!! Viruses cause many diseases • • • • • • • • Common cold Measles Mumps Chicken pox Herpes Warts Flu polio • 3 viruses of main concern to the healthcare worker: • Hepatitis B • Hepatitis C • HIV & AIDS Hepatitis B • Hepatitis B affects the liver • Vaccine has been developed to protect from HBV • Hepatitis B can kill you! Hepatitis C • Causes serious liver damage • No vaccine yet, but is in stages of development • Both B & C can remain active in dried blood for days! HIV & AIDS • There is no cure and no vaccine available • Cancer and Infections is the leading cause of death for a person infected with the virus • Healthcare workers should protect themselves Conditions required for bacteria growth • • • • Warm environment Body temperature is ideal Darkness Source of food and moisture • Some require oxygen (aerobic) • Anaerobic do not require oxygen • Endogenous: the infection originates within the body • Exogenous: the infection originates outside the body Nosocomial & Opportunistic • Nosocomial infections are acquired in a healthcare facility. • Usually passed from the healthcare worker to the patient • Hospitals usually have an infection control nurse to track these • Opportunistic infections occur when the body defense is weak • PCP or Kaposi’s sarcoma in a patient with HIV For infections to occur & spread • Causative agent or pathogen present • Enough pathogen to cause disease • A susceptible host • A portal of entry For infections to occur and spread • Reservoir or host where it can live • May include human body, animals, the environment, or fomites (objects such as doorknobs, bedpans, linens, instruments, etc.) For infections to occur and spread • Mode of transmission or way in which it can be transmitted to another reservoir • Direct contact (hands) • Indirect contact (food) • Air bourne (breathing them in) • Vector bourne (insects) For infections to occur and spread • Portal of entry, or way to enter the host is essential. • Breaks in skin • Mucous membranes • Respiratory tract • Digestive tract • Circulatory System Body Defenses • • • • • • • • Mucous Membranes: traps pathogens Cilia: propel pathogens out of the body Coughing and Sneezing Hydrochloric acid: destroys pathogens in the stomach Tears in the eye: contain bactericidal chemicals Fever Inflammation: white blood cells destroy pathogens Immune response: body produces antibodies How do we prevent infections? • Asepsis!!!(the absence of disease producing microorganisms) • Aseptic techniques • Handwashing • Good personal hygiene • Use of gloves • Proper cleaning of instruments Various levels of Aseptic control • Antiseptics prevent or inhibit growth • Usually used on the skin • Examples: Alcohol & Betadine • Antibacterial soap Various levels of Aseptic control • Disinfection: destroys or kills organisms • Can damage the skin, usually used on surfaces. • Examples: Bleach or other cleaning solutions Various levels of Aseptic control • Sterilization: destroys all microorganisms • Uses steam under pressure, gas, radiation and chemicals to sterilize objects • Example: Autoclave Handwashing!!!!! • You must know how to properly wash your hands if you work in the healthcare field! • Handwashing is the most effective way to prevent the spread of infection! • Handwashing should be done frequently! • Let’s look at some times when you should wash your hands….. Wash your hands… • When you arrive at work and before you leave work • Before and after every patient contact • Any time your hands become contaminated • After removing gloves • After handling a specimen • After using the bathroom • After you cough or sneeze • Before & After any contact with your mouth (eating) Steps to proper washing: • Use soap • Soap aids in the removal of germs through its sudsy action and alkali content • Best to use liquid soap Handwashing Step 2 • Warm water should be used • Creates a better lather than cold water • Doesn’t damage skin like hot water Handwashing step 3 • Friction must be used • This helps to rub off pathogens Handwashing Step 4 • All surfaces of the hand should be cleaned • Fingertips must be pointed downward • Dry papertowels must be used to turn the faucet on and off. Step by Step Procedure • Stand away from sink • Turn on faucet , regulate temperature • With fingertips pointing down, wet hands. • Use soap, work into lather • Rub palms together, using friction • Rub backs of hands • Interlace fingers and rub back and forth • Scrub your nails against your palms or use orange stick or nail brush • Rinse hands keeping fingertips down • Use clean papertowel to dry hands from tips of fingers to wrist • Use new dry papertowel to turn off faucet. Standard Precautions For the Healthcare Worker For Infection Control • • • • • • • • Wash Hands Wear Gloves Wear mask and eye protection if needed Wear gown if needed Use caution handling patient care equipment Disinfect surfaces per facility policy Use caution handling soiled linens Never recap needles Use private room for infectious patient Specific Precautions Airborne, Droplet, Contact Airborne Precautions • • • • Patient has private room with negative air pressure Wash hands Wear respiratory protection (mask) Patient must wear mask if transported outside room • Limit use of equipment or take in disposable equipment • Bag linens into biohazard container Airborne diseases • • • • • Measles Chicken pox Tuberculosis Shingles FYI: Pregnant women should not be exposed to patients with shingles or chicken pox! Droplet Precautions • Patient has private room • Maintain 3 feet between patient and visitors • Mask for healthcare worker or anyone else who gets closer than 3 feet from patient • Patient wears mask outside of room • Limit use of equipment or use disposable • Bag linens in biohazard • Wash hands frequently Droplet Diseases • Flu • Meningitis and pneumonias caused from certain bacteria • Mumps • Whooping cough Contact Precautions • • • • • Patient has private room Wash hands Wear gown and gloves Limit use of equipment Bag linens in biohazard Contact Diseases • • • • • • E-coli infections Hepatitis A Conjunctivitis (pink eye) Fevers Skin infections (herpes, lice) Staph infections You can help prevent infections As a Healthcare worker, it is essential that you know how infections start and how to prevent spreading.