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Guided Lecture Notes, Chapter 13, Infection Control
To the Instructor: Learning about communicable diseases can seem very frightening and
overwhelming to the student who has had no prior experience in the health care field. If students
have a good basic understanding of how communicable diseases are transmitted and what causes
them, they are more likely to develop good infection control habits. They will also have a better
grasp of why certain precautions are taken with one person and different precautions are taken
with another. The fear that surrounds communicable illnesses such as AIDS and hepatitis is often
difficult for students to overcome. It is important for the instructor not only to impress on the
students how deadly these illnesses are but also to focus very realistically on how the use of
standard precautions dramatically reduces the likelihood that they will be exposed to or contract
a bloodborne illness. Reinforce that standard precautions must be followed correctly and
consistently for every patient or resident they care for.
Be sure to utilize the “What did you learn?” quiz items found at the end of the chapter to
both reinforce and evaluate the students’ understanding of the topics contained in this chapter.
Video Support: Module 2 of Lippincott’s Video Series for Nursing Assistants, “Infection
Control,” reviews the chain of infection and how it is broken, along with the procedures for
washing hands, removing gloves, putting on and removing a gown, putting on and removing a
mask, and handling a blood spill. If time permits, showing the movie “And the Band Played On”
is an excellent introduction to this chapter. This docudrama is about how AIDS was discovered,
the race to find the cause and how it was transmitted, and some of the misconceptions and fears
that accompanied the disease.
Section A Causes of Infection
Objective A1. Briefly describe the different types of germs that can cause disease.
Objective A2. Discuss the conditions that promote the growth of germs.
Objective A3. Define the words microbe and pathogen.
Communicable infections are infections that can be spread from one person to another caused by
microbes called pathogens. Work with your students to understand that microbes are generally
classified as bacteria, viruses, fungi, or parasites.

Explain the difference between microbes and pathogens. Discuss how certain infections
are communicable. (Refer to PowerPoint slide 3.)
o Use the Infection question to reinforce the information (Refer to PowerPoint
slides 6 and 7).

Discuss the classification of microbes. (Refer to PowerPoint slides 4 and 5 and Table
13-1 in the text.)

Discuss the various infections caused by bacteria, viruses, fungi, and parasites. (Refer to
PowerPoint slide 5 and Table 13-1 in the text.)

Discuss the conditions needed for the growth of most pathogens. (Refer to PowerPoint
slide 4.)
Section B Defenses Against Infection
Objective B1. Explain the defense mechanisms the body uses to fight infection.
Objective B2. Define the word antibodies.
Discuss with your students that the immune system’s nonspecific defense mechanisms against
pathogens include the physical barriers provided by the skin and mucous membranes and the
general immune response. The signs and symptoms of infection, such as a redness, warmth, pain,
swelling, and fever, are the result of the general immune response; reporting them is a nursing assistant’s
responsibility.
The immune system’s specific defense mechanisms against pathogens include antibodies.
The fact that a person can develop antibodies either by having an infection or by receiving a
vaccination is sometimes a hard concept for your students to understand.
Discuss the role of antibiotics, antimicrobial agents, and antiviral agents as medications
that are used to treat some kinds of infections. Not all infections can be treated with medications,
and in some cases, medications that used to work against certain pathogens no longer work
because the pathogens have developed resistance. Share with your students that some antibiotics
destroy bacteria that help keep us healthy, which allows other bacteria to grow rapidly and make
us sick.

Discuss the immune system, the specific and nonspecific defenses of the body that
protect us from infections. (Refer to PowerPoint slide 9.)

Explain how the skin and mucous membrane are the first lines of defense against
infections. Discuss how the body responds to an infection in order to fight it off. (Refer to
PowerPoint slides 10–12.)

Explain the circumstances under which the body produces antibodies, which are specific
defenses to protect the body from infections. (Refer to PowerPoint slide 13.)

Discuss the medications available such as antibiotics, antimicrobial agents, and antiviral
agents to fight infections. Explain that some bacteria have become resistant to the
antibiotics and can cause serious problems. (Refer to PowerPoint slide 14.)
Section C Ways Infections Are Transmitted
Objective C1. Describe the airborne route of transmission.
Objective C2. Describe the direct route of transmission.
Objective C3. Describe the oral-fecal route of transmission.
Objective C4. Describe the bloodborne route of transmission.
Objective C5. Identify body fluids that are most likely to contain bloodborne pathogens.
Objective C6. Define the words airborne pathogens, oral–fecal route, bloodborne pathogen,
and body fluids.
Some infections are transmitted through the air and the person becomes infected when he or she
breathes contaminated air. Some infections are transmitted through contact with an infected
person or objects that the infected person has used. Other infections are transmitted when feces
containing a pathogen contaminate food or water that is then consumed by another person, while
some infections are transmitted when blood or body fluids from an infected person enters the
bloodstream of a noninfected person. Discuss these various routes of transmission with your
students. When discussing bloodborne route, help your students identify the most likely body
fluids to contain such pathogens and the most common ways they increase the risk of infection to
the nursing assistant.

Explain how certain infections are transmitted by airborne pathogens. (Refer to
PowerPoint slide 16.)

Explain how many infections spread directly from one person to another by direct
transmission. (Refer to PowerPoint slide 17.)

Explain how some pathogens are transmitted through the oral-fecal route and how such
infections can be prevented by proper hand hygiene and sanitation. (Refer to PowerPoint
slide 18 and Figure 13-2 in the text.)

Explain how certain pathogens are transmitted from one person to another through blood
or body fluids. List the body fluids and some of the infections transmitted this way.
(Refer to PowerPoint slides 19 and 20.)
Section D The Chain of Infection
Objective D1. List and describe the six key conditions that must be met for an infection to be
spread from one person to another.
Objective D2. Explain how the chain of infection can be broken.
The chain of infection describes the elements that must be present for an infection
to occur and it is an important concept for your students to understand. Discuss the six elements
of the chain of infection: pathogen, reservoir, portal of exit, method of transmission, portal of
entry, and susceptible host and how breaking just one link in the chain of infection stops the
spread of infection from one person to another.

Describe the chain of infection. Explain how this chain can be broken by taking away just
one of the required elements. (Refer to PowerPoint slides 24–27 and Figures 13-4 and
13-5 in the text.)
o Use the Defenses Against Infection question to reinforce the information (Refer to
PowerPoint slides 21 and 22).
Section E Methods of Infection Control
Objective E1. Discuss ways that a person could get an infection within the health care system.
Objective E2. List the four major methods of infection control.
Objective E3. Describe the four techniques that make up the practice of medical asepsis.
Objective E4. Explain why proper hand hygiene is the single most important method of
preventing the spread of infection, and give examples of when you should wash your hands.
Objective E5. State how personal protective equipment (PPE) is used in infection control.
Objective E6. Explain how isolation precautions are used to help prevent the spread of infection.
Objective E7. Explain when airborne precautions, droplet precautions, contact precautions, and
standard precautions are used.
Objective E8. Describe tuberculosis (TB), an airborne infection that poses a special risk to health
care workers.
Objective E9. Describe four diseases caused by bloodborne pathogens that pose a special risk to
health care workers, and explain how the viruses that cause these diseases affect the body.
Objective E10. Demonstrate proper hand hygiene, gloving, masking, gowning, and doublebagging techniques.
Objective E11. Define the words health care–associated infections (HAIs), nosocomial
infections, medical asepsis, transient flora, contaminated, personal protective equipment
(PPE), tuberculosis (TB), and standard precautions.
Infections can spread easily through a health care facility. Many of the people your students will
care for will have risk factors for infection. Stress to them that a major part of their responsibility
in caring for other people involves protecting them from infection.
Discuss with them that infection control is achieved through medical asepsis, surgical
asepsis, barrier methods, and isolation precautions. Describe that medical asepsis, or the process
of physically removing pathogens from surfaces, is achieved through processes involving soap
and water, antiseptics, disinfectants, or heat.
Stress that proper hand hygiene is the single most effective method of preventing the
spread of infection and for proper hand hygiene to be effective in preventing the spread of
infection, it must be performed thoroughly, properly, and consistently.
Barrier methods prevent a pathogen from gaining access to a health care worker’s body.
Your students need to discuss the importance and appropriate use of the commonly used barrier
methods including gloves, gowns, masks, and protective eyewear (personal protective equipment
[PPE]).
Isolation precautions are used to contain the spread of a pathogen. The discussion about
the two main types of isolation precautions, transmission-based precautions and standard
precautions can be difficult for students to understand so place close attention to their ability to
understand these topics. Transmission-based precautions are used when a person is known or
thought to have an infection that is transmitted a certain way and your students need to be able to
discuss the various routes of transmission. Be sure to include a discussion on standard
precautions and the importance of it being taken with every patient or resident. Finally discuss
common illnesses and how they are transmitted.

While explaining the terms infection control and nosocomial, list the four methods used
to control the spread of infections in the health care setting. (Refer to PowerPoint slides
32 and 33, Box 13-1, and Guidelines Box 13-2 in the text.)

Discuss the goal of medical asepsis while explaining the four techniques that make up the
practice of medical asepsis. (Refer to PowerPoint slide 33).

Discuss the proper technique of proper hand hygiene using soap and water or alcohol.
(Refer to PowerPoint slide 34, Table 13-2, Procedure 13-1, and Box 13-2 in the text.)
Activity: Demonstrate proper hand hygiene technique. Have students practice this procedure.

Discuss the situations when surgical asepsis is practiced. (Refer to PowerPoint slide 35.)

Discuss how the use of personal protective equipment (PPE) can help protect the health
care worker from infection. Explain the sequence of putting on the PPE and removing it.
Discuss the use of gloves, gown, protective eyewear, and mask. (Refer to PowerPoint
slide 36, Figures 13-6 and 13-7, Procedures 13-3–13-7, and Guidelines Box 13-2 in
the text.)
Activity: Demonstrate the proper donning and removal of PPE. Have students practice this
procedure.

Explain isolation precautions. (Refer to PowerPoint slides 37).

Discuss transmission-based precautions and standard precautions. (Refer to PowerPoint
slides 40–44, Boxes 13-4–13-6, and Procedures 13-7 in the text.)
Section F Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens
Standard
Objective F1. Describe the standards set by the Occupational Safety and Health Administration
(OSHA) to protect health care workers from exposure to bloodborne pathogens in the workplace.
Objective F2. Explain how the employer and the employee share responsibility for maintaining
the employee’s safety in the workplace.
The nursing assistant and the employer share the responsibility for protecting persons from
exposure to bloodborne pathogens in the workplace. Stress to the students that they are
responsible for taking standard precautions with each and every patient or resident, while their
employer is responsible for following the standards outlined by the Occupational Safety and
Health Administration (OSHA) to ensure that the work environment is safe (the OSHA
Bloodborne Pathogens Standard).

Discuss the need for standards in health care centers. List and explain the standards set up
by the Occupational Safety and Health Administration (OSHA). (Refer to PowerPoint
slides 47 and 48 and Box 13-8)