Download Chapter 6: Infection Control

CHAPTER 6: INFECTION
CONTROL
Roosevelt Health Science
Clinical Rotations
Successful Nursing Assistant Care, 2nd Ed.
Chapter 6 Objectives
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Define important words
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Define “infection control” and discuss
types of infections
Discuss the use of Personal Protective
Equipment (PPE)
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Discuss terms related to infection
control
List guidelines for handling linen and
equipment
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Explain how to handle spills
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Describe the chain of infection
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Discuss Transmission-Based Precautions
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Explain why the elderly are at high
risk for infection
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Describe care of the resident in an isolation
unit
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Describe the CDC and explain
Standard Precautions
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Explain OSHA’s Bloodborne Pathogen
Standard
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Define “hand hygiene” and identify
when to wash hands.
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Discuss two important bloodborne diseases
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Discuss MRSA, VRE, and C. Difficile
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Infection Control
• Communities strive to maintain clean conditions in order to help prevent the
spread of disease.
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This is known as sanitation.
• Infection Control- the set of methods used to control and prevent the spread
of disease.
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It is the responsibility of all members of the care team
Know the facility policies on infection control and follow them to protect you,
patients, visitors, and other staff members.
• By using proper infection control methods, you can prevent all people in
your care, as well as other staff members and visitors, from acquiring an
infection from someone else.
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This is called cross-infection or cross-contamination
Also prevents residents from being infected a second time, called reinfection
Infections
• Microorganism (MO) is a tiny living thing visible only by a microscope.
Also known as a microbe
• They are always present in the environment, though many are not harmful.
• Bacteria, viruses, fungi, protozoa are types of MOs
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• Pathogens are harmful microorganisms that can cause infections or
infectious disease.
For infections to develop, pathogens must invade and grow within the human
body.
• Grow best in warm, dark, and moist places where food is present, and in hosts
who have low resistance.
• Some MOs need to survive, while others do not.
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Types of Infections
• A localized infection is limited to a specific part of the body. It has local
symptoms, near the site of infection.
For example, eye infections could be red, swollen, painful, and warm to the
touch.
• S/Sx include redness, swelling, pain, heat, drainage (fluid from a wound or
cavity).
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• A systemic infection occurs when pathogens enter the bloodstream and
move throughout the body, causing generalized symptoms.
Acquired Immune Deficiency Syndrome (AIDS) is an example
• S/Sx include fever, chills, headache, change in other vital signs, nausea, vomiting,
diarrhea, mental confusion.
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Types of Infections
• As special type of infection that can be localized or systemic is a
healthcare-associated infection (HAI), an infection associated with
various healthcare setting, including long-term care facilities, hospitals,
ambulatory settings and home care.
• A second type of infection that can be localized or systemic is a
nosocomial infection, which comes from a hospital.
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Example: a resident gets a UTI from a urinary catheter after entering a facility.
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Catheter- a tube inserted through the skin or into a body opening that is used to add
or drain fluid.
• HAIs and nosocomial infections can be mild or life-threatening
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Report to nurse immediately
Infectious Disease
• A communicable disease occurs when a pathogen is spread from
one person to another.
• Ex: Hepatitis, Influenza, Polio, TB, Malaria, etc.
• A contagious disease is a communicable disease is spread easily
from person to person.
• Ex: STDs, MRSA, Varicella (Chicken Pox), etc.
• A non-communicable disease is a disease not capable of being
spread from one person to another.
• Ex: Emphysema, Diabetes, Stroke, COPD, etc.
Terms related to Infection Control
• Transmission
• Clean Technique or Medical
Asepsis
• Clean
• Contaminated
• Dirty
• Disinfection
• Autoclave
• Surgical Asepsis or Sterile
Technique
Describe the Chain of Infection
Chain Link 1: Causative Agent
• The causative agent is a pathogen that causes disease.
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Normal Flora are the microorganisms that normally live in and on the body
without causing harm to a healthy person.
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If they enter a different part of the body, they may cause infection
• There is a waiting period between the time the pathogen enters the body
and the time it causes an infection, called an incubation period.
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Ex: Varicella (10-21 days), Influenza (1-3 days), and Measles (10-21 days)
• Vaccines can give immunity to a disease w/o causing the sx of the
disease.
Immunity may not last forever
• Created from weakened or killed microbes of the disease
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Chain Link 2: Reservoir
• The reservoir is where the pathogen lives and grows; can be human,
animal, plant, soil, or substance.
• Two main ways of spreading an infection from a reservoir: direct and
indirect.
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Direct Spread occurs when a person gets a disease directly from another person
(reservoir).
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The human reservoir may be a person with an active disease or a person carrying the
disease w/o s/sx (carrier).
Indirect Spread occurs when a person gets a disease from an object, insect, or
animal (reservoir).
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Objects contaminated with a pathogen are also called fomites, such as water, food,
food utensils, bedpans, or bed linens.
Chain Link 3: Portal of Exit
• There can be different exit
routes, or portals of exit,
from a reservoir.
• The portal of exit is any
opening on an infected
person allowing pathogens to
leave.
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These include the nose,
mouth, eyes, or a cut in the
skin.
Chain Link 4: Mode of Transmission
• Mode of Transmission describes how the infectious disease
travels.
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This can include contact, droplet, and airborne transmission.
• Contact with blood or body fluids (tears, saliva, sputum, urine,
feces, semen, vaginal secretions, pus or other wound drainage)
• Droplets come from coughing, sneezing, talking, laughing,
suctioning, singing, and spitting
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Less than 3 ft
• Airborne travels in the air (more than 3 ft) through moisture and
dust.
Chain Link 5: Portal of Entry
• Pathogens enter the human host through different portals of
entry.
The portal of entry is any body opening on an uninfected person that
allows pathogens to enter.
• Includes nose, mouth, eyes, and other mucous membranes, cuts in the
skin, and cracked skin.
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Mucous membranes are membranes that line body cavities that open to
the outside of the body such as the mouth, nose, eyes, rectum, and
genitals.
• Many areas of the body are protected from invading pathogens,
sort of like an “armor.”
Chain Link 6: Susceptible Host
• A susceptible host is an uninfected person who could get sick.
• A person becomes susceptible when his/her resistance decreases due
to age, existing illness, fatigue, and/or stress.
• When a pathogen invades the body, it will start reproducing itself.
• As pathogens grow, they damage healthy tissue.
Reasons for Increased Risk of Infection for
Elderly
• Immune systems become
weaker
• Hospitalized more frequently
(nosocomial)
• Longer recovery
• Thinner skin
• Limited mobility
• Bones become more brittle
• Decreased circulation
• Slow wound healing
• Frequent use of catheters
• Dehydration
• Malnutrition
Center for Disease Control
• CDC is a federal government agency that issues guidelines to
protect and improve health.
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It promotes public health and safety through education and tries to
control and prevent disease.
• In 1996, the CDC created new guidelines to protect people in
health care from contracting infectious diseases.
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It was updated 2007
• There are two levels of precautions in the infection control
system recommended by the CDC.
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Standard Precautions and Isolation Precautions
Standard Precautions
• Standard Precautions means treating blood, body fluids, non-
intact skin, and mucous membranes as if they were infected.
• They are always followed because you cannot tell by looking at a
patient or his/her chart if they have a contagious disease.
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Assume everyone has something!!!!!!!!
• For guidelines, please view the chapter provided.
Hand Hygiene
• Hand hygiene is defined by the CDC as any
method that removes or destroys
microorganisms on hands, including
handwashing and hand sanitizer.
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Alcohol-based hand rubs ARE NOT a substitute
for frequent and proper handwashing!
• As you move between patients’ rooms,
always wash your hands.
Taking care of patients means you will get
microorganisms on your hands.
• Wash your hands before giving care.
• It will help prevent the spread of disease.
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Personal Protective Equipment (PPE)
• PPE is a barrier between a person and disease. It is what you
wear to prevent the transmission of disease.
• PPE includes gloves, gowns, masks, goggles, and face shields.
• See chapter provided for proper steps to putting on and
removing PPEs.
Handling Linen and Equipment
• Facilities handle storage and disposal of linen and equipment by
following guidelines set by the CDC.
Facilities have separate areas for clean and dirty items called clean and
dirty utility rooms.
• Linen and equipment will be placed in separate containers to be
cleaned or discarded.
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There will be disposal containers for linen, trash, equipment, and special
infectious waste disposal.
• Guidelines can be found in the chapter provided.
Handling Spills
• Spills happen when blood, body fluids, or other fluids get on any person,
object, or area in a facility.
• Spills pose a serious risk of infection and fall risk for patients.
• Clean spills using proper equipment and procedures.
Wear gloves and wipe up immediately for the outside moving in.
• Use a cleaning solution of 1 part bleach to 10 parts water. There may be ready-touse spray bottles at the facility.
• Be careful if any glass or other sharp objects are in a spill. Get help when picking up
and disposing of sharps.
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NEVER PICK UP GLASS EVEN WITH GLOVED HANDS
For large spills, call the nurse and follow your facility policy for large spills.
• If you spill on your body, wash it off immediately. Report the exposure.
• Wash your hands after cleaning spills
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Transmission-Based Precautions
• Precautions beyond Standard Precautions.
• These guidelines were for persons who are infected or may be
infected with diseases.
• Also known as Isolation Precautions, consisting of three
categories.
Airborne
• Droplet
• Contact
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• Refer to chapter provided
Isolation Unit
• Patients who require Transmission-Based Precautions are
referred to as being in “isolation.”
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A sign should be on the door indicating “isolation” or alerting people to
see the nurse before entering the room.
• Patients in isolation cannot move about freely, and are
separated from everyone else.
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May cause resident loneliness, be empathetic
• They may be allowed visitors, but all visitors must be trained in
PPEs
• Follow the guidelines in the chapter provided.
OSHA’s Bloodborne Pathogen Standard
• Bloodborne pathogens are MOs found in human blood that can cause
infection and disease.
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They may also be found in body fluids, draining wounds, and mucous membranes
• Occupational Safety and Health Administration (OSHA) is a federal
government agency that is responsible for the safety of workers in the
U.S.
• By law, employers must follow these rules to reduce the risk of acquiring
infectious disease. The Standard also guides employer and employees
through the steps to follow if exposed to infectious material.
• Refer to the chapter provided for specific guidelines
HIV/AIDS
• Bloodborne pathogen, HIV, can lead to AIDs.
• Over time, HIV damages the immune system so that the body
cannot fight infections
• HIV is transmitted by blood, infected needles, and from mother
to fetus.
• Also transmitted sexually!
Hepatitis
• Hepatitis is an inflammation of the liver caused by infection.
Liver function can be permanently damaged by hepatitis.
• There are several types of hepatitis, including A, B, C, D, and E
•
Most common are A, B, C
• Hepatitis B and C are Bloodborne Pathogens, and can cause
death.
• More people have Hepatitis B (HBV) than HIV.
• For more facts about Hepatitis see chapter provided.
Multidrug-Resistant Organisms (MDROs)
• MDROs are microorganisms, mostly bacteria, that are resistant to one or more
antimicrobial agents.
• Two common types of MDROs are MRSA and VRE
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Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of staph bacteria that can
cause disease and is resistant to powerful antibiotics in the methicillin family.
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Spreads by direct contact and indirect contact
Sx of MRSA include drainage, fever, chills, and redness
Vancomycin-resistant enterococcus (VRE) is a bacterium that is resistant to the antibiotic
Vancomycin.
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Very dangerous because it cannot be treated with antibiotics at all, causes life-threatening
infections.
Spreads by direct contact and indirect contact
Sx of VRE include fever, fatigue, chills, and drainage.
• For more information on MDROs and how to handle them, see chapter provided