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APPLIED EDUCATIONAL SYSTEMS Infection Control Health Science and Technology Education Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Overview You will learn about: The chain of infection Standard precautions and transmission-based precautions Proper hand cleansing techniques Sterile technique Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Questions 1. What risks do you take by not wearing gloves? 2. What situations do you need to remember to wear Personal Protective Equipment PPE? 3. How does forgetting to put gloves on affect your patient’s confidence in you as their medical professional? Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science What do you know about… 1. Infection control? 2. Why is it important in health care facilities? Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Microorganisms Microorganisms are small living bodies that are not visible to the naked eye. ▫ Nonpathogens - maintain body processes ▫ Pathogens – cause infection and disease ▫ Aerobic- need O2 to live ▫ Anaerobic-live and reproduce in the absence of O2 Classes of microorganisms: ▫ ▫ ▫ ▫ Bacteria Protozoa Fungi Viruses Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Classes of Microorganisms Classes of microorganisms: ▫ Bacteria ▫ Protozoa ▫ Fungi ▫ Viruses Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Bacteria Bacteria are one-celled microorganisms that are classified by shape. Spores are thick-walled cells created by bacteria to aid in reproduction and to make the bacteria resistant to harsh environments. Spores can result in serious illness. Diseases - food poisoning, strep throat, tetanus, syphilis, and cholera Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Protozoa Protozoa are the simplest organisms in the animal kingdom. Most protozoa need moisture to survive, so they are often found in watery environments. Diseases - malaria, dysentery, and African sleeping sickness Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Fungi Fungi are plant-like microorganisms that can be found in the air, in soil, on plants, or in water. There are thousands of types of fungi, including mushrooms, yeasts, and molds. Only about half of these types of fungi are pathogenic. Diseases - athlete’s foot, ringworm, yeast infections, and thrush Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Viruses Viruses are the smallest type of microorganism. They are made up of only a few molecules. Viruses invade the cells of a living organism where they reproduce more viruses. Diseases - common cold, chicken pox, measles, herpes, hepatitis B and C, HIV, and AIDS Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Types/ Classification of Infections and Diseases Endogenous – begins inside the body Exogenous – caused by something outside the body Nosocomial – acquired by an individual within a health care facility Opportunistic – occur when the body’s defenses are weak Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Infectious and Communicable Diseases An infectious disease results from an invasion of microorganisms. A communicable disease is a type of infectious disease that can be transmitted from one person to another person. Not all infectious diseases are communicable. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Lesson 2 – Chain of Infection Causative agent Reservoir Portal of exit Mode of transmission Portal of entry Susceptible host Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Mode of Transmission Airborne Transmission Bloodborne Transmission Vectorborne Transmission Sexual Transmission Foodborne Transmission Casual Contact Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Aseptic Technique Asepsis is a condition that is free of pathogens. Maintaining asepsis in a health care facility is the primary way to prevent the spread of disease from person to person. It works by breaking the chain of infection. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Lesson 3 – Medical and Surgical Asepsis Medical asepsis is maintaining a clean environment in order to reduce the number of pathogens. It is also called clean technique. Surgical asepsis is maintaining a sterile field that is free from all microorganisms and spores. It is also known as sterile technique. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Sterilizing Sterilization is the highest level of asepsis. Sterilization is a type of surgical asepsis that kills all microorganisms, including viruses and spores. The most common piece of equipment used for sterilization is called an autoclave. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Disinfecting Disinfection is a type of medical asepsis that destroys most pathogens, but is not always effective on viruses and spores. Common disinfectant solutions include chlorine and bleach. An object must soak in a disinfectant solution for at least 20 minutes to be properly disinfected. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Cleaning Cleaning is the lowest level of asepsis, and is also called sanitization. The cleaning process does not require harsh chemicals to destroy pathogens, so cleaning can be used on people. Antiseptic solutions such as iodine, betadine, and alcohol are often used in the cleaning process. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Hand Washing Hand washing is the most basic and important type of medical asepsis. Hand washing is the number one way to prevent the spread of infection. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Handwashing When arriving at the health care facility and immediately before leaving the facility Before and after every patient contact Before and after a procedure Before and after handling a specimen Before and after touching the mouth Before and after wearing gloves. After contacting soiled or contaminated items After picking up any item from the floor After using the bathroom After coughing, sneezing, or using a tissue Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Handwashing Use liquid soap Use warm water Rub hands together firmly Clean all surfaces of the hands Keep fingers pointed downward Wash for at least 15 to 20 seconds Use only dry paper towels to dry hands Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Standard Precautions The Center for Disease Control and Prevention developed a list of standard precautions that should be used for all patients, regardless of their type of illness. Two reasons for standard precautions: ▫ To protect health care workers ▫ To protect patients Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Standard Precautions for Patient Contact Use appropriate personal protective equipment Wash hands frequently Bandage cuts properly Use face shields during CPR Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Precautions for Environmental Cleanliness Place sharps in punctureproof biohazardous waste containers Clean up spills immediately Discard infectious waste in biohazardous waste bags Place contaminated linens in biohazardous laundry bags Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Gowns Gowns should be worn when using chemical solutions and during procedures where splashing or spraying of blood and bodily fluid is likely. Disposable gowns should be placed into biohazardous waste containers after use. Non-disposable gowns may be placed into biohazardous linens bags. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Masks and Eyewear Masks and eyewear must be worn for procedures that may produce splashes or sprays of blood or bodily fluid. Masks should be worn once and then discarded into biohazardous waste containers. Eyewear is often reusable. However, it must be cleaned and disinfected before reuse. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Non-Sterile Gloves Non-sterile gloves should be worn when contacting blood or other bodily fluids and when handling or cleaning contaminated items. The same pair of gloves should never be worn in more than one procedure. Wearing gloves should never replace washing hands. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Lesson 12 – Communicable Diseases A communicable disease is a type of infectious disease that can be transmitted from one person to another person. Some communicable diseases are spread through direct contact. Others may be spread through indirect contact. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Transmission of Communicable Diseases Not all communicable diseases are transmitted the same way. There are many different types of communicable diseases, and health care workers must become familiar with the mode of transmission for each disease. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Transmission-Based Precautions Transmission-based precautions are used only with patients who have been diagnosed with highly communicable diseases. Three types: ▫ Airborne ▫ Droplet ▫ Contact Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Airborne Precautions Airborne precautions are used for patients with disease that are spread through tiny airborne droplets suspended in air or dust particles Precautions: ▫ Isolation room ▫ Respiratory protection ▫ Negative pressure Examples of diseases: ▫ ▫ ▫ ▫ ▫ Table of Contents Tuberculosis Chicken pox Measles Shingles Herpes zoster APPLIED EDUCATIONAL SYSTEMS Health Science Airborne Precautions P. 399 Patient MUST be in private room Door must be kept closed Air in the room must be discharged to an outdoor air or filtered before being circulated to other areas Everyone who enters must wear mask N95 or P100specially fit tested Limit movement of patient out of the room Must wear surgical mask if moved out of room Use disposable equipment when possible Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Droplet Precautions p. 399 Droplet precautions are used for patients with diseases that are spread through large airborne dropletscoughing sneezing, talking or laughing Precautions: ▫ Isolation room ▫ Standard surgical masks Examples of diseases: ▫ Pneumonia ▫ Influenza ▫ Pertussis Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Droplet Precautions Patient MUST be in a private room A distance of 3 feet should separate the infected patient and other patients/visitors Masks MUST be worn when working within 3 feet If patients must be transported– they should wear a mask Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Contact Precautions Contact precautions are used for patients with diseases that are spread through direct and indirect contact. Precautions: ▫ Isolation room ▫ Gowns and gloves ▫ Equipment precautions Examples of diseases: ▫ MRSA ▫ VRE ▫ Hepatitis A Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Contact Precautions Patient should be placed in a private room May be placed in a room with another patient with the same infection ( same organism) Gloves MUST be worn when entering Gloves MUST be changed after contact with patient or room surroundings Gloves MUST be removed before leaning and hands thoroughly washed A Gown MUST be worn if there is any chance of contact with patient or the room environment Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Contact Precautions-- Continued Remove gown when exiting room Movement of patient out of the room should be limited Room and items should receive daily cleaning and disinfection Patient care equipment should stay in room and used only for that patient or disposable items should be utilized Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Transmission-Based Garments When health care workers enter isolation rooms, they must wear transmission-based garments. Health care workers must wear appropriate garments based on the disease of the patient. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Protective Garments Order for donning PPE ▫ ▫ ▫ ▫ Gown Mask Eyewear Gloves Order for removing PPE ▫ ▫ ▫ ▫ Gloves Eyewear Gown Mask Always cleanse hands before donning the items and immediately after removing them. Health care workers must not touch the outer surface of any protective garments. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Isolation Units Patients with communicable diseases are often placed into private rooms for isolation. This practice helps prevent the spread of communicable diseases to health care workers and other patients. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Meals in an Isolation Unit Most facilities require that disposable food trays and eating utensils are used in isolation units. Leftover food and beverages should never be taken out of an isolation unit. Liquids and soft foods should be flushed down the toilet. Solid foods should be placed in biohazardous waste bags. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Working in an Isolation Unit Most of the procedures that take place in isolation units require two health care workers. Items that are taken from isolation rooms are doublebagged to prevent the spread of dangerous pathogens. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Sterile Technique Sterile technique, also called surgical asepsis, is maintaining an area that is free from all microorganisms. Sterile technique must be practiced for all invasive procedures to protect patients from infection. To maintain a sterile area, only sterile items may touch other sterile items. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Sterile Fields Sterile fields are areas that are set up for procedures and are free from microorganisms. A sterile field is usually a tray covered with a small sterile towel. The tray contains equipment and supplies for a specific procedure. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Working with Sterile Fields Create sterile field in a clean, uncluttered area Never reach across a sterile field Keep your eyes on a sterile field at all times Keep the sterile field dry Create the sterile field again if you suspect that it has become contaminated Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Sterile Packages Most of the items used to create a sterile field are prepackaged in sterile wraps. A sterile package must be opened with care. The outside of the package is considered contaminated, but the inside is sterile. Only sterile items, such as a sterile transfer forceps, may touch the inside of a sterile package. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Sterile Glove Sterile gloves are a key tool in maintaining a sterile field. Sterile gloves should be worn whenever health care workers treat an open wound, perform an invasive procedure, or apply a dressing. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Reflect – Unit Questions 1. The common cold is a virus. Beginning with the causative agent, explain how the cold could be passed from one person to another through the chain. 2. Describe how you would decide which level of asepsis is needed for a piece of equipment and how each level of asepsis could be attained. 3. In what work situations should a health care worker wash their hands? What are some ways that you can apply proper hand washing hygiene outside of work? 4. Identify the standard precautions that should be applied if you must change the bandage of a patient with a seeping wound. What precautions should you take to clean up blood from an examination room? Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science PPE Video http://www.youtube.com/watch?v=oxdaSeq4EVU &feature=youtu.be Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Simmers, K. , Simmers-Kobrelak, K., Simmers-Narkter, K., (2009). Diversified Health Occupations . Clifton Park: NJ : Delmar Cengage Learning. Table of Contents APPLIED EDUCATIONAL SYSTEMS Health Science Short Answer Question – Worth 15 points Trace the Chain of Infection of Tuberculosis 1. Include all 6 links in the chain- make sure you include specific examples with each link 2. What type of Transmission Based Precautions would you expect the patient to be on? Why3. Include all PPE that must be used. Table of Contents