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Guided Lecture Notes, Chapter 10, 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.)

Discuss the classification of microbes. (Refer to PowerPoint slides 4 and 5 and
Table 10-1 in the text.)

Discuss the various infections caused by bacteria, viruses, fungi, and parasites.
(Refer to PowerPoint slide 5 and Table 10-1 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 to 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 handwashing and sanitation. (Refer to
PowerPoint slide 18 and Figure 10-2 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 to 27 and
Figures 10-4 and 10-5 in the text.)
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 handwashing 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 handwashing, gloving, masking, gowning, and
double-bagging 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 handwashing is the single most effective method of preventing the
spread of infection and for handwashing 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 10-1, and Guidelines Box 10-2 in the text.)

Discuss the goal of medical asepsis while explaining the four techniques that
make up the practice of medical asepsis. Discuss the proper technique of
handwashing using soap and water or alcohol. (Refer to PowerPoint slide 34,
Table 10-2, Procedure 10-1, and Box 10-2 in the text.)
Activity: Demonstrate proper handwashing 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 10-6 and 10-7, Procedures 10-2 to 10-4,
and Guidelines Box 10-2 in the text.)
Activity: Demonstrate the proper donning and removal of PPE. Have students practice
this procedure.

Explain isolation precautions. Discuss transmission-based precautions and
standard precautions. (Refer to PowerPoint slides 37 and 40 to 44, Boxes 10-3
to 10-6, and Procedure 10-7 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 slide 48.)