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Guided Lecture Notes
Chapter 10, Communicable Disease and Infection Control
Learning Objective 1. List the different types of “germs” (microbes) that cause disease
and discuss the conditions that are essential for their survival and growth. (Refer to
PowerPoint slides 5 to 16.)
 Explain the term microbe.
 A microbe, also called a microorganism, is a living thing.
 Many (but not all) microbes consist of just one cell.
 Microbes are found in the air, in the soil, in water, in food, and in and on the
bodies of plants and animals, including humans.
 Describe how microbes are classified as bacteria, viruses, fungi, and parasites.
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Bacteria
Describe types of bacteria and how are they classified according to their shapes,
the way they arrange themselves in the colony, and the way they stain (react to a
particular dye).
List the names of bacteria when classified according to their shapes. Round
bacteria are called cocci. Rod-shaped bacteria are called bacilli. Spiral-shaped
bacteria are called spirilla.
Explain the terms colonies, aerobic, and anaerobic.
Colonies
 Bacteria are unicellular organisms.
 They often group together to form colonies.
Aerobic – Aerobic bacteria need oxygen to live.
Anaerobic – Anaerobic bacteria die if oxygen is present.
List the names of bacteria classified according to their existence in colonies: pairs
of bacteria (indicated by the prefix diplo-), chains of bacteria (indicated by the
prefix strepto-), grape-like clusters of bacteria (indicated by the prefix staphylo-).
Explain the naming convention used when identifying a bacteria. What would you
know if you saw the word Staphylococcus aureus on a person’s medical record?
Explain the concept of endospores in relation to bacteria and how they adapt.
Explain the common illnesses caused by bacteria. Mention that bacteria are the
most common causes of infection in the health care setting. Give examples of
illnesses caused by bacteria.
Viruses
Explain the term virus and how host cells are used to spread infections.
List some of the illnesses caused by viruses, such as the common cold, fever
blisters (caused by herpes simplex virus), chicken pox (caused by varicella zoster
virus), hepatitis (caused by hepatitis virus), and AIDS (caused by human
immunodeficiency virus [HIV]).
Point out to students that viruses cannot be cured by antibiotics, but that some
antiviral drugs are effective for some viruses.
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Fungi
Explain the different types of fungi and the illnesses caused by them, such as
ringworm (caused by Tinea corporis), athlete’s foot (caused by Tinea pedis),
thrush (a yeast infection in the mouth), or candidiasis (a vaginal yeast infection).
Parasites
Explain the term parasite and give examples of illnesses caused by parasites, such
as scabies (mites) and pediculosis (lice).
Have learners refer to learning activities located at the end of the chapter.
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Learning Objective 2. Define the terms normal flora and pathogen. (Refer to
PowerPoint slides 5 and 6.)
 Explain the terms microbe, normal flora, pathogen, and opportunistic microbe.
Normal flora – The harmless microbes that help the human body to function
properly are called normal (resident) flora.
Pathogens – Some microbes can cause illness and are known as pathogens.
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Opportunistic Microbes
 Sometimes microbes act as normal flora in one part of the body and pathogens in
another; these types of microbes are called opportunistic microbes.
For example, Escherichia coli is a microbe that normally lives in our large
intestines, where it is harmless. However, when E. coli finds its way out of the
intestine and into another part of the body where it is not normal flora, such as the
bladder, it can cause an infection.
Have learners refer to learning activities located at the end of the chapter.
Learning Objective 3. Explain the defense mechanisms the body uses to keep us from
getting sick. (Refer to PowerPoint slides 20 to 25.)
 Discuss the immune system, nonspecific defense mechanisms, and specific defense
mechanisms.
 Define the term antibodies and how a person develops antibodies.
 Explain that an antibiotic is a drug that is able to kill bacteria or make it difficult for
them to reproduce and grow.
 Explain that antibiotics do not work on viral infections.
 Describe how certain bacteria have become resistant to antibiotics.
 Discuss the different types of vaccinations that your students have had and how that
helps to protect against many contagious illnesses.
 Have learners refer to learning activities located at the end of the chapter.
Learning Objective 4. Define the term infection and describe the chain of events
required for infection to occur. (Refer to PowerPoint slides 29 to 31.)
 Discuss communicable and contagious infections.
 What is an Infection?
 An infection is an illness caused by a pathogen.
 Identify possible signs of infection that should be reported to the nurse immediately.
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What are the Different Types of Infections?
 Infections can be local (affecting a small, defined area of the body; for example, a
skin abscess).
 Infections can be generalized (affecting a general area or an organ; for example,
strep throat).
 Infections can be systemic (affecting the entire body; for example, scarlet fever).
 A contagious infection is an infection, such as a common cold, that can be easily
transmitted from one person to another through casual contact.
 Although they are communicable, diseases such as acquired immune deficiency
syndrome (AIDS) and hepatitis are not considered contagious infections because
they are not transmitted through casual contact.
Discuss the chain of infection using the structure given below.
 For a person to get a communicable infection, six key conditions must be met.
These six key elements are known as the chain of infection.
 A pathogen, or a microbe capable of causing disease
 A reservoir, such as humans and other animals, food, water, milk, and objects
that come in contact with an infected person’s secretions or body fluids
 A portal of exit, or a way for the pathogen to leave the reservoir. When the
reservoir is a human being, common portals of exit for pathogens include the
digestive tract (through feces, saliva, or vomitus), the respiratory tract
(through mucus), the genitourinary tract (through urine, semen, or vaginal
secretions), and the skin (through blood, pus, or other drainage from wounds).
 A method of transmission, or a way for the pathogen to get from one person
to the next. Direct transmission involves physical contact with an infected
person or inhaling or ingesting droplets exhaled by an infected person (e.g.,
when that person coughs, talks, or sneezes). Indirect transmission involves
physical contact with a nonliving object that is soiled with pathogens.
 A portal of entry, or a way for the pathogen to enter the new person’s body.
The respiratory, urinary, digestive, and reproductive systems are common
portals of entry.
 A susceptible host, or a situation where the pathogen can “set up shop” and
thrive. Risk factors that make a person more likely to get an infection include
very young or very old age, poor general health, stress and fatigue, indwelling
medical devices (e.g., catheters, feeding tubes, IV lines).
 Explain that if any of the six elements in the chain of infection is not present, the
chain is broken, and that helps prevent infection.
 Have learners refer to learning activities located at the end of the chapter.
Learning Objective 5. List factors that can make a person more likely to get an
infection. (Refer to PowerPoint slide 32.)
 Discuss the factors that make a person a more susceptible host and describe why this
can happen.
 Very young: immune system is not developed
 Very old: immune system is not as active with aging
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Poor general health: Body defenses are already weak; certain medications and
treatments can adversely affect the immune system
 Stress and fatigue: lack of rest and emotional stress can weaken the immune
system
 Indwelling medical devices: IVs, urinary catheter, NG tubes, etc., can increase the
risk of infection by providing a portal of entry for pathogens
Ask students to share their own personal experiences when they or someone they
know have come down with an infection. Had there been factors affecting them at the
time that would have made them more susceptible?
Have learners refer to learning activities located at the end of the chapter.
Learning Objective 6. Define the term health care–associated infection (HAI) and
discuss ways a person could get an infection within the health care system. (Refer to
PowerPoint slides 34 and 35.)
 Explain to the students that there are more people with infections located in a health
care facility, as well as many people who have an increased susceptibility to
infection.
 Discuss that a common cause of HAI is from germs being carried on the hands of
health care workers from one patient or resident to another. Handwashing is the most
effective method of preventing the spread of infection.
 Have learners refer to learning activities located at the end of the chapter.
Learning Objective 7. List the four major methods of infection control. (Refer to
PowerPoint slides 36 to 58.)
 Discuss four methods of infection control: medical asepsis, surgical asepsis, barrier
methods, and isolation precautions.
 Have learners refer to learning activities located at the end of the chapter.
Learning Objective 8. List the four techniques of medical asepsis. (Refer to PowerPoint
slides 37 to 49.)
 Explain the techniques that make up medical asepsis, such as sanitization, antisepsis,
disinfection, and sterilization.
 Give examples of how each technique involved with medical asepsis, sanitization,
antisepsis, disinfection, and sterilization is used in the health care setting.
 Explain that surgical asepsis is used for procedures that involve entering a person’s
body. Examples of procedures that require surgical asepsis include surgical
procedures, injections, the insertion of IV catheters, and the insertion of urinary
catheters. Stress that in most states, performing procedures that require surgical
asepsis is not within a nursing assistant’s scope of practice. However, some facilities
will provide extra training in this area if performing procedures that require surgical
asepsis is part of the nursing assistant’s job description.
 Have learners refer to learning activities located at the end of the chapter.
Learning Objective 9. State how personal protective equipment (PPE) is used in
infection control. (Refer to PowerPoint slides 50 to 56.)
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Explain that barrier methods are used to control infection in the health care setting. A
barrier is an object that physically prevents microbes from reaching a health care
provider’s skin or mucous membranes.
List the types of PPE and describe the use of each.
Demonstrate and discuss the procedure of removing gloves.
Demonstrate and discuss the procedure of putting on a gown.
Demonstrate and discuss the procedure of putting on and removing a mask. Make
sure to explain how to tie the mask properly so that it fits against the face snugly,
without gaps. You should breathe through the mask, not around it.
Demonstrate and discuss the procedure of putting on and removing more than one
article of PPE.
Have learners refer to learning activities located at the end of the chapter.
Learning Objective 10. List the standard precautions that are taken with every patient or
resident. (Refer to PowerPoint slide 57.)
 Define the term standard precautions.
 Explain that standard precautions are taken with every patient or resident because
many times it is impossible to know whether the person is infected with a bloodborne
pathogen. Standard precautions are designed to reduce the health care worker’s
exposure to pathogens in blood and other body fluids.
 Have learners refer to learning activities located at the end of the chapter.
Learning Objective 11. Describe the three types of transmission-based precautions and
explain when they are used. (Refer to PowerPoint slide 58.)
 Discuss how transmission-based precautions are used to protect both the health care
worker and other people in a health care facility from infection.
 Explain the purpose of contact precautions and methods used in the health care
setting.
 Explain the purpose of airborne precautions and the methods used in the health care
setting.
 Explain the purpose of droplet precautions and the methods used in the health care
setting.
 Have learners refer to learning activities located at the end of the chapter.
Learning Objective 12. Demonstrate proper hand hygiene, gloving, masking, gowning,
and double-bagging techniques. (Refer to PowerPoint slides 42 to 46, 50 to 56.)
 Discuss proper hand hygiene. Make a note of important points on a flip chart. Prepare
a list stating when the hands should be washed. The instructor should supplement the
list with the points the participants have left out.
 Explain why you should wash your hands. Focus on the role of a nursing assistant as
a health care worker, and discuss the importance of hand hygiene together as a class.
 Explain the advantages of using alcohol-based hand rubs for routine hand
decontamination. Stress that if your hands are visibly soiled with dirt, blood, or other
body fluids or substances, you must wash them at the sink, using soap and water.
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However, if your hands are not visibly soiled, it is acceptable to use an alcohol-based
hand rub to decontaminate your hands instead of hand hygiene.
Have learners refer to learning activities located at the end of the chapter.