Download Unit 13 - Home - Fremont RE

Chapter 13
Infection Control
Objectives
Identify five classes of microorganisms by
describing the characteristics of each class
 List the six components of the chain of
infection
 Differentiate between antisepsis, disinfection,
and sterilization
 Wash hands according to recommended
aseptic technique

Objectives
Observe standard precautions while working
in the laboratory or clinical area
 Wash, wrap, and autoclave instruments,
linen, and equipment
 Operate an autoclave with accuracy and
safety
 Follow basic principles on using chemicals for
disinfection

Objectives
Clean instruments with an ultrasonic unit
 Open sterile packages without contaminating
the contents
 Don sterile gloves without contaminating the
gloves
 Prepare a sterile dressing tray without
contaminating the supplies
 Change a sterile dressing without
contaminating the materials

Objectives
Don and remove a transmission-based
isolation mask, gloves, and gown
 Relate specific basic tasks to the care of a
patient in a transmission-based isolation unit
 Define, pronounce, and spell all the key terms

Chapter 13:1
Understanding the Principles of Infection
Control

Microorganism or microbe-Small living
organism that is not visible to the naked eye
– Must be viewed under a microscope
– Found everywhere in the environment
– Two types:
• Nonpathogens
• Pathogens
– Aerobic vs anaerobic
Classes of Microorganisms
Bacteria
 Protozoa
 Fungi
 Rickettsiae
 Viruses
 Helminths

Bacteria
Simple, one-celled organisms that multiply
rapidly
 Classified by shape and arrangement

– Cocci
• Round or spherical in shape
• Diplococci, Streptococci, Staphlococci
– Bacilli
• Rod shaped
– Spirilla
• Spiral or corkscrew shaped
Protozoa
One-celled animal-like organisms
 Found in decayed materials and
contaminated water
 Many contain flagella which allow them to
move freely
 Some are pathogenic

Fungi



Simple, plant-like organisms
Live on dead organic matter
Yeasts and molds are two common forms that can
be pathogenic
Rickettsia
Parasitic microorganisms
 Cannot live outside the cells of another living
organism
 Commonly found in fleas, ticks, lice
 Transmitted to humans by bites

Viruses
Smallest microorganisms-Visible only under electron
microscope
 Cannot reproduce unless inside another living cell
 Spread from human to human by blood and other
body secretions
 More difficult to kill

Diseases of Major Concern to
Health Care workers
HBV
 HCV
 AIDS

Hepatitis B
Serum hepatitis
Transmitted by blood, serum, and other body
secretions
 Leads to destruction and scarring of liver cells
 Vaccine developed to protect individuals: Under
federal law, employers must offer the vaccine at no
cost to any health care worker with occupational
exposure to blood or other body secretions


Hepatitis C





Transmitted by blood and blood-containing body
fluids
Many individuals with Hep C are asymptomatic or
are often diagnosed with flu
Can cause severe liver damage
Vaccine is being developed
Can even remain active in dried blood for several
days
Acquired Immune Deficiency
Syndrome (AIDS)
Caused by HIV virus
 Suppresses immune system
 No cure and no vaccine available

Helminths (worms or flukes)
Multicellular parasitic organisms
 Transmitted by contaminated food/meat or
insect bites or through skin

Types of Infection

Classified by:
– Way they cause infection/disease
• Toxins
• Allergic reaction
• Attack/destroy living cells they invade
– Endogenous/exogenous
– Nosocomial
– Opportunistic
Types of Infection

Endogenous:
– Originates within the body

Exogenous:
– originates outside the body

Nosocomial:
– Acquired in a health care facility

Opportunistic:
– Occur when body’s defenses are weak
Chain of Infection
Aseptic Techniques
Major way to break the chain of infection
 Asepsis-absence of pathogens
 Sterile-free from all organisms
 Contaminated-organisms and pathogens are
present

Aseptic Techniques

Antisepsis: prevent or inhibit growth of
pathogenic organisms
– Not effective against spores/viruses
– Ex: alcohol and betadine

Disinfection: process that destroys/kills
pathogens
– Bleach solutions and zephirin

Sterilization: process that destroys all
microorganisms
Chapter 13:2 Bioterrorism

Bioterrorism-use of microorganisms as
weapons to infect humans, animals, or plants
–
–
–
–
–
Dead plague victims in 1346
Smallpox in 1763
WWI and WWII
Sarin gas in 1995
Anthrax in mail in 2001
Biologic Agents

Characteristics of ideal microorganisms:
–
–
–
–
–
–
Inexpensive/Readily available/Easy to produce
Spread through air easily/Spread by ingesting
Survives sunlight, drying, and heat
Causes death or severe disability
Easily transmitted from person to person
Difficult to prevent and/or has no effective
treatment
Biologic Agents
Smallpox
 Anthrax
 Plague
 Botulism
 Tularemia
 Filoviruses

Preparing For Bioterrorism






Community-based surveillance to detect early indications of
a bioterrorism attack
Notification of the public when a high-risk situation is
detected
Strict infection-control measures and public education about
the measures
Funding for studying pathogenic organisms, developing
vaccines, researching treatments, and determining
preventative actions
Strict guidelines and restrictions for purchasing and
transporting pathologic microorganisms
Improving the ability of health care facilities to deal with an
attack






Mass immunization, especially for military, first responders,
police, fire department, and health care personnel
Increased protection of food and water supplies
Training personnel to properly diagnose and treat infectious
diseases
Establishing emergency management policies
Criminal investigation of possible threats
Improving communications so information on bioterrorism is
transmitted quickly and efficiently
Chapter 13:3 Washing Hands
The most important method used to practice
aseptic technique and prevent spread of
infection
 Should be done:

When should Handwashing be
done?
Frequently
 When you arrive at facility and immediately
before leaving facility
 Before and after any patient contact
 Any time your hand become contaminated
 Before and after handling a specimen
 After contact with any soiled or contaminated
item
 After picking up any item off of the floor

When should Handwashing be
done?
After personal use of the bathroom
 After you cough, sneeze, or use a tissue
 Before and after any contact with your mouth,
or mucous membrane
 (eating, drinking, smoking, applying lip balm,
or inserting or removing contact lenses)

Recommended method for
Handwashing







Soap is used as a cleansing agent
Warm water
Friction in addition to soap and water
All surfaces on the hands must be cleaned
Fingertips must be pointed downward
Dry paper towels must be used to turn the faucet off
and on
Nails must be cleaned
Chapter 13:4 Observing
Standard Precautions
Bloodborne Pathogens Standard
 Three main pathogens of concern for HCW
 OSHA regulations:

–
–
–
–
–
Develop written exposure control plan
Identify employees who have exposure
Provide Hep B vaccine free of charge
Provide PPE
Provide adequate handwashing facilities
OSHA regulations cont.
–
–
–
–
–
Ensure that worksite is clean and sanitary
Enforce rules of no eating/drinking/smoking
Provide appropriate disposal containers
Post signs where there are biohazards
Provide confidential medical evaluation/follow-up
for all exposure incidents
– Provide training about the regulations and all
biohazards to employees
Needlestick Safety Act

Employers are required to:
–
–
–
–
Identify and use effective/safer medical devices
Incorporate changes annually in exposure plan
Solicit input from nonmanagerial employees
Maintain a sharps injury log
Standard Precautions
Every body fluid must be considered
potentially infectious
 Must be used when contact with:

–
–
–
–
–
Blood/any fluid that may contain blood
Body fluids/secretions/excretions
Mucous membranes
Nonintact skin
Tissue or cell specimens
Rules of Standard Precautions









Handwashing
Gloves
Gowns
Masks and Eye Protection
Sharps
Spills or Splashes
Resuscitation Devices
Waste and Linen Disposal
Injuries
Chapter 13:5
Sterilizing with an Autoclave
 Autoclave: piece of equipment that uses
steam under pressure or gas to sterilize
equipment and supplies
 Always check directions that come with the
autoclave

Chapter 13:6 Using Chemicals
for Disinfection
Many chemicals do not kill spores and viruses
 Read directions before using any solution
 Always wash hands after handling chemicals

Chapter 13:7 Cleaning with an
Ultrasonic Unit
Ultrasonic cleaning: uses sound waves to
clean
 Cavitation: bubbles explode to drive cleaning
solution onto the article being cleaned

Chapter 13:8 Using Sterile
Techniques
Sterile: free from all organisms
 Contaminated: organisms and pathogens are
present


Correct techniques must be followed to avoid
contamination and maintain sterility
Sterile Technique
Sterile object must never touch a nonsterile object
 If sterile articles touch skin or clothing-they are no longer
sterile
 Any area below the waist is considered contaminated
 Never reach across the top of a sterile field
 Keep the sterile field in constant view-never turn your back
 2-inch border around sterile field is considered contaminated
 Sterile towels/articles get wet they are contaminated
 If there is ever any suspicion that you have contaminated
any article-START OVER. Never take a change on using
contaminated equipment or supplies

Chapter 13:9 Maintaining
Transmission-Based Precautions

Communicable disease: caused by a pathogenic
organism that can be easily transmitted to others

Epidemic: communicable disease spreads rapidly
from person to person and affects large number of
people at same time

Pandemic: outbreak of disease occurs over wide
geographic area and affects high proportion of the
population
Transmission-Based Isolation
Precautions

Standard vs. transmission-based
Contaminated: objects contain diseaseproducing organisms
 Clean: objects or parts of objects do not
contain disease-producing organisms

Types of Precautions
Standard Precautions
 Airborne Precautions
 Droplet Precautions
 Contact Precautions
 Protective or Reverse Isolation

Washington State
Hospital Association
Droplet Precautions
Washington State
Hospital Association