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Infection Control Introduction to Healthcare AHS 104 Terminology Microorganisms : – Microscopic one celled organisms. – Bacteria, Fungi, Protozoa, Rickettsiae, Viruses – Often called “germs” Pathogens: – Infectious agents – Patho: Disease – Gen : Genesis/ Causing/ Producing All microorganisms are not pathogens, but all pathogens are microorganisms Bacteria Microscopic life that multiply rapidly Fungi Organisms that live on other plants or animals. Examples include: – Mushrooms – Yeast – Mold Protozoa Microscopic one celled animals Those that don’t causes illnesses are used to decompose materials, etc. Rickettsaie Prounoucned: – ri-ket-see-uh Microscopic forms of life found in tissues of fleas, ticks, etc. Transmitted to humans by insect bites. Viruses Extremely small microscopic nonliving particles that multiply in living cells. Chain of Infection Describes how a pathogen is transmitted from one person to another. There are six links – – – – – – Causative Agent Reservoir Portal of Exit Mode of Transmission Portal of Entry Susceptible Host See Drawing on the Board Signs and Symptoms of Infection Fever Pain or Tenderness Fatigue Loss of Appetite Nausea/ Vomiting Diarrhea Rash/ Sore on Mucous Membranes Redness & Swelling of body parts Discharge of drainage from infected area. Standard Precautions Two previous control systems: – Universal Precautions – Body Substance Isolation Standard Precautions combined the two and added some new features on gloving. The following body substances/fluids are covered: Blood/Blood Products, All Body Fluids, Non Intact Skin, Mucous Membranes Standard Precautions Should ALWAYS be practiced on persons in your care. – This will significantly reduce the risk of getting disease ALL Body Fluids are considered potential transmitters of infectious diseases & should be treated the same way, with caution Remember, you can not tell by how someone looks or acts whether they carry a bloodborne disease!!! Standard Precautions/Protective Measures Wash Hands – Before & after using restroom. – After touching any body surface – Before putting on gloves – Immediately after removing gloves. – Between all contacts with persons in your care. Wear Gloves – When touching blood/ body substances – When touching mucous membranes – When touching non intact skin. Protective Measures Change Gloves – Immediately before contact with mucous membranes/non-intact skin. – If gloves become contaminated material (soiled) – If gloves become worn or damaged. Remove Gloves – Promptly after use and wash your hands – Before touching noncontaminated items or environmental surfaces – Before caring for another resident/client Gloves Clean, non sterile gloves are adequate for most jobs requiring unsterile gloves. – May be latex/ vinyl – Non Sterile Gloves vs. Sterile Gloves Always let supervisor know if you have dry, cracked or non intact skin. – Also if gloves have caused you to break out. – Remember to wash hands before and after glove use!! Protective Measures Wear: Mask, Eye Protection, Face Shields : – To protect facial mucous membranes during procedures & resident/client care activities that are likely to generate splashes or sprays Wear: Gowns, Aprons, or Bibs – During a procedure or resident/client care activity that is likely to generate splashes or sprays. – When appropriate for the procedure/ activity and amount of body fluid to be encountered. Protective Measures Equipment – Handle in a manner that prevents skin/ mucous membrane contact. – Contamination of your clothing with the equipment. – Do not use re-usable equipment again until it has been properly cleaned and reprocessed. – Dispose of all single use equipment properly. Clean & Disinfect – All environment surfaces – Beds, Bedrails, Equipment – All frequently touched surfaces (Door Knobs) Linen Handling – Handle, transport & process soiled linens in a manner that prevents Skin & Mucous Membrane Exposure Contamination of Clothing Transfer of disease to other resident/ clients & Environments. Protective Measures Resident/Client/ Patient Placement – Use private rooms or cohort if possible – Cohort: Where two or more persons who have the same disease are placed in the same room. Transmission Based Precautions These are special precautions which should be used for persons in your care who are infected or suspected of being infected with a disease that requires additional precautions beyond standard precautions. Transmission Based Precautions Three Categories – Airborne Precautions Tuberculosis – Droplet Precautions Influenza, Pertussis – Contact Precautions Wound and skin infections The category used depends on the recognized pathogen that is being isolated Transmission Based Precautions Two important points to remember : – Transmission Based Precautions are always used IN ADDITION to Standard Precautions. – The infection is being isolated, not the person with the infection. Airborne Precautions Goals of Airborne Precautions – Reduce the risk of airborne transmission of pathogens that are suspended in droplets 5 microns in size or smaller. Airborne Precautions How big is a micron? – 1 Millionth of a meter – 1 Meter= 3.20 feet – Pathogens in droplets 1-5 microns in diameter are so tiny and lightweight that they can float on dust particles and moisture droplets, staying airborne for long periods of time and being widely dispersed by air currents. – They can also slip through the pores of your surgical mask ! Airborne Precautions Some common diseases that require Airborne Precautions: – Pulmonary Tuberculosis – Measles/Rubeola A viral infection spread through droplets – Varicella Zoster (Chicken Pox) May lead to complications of Pneumonia Airborne Precautions REMINDER: A mask does not protect you once it becomes damp or wet from breathing. This usually takes about 20 minutes. We’ll pick up here next class… Droplet Precautions Droplet Precautions Goal of Droplet Precautions – Reduce the risk of transmission of pathogens suspended in droplets larger than 5 microns in size! Some common disease that require droplet precautions: – – – – – Influenza Pneumonia Mumps Common Cold Bronchitis Droplet Precautions How are Droplet Precautions different from Airborne Precautions? – Large particle droplets – Droplets do not stay suspended in the air – Droplets travel short distances, usually three feet – Requires close contact between the infected person and the healthcare worker Droplet Precautions How are droplets generated? – Coughing – Sneezing – Talking – Laughing – Singing – Certain Medical Procedures Ex. Nebulizer for asthmatic patients Caring for Infected Persons Droplet Precautions have less restrictive requirements than Airborne precautions. – Private room if possible, if not, place in room with person who has same infection. – Maintain distance of at least 3 feet between the beds. – Wear surgical mask when working within 3 feet of infected person. – If you must take infected person outside room, have him or her wear surgical mask. Contact Precautions Goal of Precautions – To reduce the risk of transmission of disease by either direct or indirect contact. Contact Precautions only apply to specific persons known to be infected with an organism that can be transmitted by direct or indirect contact. Contact Precautions Some common diseases that require Contact Precautions – MRSA and VRE – – – – – – – – – Methicillin Resistant Staphylococus Aureus VRE (Vancomycin-Resistant Enterococci) Urinary Tract Infections Gastrointestinal Illness Skin & Wound Infections Respiratory Illnesses Pressure Sores Scabies and Lice Pink Eye Chicken Pox Shingles Contract Precautions Types of Contact – Direct – Indirect Direct Contract What is meant by direct contact? – Skin to skin contact – Physical transfer, Bathing,Turning and other Activities of Daily Livings (ADL’s) – Contact between two residents or clients Indirect Contact What is the meant by indirect contact? – The major route of this transmission is through contact with a contaminated environmental surface such as a door knob, faucet, clothing, soiled linen or furniture. – Contaminated objects, such as stethoscopes, thermometers, or other commonly used equipment, are also a problem. – More diseases are transmitted through indirect contact than direct contact. Indirect Contact You can easily transmit disease to yourself or another person in your care by touching a contaminated object with your hands and then touching yourself or another person. You can transmit disease by touching environmental surfaces with contaminated hands or gloves, after which someone else touches that same surface. Caring for Infected Persons Isolate the disease Private room if possible. If not possible, place in room with another person with the same infection. – What’s this called ? Transport for essential purposes only: – Take special care to avoid uninfected people during transport. Caring for Infected Persons Wash Hands – Use antimicrobial soap Make sure ungloved hands do not touch potentially contaminated environmental surfaces or items in person’s room. Wear Gloves – Remove gloves before leaving the person’s room. – Change gloves after having contact with infectious materials – Be certain gloved hands do not contaminate objects that ungloved hands will touch. Caring for Infected Persons Avoid Sharing Non Critical Care Items – If at all possible, dedicate non-critical care item, such as water pitchers, soap or soap dishes or toiletry items to a single infected person. Otherwise, be sure all commonly shared equipment is cleaned and disinfected after each use. Definitions Related to Types of Infection Local – Involves specific body part Systematic – Involves the entre body – Travels through the blood stream Nosocomial – Infection acquired after admission to healthcare facility Endogenous – Those organisms normally found in body, some can be pathogens which cause infections when patient has low resistance. Exogenous – Organisms from outside of the body that cause infection Factors that Weaken Natural Body Defenses Age Physical Inactivity Pre-existing Disease Poor Nutrition, Inadequate Hydration Invasive Therapy – Some surgeries Immune Suppressive Therapy – Treatment with agents, such as x-rays, corticosteroids, etc. Asepsis Medical Asepsis – Clean Technique: Practice used to remove or destroy pathogens and to prevent their spread Disinfection: Process by which pathogens are destroyed Surgical Asepsis – Sterile Technique: Practice that keeps equipment & supplies free of all microorganisms Sterile: Absence of all microorganisms (pathogens & non pathogens) including those that form spores Sterilization-Process which destroys microbes Asepsis: A lack of infection Disinfection Process in which pathogens are destroyed – Does not destroy spores Spores are bacteria protected by a hard shell, that can only be killed by extremely hot temperatures. Boiling Water: Simple method of disinfectant Chemical Disinfectant used for cleaning instruments & equipment /housekeeping – Germicides-Disinfectant applied to skin, tissue, & inanimate objects – Disinfectant can burn & irritate skin Sterilization Very high temperature procedure which destroys all non-pathogen, pathogen and spores. – Autoclave-Pressurized Stream Sterilizer used to sterilize metal objects, glass and surgical linens. Steam under pressure usually sterilizes in 30-45 minutes Governmental Agencies EPA-Environmental Protection Agency – Clean Air, Clean & Safe Water, Safe Food – Preventing Pollution: Homes, Workplace & Ecosystems – Better waste management/deterrent to pollution – Reduction of global/cross-border environmental risks – Explanation of right to know about the environmental risks – Sound Science-Improved understanding of risks & problems – Effective management/ responsibility Government Agencies DTAE/TCSG-Department of Technical & Adult Education – Department of Technical & Adult Education – Technical College System of Georgia Sets standards/guidelines for education Federal funding for education Testing regulations/ guidelines Government Agencies CDC-Center for Disease Control – Promote Health & Quality of Life By preventing/controlling disease, injury & disability By funding for laboratory/ diagnostic experiments By informing, educating and alerting public Government Agencies OSHA-Occupational Safety & Health Administration – Evaluates work place (environments) for hazardous conditions: Set Standards Trains & Educates: Develops approaches/technologies Evaluate Programs Inspects workplace environments Government Agencies Centers for Medicare and Medicaid Services (CMS) – They are responsible for… – Clinical Laboratory Improvement Amendments CLIA Standards for medical laboratory testing – Set standards for proficiency in tests & qualified personnel to assure accuracy – Sets testing standards for lab tests – Sets standards for licensing tests Government Agencies FDA-Food & Drug Administration – Ensures that food, cosmetics, medications, and medical devices are safe and wholesome. – Oversees food and drugs for pets & farm animals. – Enforces public health laws – Monitors the manufacture, import, transport, storage and sale of goods to consumers annually. By inspecting food, drugs, cosmetics & medical devises in the factory, retail and wholesale consumers and import/ export these products.