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Modes of Disease Transmission Objectives • Define the role of the STSR in controlling the transmission of pathogens. • Discuss factors that lead to Surgical Site Infections. • Explain the Chain of Infection, and techniques to reduce nosocomial infections. Methods of Transmission • Primary goal of the STSR is to prevent SSI’s and transmission of microbes using proper sterile technique. • 25% of all perioperative nosocomial infections do not become evident until after the patient is discharged. Methods of Transmission • Adherence to aseptic technique and standard precautions reduce the risk of nosocomial infections. Surgical Site Infection Facts 1. Primary mode of airborne bacteria in the O.R. is the surgical team. 2. Most SSI’s are caused by the patient’s own flora contaminating the wound by direct contact. 3. Most SSI’s occur because of contamination during the procedure. Surgical Site Infections • • Sources of contamination are located within the surgical suite. Divided into two sources: – Environmental • – Surgical team, air, furniture, and instruments. Endogenous • Patients own flora. Chain of Infection Infectious Agent • Pathogens: – Mostly caused by bacteria or viruses. • Pathogenicity: – Ability of microorganism to enter, survive in, and produce disease. • Virulence: – How harmful the disease will be. – Severity of the infectious agent. Reservoirs • Anyplace an infectious agent can survive, grow, or multiply. – Plants, animals, soil, water, medical equipment. – Human body. • Carrier – Person who carries and can spread a disease. Portal of Exit • Path by which the infectious agent leaves the reservoir. Mode of Transmission • Direct Contact – Person to person • Indirect Contact – Contaminated objects • Airborne – Aerosolized droplets • Common Vehicle – Contaminated blood, water, etc. Portals of Entry • Pathway for infectious agents to enter host. • Any opening in the body: – – – – Respiratory Mucous membranes GI/GU tract Broken skin Susceptible Host • Barriers to infection are compromised. – – – – – – – Immunicompromised Age Health Environment Nasal carriers of S. Aureus Pre-Existing conditions Type and duration of procedure Factors to Control Transmission • Personnel: – – – – – – Good hygiene and proper O. R. Attire Surgical hand scrub Sterile gown/gloves/drapes Careful use of sharps Standard Precautions Surgical Conscience Factors to Control Transmission • Environment: – Proper O.R. disinfection. • Furniture • Walls/floors • Equipment – Ventilation standards. – Limit personnel traffic Factors to Control Transmission • The Patient: – – – – Proper adherence to aseptic technique. Surgical skin prep/shave prep Pre-operative antibiotics Type and duration of surgical procedure Review • • • • Modes of Transmission Surgical Site Infection Chain of Infection Factors to Control Transmission Modes of Disease Transmission • QUESTIONS?