Download Major Components of Infection Prevention & Control

Major Components of Infection
Prevention & Control
Roy Thompson
Bad Boy Buggy
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Objectives
At the end of this two hour lecture students will
be able to:
1. review modes and mechanisms of
transmission of pathogenic organisms in the
health care according to Pan American health
Organization 2011
Objectives
2. define major concepts of infection prevention
and control according to WHO (2013).
3. list the main components of infection
prevention and control according to WHO
(2013).
4. discuss the components of infection
prevention and control according to WHO
(2013).
Source
People with active infections or disease carriers
• Patients
• Staff members
• Visitors
Endogenous flora
Inanimate objects
Medications
(Pan American Health Organization, 2011)
Host
• Susceptible hosts lack effective resistance
against certain microbes and develop clinical
disease
• Some hosts resist colonization by infectious
agents
• Other hosts develop commensal relationships
with microbes and become asymptomatic
carriers
(PAHO, 2011)
Factors affecting Susceptibility
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Co-morbidities
Antimicrobials
Immunosuppressive agents
Irradiation
Breaks in skins
Invasive lines
(PAHO, 2011)
Modes of Transmission
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Contact
Droplets
Airbourne
Common vehicle
Vectorbourne
(PAHO, 2011)
Contact
Direct
Indirect
• Involves body surface to
body surface contact
• Physical transfer of
microbes between host
and carrier/infected
person
• May occur when giving
clients baths, turning
and other health care
related activities
• Involves contact of
susceptible hosts and
contaminated objects
• These include needles,
dressings, contaminated
gloves and unwashed
hands between
procedures
Droplets
• Droplets from infected persons during
coughing sneezing, coughing, suctioning and
bronchoscopy
• Droplets containing microbes are deposited
on hosts conjunctivae, nasal mucosa or mouth
• Transmission requires a distance of less than 1
meter
(PAHO, 2011)
Airbourne
• Microbes are dispersed widely by air currents
• Spread by airbourne droplets nuclei
containing microbes or dust particles
• Microbes remain suspended for a longer time
• Control is challenging and requires controlling
air flow through ventilation systems
(PAHO, 2011)
Common Vehicle
• Food eg. Salmonellosis
• Water eg. Shigellosis
• Medication/Intravenous solutions
• Blood eg. HIV, Hepatitis B and C
• Equiptment and devices
Transmissions may result in explosive outbreaks
(World Health Organization, 2013)
Vectorbourne
• Occurs when vectors such as mosquitoes, flies,
rats and other vermins transmit microbes
• Prevented by good house keeping, closed or
screened windows and proper health care
facility maintenance.
(World Health Organization, 2013)
Chain of Infection
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Infectious Agent
• Microbes with the ability to cause disease.
• The greater the organism's virulence (ability to
grow and multiply), invasiveness (ability to
enter tissue) and pathogenicity (ability to
cause disease), the greater the possibility that
the organism will cause an infection.
• Infectious agents are bacteria, virus, fungi, and
parasites.
(PAHO, 2011)
Infectious Agent
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Reservoir
• A place within which microorganisms can
thrive and reproduce. For example,
microorganisms thrive in human beings,
animals, and inanimate objects such as water,
table tops, and doorknobs.
(PAHO, 2011)
Human Reservoir
• Acute Clinical Cases
-become ill
-contacts and activities
may be limited
-more likely to receive
treatment
(WHO, 2013)
• Carriers
-do no become ill from
infectious agents
-activities not restricted
-more risky as contacts
are unaware of their
infection
Human Carriers
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Incubatory carriers
Inapparent infection (subclinical cases)
Convalescent carriers
Chronic carriers
(WHO, 2013)
Incubatory carriers
• Going to become ill and begin transmitting
their infection before their symptoms start.
• Example 1: Measles virus spread in nasal and
throat secretions a day or two before any cold
symptoms or rash are noticeable.
• Example 2: HIV infection may be present for
years before the person develops any
symptoms.
(International Labour Organization, 2005)
Inapparent infection
• Persons never develop an illness, but are able
to transmit their infection to others.
• Example 1: Only 1/100 individuals infected
with poliomyelitis virus becomes paralyzed.
• 4/100 will have mild illness (fever, malaise,
headache, nausea and vomiting)
• 95/100will have no symptoms at all, although
they pass the virus in their faeces.
(WHO, 2013)
Convalescent carriers
• Person who are infectious during and even
after their recovery from illness.
• Example 1: Salmonella patients may excrete
the bacteria in faeces for several weeks and
rarely even for a year or more.
• Treatment with inappropriate antibiotics may
prolong the convalescent carrier phase
(WHO, 2013)
Chronic carriers
• People who continue to harbor infections for a
year or longer after their recovery
• Example: Chronic carrier state is common
following hepatitis B infection, whether or not
the person became ill, and may be lifelong.
• The risk of developing chronic hepatitis B
depends on the person’s age at infection.
(WHO, 2013)
Portal of Exit
• A place of exit providing a way for a
microorganism to leave the reservoir.
• Microbes may leave the reservoir through the
nose or mouth when someone sneezes or
coughs.
• Microbes carried away from the body by
faeces may also leave the reservoir of an
infected bowel.
(WHO, 2013)
Portal of exit
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Portal of Exit
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Mode of Transmission
• Method of transfer by which the organism
moves or is carried from one place to another.
The hands of the health care worker may carry
bacteria from one person to another.
Portal of Entry
• An opening allowing microbes to enter the
host
• Portals include body orifices, mucus
membranes, or breaks in the skin
• Portals also result from tubes placed in body
cavities, such as urinary catheters, or from
punctures produced by invasive procedures.
(PAHO, 2011)
Susceptible Host
• A person who cannot resist a microorganism
invading the body, multiplying, and resulting
in infection.
• The host is susceptible to the disease, lacking
immunity or physical resistance to overcome
the invasion by the pathogenic
microorganism.
(PAHO, 2011)
Susceptible Host
The last essential component in the chain of
infection is the susceptible host. Susceptibility is
affected by:
• Genetic factors
• General resistance factors
• Specific acquired immunity
(PAHO, 2011)
Specific acquired immunity
• Has most potent influence on host’s
susceptibility
• This immunity is specific to a particular
disease agent, and it may be acquired
Naturally or Artificially
(PAHO, 2011)
Natural Immunity
• May be acquired by experiencing an infection
(active natural immunity).
• A single bout of measles or chickenpox
confers lifelong immunity to that disease
• Influenza and salmonella are examples of
infections that do not confer immunity and
therefore may recur
(WHO, 2013)
Artificial Immunity
May be acquired through the use of vaccines,
toxoids and immune globulins
• Active immunity: A vaccine or toxoid
stimulates “active” immunity, since the
recipient responds by producing antibodies.
(WHO, 2013)
Artificial Immunity
• Passive immunity: Receiving an antitoxin or
immune globulin confers passive immunity,
essentially by borrowing the antibodies of
other people.
(WHO, 2013)
Breaking the Chain
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Breaking the Chain
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Look up terms
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Asepsis
Medical Asepsis
Aseptic technique
Isolation
Reverse isolation
Barrier
Barrier nursing
Nosocomial infection
Look up terms
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Bloodborne pathogens/disease
Universal precautions
Standard precautions
Basic precautions
Transmission based precautions
Air-borne precautions
Droplet precautions
Contact precautions
Look up terms
• Personal protective equipment
Recall
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List 5 infectious agents
List 3 modes of disease transmission
Review steps in chain of infection
Discuss 5 nursing interventions in breaking
chain of infection
Thank you
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Questions/Contributions
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References
International Labour Organization (2005). Joint
ILO/WHO guidelines on health services and
HIV/AIDS. Retreived from:
http://www.ilo.org/wcmsp5/groups/public/@
ed_protect/@protrav/@ilo_aids/documents/
publication/wcms_116240.pdf
References
Pan American Health Organization (2011).
Infection Prevention and Control. Polices and
guidelines for health care services (2nd ed.).
Retrieved from:
http://www.google.com.jm/?gws_rd=cr&ei=9r
0mUoC6NY_a9ASkrYHYCw#psj=1&q=manual+
for+infection+control+trinidad
References
• World Health Organization (2013). Health
worker occupational health. Retrieved from:
http://www.who.int/occupational_health/topi
cs/hcworkers/en/