Infection Control Healthcare workers are routinely exposed to potentially infectious materials during routine care of patients. They must understand the mode of transmission of a variety of infectious diseases and what type of precautions to take to reduce their exposure to and risk for these. Objectives • At the end of this lesson, the student will: – Analyze principles of infection control – Identify the Chain of Infection and its role in preventing the spread of microorganisms – Demonstrate proper use of Standard Precautions Microorganisms • A microorganism (microbe) is a small living plant or animal that can only be seen with a microscope. • Microbes are everywhere. • There are two classification ▫ Non-pathogens – do not usually cause infections and help to maintain body processes ▫ Pathogens – cause infection and disease Classes of Microorganisms • Bacteria – one celled microorganisms that are classified by shape – Multiply rapidly and can cause disease in any body system – Diseases: staph infections, strep throat, food poisoning, syphilis • Protozoa – One-celled animals that can infect the brain, blood, intestines – Diseases: malaria, dysentery Classes of Microorganisms • Fungi – Plants that live on other plants or animals – Include yeasts, molds, and mushrooms – Diseases: Vaginal yeast infections, thrush, athlete’s foot, ringworm • Rickettsiae – Found in fleas, ticks, lice, and other insects – Spread by bites of the insect – Diseases: Rocky Mountain Spotted Fever Classes of Microorganisms • Viruses – Are the smallest type of microorganism. They are made up of only a few molecules. – Viruses invade the cells of a living organism where they reproduce more viruses – Diseases: colds, herpes, chicken pox, measles, Hepatitis B and C, HIV, and Aids Requirements of Micro-organisms • Microbes need a reservoir (host) to live and grow. • Water and nourishment. • Most need oxygen to live. • A warm and dark environment is needed. • Most grow best at body temperature. • Microbes are destroyed by heat and light. Classification of Infections and Diseases • Endogenous – begins inside the body • Exogenous – caused by something outside the body • Nosocomial or Hospital Acquired Infection – (HAI) acquired by an individual within a health care facility • Opportunistic – occur when the body’s defenses are weak Classification of Infections and Diseases • Local infection - is in a body part. • Systemic infection - involves the whole body • Communicable - can be transmitted from one person to another person. • Multi-drug resistant organisms (MDRO) – Organisms that can resist the effects of antibiotics – MRSA –Methicillin Resistant Staphylococcus – VRE – Vancomycin Resistant Enterococcus Chain of Infection Source If any part of the Susceptible Reservoir Host chain is broken, the spread of the disease or Portal of Entry Portal of Exit infection Method of will stop. Transmission Mode of Transmission • Microbes may be transmitted by: – Airborne Transmission – Bloodborne Transmission – Vectorborne Transmission – Sexual Transmission – Foodborne Transmission – Casual Contact Medical Asepsis • Asepsis is being free of disease-producing microbes. • Measures are needed to achieve asepsis. – Medical asepsis (clean technique) – Surgical asepsis (sterile technique) • Sterilization is the process of destroying all microbes. • Contamination is the process of becoming unclean. Rules of Hand Hygiene • Wash your hands with soap & water when they are visibly dirty or soiled • After using the restroom • After contact with blood, body fluids, secretions, or excretions • After coughing, sneezing, or blowing your nose • Before and after handling, preparing, or eating food Rules of Hand Hygiene • Use an alcohol-based hand rub to decontaminate your hands if they are not visibly soiled • Before direct contact with a person • After contact with a person’s intact skin • After removing gloves Supplies and Equipment Most equipment is disposable, however, non disposable items must be cleaned and then disinfected. – Disinfection - process of destroying pathogens. – Germicides - disinfectants applied to skin, tissues, and non-living objects. – Chemical disinfectants - used to clean surfaces and reusable items. – Sterilization destroys all non-pathogens and pathogens, including spores. Standard Precautions • • • • Are part of the CDC’s Isolation Precautions Reduce the risk of spreading pathogens Are used when giving care for all residents Prevent the spread for infection from: – Blood – All body fluids, secretions, and excretions even if no blood is visible – Skin with open breaks or wounds – Mucous membranes Isolation Precautions – Blood, body fluids, secretions, and excretions can transmit pathogens so barriers are created to prevent the spread of communicable or contagious diseases. – Usually the person’s room is used. – Are based on clean and dirty. Isolation Precautions • Wear Personal Protective Equipment (PPE) • Gowns • Masks • Eyewear • Special measures are used for – removing linens, trash, and equipment from the room – collecting and transporting specimens – transporting persons Gloves and Gowns • Wear gloves whenever contact with blood, body fluids, secretions, excretions, mucous membranes, and non-intact skin is likely. • Gowns protect your clothes and body from contact with blood, body fluids, secretions, and excretions. – Gowns must completely cover you from your neck to your knees. – A wet gown is contaminated. – Disposable gowns are discarded after use. Masks, Goggles, Eyewear • Masks and respirators prevent the spread of microbes from the respiratory tract. – Masks are disposable & is contaminated if wet or moist • Goggles and face shields protect your face from splashing or spraying of blood and body fluids. – The outside of masks, goggles or a face shield is contaminated. • Disposable eyewear is discarded after use. • Reusable eyewear is cleaned and disinfected before reuse Isolation Precautions • Contaminated items are bagged to remove them from the person’s room. – Leak-proof plastic bags are used. – Bag and transport linens, trash, equipment, and supplies following center policy. – Double bagging is not needed unless the outside of the bag is soiled. • Use biohazard specimen bags to transport specimens to the laboratory. • Procedures for transporting persons vary among centers Bloodborne Pathogen Standard • A regulation of the Occupational Safety and Health Administration (OSHA) to protect the health team from exposure to blood and other potentially infectious materials (OPIM) • HIV and HBV are bloodborne pathogens. • The center must have an exposure control plan. – It identifies staff at risk – Includes actions to take for an exposure incident. – Staff at risk receive free training. Preventive Measures • Measures used to reduce the risk of exposure include: – Hepatitis B vaccinations – Engineering and work practice controls – Personal protective equipment (PPE) – Proper cleaning and decontamination of contaminated equipment • Decontaminate work surfaces with a proper disinfectant. • Use a brush and dustpan or tongs to clean up broken glass Regulated Waste • Any soiled with liquid or semi-liquid blood or other potentially infection material, including sharps, must be discarded using special measures • Containers used for discarding regulated waste are closable, puncture-resistant, leak-proof, and color-coded in red and have the BIOHAZARD symbol. • The center must be kept clean and sanitary. • Special measures must be used with contaminated laundry Exposure Incidents • Any contact of the eye, mouth, other mucous membrane, non-intact skin with blood or OPIM, including parental contact (needles) • Incidents must be reported at once. • Confidentiality is important.