Essentials of Infection Control

Let’s keep the bugs out!

Standards HS-IHS-9 Analyze different types of microorganisms

and their defining characteristics to reduce the risk of infection or illness. Demonstrate physicochemical methods and the use of PPE in preventing and controlling the spread of microbial growth.

9.1 Define and describe the need for asepsis and infection prevention in the classroom, laboratory, and in the healthcare environment.

9.2 Compare and demonstrate various physical (hand washing and PPE) and chemical methods (cleaning, disinfection, and sterilization) used to control or prevent microbial growth.

Standards 9.3 Examine the evolution and spread of antibiotic resistant

pathogens. 9.4 Analyze ways microorganisms are spread using the chain

of infection model. 9.5 Utilize personal protective equipment (PPE) and apply

personal safety procedures based on OSHA (Occupational Health and Safety Administration and the Centers for Disease Control and Prevention (CDCP).

9.6 Describe methods of controlling the spread and growth of microorganisms.

9.7 Discuss Hospital Acquired Infection (HAI), the HAI standards and reporting of HAI.

9.8 Discuss immunizations and the schedule for vaccinations.

Microorganisms Small living organism that is not visible to

the naked eye. We must use a microscope to see it. They are found everywhere, including in

and on us… They can be classified in many ways

How they affect us Shape Structure

Pathogen or Nonpathogen? Pathogens are

microorganisms that cause disease.

They are also called germs

Nonpathogens are microorganisms that are part of our normal flora* and are beneficial to many of our body processesEven our bodies normal

microorganisms can cause disease when they are introduced into a different body

system.

What Do Microorganisms Need To Grow and Reproduce Warm environment

Our body temperature is perfect! Darkness

Preferred by most microorganisms and some are killed by sunlight

Food Moisture Oxygen

Aerobic-requires oxygen to live Anaerobic-live and reproduce without oxygen

Bacteria Simple, one-celled organisms that

multiply rapidly. Cocci are round

in shape

Diplococci occurr in pairs Meningitis, gonorrhea

http://education-portal.com/academy/lesson/what-is-eubacteria-definition-characteristics-examples.html#lesson

Bacteria Streptococci occur in

chains Strept throat

Staphylococci occur in clusters Most common

pus producing Wound infections

Presentation

In Surgery

3 Days Post OP

Prior to Amputation

Strep A-Flesh Eating Bacteria

Bacteria

Rod-shaped bacteria are called bacilli May occur singly, in pairs or in chains Contain flagella which help them move Form spores-thick walled capsules

makes it more difficult to treat

Tuberculosis, pertussis

Bacteria Sparilla are corkscrew or spiral

shaped Also include vibrio (comma-shaped)

and spirochete (corkscrew-shaped) Syphilis

Antibiotic Resistant Bacteria Antibiotics are no

longer effective Due to overuse and

misuse of antibiotics Multidrug resistant =

resistant to several meds Superbugs

CRE Carbapenem-resistant

enterobacter

MRAB Acinetobacter baumannii

VRE Vancomycin Resistant

Enterococcus

MRSA Methicillin Resistant Staph

Aureushttp://education-portal.com/academy/lesson/mrsa-and-drug-resistant-pathogens.html#lesson

Protozoa One-celled animal like organisms

found in decayed materials and contaminated water Contain flagella to allow free

movement Some cause disease

Malaria, dysentery

http://education-portal.com/academy/lesson/what-are-protozoa-definition-characteristics-examples.html#lesson

Fungi Simple, plant-like organisms that

live on dead organic matter Yeasts and molds Ringworm,

athlete’s foot, thrush

Rickettsiae

Parasitic microorganisms They cannot live outside the cells of

another living organism Found in fleas, lice, ticks and mites Rocky Mountain spotted fever

Viruses Smallest microorganisms, visible using only

an electron microscope Cannot reproduce unless they are inside

another living cell Spread by blood and body fluids

Flu SARS West Nile H1N1 Ebola

http://education-portal.com/academy/lesson/what-are-viruses-definition-structure-function.html#lesson

Viruses to Concern Healthcare Workers Hepatitis C-can cause liver damage

No vaccine is available Hepatitis B-attacks the liver and can lead to

scarring and destruction of liver cells Hep B vaccine is available You may refuse vaccine, but you must sign a

waiver that it was offered and you refuse.

Both of these can remain active for several days in dried blood, so we must take every precaution

to protect ourselves.

Viruses to Concern Healthcare Workers HIV (Human

Immunodeficiency Virus) Suppresses the

immune system The patient cannot

fight off illness, even the common cold

No cure or vaccine

Cause of AIDS (Acquired Immune

Deficiency Syndrome)

Helminths Parasitic Organisms

Flukes Worms

Transmitted by: Ingesting eggs or larvae Bite of infected insect

How Do You Treat Infection With Microorganisms? Bacteria

Antibiotics Difficult to treat

when in spore form Protozoa

Treatment depends upon specific illness

Fungi Antifungal

medications

Rickettsiae antibiotics

Viruses Antibiotics are not

effective Many disinfectants

are not effective

Classification of Infection

Opportunistic Infections Those infections that occur when the

body defenses are weak are opportunistic infections

These diseases are usually not seen in a person with a healthy immune system

Kaposi’s sarcoma (rare cancer) and Pneumocystis carinii pneumonia commonly seen in individuals with AIDS

Classification of Infection Nosocomial Infection

Hospital Acquired Infection (HAI) Acquired while in a healthcare

facility Many are antibiotic resistant Can be life threatening

Staphylococcus (MRSA) Psuedomonas Enterococci (VRE)http://education-portal.com/academy/lesson/nosocomial-infections-de

finition-causes-prevention.html#lesson

Common Nosocomial Infections

Clostridium Difficile is a gastrointestinal infection characterized by watery diarrhea, fever and loss of appetite.

C-diff is found in the feces of infected persons. Commonly spread from person to person by

neglectful hand hygiene.

Which type of isolation?__________________

Common Nosocomial Infections

Methicillin Resistant Staph Aureus is a bacteria that can infect several places in your patients. Wounds Urine Sputum Nares

Many persons are carriers of MRSA in their nares. They do not have active infection but can spread it to others.

What type of isolation should you use? ___________________

How Infectious Diseases Spread

All of the following are necessary for a disease to spread:

A germ or pathogen, A source or reservoir, A portal of exit, A method of transmission, A portal of entry into a person, A susceptible person.

The goal is to stop germs from traveling from a source into another person.

Chain of

Infection

Chain of Infection

Shows how infections are spread and how we can prevent it

Causative Agent 1st condition that

must be met There must be a

pathogen present like a bacteria or a virus

Breaking: Early recognition

of signs of infection

rapid ID of organism

Reservoir This is the place where

the causative agent can live.

Examples include humans; animals; the environment or fomites like doorknobs, bedpans, urinals or linens

Breaking: Disinfecting Employee health Standard precautions

Portal of Exit Escape route that pathogens take as

they escape from the reservoir in which they were growing.

Examples include urine, feces, saliva, blood, tears, sexual secretions, and draining wounds.

Breaking: Handwashing standard precautions PPE

Mode of Transmission Way in which the pathogen can be

transmitted to another reservoir or host where it can live.

It can be transmitted through direct or indirect contact Contact with contaminated hands Touching contaminated equipment Breathing in infected droplets Eating contaminated foods

Breaking: Proper food handling standard precautions handwashing

Portal of Entry Way for the pathogen to

enter a new reservoir. Broken skin or mucous

membranes, the digestive or respiratory tracts and urinary tracts are all portals of entry.

Breaking: good wound and catheter

care medical asepsis Standard precautions

Susceptible Host Person likely to get an infection because

their body defenses are weak or a large number of pathogens invade the body.

HIV, chemotherapy patients, the elderly, infants

Breaking: Immunizations Recognize high-risk patients Treat underlying disease

Asepsis Absence of disease-producing

microorganisms. Aseptic techniques

Directed toward maintaining cleanliness and eliminating contamination

Handwashing, good personal hygiene, using disposable gloves, proper cleaning of instruments and the environment

Levels of Aseptic Control Antisepsis prevents or inhibits growth of

pathogens, but are not effective against spores or viruses. Alcohol and betadine are used on the skin.

Disinfection destroys/kills all pathogens, but is not always effective against spores or viruses. Bleach solutions are used on surfaces.

Sterilization destroys all microorganisms, the good and the bad, as well as spores and viruses. Steam and gas as well as using an autoclave are used to sterilize equipment

Understanding the Principles of Infection ControlGives a basic knowledge of how disease is transmitted

Allows us to see ways in which to prevent disease transmission

Handwashing The most basic thing that can be done to

prevent the spread of germs. Remember when to do handwashing Use liquid soap from a dispenser Use warm water-hot can burn hands Use friction to rub pathogens off the

surface of the skin Clean all surfaces-palms, back/top of

hands, fingers, between fingers and under nails

When do I Wash My Hands? When I get to work and before I leave Before and after each patient contact Before applying and IMMEDIATELY

AFTER removing gloves After using the bathroom After touching your hair Before and after contact with any

mucous membrane (mouth, eyes, nose) Before picking anything up off of the

floor After coughing or sneezing

Handwashing Keep fingertips

pointed downward Don’t touch the

inside of the sink Don’t lean against

the edge of the sink Use clean, dry paper

towel to turn off the water

Wash hands for at least 20 seconds.

Procedure It’s time to practice your procedure.

There are 2 sinks in the lab and one in the bathroom. Only 2 students in the bathroom at the time. Only 3 students in line at each sink in the lab at a time.

While you are waiting your turn, complete worksheet on Handwashing.

Observing Standard Precautions OSHA has established guidelines that all

facilities must follow in order to prevent the transmission of pathogens from one person to another

The most common way pathogens are spread is by blood and body fluids

As a result, OHSA devised the Bloodborne Pathogen Standard

This requires facilities to implement ways in which to keep their employees safe

What are the Regulations? Provide Hep B Vaccine Provide PPE Provide Handwashing

facilities/supplies Decontamination and

cleaning Not eating, drinking,

applying make-up in work areas

Provide appropriate containers for sharps and biohazards

Alert staff to work areas where there may be biohazardous materials

Identify Those Exposed Exposure Control Plan Provide medical eval and

follow up of those with exposure incidents

Provide Training

Tag-Teaming Infections…

Using Standard Precautions in addition to… Transmission Based Isolation Precautions

Are for the care of patients who have or may have a contagious disease.

You need to use transmission based precautions in addition to standard precautions for all patients.

There are 3 types that are based on the causative agent and mode of transmission

Useful in preventing the spread of NOSOCOMIAL INFECTIONS!!!

Transmission-Based Precautions: AIRBORNE

1. Prevent the spread of infection dust or small droplets that remain suspended in air

2. They require special air handling and ventilation

3. Wear mask at all times in the room

4. If patient travels out of the room must wear a mask at all times

DROPLET

1. Prevent the spread of large droplets that can be created by certain medical procedures, or by coughing, talking or sneezing

2. Must wear a mask if you are within 3 feet of the patient.

3. If patient travels out of the room must wear a mask at all times

CONTACT

1. Prevent the spread of infectious disease by skin-to –skin contact or by a contaminated object

2. Must wear gloves with any contact with the patient.

3. Visitors to wear gloves as well

4. During procedures that could cause splashing: wear a gown

Which type of Isolation should you use???

Patient A has tuberculosis? _________________

Patient B has the mumps? __________________

Patient C has the measles? _________________

Patient D has MRSA in a wound? ____________

Patient E has impetigo?____________________

Patient F has the flu? ______________________

How Do We Protect Ourselves?

FOLLOW STANDARD PRECAUTIONS!!

Treat all body fluids as is they were a potentially infectious material

Treat every patient as if they were a potential source of infection, regardless of disease or diagnosis

We must use standard precautions at all times with all patients.

But What Do I Do? Wash Hands Wear Gloves Wear Mask and Eye

Protection Wear Gown Watch Sharps Clean Spills in Proper

Manner

Clean Patient-Care Equipment in the Proper Manner

Use Bio-Hazard linen bags and trash bags for items contaminated with blood or body fluids

Report any exposure incident, no matter how small

Donning and Removing PPE These are items used for personal protection-

Personal Protective Equipment Gowns, masks, goggles and gloves are the

most common types of PPE They are used when there is a chance of blood,

body fluids, secretions or excretions coming into contact with you or whenever a patient is on Isolation for a contagious disease

Donning and Removing PPE

Gloves Out of the box No right way to

put on There is a right

way to take them off

Gowns Must be

removed in a way that avoids contaminating your hands or clothing

Masks For any

airborne or droplet disease

Only ties are clean