Prevention Primary Prevention Tertiary Prevention Hand Hygiene

Prevention

• Primary • Health promotion • Specific protection • Secondary • Early diagnosis and treatment • Tertiary Foundations of Infection Control • Limit disability from disease UNIT 4: Part I • Rehabilitation Prevention & Control Strategies

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Primary Prevention Secondary Prevention

• Promote general health • Early diagnosis and treatment • Protect against disease agents • Individual has contracted disease • Establish barriers against pathogens in • May be asymptomatic environment Immunizations, building Post-exposure prophylaxis, plans, outbreak plans, screening for disease, working bioreadiness plans, up an outbreak of suspected education, isolation of disease diagnosed cases

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Tertiary Prevention Hand Hygiene

• Prevent sequelae • Before patient contact • Limit disability • Before an aseptic task • Rehabilitation • After risk of blood or body fluid exposure • After patient contact • Limit impact of disease • After contact with patient surroundings Therapy for smallpox scars, Hand hygiene should rehabilitation after meningitis, occur whenever quarantine of contacts of cases gloves are removed.

http://www.who.int/gpsc/tools/Five_moments/en/ ©McGuire-Wolfe 2013 ©McGuire-Wolfe 2013 Personal Protective Equipment (PPE) Isolation vs. Quarantine • Prevent exposure to potentially Isolation Quarantine infectious materials. • Separation of • Separation of • Choose PPE based on task and risk persons with a persons who are • Standard Precautions specific illness currently well but • Used with all patients from those that who have been are healthy. exposed and • Gloves, mask, eye protection, gowns may be Act as if: All blood, body fluids, secretions, infectious. excretions except sweat, non-intact skin, and mucous membranes contain transmissible infectious agents.

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Sterilization Disinfection

• Completely free of all forms of microbial • Less lethal than sterilization. life • Eliminates nearly all pathogenic • Absolute meaning microorganisms • Physical or chemical methods • May not kill spores Steam under pressure, dry heat, • Reduces the level of microbial ethylene oxide (EtO) gas, hydrogen contamination peroxide gas plasma, liquid chemicals • Liquid chemicals or wet pasteurization

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Disinfection & Cleaning & Sterilization Decontamination • Factors which affect efficacy Cleaning Decontamination • Prior cleaning of the object • Removal of visible • Removes pathogenic • Organic and inorganic load present soil from objects & microorganisms from • Type and level of microbial contamination surfaces objects so that they • Concentration of and exposure time to the germicide • Manually or are safe to handle, use, or discard. • Physical nature of the object (crevices, hinges, mechanically lumens) • Water with detergents • Presence of biofilms or enzymatic products • Temperature and pH of the process • Relative humidity of sterilization process (EtO gas)

©McGuire-Wolfe 2013 ©McGuire-Wolfe 2013 Spaulding’s Classification Scheme • -cide or –cidal – killing action • Critical Germicide, fungicidal, bactericide • High risk for infection if contaminated • Antiseptics – A germicide that is • Objects that enter sterile tissue or applied to living tissue and skin. vascular system Typically not used on surfaces • Surgical instruments, cardiac & urinary catheters, implants, ultrasound probes • Disinfectants – A germicide applied used in sterile body cavities. only to inanimate objects. Not safe for • Must be sterilized use on skin or tissue.

Spaulding’s Spaulding’s Classification Scheme Classification Scheme • Semi-critical Complete • Noncritical • Contact mucous membranes elimination of all • Contact with intact skin but not mucous or nonintact skin microorganisms membranes in or on an • Respiratory therapy & • Patient care items – decon at point of use anesthesia equipment, instrument, except for small • Bed pans, blood pressure cuffs, phones endoscopes, cytoscopes #s of bacterial • Small #s of spores acceptable spores. • Environmental surfaces - • Requires high-level • Beside tables, rails, etc. disinfection using chemical • Low-level disinfection disinfectants