Infection Control Infection Control

Infection control is a set of practices and procedures that will help to prevent the transmission of disease within a health care facility.

• Microorganisms, or Microorganisms microbes, are small living bodies that are not visible to the naked eye. Helpful microorganisms are called nonpathogens. However, many microorganisms are harmful to the body. Microorganisms that cause infection and disease are called pathogens. Pathogens

• Pathogens can cause infection and disease in several ways: – One way is by producing toxins, or poisons, which harm the body and cause disease. – Another way pathogens can cause infection is by creating an allergic reaction in the body, which results in sneezing, watery eyes, and a runny nose. – Finally, pathogens can invade living cells, attack them, and even destroy them Microorganisms

• There are many different classes of microorganisms. The four main classes include bacteria, protozoa, fungi, and viruses. Bacteria

• Bacteria are one-celled microorganisms that are classified by shape. Cocci, bacillia, and spirilla . Though bacteria are single-celled organisms, they often join into pairs, chains, or clusters. Cocci Above, is a Cocci bacteria ‘bloom’ Spirilla Spirilla Bacteria are spiral or corkscrew in shape Bacilla Bacilla Bacteria are rod shaped Bacteria, cont’d

• Some bacteria are helpful. For example, the bacteria that exist in the small intestines help to digest food. Also, several food products, such as yogurt and cheese, are made by using bacteria. • Some bacteria, however, produce toxins that make people sick. Spores

• Bacteria can also produce spores. • Spores are thick-walled cells created by bacteria to aid in reproduction and to make the bacteria resistant to harsh environments. Spores are difficult to eliminate and can result in serious sicknesses. • Spores are NOT microorganisms themselves. Diseases caused by bacteria include:

• Food poisoning • Strep throat • Tetanus • Syphilis • Cholera

Protozoa

• Protozoa are the simplest organisms in the animal kingdom. They are single-celled microorganisms, but they often exist in colonies. Most protozoa need moisture to survive, so they are often found in watery environments. Protozoa, cont’d There are several types of nonpathogenic protozoa, such as the protozoa that exist in the large intestines. However, most protozoa are harmful. Pictured is the Plasmodium protozoa that causes Malaria Protozoan Diseases

• Diseases that are caused by protozoa include: • Malaria • Dysentery

Fungi

• Fungi are plant-like microorganisms that can be found in the air, in soil, on plants, or in water. There are thousands of types of fungi, including mushrooms, yeasts, and molds. Only about half of these types of fungi are pathogenic. Nonpathogenic fungi

• Many types of fungi have helped to make our lives easier. For example, penicillin is an antibiotic that is used to kill bacteria in our bodies. Penicillin is made from fungi. Additionally, many types of fungi, such as yeast, are used in making food. Pathogenic Fungi Mycoses • Diseases that are caused by fungi are called mycoses. These diseases include: • Athlete's foot • Ringworm • Yeast infections • Thrush

Viruses

• Viruses are the smallest type of microorganism. They are smaller than a single cell and are made up of only a few molecules. Viruses invade the cells of a living organism where they reproduce more viruses. A virus cannot reproduce outside a living cell. • Some viruses are helpful and have even been used in Viruses treatments for bacterial infections. But, like other microorganisms, many viruses are pathogenic. Diseases caused by viruses include: • Common cold • Chicken pox • Measles • Herpes

This is an artist • Hepatitis B and Hepatitis C representation of the Human Immunodeficiency • HIV and AIDS Virus Classification of Infections and Diseases • Diseases and infections are often classified according to how and where the infection occurs. An endogenous infection or disease is one that begins inside the body, such as a tumor. An exogenous infection or disease is caused by something outside the body, such as radiation or chemical solutions. Nosocomial Infection

• Nosocomial infection or disease is acquired by an individual within a health care facility. Another term for "nosocomial" is "hospital- acquired." These diseases are usually transmitted from patient to patient by the health care workers. Health care workers must practice proper infection control techniques to reduce the number of nosocomial diseases. Opportunistic Infection

• Opportunistic infections occur when the body's defenses are weak. For example, patients with AIDS have weakened immune systems. Therefore, AIDS patients are more likely to acquire infections than patients with strong immune systems. Infectious and Communicable diseases

• Diseases are also classified according to whether or not they can be transmitted from one person to another person. An infectious disease results from an invasion of microorganisms. A communicable disease is a type of infectious disease that can be transmitted from one person to another person. Infectious and Communicable diseases

• Not all infectious diseases are communicable. For example, lyme disease is caused by bacteria, but it cannot be transmitted from person to person. Hepatitis B, on the other hand, is caused by a virus. The hepatitis B virus can be passed from person to person if exposure to blood or bodily fluids occurs. Infectious and Communicable Diseases

• Remember, not all infectious diseases are communicable, but by their very nature all communicable disease are infectious. Infection Control

• One of the goals of infection control is to prevent the transmission of these communicable diseases. CHAIN OF INFECTION For a communicable disease to be passed from one person to another, certain conditions must be met. These conditions are known as the chain of infection Causative Agent

• The chain of infection begins with a pathogen, which is called the causative agent or infectious agent.

Reservoir

• The causative agent must find a reservoir, or a place for the causative agent to live and grow. A reservoir could be a human, an animal, or any surface or object Portal of Exit

• Next, the pathogen must have a portal of exit to leave the reservoir. In humans, pathogens can leave the body through blood, bodily fluids, or excrement Mode of Transmission

• After the pathogen leaves the reservoir, it must be moved to another reservoir where it can continue to live and grow. This process is called the mode of transmission Portal of Entry

• The pathogen must have access to a portal of entry, which is the place the pathogen will enter the new reservoir Susceptible Host

• If the new reservoir has weak defenses, it will contract the disease or infection. The new reservoir is called the susceptible host Mode of Transmission

• Airborne Transmission: Transmission through droplets in a sneeze or cough • Bloodborne Transmission: Transmission through blood or body fluid • Vectorborne Transmission: Transmission through an outside source, such as mosquitoes and ticks • Sexual Transmission: Transmission through sexual contact with an infected person • Foodborne Transmission: Transmission through infected or contaminated foods • Casual Contact: Transmission by close body-to-body contact or sharing personal items, such as a hairbrush or comb

Asepsis

• Asepsis is a condition that is free of pathogens. Maintaining asepsis in a health care facility is the primary way to prevent the spread of disease from person to person. It works by breaking the chain of infection. • Remember your medical terminology here: Sepsis means infection, the prefix A- refers to ‘the absence of’ Asepsis

• The two basic types of asepsis are medical asepsis and surgical asepsis. Medical vs Surgical Asepsis • Medical asepsis is • Surgical asepsis is maintaining a clean maintaining a sterile field. environment in order to A sterile field is an reduce the number of environment that is free pathogens. It is also called from all microorganisms clean technique. and spores. Surgical Common medical aseptic asepsis is also known as practices include sterile technique. It is handwashing, routine required for most invasive cleaning, and using procedures and personal protective operations equipment, such as gloves and masks. Sterilization

• Sterilization is the highest level of asepsis. It is a type of surgical asepsis that kills all microorganisms, including viruses and spores. Sterilization is used on instruments and equipment, not on people. Sterilization methods include pressurized steam, dry heat, chemical solutions, and gas. Sterilization methods

Autoclave Dry Heat • The most common piece of • Dry heat uses temperatures equipment used for of 320°F (160°C) for at least sterilization in a medical an hour for sterilization. It is office is an autoclave, which used for instruments that uses pressurized steam to corrode easily, such as kill microorganisms. those made of non-stainless Autoclaves sterilize steel. equipment at temperatures of 250°F (121°C) for 15 to 30 minutes. Sterilization Methods cont’d

Chemical Gas • Some chemical solutions can • Wheelchairs and beds are also be used for sterilization. sterilized using large gas However, items must soak in ovens. Gas sterilization is the solutions for at least 10 typically used in hospitals. hours to become sterile. Chemical sterilization is used with equipment that is too large for autoclaving or cannot withstand high temperatures, such as rubber, plastic, and fiber optics. FOMITES

• Lets talk about FOMITES….. Sounds like a bug of some sort, right?

• A Fomite is any inanimate object that can harbor and transmit infectious agents Disinfection

• Disinfection is the middle level of asepsis. Disinfection is a type of medical asepsis that destroys most pathogens, but is not always effective on viruses and spores. Because disinfectants are usually chemical solutions, the disinfection process is generally used on objects and equipment, rather than on people.

Disinfection cont’d

• Common disinfectant solutions include chlorine and bleach. An object must soak in a disinfectant solution for at least 20 minutes to be properly disinfected.

Cleaning

• Cleaning is the lowest level of asepsis. It is also called sanitization. The cleaning process does not require harsh chemicals to destroy pathogens, so cleaning can be used on people. Review

• Asepsis is a condition that is free of pathogens or any type of contamination. • Aseptic techniques can break the chain of infection. • Medical asepsis is maintaining a clean environment in order to reduce the number of pathogens. • Surgical asepsis means to maintain a sterile field or environment. • The three levels of asepsis are sterilizing, disinfecting, and cleaning.

Hand Asepsis

• Hand cleansing is the most basic and important type of medical asepsis. Hand cleansing is the number one way to prevent the spread of infection Let’s repeat: Hand cleansing is the number one way to prevent the spread of infection. Why is hand cleansing so important?

Hands can act as a mode of transmission in the chain of infection by carrying pathogens from one patient to another patient. Additionally, when pathogens are on a health care worker's hands, the health care worker is in danger of contracting the disease or infection. Because of this danger, health care workers must use appropriate hand cleansing hygiene. When to Cleanse Hands

• When arriving at the health care facility and immediately before leaving the facility. • Before and after every patient contact. • Before and after performing a procedure. • Before and after handling a specimen. • Before and after touching the mouth, eyes, or nose. • Before donning gloves and immediately after removing gloves. • After contacting soiled or contaminated items. • After picking up any item from the floor. • After using the bathroom. • After coughing, sneezing, or using a tissue.

How to cleanse hands

• According to the CDC, there are two methods health care workers should use to cleanse their hands. Hand Washing

• The first method is hand washing. Hand washing involves using plain soap and water to cleanse the hands. Health care workers should wash their hands when they are visibly dirty or soiled. Hand Sanitizer

• The second method is an alcohol-based handrub. An alcohol-based handrub involves using an alcohol-based lotion or gel to cleanse the hands. Alcohol-based handrubs are more effective than hand washing at removing microorganisms. Health care workers should use an alcohol-based handrub on their hands when they are not visibly soiled. • Washes Hands

NNAAP Handbook • 1 Address client by name and introduces self to client Handwashing Skill • by name • 2 Turns on water at sink For the Washington State NAC skills • 3 Wets hands and wrists thoroughly Examination, every NAC candidate • 4 Applies soap to hands must perform the “Washes Hands” • 5 Lathers all surfaces of wrists, hands, and fingers, skill correctly. • producing friction for at least 20 (twenty) seconds • 6 Cleans fingernails by rubbing fingertips against palms • of the opposite hand • 7 After lathering for at least 15 seconds, rinses all • surfaces of wrists, hands, and fingers keeping hands • lower than the elbows and the fingertips down • 8 Uses clean, dry paper towel to dry all surfaces of • hands, wrists, and fingers then disposes of paper towel • into waste container • 9 Uses clean, dry paper towel to turn off faucet then • disposes of paper towel into waste container or uses • knee/foot control to turn off faucet • 10 Does not touch inside of sink at any time Standard Precautions

• The Center for Disease Control and Prevention (CDC) developed a list of standard precautions that should be used for all patients, regardless of their type of sickness. • Standard precautions include guidelines for patient contact and environmental cleanliness. Health care workers must Standard Precautions for Patient Contact use appropriate personal According to the CDC, protective equipment, such every bodily fluid must be as gloves, masks, eyewear, considered infectious. and gowns, when they are likely to contact infectious materials. Infectious materials include blood and other body fluids, mucous membranes, non-intact skin, and tissue specimens. • DONNING AND REMOVING PPE • (GO WN AND GLOVES ) Donning and • 1 Picks up gown and unfolds • 2 Facing the back opening of the gown places arms Removing PPE • through each sleeve NAC candidates may be asked to • 3 Fastens the neck opening perform the donning and removing • 4 Secures gown at waist making sure that back of PPE skill as part of their NAC skills • clothing is covered by gown (as much as possible) examination • 5 Puts on gloves • 6 Cuffs of gloves overlap cuffs of gown • 7 With one gloved hand, grasps the other glove at the • palm, pulls glove off • 8 Slips fingers from ungloved hand underneath cuff of • remaining glove at wrist, and removes glove turning it • inside out as it is removed • 9 Disposes of gloves into designated waste container • without contaminating self • 10 After removing gloves, unfastens gown at neck and • waist • 11 Removes gown without touching outside of gown • 12 While removing gown, holds gown away from body, • turns gown inward and keeps it inside out • 13 Disposes of gown in designated container without • contaminating self • 14 Washes hands