Infections and infectious diseases A manual for nurses and midwives in the WHO EuropeanRegion World Health Organization Regional Office for Europe International Federation of Red Cross and Red Crescent Societies ABSTRACT There is an urgent need to re-establish basic infection control measures, which have been overlooked or played a less important role in controlling the spread of infections since the introduction of antibiotics in the 1940s. This manual has been written with the aim of developing the knowledge, skills and attitudes of nurses and midwives regarding infections and infectious diseases and their prevention and control. It is intended to be used as an interactive learning package for nurses and midwives in the WHO European region, specifically in eastern Europe. There are seven modules. Each module is in two parts: theory and practice. A workbook is provided separately, with opportunities for self-assessment through learning activities. A completed workbook is also available for each module to give further guidance to readers. Keywords INFECTION CONTROL INFECTIOUS DISEASES PREVENTION TREATMENT NURSING CARE © World Health Organization 2001 All rights in this document are reserved by the WHO Regional Office for Europe. The document may nevertheless be freely reviewed, abstracted, reproduced or translated into any other language (but not for sale or for use in conjunction with commercial purposes) provided that full acknowledgement is given to the source. For the use of the WHO emblem, permission must be sought from the WHO Regional Office. Any translation should include the words: The translator of this document is responsible for the accuracy of the translation. The Regional Office would appreciate receiving three copies of any translation. Any views expressed by named authors are solely the responsibility of those authors. Foreword Infections and infectious diseases are a great burden on many societies, including the countries in the WHO European region. To reduce that burden an integrated approach is required, combining health promotion, disease prevention and patient treatment. The prerequisite for success in this fight is the participation of all health care professionals. Nurses and midwives, as major frontline providers of care, are in a position to contribute significantly to reducing the burden. Infections and infectious diseases: A manual for nurses and midwives in the WHO European region has been written with the aim of developing the knowledge, skills and attitudes of nurses and midwives regarding infections and infectious diseases and their prevention and control. It is intended for use as an interactive learning package for nurses and midwives in the WHO European region, specifically in the more eastern part of the region. Mastery of this material will enable nurses and midwives to respond to threats to the community, to teach their patients and members of the community effective ways of preventing infections and infectious diseases, to provide high quality and effective care to people with infectious diseases and to use appropriate measures to ensure safe practice. The manual comprises seven modules. Each module is in two parts: theory and practice, with opportunities for self-assessment through learning activities and a workbook. The manual should be used as a package to ensure that, after training, nurses and midwives have a broad and up-to-date knowledge of infections and infectious diseases. Each section of the manual can also be used independently to develop knowledge in a specific area, and the manual as a whole can be used as a reference book in health care settings. The manual is a joint initiative between the Red Cross and the WHO Regional Office for Europe. It has been based on Communicable disease. Nursing course manual. Prepared for distance education by the National Nursing Centre of China, 1992. Over the last two years, the Scottish Centre for Infection and Environmental Health has adapted the Chinese manual to make it relevant to nurses and midwives in Europe. The WHO Regional Office for Europe and the Red Cross wish to thank the staff at the Scottish Centre for their work, as well as the many other people who have contributed to making the manual a reality, including the WHO collaborating centres for nursing and midwifery in the European Region and Barbara Stilwell, Scientist at WHO headquarters. Terhi Heinasmaki Ainna Fawcett-Henesy International Federation WHO Regional Office for Europe of Red Cross and Red Crescent Societies Introduction 3. practical measures that can be taken and How to use this manual implemented into your own practice to prevent This manual on infections and infectious diseases the spread of infection. is intended for use as an interactive learning package, relevant for nurses and midwives within Format the European region, and specifically within There are seven modules: Eastern Europe. It is intended that each module Module 1: The prevention and control of infection should consist of theory and also require practice Module 2: The Expanded Programme of for completion. Immunization (EPI) Module 3: Infections spread by food and water Aim Module 4: Infections spread by animals and insects To develop existing knowledge skills and attitudes and less common infectious diseases of nurses and midwives on infections and infectious Module 5: Diseases spread by person-to-person diseases and their prevention and control, within contact the European region. Module 6: Tuberculosis Module 7: Infections spread by sexual contact and Objectives blood and body fluids; Part I: Infections spread by On completion of this manual you should have an sexual contact and Part II: Infections spread by understanding of: blood and body fluids. 1. the main concepts of prevention and control of infection; Layout of each module 2. important infections and infectious diseases in Each module follows the same format and layout. the European region, including: 1. A front title page. • definition; 2. An index that indicates which topics are covered • modes of transmission; and where you can find them. • epidemiological summary; 3. A glossary of terms that explains what terms • manifestations; mean; you should refer to this throughout each • complications; module. Some words or terms may be found in • risk factors / age groups affected; more than one module. • prognosis; 4. A brief overall introduction to the module. • diagnosis; 5. Stated learning outcomes, indicating what you • methods of treatment; should achieve on satisfactory completion at the • prevention of spread; end of each module. • screening; 6. Key words, that is, words or terms of particular • contact tracing; relevance to an individual module. • nursing care; 7. The main body of the text, containing theory • rehabilitation; and factual content; the same paragraph headings • prevention strategies; and are used throughout the manual where appropriate. • general information on less common infections 8. Learning activities, to be carried out when and infectious diseases; and indicated in the text; a workbook is provided separately for this. learning activities is provided separately. The 9. Revision points: these indicate that you should workbook is designed to assist you to complete stop and note some points or answer a question. the activities, and there will be instructions. If there 10. The summary of key points is a reiteration of is a blank space under an activity, this should be the most important messages to absorb and used for notes. On completion of the each module, remember from each module. you can compare your findings with information 11. Bibliography: although numerous sources of in the completed workbook. This document is information have been used in the production of designed to help you find out if you are on the each module, the authors have tried to use WHO right track with the learning activities. It is sources whenever possible; only the main sources recommended that in order to get the most benefit used for each module are included in the from the manual, you should not refer to this until bibliography. you have completed all the learning activities for 12. Appendices, which are useful sources of further each module. information. Further information Theory versus practical learning composition The manual is designed to be self-contained. The The manual content contains most of the theory number of other sources of information in the required to provide a firm basis of knowledge on bibliography of each module has been kept to a infections and infectious disease. The purpose of minimum; those which have been cited are the revision points is to test your knowledge on particularly useful. The information within this material already covered in the manual text. Try to manual is only as up-to-date as the date of respond to the revision points without referring to publication; to obtain the most up-to-date the text in the first instance, then compare your information available, visit the websites mentioned response to the information in the manual. in the bibliography. The learning activities are intended to be more Assessment of revision points practical and are related to nursing or midwifery You can test this yourself by comparing your practice incorporating wider aspects relevant to the response to the information in the manual text. module content. For example, you may be asked to visit a laboratory, carry out an audit in your place of work or produce a leaflet to give to patients. The learning activities are