Transcript Nursing Assistant

Nursing Assistant
CHAPTER 7: COMMUNICABLE DISEASE AND INFECTION CONTROL
What is a Microbe?
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Microbe, also called microorganisms
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Cannot be seen with the naked eye
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Most consist of just one cell
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Found in air, soil, water, food, bodies of plants and animals
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Most cause no harm and are essential for healthy living
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Normal (resident) flora
Pathogens
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Microbes that cause illness
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Normal flora can become pathogenic
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Opportunistic microbes
What is a Microbe?
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Bacteria
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Most consists of only one cell
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Group together to form colonies
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Classified by:
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Shape
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Arrangement in a colony
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The way they stain
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Gram stain
What is a Microbe?
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Bacteria
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Aerobic
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Anerobic
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Need oxygen to live
Die if oxygen is present
Most common cause of infection in the health care setting
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Strep throat
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Urinary tract infections
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Skin infections
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Pneumonia
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STD’s
What is a Microbe?
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Viruses
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Smallest of all microbes
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Only be seen with an electron microscope
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Not complete cells
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Cannot reproduce on their own
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Small bundles of proteins
Need a host cell
Many illnesses caused by viruses
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Common cold
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Fever blisters
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Chicken pox
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Hepatitis
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HIV/AIDS
What is a Microbe?

Fungi
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Plant-like organisms
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Not all are microscopic
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Some are capable of causing illness
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Ringworm
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Athlete’s foot
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Thrush
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Candidiasis
What is a Microbe?

Parasites
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Live in or on a host
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Host used for food and protection
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Transmitted through physical contact
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Examples:
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Scabies
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Pediculosis
Some parasites transmitted through blood or feces
What is a Microbe?

Parasites
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Helminths
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Worm like organisms
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Pinworms, tapeworms, roundworms
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Transmission method varies
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Usually eating or inhaling the worm eggs
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Grow in digestive tract
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Larvae or eggs passed in the feces
Protozoa
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Take in food
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Animal like
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Malaria, amoebic dysentery
Defenses Against Communicable
Disease
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The Immune System
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The bodies defense system that protects us from infection
Nonspecific Defense Mechanisms
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Main one is intact skin
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Free from cuts, scrapes, and wounds
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Prevent pathogens from entering the body
Mucous membranes
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Traps pathogens
Stomach acid
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Kills many microbes in what we eat
Defenses Against Communicable
Disease
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Tears
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Kill microorganisms
Coughing and sneezing
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Expels pathogens from the body
Defenses Against Communicable
Disease

Signs of infection
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Fever
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Rapid pulse, rapid respirations, changes in blood pressure
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Pain or difficulty breathing
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Redness, swelling, or pain
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Foul-smelling or cloudy urine
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Painful or difficult urination
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Diarrhea or foul smelling feces
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Nausea or vomiting
Defenses Against Communicable
Disease
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Signs of infection
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Lack of appetite
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Skin rashes
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Fatigue
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Increased confusion or disorientation
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Unusual discharge or drainage
Defenses Against Communicable
Disease
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Specific Defense Mechanisms
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Antibodies
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Specialized proteins
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Developed from exposure to a microbe or vaccination
Antibiotics
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Drug that is able to kill bacteria or make it difficult for them produce
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Penicillin was first antibiotic
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Bacteria have used ability to change and develop resistance to
antibiotics
Defenses Against Communicable
Disease
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Multidrug resistant organisms (MDROs)
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Methicillin-resistant Staphylococcus aureus (MRSA)
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Vancomycin-resistant enterococcus (VRE)
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Easily spread from person to person
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Usually via the hands of health care workers
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Very common bacteria
When normal flora is destroyed others can take over
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Clostridium Difficile (C.Diff)
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Yellow, “seedy” diarrhea
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Unique smell
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Highly contagious
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Not killed by alcohol based hand sanitizers
Communicable Disease and the
Chain of Infection
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Infection is an illness caused by a pathogen
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Infections can be local or systemic
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Many, but not all, are communicable
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Contagious = easily transmitted through casual contact
Communicable Disease and the
Chain of Infection
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Chain of infection
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A pathogen must be present
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A reservoir must be present
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A place suitable for pathogens survival
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A portal of exit must be available
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Humans, animals, food, water, milk, and objects
How the pathogen leaves the reservoir
A method of transmission must be available
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Direct transmission
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Close contact between a infected and noninfected person
Communicable Disease and the
Chain of Infection
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Indirect transmission
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Fomites
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Vector
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Mosquito
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Portal of entry must be available
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Susceptible host
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Very young or very old
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Poor general health
As long as ONE link in the chain is broken, an infection cannot exist
Communicable Disease and the
Chain of Infection
Infection Control in the Health Care
Setting

Health care-associated infections (HAIs)
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Infections people get while they are in the hospital or other health care
setting
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Patient can get while receiving care
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HCW can get while providing care
Nosocomial infection
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Infection acquired by patients or residents while in a health care facility
Infection control
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Basic practices that are designed to decrease the chance of infection
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Four major methods
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medical asepsis, surgical asepsis, barrier methods, isolation precautions
Infection Control in the Health Care
Setting
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Medical Asepsis
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Involves physically removing or killing pathogens
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Soap, water, antiseptics, heat
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Goal is to remove pathogenic microbes from surfaces, equipment, and
hands
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Four Techniques:
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Sanitization
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Basic cleanliness
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Handwashing
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Clean linens
Infection Control in the Health Care
Setting

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Antisepsis
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Killing microbes or stopping them from growing
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Antiseptic is a chemical that is capable of killing microbes
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Rubbing alcohol
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Iodine
Disinfection
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Use of stronger chemicals to kill pathogens
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Too strong to be used on skin
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Used to clean objects
Infection Control in the Health Care
Setting

Sterilization
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Most thorough method of killing microbes
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Used on objects that need to be free of microbes
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Surgical instruments, needles, etc
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Many sterile items are disposable
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Autoclave to sterilize reuseable items
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Objects must be sanitized first
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Must be free of organic material
Infection Control in the Health Care
Setting

Sterilization
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Most thorough method of killing microbes
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Used on objects that need to be free of microbes
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Surgical instruments, needles, etc
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Many sterile items are disposable
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Autoclave to sterilize reuseable items
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Objects must be sanitized first

Must be free of organic material
Infection Control in the Health Care
Setting

Handwashing
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The form of medical asepsis that is most common
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Single most important method of preventing the spread of infection
(according to the CDC)
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When to wash
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When you first arrive at your facility
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Before entering a patient’s room
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Before entering a “clean” supply room
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Before obtaining clean linen from a linen cart
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Before handling a patient’s meal tray
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Before you go on break and before you leave your shift
Infection Control in the Health Care
Setting

Before and after drinking, eating, or smoking
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Before and after inserting contact lenses
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After using the bathroom (sometimes before!!)
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After coughing, sneexing, or blowing your nose
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After touching anything that may be considered dirty
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After picking something up off the floor
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After removing glove
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After handling your hair or applying make-up or lip wear
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Not a good idea to wear rings or bracelets on the job
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Make sure watch is “cleanable”
Infection Control in the Health Care
Setting

In October of 2002 the CDC issued guidelines for the use of alcohol
based hand rubs
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Advantages of alcohol hand rubs

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Using an alcohol based hand rub is quicker than washing your hands at the
sink
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Alcohol based rubs are gentler on the skin than soap and water
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Can be used anywhere
Remember if hands are visibly soiled, you must wash with soap and
water
Infection Control in the Health Care
Setting
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Surgical Asepsis
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Used for procedures that involve entering a person’s body
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These procedures disrupt the body’s natural protective barriers
Infection Control in the Health Care
Setting
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Barrier Methods
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PPE (Personal Protective Equipment)
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Gloves
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When there is a possibility that you will come in contact with bodily fluids or
substances
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When you are performing or assisting with mouth care
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When you have a cut or abrasion on your hands
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When you are shaving a patient or resident
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When you are performing care on a patient who has broken skin
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When handling soiled linen or clothing
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When cleaning equipment that may come in contact with body fluids or
substances
Infection Control in the Health Care
Setting

Barrier Methods

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Gowns
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Fabric, paper, or plastic
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Use when your uniform could likely be soiled with bodily fluids or substances
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Worn only once
Masks
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
Protecting you
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Surgical mask
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N-95 Respirator
Protecting the patient

Surgical mask
Infection Control in the Health Care
Setting

Barrier Methods

Protective Eyewear
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Goggles, glasses, face shields
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Wear when things can spray or splatter