Transcript Infection Control - Effingham County Schools

INFECTION CONTROL
 Understanding the basic principles of
infection control is essential for any
healthcare worker in any field of health care.
Our essential question is:
 How are diseases transmitted and what are
the main ways to prevent disease
transmission?
Principles of Infection Control
 Microorganism (or microbe) – small, living
organism that is not visible to the naked eye.
 Found everywhere in the environment,
including on and in the human body
 Nonpathogens – microorganism that is not
capable of causing disease
 Pathogens – microorganisms that cause
infection and disease
 Microorganisms can be beneficial in one body
system and pathogenic in another body
system
 EX: E. Coli – digestive system – normal flora
urinary system - infection
 To grow and reproduce, microorganisms need:
 Warm environment - body temp ideal
 Dark environment
 Source of food
 Source of moisture
 Aerobic organisms require oxygen
 Anaerobic organisms live and reproduce in absence of
oxygen
 Human body is ideal supplier of all requirements of
microorganisms
Main Classes of Microorganisms
 Bacteria
 Protozoa
 Fungi
 Rickettsiae
 Viruses
 Helminths
Group Work
 Each group will be assigned a pathogen in
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which they will become experts on.
Describe pathogen
How are they classified?
If possible, describe their shape?
What diseases does this pathogen cause?
What is some other interesting info you
would like to share?
Bacteria
 Simple one-celled organisms
 Multiply rapidly
 Classified by shape and arrangement
 Cocci
 Bacilli
 Spirilla
 Antibiotics are used to kill bacteria
Bacteria
Cocci
 Round or spherical in shape
 If occurs in pairs – diplococci
 Cause diseases such as gonorrhea,
meningitis, pneumonia
 If occur in chains – streptococci
 Causes diseases such as strep throat and
rheumatic fever
 If occur in clusters - staphylococci
Bacteria
Cocci (cont’d – Staphylcocci)
 Most common pyogenic (pus-producing)
microorganisms.
 Cause infections such as boils, wound
infections, and toxic shock.
Bacteria
Bacilli
 Rod-shaped bacteria
 Occur singly, in pairs, in chains
 Many contain flagella (threadlike projections
similar to tails – allow to move)
 Have ability to form spores (thick- walled
capsules) when conditions for growth are
poor.
 In spore form, bacilli extremely difficult to kill
Bacteria
Bacilli (cont’d)
 Causes diseases such as tuberculosis, tetanus,
pertussis, botulism, diphtheria, typhoid
Bacteria
(Spirilla)
 Comma shaped and corkscrew shaped
 Causes diseases such as syphilis and cholera
Application:
1. Divide paper in thirds
2. Label the first column Cocci Bacteria, second
column Bacilli Bacteria, third column Spirilla
Bacteria.
3. Draw a diagram of each type of bacterial
shape indicating 4 types of cocci, 3 types of
bacilli, and 3 types of spirilla
4. Label diagrams
5. List at least 5 diseases caused by cocci and
bacilli, and 2 diseases caused by spirilla
Protozoa
 One-celled animal like organism
 Usually found in decayed materials and
contaminated water, animal or bird feces,
insect bites
 Many contain flagella to allow them to move
freely
 Cause diseases such as malaria, amebic
dysentary, trichomonas (STD) , African
sleeping sickness
Protozoa (Malaria)
Fungi
 Small, plant-like organisms
 Live on dead organic matter
 Yeasts and molds are 2 common forms
 Causes diseases such as ringworm, athlete’s
foot, thrush, yeast vaginitis
 Antibiotics do not kill fungi
 Antifungal medicines - expensive, long
course of treatment, may cause liver damage
Rickettsiae
 Parasitic microorganisms (cannot live outside
the cells of another organism)
 Found in fleas, ticks, lice, and mites and
transmitted to humans by the bites of the
insects
 Causes diseases such as Rocky Mountain
Spotted Fever
 Treat with antibiotics
Viruses
 Smallest microorganism– visible only with
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electron microscope
Cannot reproduce unless inside another living
cell
Spread from human to human by blood and
other body secretions
Can be resistant to disinfectants
Antibiotics not effective
Virus
(cont’d)
 Causes diseases such as common cold,
measles, mumps, chickenpox, herpes, warts,
influenza, polio
 3 diseases of major concern to healthcare
worker:
Hepatitis B
Hepatitis C
AIDS
 New and different viruses emerge constantly
because viruses are prone to mutating and
changing genetic information.
 Viruses that infect animals can mutate to
infect humans – often fatally
 Examples: SARS (severe acute respiratory
infection), West Nile Virus, monkeypox, Ebola
HIV and Flu Viruses
Viruses of Special Concern
to the Healthcare Worker
 Hepatitis B
 Hepatitis C
 AIDS
Hepatitis B
 Caused by HBV virus
 Transmitted by blood, serum and other
secretions
 Affects liver – can lead to destruction of liver
cells
 Can remain active for several days in dried blood
 Vaccine available – expensive – series of 3
 By law, employers must provide vaccine to
healthcare worker for free
Hepatitis C
 Caused by HCV virus
 Transmitted by blood or blood-containing fluids
 No vaccine available
 Patients often asymptomatic or mild flu
symptoms
 Can cause liver damage
 Extremely difficult to destroy
 Can remain active for several days in dried blood
AIDS
 Acquired Immune Deficiency Syndrome
 Caused by HIV (human immunodeficiency
virus)
 Suppresses immune system
 Cannot fight off cancers or infections that
would not normally affect healthy person
 No cure
 No vaccine
 Microorganisms need certain
things to grow and reproduce:
 Most prefer a warm
environment – body temp
 Most prefer darkness
 Most need food
 Most need moisture
 Aerobic organisms – are organisms
which require oxygen to live
 Anaerobic organisms – do not require
oxygen
Microorganisms can produce
toxins:
 Toxins = poisons
 Ex: tetanus produces a toxin that damages
the CNS (central nervous system)
Helminths
 Multicellular parasitic organisms
 Called worms or flukes
 Transmitted to humans when humans ingest
the eggs or larvae in contaminated food,
ingest meat contaminated with worms, or
the worm penetrates the skin.
Examples of Helminths:
 Hookworms – attach to small intestine and
can infect heart and lungs
 Ascariasis – live in small intestine and can
cause obstruction of the intestine
 Trichinella spiralis – causes trichinosis
contracted by eating raw or inadequately
cooked pork
 Enterobiasis (pinworms) mainly affects young
children
Hookworm in intestine
Hookworm beneath skin
ascriasis
Trichinella spiralis
4 Classifications of Infectious
Diseases
 Endogenous
 Exogenous
 Nosocomial
 Opportunistic
 Endogenous - infection /disease originates in
body . Ex: tumor, congenital abnormality
 Exogenous – infection/disease originates
outside body. Ex: pathogenic organisms
that invade body
 Nosocomial infection – infection acquired by
an individual in a healthcare facility. Ex: staph
 Opportunistic – occurs when the body’s
defenses are weak. Ex: Kaposi’s sarcoma
Chain of Infection:
 For diseases to occur and spread from one
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individual to another, certain conditions
must be met… Chain of Infection
Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Causative Agent:
 A pathogen:
 Bacteria
 Virus
 Fungi
 Protozoa
 Rickettsiae
 Helminth
What causes the infection/disease?
Reservoir:
 A place where the pathogen can live:
 Human body
 Animals
 Environment
 Fomites (objects contaminated with infectious
material) Ex: door knobs, linens, instruments, etc
Portal of Exit:
 A way to escape from the reservoir where it
has been growing
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urine
Feces
Saliva
Tears
Blood
Draining wounds
Mucous discharge
Mode of Transmission:
 Way it can be transmitted to another
reservoir or host where it can live.
 Direct person to person contact
 Direct contact with body secretion containing
pathogen
 Ex: contaminated hands
 Indirect contact such as food, air, soil, insects,
feces, clothing, instruments and equipment
Portal of Entry:
 Way to enter a new reservoir or host
 Breaks in skin
 Breaks in mucous membranes
 Respiratory tract
 Digestive tract
 Circulatory system
 If the defense mechanisms of the body are
intact and functioning, a human can
frequently fight off the causative agent and
not contract the disease.
Susceptible Host:
 Person likely to get an infection
Application:
 Using your textbook, identify 8 Body
Defenses that work to prevent a causative
agent from entering the human body.
 Give an example of each
 Identify how each defense mechanism
prevents the causative agent from entering
the body
Body Defenses
 Mucous membranes
 Cilia
 Coughing and sneezing
 Hydrochloric acid – in stomach
 Tears in the eye
 Fever
 Inflammation (WBC destroy pathogens)
 Immune response (antibodies)
Scenario:
Flu is caused by the influenza virus. Anyone can
get the flu, which is a viral infection that attacks
the respiratory system including your nose,
throat, bronchial tubes and lungs. You’re
especially at risk if you’re older, have diabetes,
chronic heart disease or an impaired immune
system. Someone you know has the flu, coughs
and sneezes and then you touch something
they’ve handled. That’s why the flu spreads
anywhere people congregate…schools, cruise
ships, day cares, etc.
Identify the:
 Causative agent
 Reservoir
 Portal of exit
 Mode of transmission
 Portal of entry
 Susceptible host
E. coli is short for Escherichia coli—a germ that causes severe cramps
and diarrhea. E. coli is a leading cause of bloody diarrhea. The
symptoms are worse in children and older people, and especially in
people who have another illness. E. coli infection is more common
during the summer months and in northern states.
Healthy beef and dairy cattle may carry the E. coli germ in their
intestines. The meat can get contaminated with the germ during the
slaughtering process. When beef is ground up, the E. coli germs get
mixed throughout the meat.
The most common way to get this infection is by eating
undercooked hamburgers. You can be infected
with the E. coli germ if you don’t use a high enough temperature to
cook your beef, or if you don’t cook it long enough. When you eat
undercooked beef, the germs enter your stomach and intestines.
 If any part of the chain of infection is
eliminated, the spread of disease or infection
will be stopped.
 Healthcare workers must understand chain of
infection to interrupt or break the chain and
prevent spreading of disease.
 Pathogens are everywhere ….preventing
their transmission is an ongoing process
Ways to Break Chain of Infection
 Contamination – organisms and pathogens
are present
 Aseptic techniques – maintaining cleanliness,
and eliminating or preventing contamination
 Examples of common aseptic techniques:
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Handwashing
Good personal hygiene
Disposable gloves
Proper cleaning of instruments
Thorough cleaning of environment
Levels of Aseptic Control
 Antisepsis – antiseptics prevent growth of
pathogens….not effective against spores or
viruses. Can be used on skin (alcohol,
betadine)
 Disinfection – process that destroys or kills
pathogens…sometimes effective against
spores or viruses. Usually used on objects
and not skin (disinfectants such as bleach)
 Sterilization – destroys all microorganisms
including spores and viruses (autoclave)
 How to use an Autoclave
Application:
1. Draw the chain of infection
2. Label each of the 6 sections of the chain of
infection
3. Identify 3 ways to break each section of the
chain of infection
Bioterrorism
 Bioterrorism is the use of microorganisms or
biological agents as weapons to infect
humans.
 Major concern of biological agents used not
only in wars, but also against unsuspected
civilians (ex: mail attack with anthrax)
 Could cause an epidemic and public health
emergency
 Every healthcare worker must be alert to the
threat of bioterrorism
Application:
 Discussion of high priority agents that have
been identified as potential bioterrorism
agents
Handwashing
 Handwashing is the most important method
used to practice aseptic technique.
 Most effective way to prevent spread of
infection.
 Hands are perfect medium for the spread of
pathogens.
 Proper handwashing helps prevent and
control spread of pathogens AND protects
health worker from disease and illness.
When should you wash hands?
 Before and after every patient
contact
 Anytime hands become
contaminated during procedure
 Before applying and immediately
after removing gloves
CDC recommendations for
handwashing:
 Regular handwashing – soap and water;
routine cleansing of hands when hands are
visibly dirty or soiled with blood/body fluids
 Antiseptic handwashing – antimicrobial soap
and water; before invasive procedures,
critical care units, specific organism
transmission based precautions
 Antiseptic handrubs – alcohol based hand
cleaners – ONLY if hands are not visibly dirty
and are not soiled with blood/body fluids
Principles of Handwashing
 Soap
 Warm water
 Friction
 Clean all surface areas
 Point fingertips downward
 Use paper towels to turn faucet off and on
 Clean nails also
Proper Handwashing Tips:
 Soap – preferably dispenser – sudsy action/alkali
content removes germs
 Warm water – creates better lather than cold
 Friction – rubs off pathogens from skin surface
 Clean all surface area of hands
 Point fingertips downward
 Dry paper towels to turn faucet on and off –
pathogens can travel through wet paper towel
 Clean nails – brush or rubbing against palms
Soap
 Used as a cleansing agent
 Aid in removal of germs through sudsing and
alkali content
 Pathogens trapped in soap suds and rinsed
away
 Liquid soap better than bar soap
Warm water
 Less damage to skin than hot water
 Increases lather of soap better than cold
water
Friction
 Must use friction - rubs off pathogens from
surface of skin
 Rub hands together using friction for
approximately 20 seconds.
Clean all Surfaces
 Clean all surfaces of hands – including palms,
back and tops of hands, between fingers.
Nails
 Nails must be cleaned with an orange/cuticle
stick, brush, or rubbing the nails against the
palm of the opposite hand.
 Nails must be kept short to prevent
scratching the skin, injuring patients,
breaking through gloves.
Point Fingertips Downward
 Keep fingertips pointed downward.
Downward direction prevents water from
going up forearms and then running down to
contaminate clean hands.
Turn faucet off with dry paper
towels
 Dry paper towels must be used to turn faucet
off. This prevents the contamination of the
hands from pathogens on the faucet.
Pathogens can travel easier through a wet
paper towel than a dry paper towel.
Application:
 Head to sinks to practice!
Standard Precautions
 Standard Precautions – rules developed by
the CDC to prevent the spread of infection
 Every body fluid and every patient is
considered a potential source of infection
 OSHA developed:
Bloodborne Pathogen Standard
Needlestick Safety Act
Application:
 Read pg 377 Bloodborne Pathogen Standard
 What are the 3 pathogens of major concern
to healthcare workers?
 Who created the Bloodborne Pathogen
Standard?
 What is PPE and what is an employer’s
responsibility regarding PPE?
Application:
 Read pg 377 Needlestick Safety Act
 Who developed the Needlestick Safety Act?
 Why was this act passed?
 List 4 requirements of employers regarding
the Needlestick Safety Act. Give an example
of each.
Standard Precautions
 Basic rules of standard precautions:
 Hand hygiene
 Gloves
 Gowns
 Masks and eye protection
 Sharps
 Spills and splashes
 Resuscitation devices
Cont’d
 Waste and linen disposal
 injuries
PPE
 PPE – Personal Protective Equipment
Donning PPE
 Gown
 Mask
 Goggles
 Gloves
Removing PPE
 Gloves
 Gown
 Eyewear
 Mask
Application:
 Read pgs 385—387 Sterilizing with Autoclave
 Read pgs. 392-393 Using Chemicals for
Disinfecting
 Read pgs. 394-395 Cleaning with an
Ultrasonic Cleaner
Describe each method.
Sterile Technique
 Sterile = free from all pathogens
 Contaminated = pathogens present
 Sterile field – never reach across a sterile field
 What is the difference between clean and
sterile?
 Create a double bubble map comparing and
contrasting using an autoclave vs.
disinfecting with chemicals.
 How to don sterile gloves
Transmission-Based Isolation
Procedures
 Communicable disease – a disease which is
caused by a pathogen which can easily be
transmitted to others.
 Read pg 408
 What is the difference between a pandemic
and an epidemic
 Epidemic – occurs when communicable
disease spreads rapidly from person to
person and affects a large number of people
at the same time
 Pandemic – exists when the outbreak of
disease occurs over a wide geographical area
and a effect a large portion of the population
Transmission-Based Isolation
Precautions
 Methods or techniques of caring for people
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with communicable diseases
Ex: TB, whooping cough, wound infections
Standard Precautions are used on all patients
Transmission –Based Isolation techniques are
used to provide extra protection against
specific diseases.
The type of transmission –based isolation
precaution used depends on the diseaes
Application:
 Read pgs.409-413
 Create a double bubble map which compares
and contrasts 2 types of transmission-based
isolation precautions
Airborne Precautions
 Patients who are infected with pathogens
transmitted by airborne droplet nuclei
 Ex: measles (rubella), varicella (chicken pox),
TB
 Precautions: door kept closed, healthcare
providers and visitors wear HEPA mask
 Pt wears surgical mask if leaves room
Droplet Precautions
 Pt infected with pathogens transmitted by
large-particle droplets expelled during
coughing, sneezing, talking,etc
 Ex: flu (influenza), meningitis, pneumonia
 Private room
 Masks
Contact Precautions
 Pt infected with pathogens that can be easily
transmitted by either direct or indirect
contact
 Ex: gastrointestinal, respiratory, skin or
wound infections
 Private room, gloves, gown, linens changed
daily
Reverse Isolation
 Methods used to protect certain patients
from microorganisms
 Used mainly for immunocompromised pts
 Ex: transplant pts, chemotherapy , severely
burned pts, weak immune system
 Place in room that has been cleaned and
disinfected, gloves, gown, mask, frequent
disinfecting of room, special filters may be
used to purify air.
Group Work to Demonstrate
Working in a Hospital
Isolation Unit
 Divide into 7 groups
 Reader
 Recorder
 Reporter
 Group 1: Donning Isolation Garments
 Group 2: Transfer food
 Group 3: dispose of leftover food
 Group 4: transfer of soiled linens
 Group 5: transfer trash
 Group 6: transfer equipment
 Group 7: Removing Isolation Garments