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Chapter 10 Infection Control Definitions • Infection control • Infectious disease • Pathogens Signs and Symptoms of Infections • Generalized or systemic – Affecting whole body • Localized – Affecting one area of body Question • Which of the following may be signs or symptoms of a localized infection? A. Fever, headache, and increased pulse rate B. Vomiting, diarrhea, and fatigue C. Red, swollen, draining wound Answer • C. Red, swollen, draining wound • Localized – Affecting one area of body – Signs and symptoms: • Red, swollen, and warm to touch area • Drainage • Pain Answer • C. Red, swollen, draining wound • Generalized or systemic infection may cause fever, headaches, fatigue, vomiting, diarrhea, and increased pulse and respirations Microbiology • • • • • • Microscope Microbiology Germ theory Communicable or contagious disease Contaminated Normal flora (continued) Microbiology • • • • • • Immune response Antibiotic Opportunistic infection Aerobic Anaerobic Hosts (continued) Microbiology • • • • • Symbiosis Neutralism Parasitic Parasite Microbes Question • True or False: – Microorganisms that are aerobic require oxygen to live. Answer • True • Aerobic microorganisms – Require oxygen to live • Anaerobic microorganisms – Do not require oxygen to live Microbes • • • • • Bacteria Viruses Fungi Rickettsia Protozoa Question • True or False: – Protozoa are the smallest of the microbes. Answer • False • Viruses – Smallest microbes Chain of Infection • • • • • • Infectious agent Reservoir host Portal of exit Route of transmission Portal of entry Susceptible host (continued) Chain of Infection Defense Mechanisms • • • • • • • Cilia Cough and sneeze Tears Hydrochloric acid Mucous membranes Rise in body temperature Increase in leukocytes Scope of the Problem • Nosocomial infection (HAI or health careassociated infection) • Industrial illness • Needlestick injuries • Handwashing – Most important procedure for preventing health care-acquired infections Handwashing for Patient Care Infection Control • Regulatory agencies – CDC – OSHA Question • True or False: – A patient is admitted to the hospital for an infected leg. This would be called a nosocomial infection. Answer • False • Nosocomial infection – Infection occurs while patient receiving health care Asepsis • Asepsis – Also known as aseptic technique • Medical asepsis – Clean technique • Surgical asepsis – Sterile technique Breaking the Chain of Infection • Breaking just one link stops infection • Six elements summarized – Source of infecting microorganism – Means of transmission – Susceptible host How to Break Chain • Decrease source of microorganisms – Wash hands – Decontaminate surfaces and equipment – Avoid contact when contagious • Prevent transmission of microorganisms – Wear personal protective equipment (PPE) – Follow isolation precautions (continued) How to Break Chain • Maximize resistance – Provide good hygiene – Ensure proper nutrition and fluid intake – Decrease stressors that weaken immune response Question • True or False: – The chain of infection must be kept intact to stop an infection from being transmitted. Answer • False • Breaking chain of infection prevents transmission Normal Flora • • • • Transient flora Resident flora Standard precautions Handwashing – Removes transient flora – Diminishes resident flora Standard Precautions • Follow at all times • Potential fluid sources of microbes: – Blood – Body fluids, secretions, and excretions • Except sweat – Nonintact skin (continued) Standard Precautions • Potential fluid sources of microbes: – Mucous membranes – Any identified body fluids • Handwashing • PPE • Patient-care equipment (continued) Standard Precautions • Environmental control • Linen • Needle handling and disposal Isolation • Transmission-based precautions – Airborne – Droplet – Contact • Neutropenic • Consequences to patient, staff, and visitors • Impact on facility Question • Which of the following activities is the most critical in preventing the spread of infections? A. Wearing gloves B. Wiping down surfaces C. Handwashing Answer • C. Handwashing • Number one prevention tool: – Good handwashing Methods to Inhibit or Destroy Microbes • • • • • Bacteriostatic Bactericidal or germicidal Antiseptics Disinfectants Sterilization Surgical Asepsis • Also known as sterile technique • Eliminates presence of pathogens from objects and areas • Sterile field Risks • Blood-borne pathogens – Hepatitis B – HIV – Tuberculosis (TB) – Drug-resistant infections Question • Which of the following methods is bacteriostatic? A. Sterilization B. Using an antiseptic for cleaning C. Using a disinfectant for cleaning Answer • B. Using an antiseptic for cleaning • Bacteriostatic – Methods that only inhibit growth of microorganisms • What antiseptic does • Bactericidals kill microorganisms – Include sterilization and disinfectants Hepatitis Virus • • • • • Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E Human Immunity Virus • HIV and AIDS – Carriers – Transmission – Symptoms – Treatment – Prevention TB • • • • • • • Airborne pathogen Caused by Mycobacterium tuberculosis No prevention Skin test give for detection Latent TB infection and TB disease Still problematic in U.S. Drug-resistant strains developing Question • Which of the following patients would test positive with a TB screening test? A. Latent TB infection B. Active TB disease C. Both latent TB infection and active TB disease Answer • C. Both latent TB infection and active TB disease • Both latent TB infection and active TB disease will test positive – But only someone with active TB disease can transmit it to others Other Infectious Organisms • Ebola virus • Bird flu – H5N1 avian influenza • Mad cow disease – Bovine spongiform encephalopathy (BSE) • West Nile virus • Swine flu – H1N1 influenza Drug-Resistant Organisms • Developed from overuse of antibiotics • Developed from patients who do not complete antibiotic treatment (continued) Drug-Resistant Organisms • Methicillin-resistant Staphylococcus aureus (MRSA) – Health care-associated MRSA (HA-MRSA) – Community-acquired MRSA (CA-MRSA) • Vancomycin-resistant enterococcus (VRE) • Clostridium difficile (C. difficile) Question • Which of the following diseases is transmitted by mosquitoes? A. West Nile virus B. Mad cow disease C. H1N1 Answer • A. West Nile virus • West Nile virus – Transmitted by mosquitoes • Mad cow disease – Presumably transmitted by eating infected meat • H1N1 – Primarily transmitted human-to-human Reporting Exposure • Must immediately report any exposure to blood or body fluids • Write incident or injury report • Refer to exposure control plan