Transcript Case presentation

COMMON TERMINOLOGIES IN
INFECTION CONTROL
CONTAMINATION
Bacteria present on surface
COLONIZATION :
presence and multiplication of microorganisms
in or on a host without tissue damage.
Bacteria present on surface.
INFECTION :
invasion and multiplication
of an infectious agent in
the tissues of the host.
COMMON TERMINOLOGIES
IN INFECTION CONTROL cont’d
ENDOGENOUS INFECTION :
The organisms derived from patients own
flora.
EXOGENOUS INFECTION :
Organisms are derived from outside
forces.
INCUBATION PERIOD : time of initial
contact with the infectious agent to the
appearance of the first symptoms.
COMMON TERMINOLOGIES
IN INFECTION CONTROL cont’d
Asepsis : The freedom from disease causing microorganism.
Medical asepsis: Includes all practices intended to confine
a specific microorganism to a specific area, limiting the
number, growth, & transmission of microorganisms.
Surgical asepsis (sterile technique) : Refers to those
practices that keep an area or object free of all
microorganisms; it include all practices that destroy all
microorganisms & spores.
COMMON TERMINOLOGIES IN
INFECTION CONTROL cont’d
COMMUNITY ACQUIRED INFECTION :
infection present or incubating on admission with
no association to previous hospitalization at the
same facility
HOSPITAL ACQUIRED INFECTION :
A nosocomial infection can be defined as an
infection acquired in the hospital after 72 hours of
admission to hospital.
HOSPITAL AQUIRED INFECTION
( NOSOCOMIAL INFECTION )
It is an infection meeting the following criteria :
Not present or incubating on admission
1.
An infection temporarily associated with
admission to or a procedure done at health care
facility .
2.
An infection incubating at that time of admission
that is related to previous hospitalization at the
same facility or identified on admission following
performance of the procedure during a previous
admission
COMPONENTS OF INFECTION
PROCESS
CAUSATIVE AGENTS
RESERVOIR OF THE AGENT
PORTAL OF EXIT
MODE OF TRANSMISSION
PORTAL OF ENTERY
SUSCEPTIBLE HOST
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Any biological ,physical or chemical entity
capable of causing disease is called an agent
)The micro-organism that can cause
infection).
MICRO-ORGANISMS: Organisms that can be
seen only with the magnification of a
microscope .
# Bacteria
# Viruses
# Fungi
# Parasites
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Some Micro-organisms are normally present on people’s
skin & in Respiratory ,Intestinal , & Genital tract ;
these micro-organisms are called NORMAL FLORA.
Other Micro-organisms are normally not found on or in
the human body & are usually associated with disease
;these micro-organism are known as PATHOGENS.
ALL MICRO-ORGANISMS, including normal flora ,can
cause infection or disease if certain conditions exist:
Normal flora are introduced an area of the body in which
they are not normally found .
Pathogens are introduced into the body .
Micro-organisms are introduced into the body of a person
who is immunocomprimised & thus susceptible to infections
to which he or she otherwise would not be susceptible .
It is a place in which an infectious agent
can survive but may or may not multiply
# Human-Beings (most common).
# Animals
# Plants
# Soil
# Air
# Water
# Solutions & Instruments
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It is the path by which an infectious agent leaves
the source.
Respiratory tract (e.g., lung, nose).
Genitourinary tract (e.g., vagina, penis).
Mucous membranes (e.g., eyes, nose, mouth).
Gastrointestinal tract (e.g., mouth ,anus).
Blood-stream (open wound, needle puncture).
Broken skin (e.g., puncture ,cut, surgical site, rash).
Trans-placental ( mothers –to- fetus ).
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The mechanisms or the way in which the
infectious agent moves from the reservoir to a
susceptible host.
Transmission can occur by four modes:
CONTACT TRANSMISSION :The infectious
agent can be transmitted directly from the
reservoir to a susceptible host through touch
(e.g.,staphyllococcus) ,sexual inter-course (e.g.,
gonorrhea, HIV), or droplets (e.g., influenza).
VEHICLE TRANSMISSION : The infectious agent
can be transmitted indirectly from the reservoir to
a susceptible host by material that maintains the
life of the infectious agent .
 Food (e.g, salmonella )
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
Blood (e.g, Hepatitis B , HIV)

Water (e.g, Cholera , Shigella)
Instruments & Others Items (e.g, Hepatitis B ,
HIV , Pseudomonas )
 AIRBORNE
TRANSMISSION :
The infectious agent can be carried by air
currents (e.g, Measles , Mycobacterium
Tuberculosis , Varicella zoster ).
 VECTOR
TRANSMISSION: The
infectious agent can be transmitted to a
susceptible host through insects & other
invertebrate animals (e.g, Mosquitoes can
transmit Malaria & Yellow Fever ; fleas
can transmit plague ) .

The route by which the infectious agent
moves into (enters ) susceptible host.
Respiratory tract (e.g., lungs).
Genitourinary tract (e.g., vagina, penis).
Mucous membranes (e.g., eyes, nose, mouth).
Gastrointestinal tract (e.g., mouth ,anus).
Blood-stream .
Broken skin (e.g., puncture ,cut, surgical site,
rash).
Trans-placental ( mothers –to- fetus ).
Host is any person who is at risk for infection.
Characteristics that influence
susceptibility & severity of disease are :
Age
Sex
Socio-Economic status
Disease history
Nutritional status
Occupation
Immunization status
Diagnostic /Therapeutic procedures
Medications
Pregnancy
Trauma
Heredity
Ethnicity
How can we break the chain
of infection?
Link
1-Infectious or
Causative Agent
Intervention
Accurate and rapid
identification of
micro-organisms
Early recognition
of sign and
symptoms of
infection
How can we break the chain
of infection?
Link
Intervention
2-Reservoirs
Employee health examinations and
screening
Environmental sanitization including
floors, walls, exam tables and beds
Disinfection/Sterilization of
equipment and instruments
Standard Precautions
Medical Asepsis
Proper Hygiene - bathing and hand
washing
Clean gowns, linens and towels
Clean wound dressings
How can we break the chain
of infection?
Link
Intervention
3-Portal of Exit
Hand washing
Use of Personal Protective
Equipment such as gloves, gowns,
facemask, N95 .
Clean dressings over wounds
Medical Asepsis or Clean Technique
Control of excretions and secretions
Covering the mouth and nose when
coughing or sneezing
Proper trash and waste disposal
Standard Precautions
How can we break the chain
of infection?
Link
Intervention
4-Method or
Mode of
Transmission
Hand washing
Standard Precautions
Rooms with air flow control
Safe Food handling
Isolation
Transmission-based precautions
Sterilization of equipment and supplies
Medical and Surgical Asepsis
Use of Personal Protective Equipment
such as gloves, gowns, facemask, N95 .
Proper disposal of contaminated objects
How can we break the chain
of infection?
Link
Intervention
5-Portal of Entry
Sterile technique or Surgical
Asepsis (dressing, injections,
catheterization).
Medical Asepsis or Clean
Technique
Catheter Care
Wound care
Proper Disposal of needles or
sharps
Maintaining skin integrity
Standard Precautions
How can we break the chain
of infection?
Link
6-Susceptible
Host
Intervention
Treatment of
Disease
Recognition of
clients at risk
Immunization
Exercise
Proper Nutrition
Patient Education
PREVENTIVE PATIENT CARE
PRACTICES
1. Hand washing
2. Aseptic technique
3. Standard precautions
4. Sterilization
5. Disinfection
6. Isolation Precaution
HAND WASHING:
It is the process for the removal of dirt and
transient microorganisms(E.g. E. COLI) from the
hands. (it is considered the most effective
infection control measure).
HAND ANTISEPSIS:-
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It is a process of the removal or destruction of
transient microorganisms.
SURGICAL HAND SCRUB :-
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It is a process to remove or destroy the transient
microorganisms and reduced resident flora, (E.g.
Diphtherias )
Types of the Hand Washing
♣ ROUTINE HAND WASHING or
HYGIENIC HAND WASHING:-
It is accomplished by vigorously rubbing
together all surfaces of lathered hands
followed by thorough rinsing under a
stream of water.
This should take
complete.
10-15 seconds to
The hands should be dried with a paper
towel.
Types of the Hand Washing cont’d
♣ SURGICAL SCRUB:It is the process that begin with washing
hands and forearms thoroughly to remove dirt
and transient bacteria .
A nail cleaner should be used to clean under
the nails.
It should take about 5 minutes.
VARIOUS HAND DECONTAMINANTS
Soap solution:Soap have a detergent effect.
They remove transient microorganisms
physically but have no effect on the
resident microbial population.
VARIOUS HAND DECONTAMINANT cont’d

CHLOROHEXIDINE: It has a broad - spectrum activity .

It binds to the stratum corneum, continuing to
destroy bacteria for at least six hours.
VARIOUS HAND DECONTAMINANTS cont’d
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POVIDINE IODINE:It is often used in the operating theatre
because it destroys spores more
effectively than many other antiseptics.
VARIOUS HAND DECONTAMINANTS cont’d
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ALCOHOL HAND-RUBS, GEL & WIPES:They have excellent bactericidal activity
against most gram – positive and gramnegative bacteria but have no effect on
spores.
INDICATIONS FOR HAND WASHING
 When coming on duty.
 After removing gloves.
 When hands are soiled including after sneezing,
coughing, or blowing your nose.
 Between patients’ contacts.
 Before & after medication administration.
 After personal use of the toilet.
 Before performing invasive procedures.
INDICATIONS FOR HAND WASHING
cont’d
 Before taking care of particularly susceptible
patients, such as who are severely Immunocompromised & Newborns.
 Before and after touching wounds.
 Before & after eating.
 After touching objects that are likely to be
contaminated with pathogenic micro-organisms
E.g. urine measuring devices, secretion collection
INDICATIONS FOR HAND WASHING
cont’d
 After taking care of infected patients or
patients who are likely to be colonized with
microorganisms for special clinical or
epidemiologic significance. (E.g. Multi-drug
resistant bacteria-M.D.R.O).
ASEPTIC TECHNIQUE
It is an a method used to prevent
contamination of wounds and other
susceptible sites by organisms that could
cause infection.
This can be achieved by using sterile
equipment and fluids used for invasive
medical and nursing procedures.
STERELIZATION
It is the complete elimination of all
viable microorganisms including viruses,
fungi, and their spores both pathogenic
and non- pathogenic.
DIS-INFECTION
Disinfection implies the removal of all
life forms capable of causing disease.( all
viable microorganisms except bacterial
spores).
STANDARD PRECAUTIONS
The term standard precautions refers to a
system of infection control practices which
assume that every direct contact with blood
and body fluids is potentially infectious.
CONCEPT OF STANDARD PRECAUTIONS:
1. It should be implemented to all patients.
2. Standard precautions are not generally
intended to reduce cross contamination among
patients and they do not replace other
precautions.
ELEMENTS OF STANDARD
PRECAUTIONS
Hand washing
Gloves
Masks, eyewear, face shields
Gowns and aprons
Care of sharps and needles
Care of spills of blood and body fluids
Care of laboratory specimens
Disposal of waste
Disposal of linen
Care of resuscitation equipment
ISOLATION PRECAUTION
 These are guidelines created to prevent
transmission of microorganisms in hospitals.
 They are Transmission Based Isolation
designated for care of patients with known or
suspected infectious disease that can spread
by one of the following routes:-
 AIR-BORNE: (e.g measels, Rubella & TB)
 DROPLET: (e.g Diphteria & Pertusis)
 CONTACT: (e.g Hepatitis A, herpes simplex).
ISOLATION
The separation of a person
with infectious disease from
contact with other human
beings, for the period of
communicability
BASIC PRINCIPLES FOR ALL
CATEGORIES OF ISOLATION
1.Necessity
of a single room
2.Hand washing
3. Use of protective barriers as per need
4.Disposal of waste in orange bags.
5.Disposal of linen in water- soluble linen
bags.
6.Request for a isolation diet tray (with
disposable cutleries)