Mastering Infection Control in Medical Practice

1. Chapter 19 Infection Control

3. Learning Objectives • Define and spell key terms • Identify the role of the medical assistant in infection control • Identify disease-producing microorganisms • List common infectious diseases • Identify the links in the chain of infection

4. Learning Objectives • Differentiate between the stages of disease • Describe the body’s defense mechanisms • Demonstrate the performance of handwashing with soap and water • Demonstrate the performance of hand sanitization with an alcohol-based hand rub • Explain standard precautions

5. Learning Objectives • List common types of personal protective equipment • Describe strategies to increase health and safety in the workplace • Differentiate medical asepsis and surgical asepsis • Differentiate sanitization, disinfection, and sterilization

6. Learning Objectives • Demonstrate equipment and instrument sanitization • Demonstrate equipment and instrument disinfection • Demonstrate wrapping a pack for sterilization

7. Learning Objectives • Demonstrate the performance of sterilization using an autoclave • Educate patients regarding methods to reduce disease transmission

8. Microorganisms and Pathogens • A microorganism is a microscopic organism seen only by using a microscope • Not all microorganisms cause disease • Harmless microorganisms on our body are called “normal flora” • Microorganisms that cause disease are called “pathogens”

9. Pathogens • Require nutrients, moisture, warmth, and neutral pH to grow and thrive • Aerobic pathogens require oxygen to survive • Anaerobic pathogens require oxygen-free environment to survive

10. Types of Pathogens • Five main types of pathogens: • Bacteria • Rickettsia • Virus • Fungus • Protozoa

11. Bacteria • One-celled organisms • Three types: cocci—round shape, bacilli— rod shape, spirilla—spiral shape • Bacterial infections include staph infections, strep throat, Lyme disease, and gonorrhea

12. Rickettsia (parasite) • Parasitic nature—organism depends on host to survive • Spread to humans via vectors: lice, ticks, fleas • Infections include Rocky Mountain spotted fever, and typhus

13. Virus • Pathogen that grows and reproduces after infecting a host cell • More than 400 types • Smallest of all pathogens • Viral infections include common cold, hepatitis, chicken pox, and HIV

14. Fungus • Yeast, mold, and mushroom • Many present in body’s normal flora • Many do not cause disease • Fungal infections include athlete’s foot, ringworm, and yeast infections

15. Protozoa • Live mainly in soil • Spread through fecal–oral route by ingested contaminated food or water • Some spread by mosquitoes or other insects • Protozoan infections include malaria, Giardia, and trichomoniasis

16. Chain of Infection • Pathogen • Reservoir host • Means of exit • Method of transmission • Means of entry • Susceptible host

17. Disease-producing microorganism; bacteria, virus, fungus, protozoa, and rickettsia Present in blood or body fluids, called “bloodborne pathogens” Pathogens need an environment that enables them to survive, grow, and multiply The human body is a perfect environment Pathogen

18. Human, animal, or insect that is infected with disease Other reservoirs may be water, food, and contaminated objects Host may be symptomatic or asymptomatic Reservoir host is contagious even though he or she may not appear ill Reservoir Host

19. Pathogen must be able to exit reservoir host Any body opening lined with mucous membranes: eyes, nose, throat, vagina, rectum, penis Injury or surgery Blood, body fluids: vaginal secretions, semen, urine, feces Means of Exit

20. Direct contact—person-to-person contact or skin-to-skin contact Handshaking, kissing, and sexual contact Indirect contact— fomites; ticks, fleas, lice, and countertops Indirect contact includes airborne and droplet infection—sneezing, coughing, and talking Mode of Transmission

21. Pathogen must find entry into new host Any opening in the body lined with mucous membranes: nose, mouth, throat, vagina, penis, rectum Wounds to the skin Means of Entry

22. Weakened immune system Poor hygiene Inadequate nutrition Stress Chronic disease Poor environmental conditions Elderly Very young Certain medications Smoking Alcohol abuse Susceptible Host

23. Stages of Disease • Incubation stage • Prodromal stage • Acute stage • Declining stage • Convalescent stage

24. Incubation Stage • Beginning stage of infection (latent) • Starts when person first contacts pathogen • Person may be asymptomatic • Person is contagious • First appearance of symptoms

25. Prodromal Stage • Earliest symptoms • Fever (febrile) or rash • Person may state “I just don’t feel right” • Person is contagious

26. Acute Stage • Symptoms are at their worst • Person is obviously ill • Person is contagious • During this time the patient should take medications, rest, and avoid contact with others

27. Declining Stage • Acute stage ends • Symptoms begin to decrease • Patient starts to feel better

28. Convalescent Stage • Symptoms are gone • Recovery time • Continues until patient regains homeostasis

29. Defense Mechanisms • The body has natural defense mechanisms to protect itself against disease: • Mechanical • Chemical • Cellular

30. Mechanical Defenses • First line of defense against pathogens is “intact” skin • Serves as barrier to environment • Cilia movement in lower airways • Coughing and sneezing • Eyelashes and eyebrows

31. Chemical Defenses • Sebaceous glands • Stomach fluids • Tears and saliva contain lyzozyme • Interferons have antiviral activity

32. Cellular Defenses • Various cells also act to protect the body from pathogens • Inflammatory response • Cell-mediated immunity • Antibody-mediated immunity

33. Inflammatory Response • Inflammation occurs when damage or trauma is done to tissues • Body responds by releasing chemical substances such as histamine, prostaglandins, and kinins

34. Inflammatory Response • Chemical substances initiate changes: dilation of blood vessels, increased permeability of blood vessels, attraction of white blood cells

35. Phagocytosis • Phagocytosis—the ability of white blood cells to engulf pathogens and cellular debris and then destroy that matter

36. Immunity • Protection from infectious disease • Active or passive • Further categorized as acquired naturally or passively

37. Active Natural Immunity • Develops when body is exposed to pathogenic microorganisms • Microorganisms contain antigens (cell markers) • White blood cells develop antibodies • Antibodies protect during second exposure

38. Active Artificial Immunity • Develops when antigen is purposely introduced into body • Vaccine • Live, weakened, dead microorganism • Stimulates antibody formation without causing disease

39. Passive Natural Immunity • Develops when antibodies from mother cross placenta to fetus • Provide protection to fetus for several months • Additional antibodies are found in breastmilk

40. Passive Artificial Immunity • Develops when preformed antibodies from animal or human are then injected into an individual with known exposure • Antiserum provides temporary passive immunity • Helps in cases of exposure to rabies, botulism, venomous snake or spider bites, hepatitis, and diptheria

41. Standard Precautions • Centers for Disease Control and Prevention (CDC) • Occupational Safety and Health Administration (OSHA) • Workplace guidelines to promote safety • Bloodborne pathogens • Personal protective equipment

42. Personal Protective Equipment • Degree of risk to exposure • Gloves, masks, eye protection, shoe covers, and gowns

43. Disposal of Biohazardous Waste • Containers that hold blood or body fluids • Containers are required to have biohazardous labels

44. Sharps and Needlestick Safety • “Sharps”—needles, scalpel blades, capillary tubes, and broken glass or slides • Dispose of in puncture-resistant containers • Never recap an uncapped needle • Replace biohazard containers when full

45. Vaccinations • If no Hepatitis B vaccination prior to employment, the employer must provide it for the employee within 10 days of employment at no cost to employee • Series of three injections • Documentation • Test for TB exposure

46. Exposure Control • All employers must have exposure control plan and review with employees • Exposure incident is any contact with blood or body fluid, and any accidental injury • Report exposure to employer immediately • Follow policy and procedure for your facility

47. Biohazard Spill • Protect yourself with PPE, control spill with paper towels • Cover entire spill with 10% bleach solution and let stand for 20 minutes • Clean up spill with mechanical device, do not use hands • Repeat bleach application, wait another 20 minutes

48. Asepsis • Condition free from pathogens • Handwashing • Sanitization • Disinfection

49. Hand Sanitization • Single most effective way to prevent the spread of disease • Soap and warm water, rub vigorously 15 seconds • Antiseptic hand wash, cover all surfaces of hands, and air dry

50. Beginning work Before and after rooming patients Before and after cleaning exam rooms Before and after assisting the physician with procedures Before and after cleaning equipment Before and after using the restroom Before and after taking a break or eating lunch At the end of the day Typical Times to Wash Hands