Health Skills I Student Lecture Packet

1. Health Skills I Student Lecture Packet

2. HealthSkillsI Unit 101 Infection Control

3. Objectives • Identify the nature of microorganisms, how organisms grow, their transmission, body defenses of the human host, and related terminology

4. Unit 101.1Microorganisms • Anton Van Leeuwenhoek • first observed microorganism under a microscope in 1693

5. Microorganisms are Everywhere! • inside and outside our bodies • in food, air, and water • some are useful • fermentation of food • small percentage cause disease • organisms can be spread • healthcare workers need to understand how to break cycle

6. Exciting Moments in Microbiology • Ignatz Semmelweiss 1860 • reduced the transmission of puerperal fever by handwashing

7. More Exciting Moments in Microbiology • LOUIS PASTEUR 1861 • proposed the “Germ Theory”

8. Definitions • Microorganism • microscopic living things that individually are too small to be seen with the naked eye, only seen under microscope • example: germs & microbes • Pathogen • microorganisms capable of causing disease

9. Definitions • Communicable disease • a pathogenic organism passed from one host to another • Host • one infected with a pathogenic microorganism • Susceptible host • one unable to fight off infection due to low resistance

10. Definitions • Colonized • presence of microorganisms in or on a patient, without clinical signs and symptoms • Infection • colonization invasion of body tissues by disease producing pathogenic microorganisms • Re-infection • infected a second time by same pathogen

11. Definitions • Cross infection • spread to another person by air currents or health worker • Co-infection • infected with more than one organism • Secondary infection • an infection acquired following a primary illness • Nosocomial • infection acquired within a healthcare facility.

12. Pathogenic OrganismsVirus • acellular • cannot survive independently • parasite • can only survive on living tissue • cannot be treated by antibiotics, may use antiviral drugs • vaccinations can prevent a number of viral infections

13. Pathogenic OrganismsVirus • Examples: • polio, influenza, common cold, HIV, Hepatitis B, mumps, herpes Bacteriophage (virus that infects bacteria)

14. Pathogenic OrganismsBacteria • simple unicellular organism • three shapes • coccus, bacillus, spirillium • Clostridium tetani • bacterium that causes tetanus

15. Pathogenic Organisms Bacteria • can be treated by antibiotics • examples: • strep throat, abscesses, gonorrhea, syphilis, chlamydia, Rocky Mountain Spotted Fever, Lyme disease • vaccinations can prevent some bacterial infections • example: • pneumonia

16. Pathogenic Organisms Fungi • molds and yeast • multicellular or unicellular organisms, more complex than bacteria

17. Pathogenic Organisms Fungi • Examples: • athletes foot, ringworm, vaginal yeast infection, thrush Pilobolus, a fungus

18. Pathogenic Organisms Protozoa • largest single celled organism • relatively few cause disease in humans • many parasites passed by insects • transmitted by food

19. Pathogenic Organisms Protozoa • Examples: • malaria, dysentery, sleeping sickness Amoeba, a protozoan

20. Pathogenic OrganismsClostridium difficile (C. difficile) • C. difficile is: • a pathogenic species of anaerobic bacteria causing pseudomembranous colitis and diarrhea, after receiving antibiotic therapy. This is frequent cause of nosocomial diarrhea

21. Definitions • Anaerobic • a microorganism that grows and lives in the complete or almost complete absence of oxygen • Pseudomembranous colitis • diarrhea caused by overuse of antibiotics transmitted by healthcare workers not washing hands properly

22. Pathogenic Organisms C. difficile • common hazard of antibiotic use • most common cause of nosocomial infectious diarrhea • may cause bleeding & bowel perforation • can exist months on environmental surfaces & flourishes on hands of healthcare workers • At risk patients: • chemotherapy, antibiotic therapy & gastrointestinal procedures

23. C. difficile • Standards of care for patient w/ diagnosis of C. difficile • good handwashing before & after patient care procedures • use of Standard Precaution barriers for Contact Isolation guidelines (gown, gloves, private room) • the antibiotic related to the cause of C. difficile will be discontinued by physician and further care will begin

24. Pathogenic OrganismsVancomycin Resistant Enterococcus (VRE) • VRE is: • a bacteria that normally lives in the digestive tract that has developed a resistance to the antibiotic vancomycin and most other antibiotics

25. Definitions • Vancomycin • antibiotic used to treat strep and staph infections • Enterococcus • any Streptococcus that inhabits the intestinal tract

26. Pathogenic Organisms VRE • caused by overuse of antibiotics • VRE infections frequently found in: • urinary tract, at surgical sites, and in the bloodstream • spreads through: • direct contact with a VRE infected patient • direct contact with surfaces & equipment contaminated with VRE • hands of a healthcare worker contaminated with VRE • lives weeks on surfaces

27. VRE • At risk patients for VRE: • immunosuppressed conditions • history of vancomycin therapy • indwelling urinary or central venous catheters • elderly • abdominal surgery patients • wounds/burn victims

28. VRE • Standards of Care for VRE diagnosed patients: • good handwashing before & after care • use Standard Precaution barriers and contact Isolation Precautions • the antibiotic will be discontinued by a physician with plan for further care

29. Pathogenic Organisms(MRSA) • Methicillin Resistant Staphylococcus Aureus (MRSA) is: • bacteria that populates the skin, mucous membranes and upper respiratory tract, the intestines and genitourinary tracts that has become resistant to the antibiotics methicillin and penicillin

30. Pathogenic Organisms MRSA • endemic (expected “normal” incidence) within community &tertiary hospitals, skilled-nursing facilities & long-term care • most frequent sites of this bacteria is the nares, groin, axilla and gut • transmitted primarily on the hands of the healthcare workers

31. MRSA • At risk patients for MRSA: • those on broad-spectrum antibiotics therapy • immunosuppressed patients • burn patients • central venous catheters • surgical wounds • prolonged hospital stays

32. MRSA • Standard of care for patient w/MRSA diagnosis: • topical ointment to nostrils • if infected, vancomycin

33. Key FactorsC. difficile, VRE, MRSA • handwashing & standard precautions • single room for infected/colonized patients • use antiseptic cleansers in high risk areas • daily cleansing of environmental surfaces that have had direct hand contact

34. Key FactorsC. difficile, VRE, MRSA • dedicate equipment for exclusive use for infected patient(stethoscopes, BP cuffs, etc.) • keep equipment off bed & bed tables • provide protective gear to patient when leaving their room (mask, gown, etc.)

35. Infection Cycle • Three Elements Required: • source of infecting microorganisms • susceptible host • mode of transmission source susceptible host mode of transmission

36. Infection Cycle • Source • may include persons with acute disease • persons in the incubation period of disease • persons who are colonized by infectious agent • persons who are chronic carriers • can be inanimate objects

37. Infection Cycle • Host • one infected with a pathologic microorganism • resistance varies • may develop immunity • may be an asymptomatic carrier • may develop clinical disease

38. Infection CycleTransmission • May be transmitted by more than one route • Five main routes: • contact-direct or indirect • droplet • airborne • common vehicle • vectorborne

39. 1. Contact Transmission • *most frequent mode of noscomial infection • Direct Contact • skin to skin • Indirect Contact • contact with an inanimate object contaminated by the infected patient

40. 2. Droplet Transmission • a form of contact transmission • droplets are propelled a short distance (3 feet) • droplets are deposited on hosts such as the mucous membranes of eye, nose or mouth • droplets are generated by • coughing, sneezing or talking

41. 2. Droplet Transmission • droplets transmitted during medical procedures of bronchoscopy or suctioning that put healthcare workers at risk • private room ideal • Can be placed w/other similar conditions 3’ apart if room availability is an issue • healthcare worker must wear mask when caring for a person with droplet isolation precautions • Example: • Influenza

42. 3. Airborne Transmission • spreads by way of airborne dropletsor dust particles containing infectious agents (microorganisms) and inhaled by the new host • spread by air currents • special handling and ventilation required to prevent transmission • requires private room • Examples • tuberculosis, rubeola, and varicella (chicken pox), herpes zosters viruses spread via airborne transmission

43. 3. Airborne Transmission • spreads by way of airborne dropletsor dust particles containing infectious agents • spread by air currents • special handling and ventilation required to prevent transmission • requires private room • Examples • tuberculosis, rubeola, and varicella (chicken pox), herpes zosters viruses spread via airborne transmission

44. 4. CommonVehicle Transmission • microorganisms transported by contaminated food, water, medication or equipment • Examples: • Hepatitis A, salmonella, Typhoid Fever

45. 5. Vectorborne Transmission • vectors transport disease • mosquitoes, flies, ticks, rats and other vermin transmit disease • Examples: • rabies, malaria, Rocky Mountain Fever Tick

46. How Microorganisms Grow in Humans • Need: • food • oxygen • aerobes-need oxygen • anaerobes-do not need oxygen • temperature • 98.6 F or 36 C or warmer • moisture • pH • acidity or alkalinity

47. Natural Defensesof the Host • Hairs • cilia • Fluid • tears, ear wax, blood • Skin Tissue • intact and healthy • Proper Rest • Proper Nutrition • Natural Immunity • childbirth & disease process • Phagocytosis • cells that can destroy bacteria • Normal flora • bacteria present that do not normally cause disease • streptococci

48. Predisposing Factors for Disease • Poor nutrition • Fatigue • Poor health habits • Pre-existing illness • Gender • Genetics • Climate/Weather • Occupational • Age • very young • very old • Medical treatment • chemotherapy, radiation therapy, bone morrow transplants, immuno-suppressed conditions, indwelling catheters

49. Knowledge Assessment • 1. Give the definition for microorganism. • 2. List two examples of virus, bacteria, and fungi. • 3. List the 3 required elements of the infection cycle. • 4. Compare and contrast contact, droplet, and airborne transmission of microorganisms. • 5. List five natural defenses of the body.