Infection Control

1. Infection Control

2. Invisible Enemies • Early 1980’s important aspect of care. • Infection control is a safety issue. • Infectious Diseases • Caused by pathogens • Best control is to prevent spread.

3. Centers for Disease Control and Prevention • Purpose • Assist in formulating guidelines • Responsibility to protect public • Characteristics • US Dept. of Health and Human Services • Standards & guidelines require all employers to provide continuous training for employees re: management of infectious & hazardous waste products

4. Infection Control Department • Responsible for writing & implementing hospitals policies and procedures designed to reduce risk of industrial illnesses and nosocomial infections. • Industrial illness • Nosocomial infection

5. Infection Cycle • Harmful (pathogenic) organisms and nonharmful microorganisms in Hospital • Infectious agent • Reservoir • Portal or exit • Route of transmission • Portal of entry • Susceptible host

6. Interruption of Cycle • Infectious agent • Reservoir • Portal or exit • Route of transmission • Portal of entry • Susceptible host

7. Microorganisms and Disease • An organism is any living thing that is composed of one cell or many cells • Bacterium • Human • Pathogen

8. Types of Microorganisms • Fungi • Molds & yeast • Protozoa • Single celled • Virus • > 300 types • Simple in composition

9. Types of Microorganisms • Bacteria • Single celled • >1600 species • Normal flora • Shapes • Staning • Spores • Most are susceptible to antibiotics

10. Medical and Surgical Asepsis and Handwashing • Consistent and thorough handwashing is the most effective way to fight the transmission of disease.

11. Medical Asepsis • Clean technique: practices & procedures designed to insure a clean enviornment by removing or destroying microorganisms. • Steps: • Proper & adequate handwashing • Wearing a clean uniform • Not touching hair or face with hands • Hold contaminated items away from you

12. Surgical Asepsis • Highest level of protection for patient • Sterile technique • Used whenever skin is broken • When sterile body cavity is opened • During treatment of open wounds • To decontaminate items between patients

13. HandwashingKey to Medical Asepsis • Staphylococci normal on skin • Minimize spread • Guidelines • When arriving at work • Before procedure on each patient • During procedure if hands get contaminated

14. HandwashingKey to Medical Asepsis • Between patients • After using restroom • After removing gloves • Before eating

15. Disinfection, Sterilization, & Sterile Technique • All of the processes needed and used to maintain an environment free from many pathogens.

16. Disinfection • 10% bleach or other CDC approved solutions • Cidex, Enzol, some floor cleaners • Household bleach kills most pathogens • Strong respiratory irritant • Removes contamination • Specific disinfectants & germicides • Alcohol and iodine on the skin • Specific approved solutions on contaminated objects

17. Sterilization • Sterilized = free from all Microorganisms A. Many items are disposable • Always check expiration date • Replace ant item that falls on the floor a. Holes too small to be seen by naked eye may be present

18. Sterilization • Autoclave • Effective means of sterilization that uses heat and steam under pressure • Preferred method of sterilization because it destroys all pathogens including viruses and spores • All items must be properly prepared prior to autoclaving • All secretions & debris must be removed a. Usually by ultrasound

19. Sterilization • Gas sterilization A. Preferred method for those items that may be damaged by heat or steam.

20. Sterilization 4. Pack formation • Linens and other supplies will be combined with clean, designated instruments. • Each pack prepared and labeled for a specific procedure. • Wrapped in disposable towels & secured in tough plastic wrap. • Sterilization indicator strip on outside of towels before plastic wrap—turns a different color

21. Sterilization • Autoclave tape applied to outside of pack. 1. Black lines will appear after sterilization • Expiration date are indicated on the outside.

22. Sterile Technique: Surgical Asepsis • Always be aware of the sterile field. A. Includes the area & supplies that are sterilized • Requires forethought and preparation • Remember: • Sterile to sterile = sterile • Sterile to unsterile = unsterile • Steile to unsure = contaminated

23. Avoiding Contaminating Sharps 1. Serious risk associated with providing clinical patient care of receiving a punture wound from a needle or other sharpe object contaminated with infected body fluid and blood. • Hepatitis B, C, and/or AIDS

24. Avoiding Contaminating Sharps • Disposal A. Puncture proof sharps container (red or beige)

25. Avoiding Contaminating Sharps • Risk reduction guidelines • Never recap, bend, or manually remove dirty needle • Deposit entire syringe, needle or sharp • Clean any puncture wound with alcohol or betadine & report incident to supervisor. • When carrying dirty sharps always point toward floor. • Most needle sticks occur because of carelessness

26. The Risks: Hepatitis • Caused by many different pathogens or physical or chemical agents. • Most common types: A. Hepatitis A • Caused by a virus • Most common form occurring in children/young • Transmitted via fecal-oral route • Poor or no handwashing after using restroom and then eating.

27. The Risks: Hepatitis • Hepatitis B • Caused by a virus • Transmitted via blood & infected body secretions • Hepatitis C • Caused by virus • Transmitted via blood & infected body secretions • Chronic & sometimes fatal

28. The Risks: Hepatitis • Hepatitis D • Hepatitis E

29. Acquired Immune Deficiency Syndrome • Incurable disease effects immune system • Transmitted via blood & body secretions & sexual contact • Opportunistic infections • Potentially occur secondary to the comprised immune system • Certain cancers and pneumonia

30. Acquired Immune Deficiency Syndrome • Reporting • SC Law– cannot disclose a persons status

31. Acquired Immune Deficiency Syndrome • Stats & information • Worldwide • Does Not discriminate • CDC: > ½ mil. Cases in US • WHO: 30.6 Mil. Worldwide • 29.5 million adults • 1.1 million children

32. Acquired Immune Deficiency Syndrome • Global AIDS Policy Coalition • HIV+ persons may be asymptomatic for many years • Virus may still be transmitted

33. Isolation • One method of reducing the transmission of industrial and nosocomial diseases 2. During isolation, the pathogens are isolated to the patient care area. 3. Signs posted on patient care plan and unit 4. Reverse isolation • Patients with compromised immune system • Room with a special air flow & filtering system

34. Types of Precautions CDC RecommendationsStandard Precautions Must be used exactly as recommended during the provision of care for every patient. Gloves and personal protection equipment as determined by risk of exposure to body secretions: Urine, saliva, sputum, fecal material, wound drainage, 0semen, vaginal secretions, tissues, synovial fluid, CSF, amniotic fluid, pleural fluid, peritoneal fluid, and pericardial fluid.

35. Types of Precautions CDC RecommendationsTransmission Based • Used in ADDITION to standard precautions • Utilized if patient is strongly suspected of having a disease transmitted: • Droplets • Through the air • Via direct contact • Via indirect contact

36. Types of Precautions CDC RecommendationsTransmission Based • Contact transmission- most frequent A. Direct contract • Gloves, gowns, eye & mucus membrane protection • Patient care activities that may potentiate an exposure for the healthcare worker: • Changing patient gown • Bathing the patient • Providing oral care • Emphasizes frequent hand washing

37. Types of Precautions CDC RecommendationsTransmission Based • Indirect contract 1. May occur when susceptible host comes into contact with contaminated inanimate object 2. Patient care activities that may potentiate an exposure for the healthcare worker: • Changing patient gown • Cleaning up the bedside. • Not cleaning a stethoscope after use • Not cleaning after after use by patient

38. Types of Precautions CDC RecommendationsTransmission Based • Types of contact diseases: • AIDS • Staphylococcus • Hepatitis • Varicella • Herpes zoster • Shigella • Scabies • Pediculosis • impetigo

39. Types of Precautions CDC RecommendationsDroplet Based • Occurs when a susceptible host is exposed through contact with droplets emitted during talking, coughing, singing, etc. • Infected droplets propelled up to 3 feet • > 5 microns in size • Protection: gloves, gown, eye, mask • Includes: streptococcal pharyngitis, pneumonia, scarlet fever, influenza, rubella, mumps, etc

40. Types of Precautions CDC RecommendationsAirborne Transmission • Occurs when susceptible host exposed to nuclei of evaporated infected droplets. • Less than or equal to 5 microns (small) • Emitted in same ways droplets are. • Remain suspended in air longer than droplets • May be emitted further distance than droplets

41. Types of Precautions CDC RecommendationsAir transmission • Requires special handling of patient • Patient care unit must have special ventilation and negative pressure. • Protection: gloves, gown, eye wear, mucous protection, N95 respirator mask • Diseases: measles, tuberculosis, varicella

42. Types of Precautions CDC Recommendations • Summary: • Know when and how to utilize personal protective equipment. • Frequent and through hand washing during and between patient care. • Proper care and cleaning of equipment.