1. Define infection prevention and discuss types of infections

1. 1. Define infection prevention and discuss types of infections • Define the following terms: • infection prevention • the set of methods practiced in healthcare facilities to prevent and control the spread of disease. • microorganism/microbe • a living thing or organism that is so small that it can be seen only under a microscope. • infection • the state resulting from pathogens invading the body and multiplying.

2. 1. Define infection prevention and discuss types of infections Define the following terms: pathogens microorganisms that are capable of causing infection and disease. localized infection an infection that is limited to a specific location in the body and has local symptoms. systemic infection an infection that is in the bloodstream and is spread throughout the body, causing general symptoms. healthcare-associated infection (HAI) an infection acquired within a healthcare setting during the delivery of medical care.

3. 1. Define infection prevention and discuss types of infections • It is important to observe and report the following signs and symptoms of localized infections: • Pain • Redness • Pus • Swelling • Drainage (fluid from a wound or cavity) • Heat

4. 1. Define infection prevention and discuss types of infections It is important to observe and report the following signs and symptoms of systemic infections: • Fever • Body aches • Chills • Nausea, vomiting • Weakness • Headache • Mental confusion • Drop in blood pressure

5. 2. Describe the chain of infection Define the following terms: chain of infection a way of describing how disease is transmitted from one being to another. causative agent a pathogenic microorganism that causes disease. reservoir a place where a pathogen lives and grows.

6. 2. Describe the chain of infection Define the following terms: portal of exit any body opening on an infected person that allows pathogens to leave. mode of transmission the method of describing how a pathogen travels. direct contact a way of transmitting pathogens through touching the infected person or his or her secretions. indirect contact a way of transmitting pathogens from touching something contaminated by the infected person.

7. 2. Describe the chain of infection Define the following terms: portal of entry any body opening on an uninfected person that allows pathogens to enter. mucous membranes the membranes that line body cavities that open to the outside of the body, such as the linings of the mouth, nose, eyes, rectum, or genitals. susceptible host an uninfected person who could get sick. transmission passage or transfer.

8. 2. Describe the chain of infection Define the following terms: infectious contagious. medical asepsis refers to practices such as handwashing that reduce, remove, and control the spread of microorganisms. surgical asepsis the state of being free of all microorganisms; also called sterile technique.

9. Transparency 5-1: The Chain of Infection

10. 2. Describe the chain of infection REMEMBER: If even one link in the chain of infection is broken, the spread of infection is stopped.

11. 2. Describe the chain of infection Think about these questions: What is an example of each link in the chain of infection? How could that link be broken?

12. Handout 5-1: Infection Prevention Definitions Microorganism: Microorganisms are single-celled organisms that only can be viewed with the aid of a microscope. Microorganisms can be divided into five basic categories—bacteria, viruses, fungi, protozoa, and helminthes. Most microorganisms are harmless—some are even beneficial. Others are capable of causing infection or disease. Microorganisms are often classified as either pathogenic or nonpathogenic. Nonpathogenic microorganism: A nonpathogenic microorganism is a type of microorganism that is incapable of causing or unable to cause infection or disease. Pathogenic microorganism: A pathogenic microorganism is a type of microorganism that is capable of causing infection or disease; it is also called a pathogen.

13. Handout 5-1: Infection Prevention Definitions (cont’d) Bacteria: Bacteria are single-celled microorganisms that lack nuclei and organized cell structures. Bacteria can exist independently (on their own) or as parasites, dependent upon a host for life. Bacteria can be found in three basic shapes—round, rod, or spiral. While some bacteria are capable of causing disease, most are non-infectious and many have critical roles in decay, fermentation, and nutrient recycling. Bacteria help people digest food. Some bacteria destroy disease-causing cells, and some produce important vitamins in the gastrointestinal tract. Bacteria also play a role in food processing, such as in the production of yogurt and cheeses. Pathogenic bacteria can cause cell damage or death by producing substances known as toxins. Other cell damage can occur when the host’s immune system produces substances to eliminate bacteria, and these substances damage the infected cells and adjacent cells.

14. Handout 5-1: Infection Prevention Definitions (cont’d) Virus: Viruses are small packages of DNA or RNA encased in protein shells that invade a cell (host cell) and incorporate themselves into the host cell’s DNA. When the infected host cell begins to produce (replicate) new viral particles, the infected cell dies. Fungi: Fungi are multi-celled or single-celled organisms. They can be pathogenic, causing infections in healthy persons, or opportunistic, causing infections in people with weakened immune systems. Fungi can be nonpathogenic as well, and some types of fungi are even beneficial, such as those used to make antibiotics. A few types of fungi are considered delicacies, such as truffles and edible mushrooms. Yeasts and molds are examples of fungi. Fungi are the most common causes of disease in crops and plants. Fungi receive their nourishment by secreting enzymes that break down surrounding cells. When this happens on living tissue, it is irritating and uncomfortable.

15. Handout 5-1: Infection Prevention Definitions (cont’d) Parasite: A parasite is an organism that lives on or in an organism of a different species—a host. Infection: An infection occurs when microorganisms enter and multiply within the tissue of a host, causing damage to that tissue. Symptoms may be apparent, or the host may display no symptoms. Disease: A disease occurs when tissue that has been damaged due to the entry and multiplication of microorganisms results in clinical signs and symptoms of a recognizable process. Host: A host is an organism or cell on or in which a microorganism lives or feeds.

16. 3. Explain why the elderly are at a higher risk for infection Define the following terms: malnutrition poor nutrition due to improper diet. dehydration a serious condition resulting from inadequate fluid in the body.

17. 3. Explain why the elderly are at a higher risk for infection The following factors place the elderly at a higher risk for infection than the general public: • Weakened immune systems • Decreased circulation • Slow wound healing • Malnutrition • Dehydration • Limited mobility • Hospitalization • Difficulty swallowing • Incontinence • Feeding tubes and other tubing

18. 4. Explain Standard Precautions Define the following terms: Occupational Safety and Health Administration (OSHA) a federal government agency that makes rules to protect workers from hazards on the job. Centers for Disease Control and Prevention (CDC) a government agency under the Department of Health and Human Services (HHS) that issues information to protect the health of individuals and communities. isolate to keep something separate, or by itself.

19. 4. Explain Standard Precautions Define the following terms: Standard Precautions a method of infection prevention in which all blood, body fluids, non-intact skin, and mucous membranes are treated as if they were infected with an infectious disease. sharps needles or other sharp objects.

20. 4. Explain Standard Precautions The CDC defines body fluids as including the following substances: Saliva Sputum (mucus coughed up) Urine Feces Semen Vaginal secretions Pus or other wound drainage Vomit

21. 4. Explain Standard Precautions Think about this question: Why should Standard Precautions be followed with every resident in an NA’s care?

22. 4. Explain Standard Precautions REMEMBER: It is impossible to tell from looking at a person whether he or she has an infectious disease.

23. 4. Explain Standard Precautions Standard Precautions include the following measures: • Wash hands. • Wear gloves. • Remove gloves immediately when finished with a procedure. • Immediately wash skin surfaces. • Wear a disposable gown. • Wear a mask and goggles.

24. 4. Explain Standard Precautions Standard Precautions (cont’d): • Wear gloves when handling sharp objects. • Never attempt to recap needles or sharps. • Avoid nicks and cuts. • Bag all contaminated supplies. • Clearly label body fluids. • Dispose of contaminated waste properly.

25. 5. Explain hand hygiene and identify when to wash hands Define the following terms: hand hygiene washing hands with either plain or antiseptic soap and water and using alcohol-based hand rubs. antimicrobial an agent that destroys, resists, or prevents the development of pathogens.

26. 5. Explain hand hygiene and identify when to wash hands REMEMBER: It is very important to wash hands with soap and water. NAs should not rely solely on alcohol-based rubs.

27. 5. Explain hand hygiene and identify when to wash hands NAs should wash their hands at the following times: • When first arriving at work • Any time they are visibly soiled • Before, between, and after all resident contact • Before putting on gloves and after removing gloves • After contact with body fluids, mucous membranes, non-intact skin, wound dressings • After handling contaminated items • After contact with objects in resident’s room

28. 5. Explain hand hygiene and identify when to wash hands Times to wash hands (cont’d): • Before and after touching meal trays or handling food • Before and after feeding residents • Before getting clean linen • Before and after using the toilet • After touching garbage or trash • After picking up things from the floor

29. 5. Explain hand hygiene and identify when to wash hands Times to wash hands (cont’d): • After blowing nose or sneezing into hand • Before and after eating • After smoking • After touching areas on the body • Before and after applying makeup • After any contact with pets/pet care items • Before leaving facility

30. 5. Explain hand hygiene and identify when to wash hands REMEMBER: Hand-washing is the single most important thing an NA can do to prevent the spread of disease.

31. Washing hands (hand hygiene) • Equipment: soap, paper towels 1. Turn on water at sink. Keep your clothes dry, because moisture breeds bacteria. • Wet hands and wrists thoroughly. 3. Apply soap to your hands.

32. Washing hands (hand hygiene) • Keep your hands lower than your elbows and your fingertips down. Rub hands together and fingers between each other to create a lather. Lather all surfaces of wrists, fingers, and hands, using friction for at least 20 seconds. Friction helps clean. 5. Clean your nails by rubbing them in the palm of your other hand.

33. Washing hands (hand hygiene) 6. Being careful not to touch the sink, rinse thoroughly under running water. Rinse all surfaces of your hands and wrists. Run water down from wrists to fingertips. Do not run water over unwashed arms down to clean hands.

34. Washing hands (hand hygiene) 7. Use a clean, dry paper towel to dry all surfaces of your hands, wrists, and fingers. Do not wipe towel on unwashed forearms and then wipe clean hands. Dispose of paper towel into waste container without touching the container. If your hands touch the sink or wastebasket, start over.

35. Washing hands (hand hygiene) • Use a clean, dry paper towel to turn off the faucet then dispose of paper towel into waste container. Do not contaminate your hands by touching the surface of the sink or faucet.

36. 6. Discuss the use of personal protective equipment (PPE) in facilities Define the following terms: personal protective equipment (PPE) equipment that helps protect employees from serious workplace injuries or illnesses resulting from contact with workplace hazards. don to put on. doff to remove.

37. 6. Discuss the use of personal protective equipment (PPE) in facilities Define the following terms: perineal care care of the genitals and anal area. non-intact skin skin that is broken by abrasions, cuts, rashes, acne, pimples, lesions, surgical incisions, or boils.

38. 6. Discuss the use of personal protective equipment (PPE) in facilities PPE must be worn when a caregiver might come into contact with any of the following: Body fluids Mucous membranes Open wounds

39. 6. Discuss the use of personal protective equipment (PPE) in facilities REMEMBER: NAs must wear gowns, masks, goggles, and face shields any time splashing or spraying of body fluids or blood could occur

40. 6. Discuss the use of personal protective equipment (PPE) in facilities NAs should remember these points about gowns: Gowns protect exposed skin They prevent soiling of clothing They should fully cover the torso, and the sleeves should fit snugly.

41. Putting on (donning) and removing (doffing) gown 1. Wash your hands. 2. Open the gown. Hold out in front of you and allow gown to open/unfold. Do not shake it. Facing the back opening of the gown, place your arms through each sleeve. • Fasten the neck opening. • Reaching behind you, pull the gown until it completely covers your clothing. Secure gown at waist.

42. Putting on (donning) and removing (doffing) gown 5. Use a gown only once and then remove and discard it. If gown becomes wet or soiled during care, remove it. Check your clothing, and put on a new gown. OSHA requires non-permeable gowns—gowns that liquids cannot penetrate—when working in a bloody situation. 6. Put on your gloves after putting on gown. The cuffs of gloves should overlap the cuffs of the gown.

43. Putting on (donning) and removing (doffing) gown 7. When removing a gown, remove and discard gloves properly (see procedure later in the chapter). Unfasten gown at neck and waist. Remove the gown without touching the outside of gown. Roll the dirty side in, while holding gown away from your body. Dispose of gown properly and wash your hands.

44. 6. Discuss the use of personal protective equipment (PPE) in facilities NAs should remember these points about masks and goggles: Masks are worn when the resident has a respiratory illness. • Masks should fully cover the nose and mouth. • Masks should fit snugly over nose and mouth. • It is important to change masks between residents. • Goggles should fit snugly over eyes or eyeglasses.

45. Putting on (donning) mask and goggles 1. Wash your hands. 2. Pick up the mask by top strings or elastic strap. Do not touch the mask where it touches your face. 3. Pull elastic strap over your head, or if mask has strings, tie top strings first, then bottom strings. Do not wear a mask hanging from only the bottom tie or strap. Masks must always be dry or they must be replaced

46. Putting on (donning) mask and goggles 4. Pinch the metal strip at the top of the mask (if part of the mask) tightly around your nose so that it feels snug. • Put on the goggles over your eyes or eyeglasses. Use the headband to secure them to your head. Make sure they are on snugly. 6. Put on gloves after putting on mask and goggles.

47. 6. Discuss the use of personal protective equipment (PPE) in facilities Gloves must be worn in the following situations: • If the NA might touch blood or any body fluid • During mouth care or care of any mucous membrane • During perineal care • When providing personal care on non-intact skin • When providing personal care if NA has cuts on hands • When shaving resident • When disposing of soiled linens, gowns, dressings, and pads • When touching contaminated surfaces or equipment

48. 6. Discuss the use of personal protective equipment (PPE) in facilities Gloves must be changed in these situations: • Immediately before contact with mucous membranes or broken skin • If gloves become soiled, worn, or damaged

49. Putting on (donning) gloves 1. Wash your hands. 2. If you are right-handed, slide one glove on your left hand (reverse if left-handed). 3. Using your gloved hand, slide the other hand into the second glove. 4. Interlace fingers to smooth out folds and create a comfortable fit. 5. Carefully look for tears, holes, or discolored spots. Replace the glove if needed.

50. Putting on (donning) gloves 6. If wearing a gown, pull the cuff of the gloves over the sleeves of the gown.