Infection Control II. Elements Needed to Transmit Infection. An infectious agent A reservoir or an environment in which the pathogenic microbes can live and multiply. A portal from which to exit the reservoir.
Bacterium, a fungus, a virus, a prion, or a parasite. Infectious agents vary in their ability to cause disease
The reservoir can be a human being, an animal, a plant, water, food, earth, or any combination of organic materials that support the life of a particular pathogen
The portals of exit might be the nose, mouth, urinary tract, intestines, or an open wound from which blood or purulent exudate can escape.
Infection is transmitted by direct or indirect contact, by droplet, by vehicle, by vector, or by airborne route. Contact is direct when a person or an animal with a disease or his blood or body fluids are touched. This contact can be by touching with the hands, by kissing, by percutaneousinjection, or by sexual intercourse. A person who transmits disease-causing organisms but has no apparent signs or symptoms of that disease is called a carrier. Particular organisms require specific routes of transmission for infection to occur.
Indirect contactis defined as the transfer of pathogenic microbes by touching objects (called fomites) that have been contaminated by an infected person. These objects include dressings, instruments, clothing, dishes, or anything containing live infectious microorganisms.
Droplet contactinvolves contact with infectious secretions that come from the conjunctiva, nose, or mouth of a host or disease carrier as the person coughs, sneezes, or talks. Droplets can travel from approximately 3 to 5 feet and should not be equated with the airborne route of transmission, which is described later.
Vehicles may also transport infection. Vehicle route of transmission includes food, water, drugs, or blood contaminated with infectious microorganisms.
The airborne routeof transmission indicates that residue from evaporated droplets of diseased microorganisms are suspended in air for long periods of time. This residue is infectious if inhaled by a susceptible host.
Vectors are insect or animal carriers of disease. They deposit the diseased microbes by stinging or biting the human host.
Entry of pathogenic microorganisms into a new host can be by ingestion, by inhalation, by injection, across mucous membranes, or, in the case of a pregnant woman, across the placenta
The body has a highly complex immune system that reacts to specific invaders that are able to bypass the nonspecific body defenses by forming antigens. Antigens are foreign or unrecognizable organic substances that invade the body and induce it to produce antibodies
Antibodies are also found in human tears, saliva, and colostrum.
is a state in which the immune system\'s ability to fight infectious disease is compromised or entirely absent. Most cases of immunodeficiency are acquired ("secondary") but some people are born with defects in the immune system, or primary immunodeficiency. Transplant patients take medications to suppress their immune system as an anti-rejection measure, as do some patients suffering from an over-active immune system. A person who has an immunodeficiency of any kind is said to be immunocompromised. An immunocompromised person may be particularly vulnerable to opportunisticinfections, in addition to normal infections that could affect everyone
HIV usually results in AIDS, a disease that is currently incurable and has a high mortality rate.
A patient must reach the 5th stage of the disease before it is classified as having AIDS.
Once reaching this stage, 80-90% die with in 3 years.
What if you get exposed to HIV???
Immediately report to your supervisor and follow the policy and procedures protocol of your hospital.
An infectious disease commonly seen in persons with AIDS is Pneumocystis carinii, a type of pneumonia. Also seen are cytomegalovirus infections, Candida, herpes simplex, Kaposi\'s sarcoma (a malignant tumor of the endothelium), AIDS dementia complex (in which it is believed that nerve cells are directly attacked resulting in dementia), tuberculosis, and many other diseases. Death is usually the result of recurrent opportunistic infections. Malignant diseases may also be the cause of death.
Health care workers most often contract hepatitis B from needle stick injuries.
Hepatitis C has also become more prevalent in recent years and has become the most common blood-borne infection in the United States. Persons with this disease frequently become chronic carriers and are at increased risk of developing chronic liver disease, cirrhosis, or liver cancer.
Is a chronic disease caused by the spore – forming Mycobacteriumtuberculosis bacterium.
It affects the lungs, but can possibly infect any part of the body.
It is a communicable disease and must be treated as such by all health care workers.
Methicillin-Resistant Staphylococcus Aureus (MRSA)
Vancomycin-Resistant S. Aureus (VRSA)
Vancomycin-Resistant Enterococcus (VRE)
Bacterium and Fungemia
Extended spectrum beta-lactamase (ESBL)
OSHA states that all workplaces in which employees may be exposed to human blood or body substances shall formulate a plan to control employee exposure to pathogenic microorganisms borne by these substances. This plan was to be implemented in all affected workplaces by spring of 1992. These precautions must be followed at all times. The regulations required of all employers are as follows:
Body substance isolation procedures define body fluids and substances as infectious (National Safety Council, 1993). Body substances and fluids that may be infectious include vaginal secretions, breast milk, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, and amniotic fluid. Urine, feces, nasal secretions, tears, saliva, sputum, and any purulent or non-purulent drainage from wounds are also considered potentially infectious.
(A) Pull the first glove off by grasping it on the outside with the other gloved hand. Hold the glove that has been removed in the remaining gloved hand. (B) With the bare fingers, reach inside the top of the remaining soiled glove and pull it off. (C) Turn the glove inside out and encase the other glove inside it. (D) Drop the soiled gloves into a designated waste receptacle
If exposure to blood or body fluids is possible, wear gloves, gown, mask, and eye protection!
Approximately 8% to 12% of health care workers have reported a latex sensitivity. Reactions range from local skin reactions to urticaria (hives) to systemic anaphylaxis, an exaggerated allergic reaction that can result in death (OSHA, 2005). The powder placed on the gloves may exaggerate this allergic response. It is the employer\'s responsibility to make non-latex, powder-free gloves available for any employee that has a need. A policy must be in place to deal with latex-sensitive employees and patients.
Not all disinfectants are equally effective. Before a disinfectant is chosen for the diagnostic imaging department, it should be thoroughly studied by an infection-control consultant. Microorganisms begin to grow in disinfectant solutions left standing day after day. This is also true in liquid-soap containers. If such items are used, they should be changed and cleaned every 24 hours.
The following are guidelines for the disposal of waste or the cleaning of equipment after each patient use in the diagnostic imaging department
Use equipment and supplies for one patient only. After the patient leaves the area, supplies must be destroyed or re-sterilized before being used again.
The radiographic table or other imaging or treatment equipment should be cleaned with a disposable disinfectant towelette or sprayed with disinfectant and wiped clean and dried from top to bottom with paper towels after each patient use.
Pour liquids to be discarded directly into drains or toilets. Avoid splashing or spilling them on clothing.
Always treat needles and syringes used in the diagnostic imaging department as if they are contaminated with virulent microbes. Do not recap needles or touch them after use. Place them immediately (needle first) in a puncture-proof container labeled for this purpose. Do not attempt to bend or break used needles because they may stick or spray you in the process.
Disinfection is a term used to describe the removal, by mechanical and chemical processes, of pathogenic microorganisms, but frequently not their spores, from objects or body surfaces. Usually in reference to body surfaces, the term antisepsis or antiseptic is used rather than disinfect or disinfectant. Items are disinfected when they cannot withstand the process necessary to sterilize them or when it is not practical to sterilize. This is often the case with objects leaving an isolation unit. If an object leaving an examining room or isolation unit has been contaminated, it is cleaned first by vigorous scrubbing (mechanical means) and then disinfected by wiping it with, or soaking it in, a chemical selected by the institution for this purpose.
When a patient enters the diagnostic imaging department and it is known or suspected that this patient has a contagious disease, it is the radiographer\'s responsibility to prevent the spread of infection. If the patient is coughing and sneezing, the patient must be provided with tissues and a place to dispose of them. Instruct the patient to cough and sneeze into the tissues and then discard them safely. The patient should be removed from a crowded waiting room to prevent infecting other persons. The radiographer must put on a gown to protect his uniform. Put on a mask and goggles, if necessary. The patient should be cared for and returned to his or her room or discharged as quickly as possible.
Standard precautions to prevent spread of infection are used daily for all persons cared for in all health care settings. Some diseases, or the suspicion of a communicable disease, require radiographers and all health care workers to take additional precautions, as well as standard precautions to prevent infection of other health care workers, patients, other persons in the health care setting, and oneself. These precautions are presently called transmission-based precautions or Tier 2 precautions and are designed to place a barrier to the spread of highly infectious diseases between persons with such diseases and the persons caring for them.
Before entering the isolation room, the radiographer must have the portable imaging machine prepared with as many image receptors on hand as are needed. Make sure they are covered with protective plastic cases to keep them from becoming contaminated. Also, place an extra pair of clean gloves on the machine before placing it in the patient\'s room. Have an assistant available.
Rationale for steps 2 and 3: Prevent transmission of microorganisms.
When imaging exposures are completed and before gloves are contaminated by removing the last image receptor, push the machine out of the room and notify the assistant to prepare to receive the image receptors.
Return to the patient. Make the patient comfortable. Place the bed in the low (closest to the floor) position; put the side rails up and the call button within the patient\'s reach.
Place a protective sheet on the radiographic table, transfer the patient to the table, and place a draw sheet over him or her. Make the necessary exposures. Arrange work so that the patient does not have to spend more time than is necessary in the department.