Chapter 16 Infection Control and Standard Precautions

1. Chapter 16 Infection Control and Standard Precautions HSTE II Mrs. Burgstiner

2. Objectives • By the end of this ppt the student will be able to: • Name the 6 types of pathogenic microorganisms • Explain Infection • Describe methods to break the chain of infection • Discuss normal defense mechanisms • Describe stages of infection • Explain Standard Precautions • Define Key Words as relate to the chapter

3. Infection Control Principles • As they relate to: • Microorganisms • Pathogens • Infection & Colonization • Chain of Infection • Normal Defense Mechanisms • Stages of the Infectious Process • Nosocomial Infections

4. Flora • Microorganisms that occur or have adapted to live in a specific environment such as the: • Intestines • Skin • Vagina • Oral Cavity • 2 Types • Resident/Normal • Flora are always present • Transient • Occur in periods of limited duration

5. Pathogenicity & Virulence • Disease • Change in structure or function within the body which is considered abnormal • Or an alteration of HOMEOSTASIS • Pathogens • Disease producing microorganisms • Pathogenicity • Ability of a microorganisms to produce disease • Virulence • Frequency with which a pathogen causes disease

6. Six Types of Pathogenic Microorganisms • Bacteria • Viruses • Fungi • Protoza • Rickettsia • Helminth

7. Bacteria • Small, one-celled microorganisms • Most divide by simple cell division • Some form spores • A resistant stage that makes them hard to kill • Cause wide range of illnesses • Diarrhea • Pneumonia • Sinusitis • UTI • Gonorrhea

8. Bacteria Images • staphylococcusbacteria.info • cdn.physorg.com/.../news/2008/streptococcu.jpg

9. VIRUSES • Organisms that can only live inside cells • Cannot be nourished or reproduce outside the cell • Contain a core of DNA or RNA surrounded by a protein coating • Envelope • Protects them from immune system • Damage the cell they inhabit • Viral Infections Include: • Common cold • Influenza (Flu) • Measles • Hepatitis • Genital Herpes • HIV • West Nile Vius

10. Virus Images • www.ifpma.org/.../001a_Influenza_Virus.html • www.canterbury.ac.uk/.../swine-flu-index.asp

11. Fungi • Microscopic Plant-Like Organisms • Diseases Referred as: • Mycoses • Yeast is a single cell form of fungi • Some fungi and yeast are beneficial • Fungi Infections found mainly in: • Hair • Skin (Athlete’s Foot) • Nails • Mucous Membranes

12. Images Fungi • Dermtophytes • Athelete’s Foot Trichophyton mentagrophytes

13. Protozoa • Single-celled parasitic organisms with the ability to move • Most find food from dead or decaying organic matter • Infection occurs when ingested through • Contaminated Food or • Insect Bites • Common Infections • Malaria • Gastroenteritis • Vaginal Infections

14. Protozoa • www.nhc.ed.ac.uk/index.php?page=24.25.366

15. Rickettsia • Intercellular Parasites • Must live in the cells to reproduce • Spread through bites from • Fleas • Ticks • Mites • Lice • Common Infections • Lyme Disease • Rocky Mountain Spotted Fever • Typhus

16. Rickettsia • blog.k9cuisine.com/.../ • unconditional.co.nz/.../

17. Helminths • Parasitic Worms • Round • Pinworms – Anal Itching • Tapeworms – Intestinal Disease • All Tapeworms are acquired by • Eating uncooked or Inadequately Cooked • MEAT

18. Images Helminths Hookworm • En.wikipedia.org Tapeworm Pinworms

19. Chain of Infection • Interactive process involves • Agent • Host • Environment • Knowledge about the chain • Facilitates Control or • Prevention of Disease by • Breaking the links in the chain

20. http://faculty.ccc.edu/tr-infectioncontrol/chain.htm

21. Entity capable of causing disease 3 Types Biological Agents Bacteria Virus Fungi Protozoa Rickettsia Chemical Agents Pesticides Food Additives Medications Industrial Chemicals Physical Agents Heat Light Noise Radiation Chain of Infection Concerned with Biological Agent

22. Place where the agent can survive Favorable /Promotes Growth Most common Humans Animals Environment Fomites Objects contaminated with infectious agent such as Instruments Dressings Human and Animals Can be infected or Just be carriers Either way can spread it to others Reservoir

23. Route Infectious agent leaves Reservoir Transfers to Susceptible Host Agent leaves Reservoir Though Body Secretions Sputum Semen Vaginal Secretions Urine Saliva Feces Blood Draining wounds Portal of Exit

24. Process Bridges Gap Between Portal of Exit Infectious Agent From Reservoir To Portal of Entry of Susceptible “New” Host 4 types of Transmission Contact – Physical Transfer Airborne - Droplets/Dust particles Vehicle – Contaminated inanimate object Vectorborne – animate means Mode of Transmission

25. Route Infectious Agent Enters the Host 5 Portals of Entry Integumentary System Break in skin or Mucous Membrane Respiratory System Inhaling Contaminated Droplets Genitourinary Tract Contamination through Infected Vaginal Secretions or Semen Gastrointestinal Tract Ingesting Contaminated Food/Water Transplacental Microorganisms from mother to fetus via Placenta/Umbilical Cord Portal of Entry

26. HOST • Simple or Complex Organism • Affected by an Agent • Term HOST used Here means • An individual “at risk” of contracting an infectious disease • Susceptible HOST • Person who lacks resistance to an agent • Vulnerable to Disease • Compromised HOST • Person whose normal defense mechanisms are impaired Ex. On immunosuppressive drugs

27. Age Immunity Declines Concurrent Disease Existence of Another Disease Stress Compromised Emotional State Immunization/Vaccination Status Not fully Immunized Lifestyle Practices Multiple Sex Partners, Sharing Needles, Tobacco/Drug Use Occupation Increased Exposure to Pathogenic Sources Needles/Chemical Agents Nutritional Status Maintenance of Ideal Wt for Ht Less Prone to Illness Heredity Naturally Born More Susceptible to Infections Characteristics of a Host That Might Influence Susceptibility or Severity of an Infection

28. Breaking the Chain of Infection • HCW • Main Focus to Break the Chain of Infection • HOW? • Proper Infection Control Practices • Breaking/Blocking Transmission • Break a Link in the Chain

29. HOW? Between Agent & Reservoir • Keys • Cleansing • Disinfection • Sterilization • Prevent a Formation of a Reservoir so an Agent Can’t Live and Multiply

30. Cleansing • Removal of Soil/Organic Matter From Equipment/Object Prior to Disinfection/Sterilization • Rinse Under Cold Water • Apply Detergent/Scrub • Rinse Under Warm Water • Dry the Object

31. Disinfection • Elimination of Pathogens except Spores • Chemical Solutions • Alcohol • Sodium Hypochlorite • Home Use • Lysol • Bleach

32. Sterilization • Total Elimination of All Microorganisms, Including Spores • Methods • Moist Heat/Steam • Radiation • Chemicals • Ethylene Oxide Gas • Chosen Method Depends on Type and Amount of Contamination • Boiling Water • Best and Most Common Method of Sterilization (Especially in HOME) • Some Spores/Viruses can still survive

33. Proper Hygiene HCW must teach importance of maintaining cleanliness and integrity of the skin and mucous membranes Bathing/Hand Washing/Flossing Clean Dressings Open injuries must be changed and cleansed regularly Clean Linens Dressing gowns, Linens, towels – catchalls for body secretions Must be kept clean Clean Equipment Must be cleansed and disinfected after each use HCW must wear PPE’s How to Break the Link Between Reservoir and Portal of Exit?

34. How Between Portal of Exit and Mode of Transmission? • Goal is to Block the Exit of the Infectious Agent • Cover and maintain clean dressings on open wounds/injuries • Cover mouth/nose when sneezing/coughing • Gloves • Dispose of Contaminated Articles Properly

35. How Between Mode of Transmission and Portal of Entry? • HCW • Must always Wash Hands Between clients/pts • Wear PPE’s appropriate to the case

36. How Between Portal of Entry and HOST • Goal Prevent Transmission of Infection to an Uninfected Person Including HCW • Maintain Skin Integrity • Use Sterile Technique

37. How Between Host and Agent? • Eliminate Infection Before it Begins • Prevention • Proper Nutrition • Exercise • Immunization • Maintain Intact Immune System • Change an Unhealthy Lifestyle/Habit

38. Normal Defense Mechanisms • Immune System • Unique Feature • Recognizes Which Agents Are Not Consistent With the Genetic Make-up of the Host • These Agents are called Antigens • Then forms • Antibodies to protect the body against the Antigen • Two Forms • Nonspecific Immune Defense • Specific Immune Defense

39. Nonspecific Immune Defense • Mounts a Response to Protect From • All Microorganisms • Not dependent on prior exposure to antigens • Skin/Normal Flora • Mucous Membranes • Sneezing • Coughing • Tearing Reflexes • Elimination • Acidic Environment • Inflammation

40. Skin/Normal Flora Physical Barrier Mucous Membranes Entrap Infectious Agents Contain Antibodies Lactoferin Lyozyme Inhibit Growth Sneezing, Coughing, Tearing Reflexes Physically Expel Mucus Contain Bactericides Tears Continuously Flush Away Microorganisms Elimination/Acidic Environment Prevents Microbial Growth Include Resident Flora of the Large Intestine Acidity of Urine Normal Vaginal Flora Mechanical Process of Defecation Evacuates Bowels of Feces and Microorganisms Flushing Action of Urination Removes microorganisms Inflammation Nonspecific Response to Cellular Injury Nonspecific Immune Defense

41. Lymphocytes Range of Cells Involved in the Immune Response B cells – Lymph Node/Spleen Plasma Cells – Immunoglobin Helper T-cells – thymus gland Killer T Cells – Kill Virus invaded and Cancerous Body Cells – Involved in Graft Rejection Suppressor T cells – Slow down B and T cells Memory Cells – Exist in body for years – For a quick response Macrophages – Lg WBC engulf and digest antigen Specific Immune Defense

42. Stages of the Infectious Process • Two types of Infectious Responses • Localized Infection – Defined area • Ex. Cold Sore • Systemic Infection – Infects whole body • Ex. AIDS • 4 Stages of Progression • Incubation • Time interval between entry of an infectious agent into the host and onset of symptoms (sx) • Infectious agent invades tissues and multiplies

43. Stages • Prodromal • Time Interval from the onset of non-specific sx until specific sx appear • Agent continues to invade and multiply

44. Stages • Illness Stage • Time Period when client manifests specific s/sx of an infectious Process • Convalescent Stage • Period of time from the beginning disappearance of acute sx until client returns to a state of health

45. Nosocomial Infections • Acquired in a Hospital or other Health Care Facility • Not present on pt/client admission • Hospital-Acquired Infection • 4 Categories • Urinary Tract • Surgical Wounds • Pneumonia • Septicemia • Hospitalized pt/clients are at risk • Most Common Are: • Urinary Tract, Upper/Lower Respiratory, Digestive, Conjunctiva of the Eyes, and Skin Infections

46. Bioterrorism • Use of Bacteria, Viruses, or Germs to Cause Illness and Spread Fear • Could use biological agents that spread through • Air • Water • Food • HCW must be aware that these attacks could occur • Alert • Heightened Security • Updated Info at www.cdc.gov/ncidod/disease/bioterr.htm

47. Standard Precautions • Used at all times in all places in Healthcare • Routine pt care • Cleaning Duties • Contact with blood or body fluids • Handwashing • PPE’s – Gloves, Gowns, Masks, Face Shield, Eye Protection • Handle all Linens/pt care equipment so as to prevent exposure to yourself, or contamination of your clothing

48. Standard Precautions/Bloodborne Pathogen Standard • Never Recap a Needle • Most won’t allow you to anymore, made with a shield • Dispose of Needles in Sharps Container • Use Barriers when performing CPR • Isolate pt/clients if contagious • Called Isolation • Provide a private room • Use standards established by the CDC 1996

49. Reverse Isolation • Protective Isolation • Protects pt/client from HCW • Used when immune system is compromised • Or highly susceptible to Infection • Ex. • Receiving Immunosuppressive Medication • Receiving Chemotherapy/Radiation Therapy • Diseases such as Leukemia • Extensive burns • Extensive Dermatitis/Other Skin Impairments