Health Occupations

1. Health Occupations Infection Control

2. Microorganism • Small living organisms • Not visible to the naked eye • Need microscope to view • Found everywhere in environment • Normal body flora • Need for normal body processes • Called NONPATHOGENS(NOT disease producing) • Others cause disease or infections – • Called PATHOGENS • At some times, can be beneficial in one system, but pathogenic in another (E coli)

3. Classification of microorganisms • Bacteria • 1 celled plant that multiplies rapidly • Classified by shape & arrangement • Cocci – round or spherical • Diplococci – occurs in pairs or 2 circles • Gonorrhea, meningitis, pneumonia • Streptococci – occurs in chains • Strep throat, rheumatic fever • Staphylococci – occurs in clusters or groups • Most common pyogenic (pus causing) • Boils, wound infections, toxic shock

4. Classification of microorganisms • Bacteria – classified by shape • Bacilli • Rod shaped • Single, pairs, or chains • Many contain flagella – tails that allow movement • Can form spores or thick walled capsules • Very hard to kill • TB, tetanus, pertussis, botulism, diptheria, typhoid

5. Classification of microorganisms • Bacteria – classified by shape • Spirilla • Spiral or corkscrew shape • Comma-shaped – vibrio • Corkscrew – spirochete • Syphilis, cholera • Antibiotics used to kill bacteria • Some are antibiotic resistant

6. Classification of microorganism • Protozoa • 1 celled animal like organism • Often found in decayed materials & contaminated water • May have flagella – allows for movement • May be pathogenic • Malaria • Amebic dysentery • Trichomonas • African sleeping sickness

7. Classification of microorganism • Fungi • Simple plant like organisms • Live on dead organic matter • Yeasts & molds common • Ringworm, athletes foot, histoplasmosis, yeast vaginitis, thrush • Antibiotics don’t kill • Antifungals – taken for long time • May cause liver damage

8. Classification of microorganisms • Rickettsiae • Parasites • Can’t live outside of another organisms • Found on fleas, lice, ticks, mites • Transmitted by insect bites • Typhus fever, Rocky Mountain spotted fever • Antibiotics effective

9. Classification of microorganisms • Virus • Smallest, visible only with electron microscope • Can’t reproduce unless inside another living cell • Spread from human to human • Difficult to kill • Resistant to disinfectants • Not affected by antibiotics • Cold, measles, mumps, chicken pox, herpes, warts, influenza, polio

10. Diseases of major concern • Hepatitis B • Caused by HBV virus • Transmitted by blood & body fluids • Vaccine developed – 3 immunizations • Employers MUST provide vaccine at NO cost to employees when have risk for exposure – employee may refuse but MUST be offered

11. Diseases of major concern • Hepatitis C • Caused by HCV virus • Transmitted by blood & body fluids • Often asymptomatic – no symptoms • Mild symptoms often – flu like • Causes major liver damage • No preventive immunization at present • Difficult to destroy, remains active for several days in dried blood

12. Diseases of major concern • Acquired Immune Deficiency Syndrome • Caused by HIV virus • Suppresses immune system • Can’t fight off cancers & infections that would not affect a healthy person • No cure, no vaccine • TAKE PRECAUTIONS

13. Factors Required for Growth • Prefer warm environment (body temp) • Darkness also preferred • Many killed by light • Need food & moisture source • Need for oxygen varies • Aerobic – need oxygen • Anaerobic – need oxygen free environment • Human body IDEAL

14. Pathogens work how? • Produce poisons (TOXINS) • Harm body (tetanus) • Some damage CNS (Botulism) • Can cause allergic reaction • Runny nose, watery eyes, sneezing • Can attack & destroy living cells they invade • Malaria – protozoa invades RBC & causes rupture

15. Classification of disease • Endogenous • Originates within body • Metabolic disorders, congenital abnormalities, tumors, infections • Exogenous • Originates outside body • Pathogens, radiation, chemical agents, trauma, electric shock, temp extremes

16. Classification of disease • Noscomial • Hospital acquired infection • Present in facility, transmitted by HCP to pt • Many are antibiotic resistant • Cause serious/life threatening illness • Staphylococcus, pseudomonas, enterococci • Infection control programs in facilities to prevent & deal with infections • Opportunistic • Occur when body defenses are weak • Don’t usually occur in pts with good immune systems (common in AIDS pts)

17. Chain of infection

18. Chain of infection Causative Agent Reservoir Susceptible host Portal of exit Portal of entry Mode of Transmission

19. Chain of infection • Factors that MUST exist to spread disease from one person to another • Causative agent • Pathogen • Reservoir • Place where causative agent can live • Human body, animals • Environment, fomites (contaminated objects) • Doorknobs • Bedpans • Linens • Urinals • Instruments, etc

20. Chain of infection • Portal of exit • Way for causative agent to escape reservoir • Urine • Feces • Saliva • Blood • Tears • Mucous discharge • Sexual secretions • Draining wounds

21. Chain of infection • Mode of transmission • Direct contact • Person-to-person • Contact with body secretion • CONTAMINATED HANDS! • Indirect contact • Transmitted from contaminated substances like food, air, soil, insects, feces, clothing, instruments, equipment • Touching contaminated objects & spreading pathogens on hands • Breathing in droplets carrying airborne infections • Receiving bite of insect or animal carrying pathogen

22. Chain of infection • Portal of entry • Way to enter a reservoir or host • Different portals • Breaks in skin or mucous membranes • Respiratory tract • Digestive tract • Genitourinary tract • Circulatory system

23. Chain of infection • Susceptible host • Person who can contact disease • Usually human can fight off causative agent & not contract disease • Body defenses • Mucous membranes – trap pathogens • Cilia- propel pathogens out of body • Coughing & sneezing • HCL in stomach • Tears – bacteriocidal • Fever • Inflammation – WBC destroys pathogens • Immune response – antibodies, cells secrete protective chemicals • Humans become susceptible when large numbers of pathogen invade & defenses are weak

24. Breaking Chain of infection • Can break ANY part of chain • Follow practices to interrupt or break chain • Prevent disease transmission • Pathogens are everywhere • Prevention is continuous

25. Aseptic technique • Major way to break chain • Asepsis – absence of disease producing microorganisms (pathogens) • Contaminated – any area that may contain pathogens • Aseptic techniques – directed towards maintaining cleanliness & eliminating contamination

26. Common aseptic techniques • Handwashing & good hygiene • Disposable glove use when handling secretions or contaminated objects • Proper cleaning of instruments & equipment • Thorough cleaning of environment

27. Levels of aseptic control • Antisepsis • Prevents or inhibits pathogenic growth • Ineffective against spores & viruses • Can be used on skin • Alcohol, betadine • Disinfection • Kills pathogens • Not always effective against spores/viruses • Chemical disinfectants – can irritate skin • Used mainly on objects, not people • Lysol, bleach, zephirin

28. Levels of aseptic control • Sterilization • Process that destroys ALL microorganisms, both good & bad • Includes spores & viruses • Steam under pressure, gas, radiation, & chemicals • Autoclave is most common

29. Observing Standard Precautions

30. Blood & Body Fluids • Main way that pathogens are spread • 3 pathogens of major concern • Hepatitis B virus • Hepatitis C virus • HIV • Must take extreme care when an area, object, or person is contaminated

31. Bloodborne Pathogen Standard • 1991 – OSHA • Must be followed by ALL HCF • Employer may face civil penalties if not enforced • Regulations require: • Written exposure control plan – annual • I.D. all employees that have occupational exposure • Provide Hepatitis B vaccine free of charge • Provide PPE

32. Bloodborne Pathogen Standards • Regulations (cont): • Adequate handwashing facilities • Worksite is clean & sanitary • Immediate decon of contaminated surfaces • Infectious waste disposal • No eating, drinking, make-up application, contacts, mouth pipetting, or suctioning in a potentially contaminated area • Signs posted as biohazardous material • Evals & follow-up exams for any exposure • No cost training during work hours

33. Needlestick Safety & Prevention Act • Congress, November 2000 • CDC estimate – 600,000 – 800,000 needle sticks each year • Bloodborne Pathogen Standard revised • Employers must use safer devices • Syringes with sliding sheaths • Retractable needles • Needle free connections & systems • Annual updates of Exposure Control plan • Ask input from employees giving pt care • Sharps injury log

34. Standard Precautions • Employers required to enforce rules • Developed by CDC • Every body fluid is potential source of infection • ALL patients are considered potential sources of infection regardless of dx • Standard precautions used when: • Blood or fluid containing blood contact • Mucous, sputum, saliva, CSF, urine, feces, vomitus, amniotic fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, semen, vaginal secretions • Mucous membranes • Nonintact skin • Tissue or cell specimens

35. Handwashing • MAJOR part of standard precautions • Aseptic technique • Hands SPREAD INFECTIONS! • Purpose of handwashing • Prevent spread of pathogens • Protect HCP from disease & illness

36. Hands should be washed when? • Arrival at facility, before leaving facility • Before & after every pt. contact • Anytime hands are contaminated • Before applying & after removing gloves • Before & after handling specimens • After contact with soiled item • After picking up item off floor • After use of bathroom • After cough, sneeze, blowing nose • Before & after contact with your own mucous membrane or mouth

37. Principles of handwashing • Use soap as a cleaning agent • Aids in removal of pathogens by • Suds • Alkali content • Pathogens trapped in soap & washed away • Use liquid soap from a dispenser – bar soap can contain pathogens

38. Principles of handwashing • Use warm water • Less damaging to skin than hot • Creates better lather • Use friction to rub off pathogens • Clean all hand surfaces • Palms • Backs/tops of hands • Areas between fingers

39. Principles of handwashing • Point fingertips downward when washing • Prevents water from getting on forearms & running down to contaminate clean hands • Use dry paper towel to turn faucet off • Prevents contamination from faucet • Pathogens travel faster through wet towels • Clean nails • Can use orange stick or cuticle stick (blunt end) • Scrub with a brush • Nails can be rubbed against opposite palm

40. Gloves • Times to wear gloves • Contact with blood, body fluids, secretions, excretions, mucous membranes, tissue specimens, nonintact skin possible • Handling or cleaning contaminated items • Performing any invasive procedures • Blood tests or IVs

41. Gloves • Must be changed after pt. contact • Be careful not to contaminate skin when removing gloves • Wash hands IMMEDIATELY after removal of gloves • Do NOT wash or reuse gloves

42. Gowns • Worn when splashing or spraying of body fluids, blood, secretions, or excretions is likely • Prevents contamination of clothing • Handle contaminated agents according to agency policy • Wash hands after removing gown

43. PPE – Personal Protective Equipment • Wash hands • Apply gown – tie neck, waist • Apply mask – tie top, then bottom • Apply gloves • Remove gloves • Wash hands • Remove mask – untie bottom, then top • Remove gown – untie waist, then neck • Wash hands

44. Masks & Eyewear • Worn when splashes or sprays of blood, body fluids, secretions, or excretions possible • Irrigating wounds • Suctioning • Dental work • Delivery of baby • Surgical procedures • Prevents mucous membrane exposure to pathogens

45. Masks & Eye wear • Must be used once & discarded • Change every 30 min or when moist or wet • Remove by grasping ties or elastic • Wash hands immediately after removal • Protective eyewear • Should protect front, top, bottom, & sides • If not disposable, needs to be cleaned & disinfected before reuse

46. Sharp objects • Use care when handling to prevent accidental cuts or sticks • Needles • Never bend or break after use • Leave uncapped & attached to syringe • Place in Sharps container (leak-proof) • Label Sharps container with biohazard symbol • Throw away surgical blades, razors, & other sharp objects in Sharps containers also • Disposal of Sharps container • Cannot be empties or reused • Follow facility policy

47. Spills of blood, body fluids, secretions, excretions • Wipe up immediately • Wear gloves, use disposable cloths to wipe up • Then use 10% Bleach solution to disinfect • If large spill, use absorbent powder to soak up fluid & then sweep away

48. Mouthpieces or resuscitation devices • Use to avoid mouth-to-mouth • Place in convenient location & be readily accessible

49. Waste & soiled linen disposal • Wear gloves • Follow agency policy • Biohazard bags to hold contaminated dressings, gloves, foley catheter bags, incontinent pads, vaginal pads, emesis basins, bedpans, urinals, & body tissues • Trash should be burned • Soiled linen – • Laundry bags & wear gloves • Label & color code contaminated linen • If soiled with blood, body fluids, secretions, or excretions, usually placed in special bag & soaked in disinfectant before laundering

50. Reporting cuts & injuries • Employees required to report injuries, needle sticks, or splashing of blood or body fluids immediately • Follow agency policy