Essentials of Infection Control

1. Essentials of Infection Control Let’s keep the bugs out!

2. Standards • HS-IHS-9 Analyze different types of microorganisms and their defining characteristics to reduce the risk of infection or illness. Demonstrate physicochemical methods and the use of PPE in preventing and controlling the spread of microbial growth. • 9.1 Define and describe the need for asepsis and infection prevention in the classroom, laboratory, and in the healthcare environment. • 9.2 Compare and demonstrate various physical (hand washing and PPE) and chemical methods (cleaning, disinfection, and sterilization) used to control or prevent microbial growth.

3. Standards • 9.3 Examine the evolution and spread of antibiotic resistant pathogens. • 9.4 Analyze ways microorganisms are spread using the chain of infection model. • 9.5 Utilize personal protective equipment (PPE) and apply personal safety procedures based on OSHA (Occupational Health and Safety Administration and the Centers for Disease Control and Prevention (CDCP). • 9.6 Describe methods of controlling the spread and growth of microorganisms. • 9.7 Discuss Hospital Acquired Infection (HAI), the HAI standards and reporting of HAI. • 9.8 Discuss immunizations and the schedule for vaccinations.

4. Microorganisms • Small living organism that is not visible to the naked eye. • We must use a microscope to see it. • They are found everywhere, including in and on us… • They can be classified in many ways • How they affect us • Shape • Structure

5. Pathogen or Nonpathogen? • Pathogens are microorganisms that cause disease. • They are also called germs • Nonpathogensare microorganisms that are part of our normal flora* and are beneficial to many of our body processes • Even our bodies normal microorganisms can cause disease when they are introduced into a different body system.

6. What Do Microorganisms Need To Grow and Reproduce • Warm environment • Our body temperature is perfect! • Darkness • Preferred by most microorganisms and some are killed by sunlight • Food • Moisture • Oxygen • Aerobic-requires oxygen to live • Anaerobic-live and reproduce without oxygen

7. Bacteria http://education-portal.com/academy/lesson/what-is-eubacteria-definition-characteristics-examples.html#lesson • Simple, one-celled organisms that multiply rapidly. • Cocci are round in shape • Diplococci occurr in pairs • Meningitis, gonorrhea

8. Bacteria • Streptococci occur in chains • Strept throat • Staphylococci occur in clusters • Most common pus producing • Wound infections

9. Strep A-Flesh Eating Bacteria In Surgery Prior to Amputation 3 Days Post OP Presentation

10. Bacteria • Rod-shaped bacteria are called bacilli • May occur singly, in pairs or in chains • Contain flagella which help them move • Form spores-thick walled capsules • makes it more difficult to treat • Tuberculosis, pertussis

11. Bacteria • Sparilla are corkscrew or spiral shaped • Also include vibrio (comma-shaped) and spirochete (corkscrew-shaped) • Syphilis

12. Antibiotic Resistant Bacteria • Antibiotics are no longer effective • Due to overuse and misuse of antibiotics • Multidrug resistant = resistant to several meds • Superbugs • CRE • Carbapenem-resistant enterobacter • MRAB • Acinetobacter baumannii • VRE • Vancomycin Resistant Enterococcus • MRSA • Methicillin Resistant Staph Aureus http://education-portal.com/academy/lesson/mrsa-and-drug-resistant-pathogens.html#lesson

13. Protozoa • One-celled animal like organisms found in decayed materials and contaminated water • Contain flagella to allow free movement • Some cause disease • Malaria, dysentery http://education-portal.com/academy/lesson/what-are-protozoa-definition-characteristics-examples.html#lesson

14. Fungi • Simple, plant-like organisms that live on dead organic matter • Yeasts and molds • Ringworm, athlete’s foot, thrush

15. Rickettsiae • Parasitic microorganisms • They cannot live outside the cells of another living organism • Found in fleas, lice, ticks and mites • Rocky Mountain spotted fever

16. Viruses http://education-portal.com/academy/lesson/what-are-viruses-definition-structure-function.html#lesson • Smallest microorganisms, visible using only an electron microscope • Cannot reproduce unless they are inside another living cell • Spread by blood and body fluids • Flu • SARS • West Nile • H1N1 • Ebola

17. Viruses to Concern Healthcare Workers • Hepatitis C-can cause liver damage • No vaccine is available • Hepatitis B-attacks the liver and can lead to scarring and destruction of liver cells • Hep B vaccine is available • You may refuse vaccine, but you must sign a waiver that it was offered and you refuse. • Both of these can remain active for several days in dried blood, so we must take every precaution to protect ourselves.

18. Viruses to Concern Healthcare Workers • HIV (Human Immunodeficiency Virus) • Suppresses the immune system • The patient cannot fight off illness, even the common cold • No cure or vaccine • Cause of AIDS • (Acquired Immune Deficiency Syndrome)

19. Helminths • Parasitic Organisms • Flukes • Worms • Transmitted by: • Ingesting eggs or larvae • Bite of infected insect

20. How Do You Treat Infection With Microorganisms? • Bacteria • Antibiotics • Difficult to treat when in spore form • Protozoa • Treatment depends upon specific illness • Fungi • Antifungal medications • Rickettsiae • antibiotics • Viruses • Antibiotics are not effective • Many disinfectants are not effective

21. Classifications of Infection • Exogenous • Infection or disease originates outside the body • Radiation, trauma, temperature extremes, infection from pathogens invading the body • Endogenous • Infection or disease originates within the body • Congenital abnormalities, tumors, infections caused by microorganisms within the body

22. Classification of Infection • Opportunistic Infections • Those infections that occur when the body defenses are weak are opportunistic infections • These diseases are usually not seen in a person with a healthy immune system • Kaposi’s sarcoma (rare cancer) and Pneumocystis carinii pneumonia commonly seen in individuals with AIDS

23. Classification of Infection • Nosocomial Infection • Hospital Acquired Infection (HAI) • Acquired while in a healthcare facility • Many are antibiotic resistant • Can be life threatening • Staphylococcus (MRSA) • Psuedomonas • Enterococci (VRE) http://education-portal.com/academy/lesson/nosocomial-infections-definition-causes-prevention.html#lesson

24. Chain of Infection • Shows how infections are spread and how we can prevent it

25. Causative Agent • 1st condition that must be met • There must be a pathogen present like a bacteria or a virus • Breaking: • Early recognition of signs of infection • rapid ID of organism

26. Reservoir • This is the place where the causative agent can live. • Examples include humans; animals; the environment or fomites like doorknobs, bedpans, urinals or linens • Breaking: • Disinfecting • Employee health • Standard precautions

27. Portal of Exit • Escape route that pathogens take as they escape from the reservoir in which they were growing. • Examples include urine, feces, saliva, blood, tears, sexual secretions, and draining wounds. • Breaking: • Handwashing • standard precautions • PPE

28. Mode of Transmission • Way in which the pathogen can be transmitted to another reservoir or host where it can live. • It can be transmitted through direct or indirect contact • Contact with contaminated hands • Touching contaminated equipment • Breathing in infected droplets • Eating contaminated foods • Breaking: • Proper food handling • standard precautions • handwashing

29. Portal of Entry • Way for the pathogen to enter a new reservoir. • Broken skin or mucous membranes, the digestive or respiratory tracts and urinary tracts are all portals of entry. • Breaking: • good wound and catheter care • medical asepsis • Standard precautions

30. Susceptible Host • Person likely to get an infection because their body defenses are weak or a large number of pathogens invade the body. • HIV, chemotherapy patients, the elderly, infants • Breaking: • Immunizations • Recognize high-risk patients • Treat underlying disease

31. Asepsis • Absence of disease-producing microorganisms. • Aseptic techniques • Directed toward maintaining cleanliness and eliminating contamination • Handwashing, good personal hygiene, using disposable gloves, proper cleaning of instruments and the environment

32. Levels of Aseptic Control • Antisepsis prevents or inhibits growth of pathogens, but are not effective against spores or viruses. Alcohol and betadine are used on the skin. • Disinfection destroys/kills all pathogens, but is not always effective against spores or viruses. Bleach solutions are used on surfaces. • Sterilization destroys all microorganisms, the good and the bad, as well as spores and viruses. Steam and gas as well as using an autoclave are used to sterilize equipment

33. Understanding the Principles of Infection Control Gives a basic knowledge of how disease is transmitted Allows us to see ways in which to prevent disease transmission

34. Handwashing • The most basic thing that can be done to prevent the spread of germs. • Remember when to do handwashing • Use liquid soap from a dispenser • Use warm water-hot can burn hands • Use friction to rub pathogens off the surface of the skin • Clean all surfaces-palms, back/top of hands, fingers, between fingers and under nails

35. When do I Wash My Hands? • When I get to work and before I leave • Before and after each patient contact • Before applying and IMMEDIATELY AFTER removing gloves • After using the bathroom • After touching your hair • Before and after contact with any mucous membrane (mouth, eyes, nose) • Before picking anything up off of the floor • After coughing or sneezing

36. Handwashing • Keep fingertips pointed downward • Don’t touch the inside of the sink • Don’t lean against the edge of the sink • Use clean, dry paper towel to turn off the water • Wash hands for at least 20 seconds.

37. Procedure • It’s time to practice your procedure. • There are 2 sinks in the lab and one in the bathroom. Only 2 students in the bathroom at the time. Only 3 students in line at each sink in the lab at a time. • While you are waiting your turn, complete worksheet on Handwashing.

38. Observing Standard Precautions • OSHA has established guidelines that all facilities must follow in order to prevent the transmission of pathogens from one person to another • The most common way pathogens are spread is by blood and body fluids • As a result, OHSA devised the Bloodborne Pathogen Standard • This requires facilities to implement ways in which to keep their employees safe

39. What are the Regulations? • Provide Hep B Vaccine • Provide PPE • Provide Handwashing facilities/supplies • Decontamination and cleaning • Not eating, drinking, applying make-up in work areas • Provide appropriate containers for sharps and biohazards • Alert staff to work areas where there may be biohazardous materials • Identify Those Exposed • Exposure Control Plan • Provide medical eval and follow up of those with exposure incidents • Provide Training

40. How Do We Protect Ourselves? • FOLLOW STANDARD PRECAUTIONS!! • Treat all body fluids as is they were a potentially infectious material • Treat every patient as if they were a potential source of infection, regardless of disease or diagnosis • We must use standard precautions at all times with all patients.

41. But What Do I Do? • Wash Hands • Wear Gloves • Wear Mask and Eye Protection • Wear Gown • Watch Sharps • Clean Spills in Proper Manner • Clean Patient-Care Equipment in the Proper Manner • Use Bio-Hazard linen bags and trash bags for items contaminated with blood or body fluids • Report any exposure incident, no matter how small

42. Donning and Removing PPE • These are items used for personal protection-Personal Protective Equipment • Gowns, masks, goggles and gloves are the most common types of PPE • They are used when there is a chance of blood, body fluids, secretions or excretions coming into contact with you or whenever a patient is on Isolation for a contagious disease

43. Donning and Removing PPE • Masks • For any airborne or droplet disease • Only ties are clean • Gloves • Out of the box • No right way to put on • There is a right way to take them off • Gowns • Must be removed in a way that avoids contaminating your hands or clothing