Infection Control

1. Infection Control

2. Resources • DHO Chapter 14 • 1st Responder Chapter 3 • Internet

3. Objectives • The student will: • Demonstrate understanding of the chain of infection • Demonstrate understanding of infection prevention • Demonstrate the use of personal protection equipment • Demonstrate correct handwashing technique

4. Why do healthcare providers need to know about Infection Control? • Healthcare providers must understand the chain of infection & strategies to prevent infection. • Healthcare providers are instrumental in preventing the spread of infection between patients.

5. What is infection? • “the pathological state resulting from the invasion of the body by pathogenic microorganisms” • Source: wordnetweb.princeton.edu/perl/webwn

6. Key terms • Microorganism – small living organism that is not visible to the naked eye • Nonpathogen – microorganism that do not cause infection but live in the body. Also called “normal flora” • Throat • Nose • Large intestines

7. What is a Pathogen? • Pathogen – microorganism that cause infection • Anaerobic – do not require oxygen to live • Aerobic – require oxygen to live • Classes of Organisms • Bacteria – single celled organism that multiply rapidly • Cocci – round & spherical in shape • Diplococci – cocci occurs in pairs • Gonorrhea • Menegitis • pneumonia

8. Cocci • Strep – cocci in chains • Causes severe throat pain (Strep Throat) • Staph – cocci in clusters usually cause pus • wound infection • Urinary tract infection • Toxic schock

10. Bacilla – rod like bacteria that have the ability to form spores & can have a flagella (whip like tail). These are difficult to kill • Tuberculosis • Tetanus • Pertussis (Whooping cough) • Botulism • Diphtheria • Typhoid • Childhood immunizations are given against DPT

12. Spirilla spiral or corkscrew in shape • Cholera • Syphilis

13. Viruses • Smallest microorganism • Reproduce in another living organism • Do not respond to antibiotic treatment • Transmitted direct contact (human to human) through body fluids (secretions & blood) • Diseases: • Cold Polio • Chicken Pox Hepatitis • Influenza HIV/AIDS • Measles Herpes (1 & 2) • Mumps Warts

14. Types of infection • Endogenous – infection/disease originating within the body (diabetes, congential disorders, tumors) • Exogenous – infection/disease originating outside the body (pathogenic disorders, trauma, radiation) • Nosocomial – infection that is acquired in a healthcare facility (pneumonia, UTI) • Opportunistic – occur when the body’s defenses are weak (Kabosi Sarcoma)

15. Chain of Infection • Agent – pathogen • Reservoir (Host) – where the agent lives (fomite, human body, animals, etc.) • Fomite – objects contaminated with pathogen • Portal of exit – agent to escape from reservoir • Mode of transmission – way an agent can be transmitted to another reservoir • Direct contact- person to person contact • Indirect contact – transmit from substance to person • Portal of entry – way that an agent to enter a reservoir

16. Body Defense mechanism • Mucous membranes – trap pathogens • Respiratory system • Digestive system • Reproductive system • Cilia – tiny, hair like structures & propel path out of body • Respiratory system • Hydrochloric acid – destroys pathogens • Digestive system • Tears – contain bacteriocidal agents • Fever – raises body temperature for bacteriocidal • Immune response – antibodies produced by body

17. Immune Response • Leukocytes (White Blood Cells) • Crucial to fighting disease • Type of blood cell • Normal 4,000 – 11,000 WBC/mm3 • Protect the body from damage from bacteria, viruses, tumors, & other pathogens • Produce an “inflammation response” or immune response • Diapedesis – “leaping across” is the process in which WBC’s enter & exit the blood vessels to be transported to different sites in the body

18. WBC’s • Positive chemotaxis – “smell” or respond to certain chemicals that come from damage cells • Ameboid motion – form flowing extensions to damaged areas to surround & engulf damaged tissues & pathogens • When a response is triggered by the immune system, there is an increase in production. • Leukocytosis – 11,000 < • Leukopenia – abnormally low (4,000 >)

19. Types of White Blood Cells • Granulocytes – granules containing WBC • Neutrophils– Phagocytes (Eaters) at infection • Eosinophils – respond to allergies & parasitic worms • Basophils – contain HISTAMINE (inflammatory chemical that makes blood vessels leaky & attract other WBC to site)

20. Agranulocytes – lack granules • Lymphocytes – live in lymph nodes • Monocytes - largest WBC; macrophages & instrumental in fighting chronic disease

21. Lymph System • 1 function is to assist in the Immune process • Lymph nodes – • contain lymphocytes & macrophages • “filter” the blood & “trap” pathogens • Kidney shaped & buried in the connective tissue • Usually grouped in clusters • Cluster Locations • Cervical • Axillary • Inguinal

22. Viruses that Healthcare Providers should know • Hepatitis B • HBV • Transmitted by blood & body fluids • Infection of the Liver that can destroy or scar the liver • A vaccine is available & is required for all healthcare workers • It involves a series of 3 shots

23. Hepatitis C • HCV virus • Transmitted by blood & body fluids • May be exposed & carry the virus for years before symptoms develop • No vaccine available • Both Hep B & C viruses can live several days in dried blood

24. HIV • Human Immunosufficiency Virus • Causes AIDS (Acquired Immune Deficiency Syndrome) • Transmitted through blood & body fluids • No vaccine available

25. H1N1 Influenza

26. H1N1 • First detected in humans in April 2009 • Spread person to person (direct contact) (like typical influenza) • Originally called “swine flu” because the virus has similar genetics to the virus that make pigs sick in North America • Signs & symptoms • Cough Body aches Vomitting • Fever Chills • Sore throat Headache • Runny nose Diarrhea • www.cdc.gov

27. High risk for H1N1 and other Influenza • Older individuals over 65 years of age • Children under 5 • Pregnant women • Individuals with chronic conditions • Heart disease • Asthma • Kidney disease • diabetes • H1N1 has shown that older individuals have some immunity to H1N1 • www.cdc.gov

28. Prevention • Wash hands frequently • Do not touch mucous membranes (eyes, nose, mouth) • Avoid close contact with people • Infected people should be fever free for 24 hours

29. Handwashing is the MOST SIGNIFICANT defense against infection!!

30. Healthcare providers should wash their hands………. • Before treating patients • After treating patients • Before moving from a contaminated body part to a clean (ie. Wound to taking a BP) • Before/after wearing gloves • After coughing, sneezing, or using tissue • Before/after eating, drinking, or touching any mucous membrane

31. Handwashing • Place towel for easy access for drying • Use warm water & soap • Use friction to rub off pathogens • Vigorously scrub fingernails, palms, between each finger, & backs of hands for at least 30 seconds • Rinse with fingers pointed downward • Dry hands with towel • Obtain another towel to turn off water

32. Standard (Universal) Precautions • Safety measures taken to prevent exposure to blood & body fluids when giving care to ill or injured persons • Developed by the CDC (Center for Disease Control) • Every person’s body fluid & blood should be considered potentially infectious • Blood Amniotic fluid • Urine fluid around lungs • Mucous Semen • Fesces Vaginal secretions • Vomit Open skin (wounds) • Cerebral Spinal fluid Tissue taken for biopsy

33. Standard Precautions • Includes the use of: gloves Gown Mask eye protection face shield injection practices. www.cdc.gov

34. For some interactions (e.g., performing venipuncture), only gloves may be needed • during other interactions (e.g., intubation), use of gloves, gown, and face shield or mask and goggles is necessary. gents may not be suspected, but later are identified • Standard Precautions are also intended to protect patients by ensuring that healthcare personnel do not carry infectious agents to patients on their hands or via equipment used during patient care.

35. Standard Precautions • Assume that ALL patients have a possible transmittable disease. • Follow Standard Precautions for ALL patients • Used for suspected Hep B, Hep C, & HIV

36. Transmission Precautions • In addition to Standard Precautions, Transmission should be followed when there is a known infection or highly suspected, contagious infection • Used when contact, airborne, or droplet transmission is the most common mode of infection

37. Transmission – Based Precautions • Contact • Droplet • Airborne • www.cdc.gov

38. Contact Precautions • Intended to prevent transmission of infectious diseases by direct or indirect contact with the patient or the patient's environment • Should be followed: • Excessive wound drainage • Fecal incontinence • Significant drainage that can contaminate the patient’s environment • Infections like MRSA (Methicillin Resistant Staph Aureus); & VRE (Vancomycin Resistant E Coli)

39. Contact Precautions • Patient should be in a private room • Healthcare worker must wear gown & gloves for ALL contact with the patient • These are put on before entering the room & removed before leaving the room • Wash your hands!! • www.cdc.gov

40. Droplet Precautions • Protection from transmission from respiratory secretions & mucous membranes in close contact • Patient should be in a private room • No special ventilation necessary • Healthcare workers should wear gloves & mask • If the patient leaves the room, the patient should wear a mask to prevention transmission • Diseases: Pertussis, Influenza, Rhinovirus, Group A streptococcus

41. Airborne Precautions • Prevention for diseases that are infectious over a long distance in the air • Patient must be placed in a special ventilation private room • Healthcare providers must wear a special respirator mask prior to entering patient’s room • Diseases: TB, Varicella (chicken pox), Rubella (Measles), SARS