Infection Control

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• Infection Control
• UNIT-F

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2H06. Apply infection control measures in a
clinical setting.

• Specific Objectives
• 2H06.01Analyze principles of infection control.
• 2H06.02 Maintain sterile technique and isolation.

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Basic Principles (disease transmission)
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Microbe Classifications

• Bacteria
• Protozoa
• Fungi
• Rickettsiae
• Viruses

Bacteria
Rickettsiae
Protozoa
Viruses
Fungi
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Microorganisms orMicrobes

• Small living organisms
• Not visible to the naked eye
• Microscope must be used to see them
• Found everywhere in the environment
• Found on and in the human body
• Many are part of normal flora of body
• May be beneficial

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Microorganisms

• This consist of any organism that can be seen
  with the aid of a microscope
• Also known as microbe

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Pathogens

• Also known as germs
• Disease producing organism
• At times, non-pathogens can become pathogenic
  when it is present in another body system.
• Ex. E. Coli

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Non-Pathogens

• Microorganisms that are part of the normal flora
  and are beneficial in maintaining certain body
  processes.

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Bacteria

• Simple, one-celled organisms that multiply
  rapidly
• Some are beneficial and some cause disease
• Classified by shape and arrangement
• Cocci- round or spherical in shape
• Bacilli- rod-shaped
• Spirilla- spiral or corkscrew in shape

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Flesh Eating Bacteria

• Necrotizing fasciitis (NF)
• NF is a bacterial infection that attacks the soft
  tissue and the fascia which covers the muscles.
  NF can occur from minor trauma but is usually
  related to surgery.
• The NF Bacteria is commonly called strep type A.

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Protozoa

• One-celled animals often found in decayed
  materials and contaminated water
• May contain flagella, which allows better
  movement
• Some are pathogenic cause disease
• Ex. Malaria, amebic dysentery trichomonas, and
  African sleeping disease

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Fungi
Ring Worm

• Simple, plantlike organisms that live on dead
  organic matter.
• Yeast and molds are two common forms that can be
  pathogenic.
• Cause diseases
• Ex. Ring worm, athletes foot, thrush,
  histopasmosis, and yeast vaginitis
• Cannot be killed by antibiotics
• Antifungal medications are available for
  pathogenic fungi.
• Must be taken internally for long periods of time
  and may cause liver damage.

Thrush
Athletes Foot
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Rickettsiae

• Micro parasite that lives within an organism.
• Commonly found in fleas, lice, ticks, mites.
• Transmitted to humans by the bites of these
  insects. Causes diseases
• Ex. Typhus fever and Rocky Mountain spotted
  fever.
• Antibiotics are effective against many different
  rickettsiae.

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Viruses

• Lives on living cells
• Smallest microorganisms
• Cannot reproduce unless they are inside another
  living cell.

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Viruses

• Spread human to human by blood other body
  secretions.
• Difficult to kill because they are resistant to
  many disinfectants and are not affected by
  antibiotics.
• Visible only through electron microscope.
• Causes diseases

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Hepatitis B
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Hepatitis B

• Also known as Serum hepatitis
• Caused by HBV virus and is transmitted by blood,
  serum, and other body secretions.
• Affects the liver, leads to scarring or
  destruction of liver cells.
• Life long infection
• Cirrhosis of liver

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Hepatitis C

• Caused by HCV virus
• Transmitted by blood and blood containing fluids.
• Referred to as silent epidemic.
• Sometimes dont experience symptoms for decades
  after infection.
• No vaccination, unlike Hep B

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OpportunisticInfections

• Infections that occur when bodies immune systems
  are weak
• Do not usually occur within individuals with good
  immune systems
• Ex. Kaposis sarcoma or neumocystis carinii

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AIDS

• Acquired Immune Deficiency Syndrome
• Caused by the HIV virus (Human immunodeficiency
  virus)
• Suppresses immune system
• Contracted by body fluids

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Mouth yeast infection
Kaposis sarcoma
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Aerobic

• Organisms that need oxygen to live.

Escherichia coli
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Anaerobic

• Lives without oxygen
• Facultative Bacteria

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Endogenous

• Infection or disease originating within the body.
• Include metabolic disorders, congenital
  abnormalities, tumors, and infections caused by
  microorganisms.

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Exogenous

• Infection or disease
• originating outside of the body.
• Include pathogenic organisms that invade body,
  radiation, chemical agents, trauma, electric
  shock, temperature extremes.

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Noscomial

• Pertaining to or originating in a health care
  facility such as a hospital.
• Usually transmitted from health care worker to
  the patient.
• Antibiotic-resistant
• Staphylococcus, pseudomonas, and enterococci.

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Stop Infection - Break the Chain

• Must be present for disease to occur spread
  from one individual to another.
• Causative agent
• Reservoir
• Portal of exit
• Mode of transmission
• Portal of entry
• Susceptible host

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Asepsis

• Being free from infection
• Any object or area that may
• contain pathogens is
• considered to be contaminated.
• Aseptic techniques are
• directed toward maintaining
• cleanliness and eliminating or
• preventing contamination.

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• 10 bleach solutions are used around a house to
  control pathogens on counter surfaces.
• Sterilized instruments expire in 30 days.
• The drop technique is use to add sterile items to
  a sterile field.
• During a procedure that produces blood and body
  floods your mask and eyewear should be worn.

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HANDWASHING

• Standard precautions are used for all patients.
• 2.Use continuously running H2O
• 3. Use generous amt. of soap
• 4. Apply vigorous contact/scrubbing
• 5. Wash for 15-30 seconds
• 6. When washing hands keep fingertips pointed
  down.
• 7. After washing your hands turn
• faucet off with a dry paper towel.
• 8. Health care workers can prevent
• the spread of microorganisms from
• one patient to another by proper
• hand washing.
• 9. A health care worker should
• change gloves between patients.

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Standard Precautions

• Standard precautions refer to
• Safeguards taken that help to
• Keep employees consumers
• protected and healthy when there
• may be the potential to come into
• contact with blood or other body
• fluids. The Occupational Safety
• Health Administration (OSHA)
• sets many standards for
• employers workplaces.

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Standard Precautions

• Used for all patients.
• Must wear gloves when touching
• Blood
• All body fluids
• Non-intact skin
• Mucous membranes
• Wash hands immediately after glove removal and
  between patients

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Standard Precautions

• Masks, eye protection, face shield
• Wear during activities likely to generate
  splashes or sprays
• Gowns
• Protect skin and soiling of clothing
• Wear during activities likely to generate
  splashes or sprays
• Sharps
• Avoid recapping of needles
• Avoid removing needles from syringes by hand
• Place used sharps in puncture resistant
  containers

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HBV/HIVAssume that every persons blood body
fluids are infectious.

• Top 4 ways to prevent
• the spread of disease.
• Wash your hands often.
• Get immunized
• Practice standard precautions.
• Disinfect regularly

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Body fluids known to be infectious for HBV, HIV .

• Semen
• Vaginal secretions
• Cerebrospinal fluid
• Synovial fluid
• Pleural fluid
• Pericardial fluid
• Peritoneal fluid
• Amniotic fluid
• Saliva

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2H06.02 Maintain sterile technique isolation.

• Sterilization - autoclave
• pressure steam
• sterilization.

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Disinfection Methods

• 1. Chemical disinfection-
• to disinfect using a
• chemical to kill the germs.
• 2. Boiling water-hot water
• to kill germs.
• 3. Ultrasonic unit-sound
• waves terms.

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Autoclave

• Before wrapping instruments to be autoclaved make
  sure to clean them first.
• Ultrasonic units uses the process of Cavitations
  to disinfect instruments.
• Cavitations uses millions of microscopic bubbles
  produced by sound waves.
• In a medical office they buy a autoclave to
  sterilize instruments
• Disinfections are use on hospital beds.

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Sterilized Article

• Used instruments should be put in a puncture
  resistant container

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Wrapping Instruments for Autoclave

• Before using a sterile package check expiration
  date indicators.
• When the indicators has changed colors you know
  the article is sterile.

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Using Sterile Technique
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Principles of Sterile Technique

1. Only Sterile Items Are Used Within the Sterile
   Field.
2. Gowns Are Considered Sterile Only from the Waist
   to Shoulder Level in Front and the Sleeves.
3. Tables Are Sterile Only at Table Level.
4. Persons Who Are Sterile Touch Only Sterile Items
   or Areas
5. Persons Who Are Not Sterile Touch Only Unsterile
   Items or Areas.
6. Edges of Anything That Encloses Sterile Contents
   Are Considered Unsterile.
7. Sterile Field Is Created as Close as Possible to
   Time of Use.
8. Sterile Areas Are Continuously Kept in View.
9. Sterile Persons keep Well within the Sterile
   Area.
10. Sterile Persons Keep Contact with Sterile Areas
    to a Minimum.
11. When working in a sterile field never turn your
    back on the field.

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Opening Sterile Packages

• 1. Place in center of work area
• 2. Reaching around (not over it!), pinch 1st flap
  on
• outside of wrapper.
• 3. Repeat for side flaps
• 4. Pull the 4th flap toward you grasping the
  turned
• down corner.
• 5. Establish a sterile field using a drape- pluck
  the back
• of the drape allow it to open freely without
• touching anything.
• 7. Lay drape across a clean, dry surface without
• reaching over it.
• 8. Use sterile forceps to handle sterile supplies.

Drop Method
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Putting on Sterile Surgical Gloves

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• Preparation for putting on surgical gloves
• Gloves are cuffed to make it easier to put
  them on without contaminating them. When putting
  on sterile gloves, remember that the first glove
  should be picked up by the cuff only. The second
  glove should then be touched only by the other
  sterile glove.
• Step 1Prepare a large, clean, dry area for
  opening the package of gloves. Either open the
  outer glove package and then perform a surgical
  scrub or perform a surgical scrub and ask someone
  else to open the package of gloves for you.
• Step 2Open the inner glove wrapper, exposing the
  cuffed gloves with the palms up.
• Step 3Pick up the first glove by the cuff,
  touching only the inside portion of the cuff (the
  inside is the side that will be touching your
  skin when the glove is on).
• Step 4While holding the cuff in one hand, slip
  your other hand into the glove. (Pointing the
  fingers of the glove toward the floor will keep
  the fingers open.) Be careful not to touch
  anything, and hold the gloves above your waist
  level.

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• NOTE If the first glove is not fitted correctly,
  wait to make any adjustment until the second
  glove is on. Then use the sterile fingers of one
  glove to adjust the sterile portion of the other
  glove.
• Step 5Pick up the second glove by sliding the
  fingers of the gloved hand under the cuff of the
  second glove. Be careful not to contaminate the
  gloved hand with the ungloved hand as the second
  glove is being put on.
• Step 6Put the second glove on the ungloved hand
  by maintaining a steady pull through the cuff.
• Step 7Adjust the glove fingers until the gloves
  fit comfortably.
•  

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• Donning removing isolation garments

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Applying the sterile dressing

• 1. Loosen the tape on the patient's existing
  dressing.
• 2. Put on sterile gloves.
• 3. Remove the dressing, using forceps, if
  required.
• 4. Place the used dressing and forceps in a
  plastic bag.
• 5. Does the wound require cleaning?
• 6. Clean the wound with a sterile applicator
  using a circular motion beginning at the center
  of the wound and extending outward.
• 7. Place the used applicator's) in a plastic bag.
• Caution Do not touch the wound site with a used
  applicator's).
• 8. Observe the wound for complications.
• Examples Discoloration, edema, purulent drainage

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Sterile Dressing Change

• 1. Gather the following
• PPE
• Dressing Supplies
• Equipment
• 2. Make the necessary arrangements to maintain
  privacy during the procedure.
• Note Dressing changes should take place in the
  examination room.
• 3. Explain the procedure to the patient.
• 4. Position the dressing set on the table.
• 5. Wash your hands with antiseptic solution.
• 6. Open the dressing set without touching the
  contents.
• 7. Leave the dressing set on the open wrapper.
• Reason The wrapper provides a sterile
  environment for the dressing set.
• 8. Open the sterile supplies and pour the
  necessary solutions

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Applying the sterile dressing

• Apply the sterile dressing.
• Remove your gloves and place them in a plastic
  bag.
• Tape the new dressing in place.
• Double-bag the contaminated articles closing each
  bag securely.
• Place these bags inside a red plastic bag outside
  of the room.
• Wash your hands using the proper technique.
• Clean up the treatment room and complete the
  charge tickets for materials used.
• Document the following in the patient's record
• Name of person performing the procedure
• Time of procedure
• Description of the woundExample Absence or
  presence of edema, discoloration, and/or drainage
  
• Patient's reaction to dressing change.
• 9. Report any unusual findings to the physician.

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Isolation

• Goal Prevent transmission of microorganisms from
  infected or colonized patients to other patients,
  hospital visitors, and healthcare workers.

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Types of Isolation

• Airborne
• Droplet
• Contact Transmission

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Airborne Precautions

• Designed to prevent airborne transmission of
  droplet nuclei or dust particles containing
  infectious agents
• For patient with documented or suspected
• Measles
• Tuberculosis (primary orlanryngeal)
• Varicella(airborne contact)
• Zoster (disseminated orimmunocompromisedpatient
  (airborne and contact)
• SARS (Contactairborne)

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Airborne Precautions

• Room
• Negative pressure
• Private
• Door kept closed
• Mask
• Orange duckbill mask required to enter room

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Droplet Precautions

• Designed to prevent droplet (larger particle)
  transmission of infectious agents when the
  patient talks, coughs, or sneezes
• For documented or suspected
• Adenovirus (dropletcontact)
• Group A steppharyngitis, neumonia, scarlerfever
  (in infants, young children)
• H. Influenzameningitis, epiglottitis
• Infleunza, Mumps, Rubella
• Meningococcal infections

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Contact Precautions

• Used to prevent transmission of
• epidemiologically important
• organisms from an infected or
• colonized patient through
• direct (touching patient) or indirect
• (touching surfaces or objects in
• the patients environment) contact.
• For suspected or documented
• Adenovirus (contact droplet)
• Infectious diarrhea in diapered/incontinent
  patients
• Group A strep wound infections
• MDR bacteria (MRSA,VRE)
• Viral conjunctivitis
• Lice, scabies
• RSV infection
• Varicella (Contact airborne)
• Zoster (disseminated or immunocompromised
  contact airbrone
• SARS (Contact airborne)