5 preventing infection define the following terms: infection control the measures practiced in...

5Preventing Infection

Define the following terms:

Infection control the measures practiced in healthcare facilities to prevent and control the spread of disease.

Microorganism or Microbea living thing or organism that is so small that it can be seen only through a microscope.



Infectionthe state resulting from pathogens invading the body and multiplying.

Pathogens harmful microorganisms.

Systemic infection an infection that is in the bloodstream and is spread throughout the body, causing general symptoms.



Localized infection an infection that is confined to a specific location in the body and has local symptoms.

Healthcare-associated infections (HAIs)infections that patients acquire within healthcare settings that result from treatment for other conditions.

Medical asepsisthe process of removing pathogens, or the state of being free of pathogens.



Clean in health care, a condition in which objects are not contaminated with pathogens.

Dirtyin health care, a condition in which objects have been contaminated with pathogens.

Surgical asepsisthe state of being free of all microorganisms, not just pathogens; also called sterile technique.


1. Define “infection control” and related terms

REMEMBER:Working to prevent the spread of disease is the responsibility of all care team members.



Causative agenta pathogen or microorganism that causes disease.

Reservoira place where a pathogen lives and grows.

Portal of exitany body opening on an infected person that allows pathogens to leave.



Mode of transmissionmethod of describing how a pathogen travels from one person to the next person.

Direct contacttouching an infected person or his secretions.

Indirect contacttouching something contaminated by an infected person.

Portal of entryany body opening on an uninfected person that allows pathogens to enter.



Mucous membranesthe membranes that line body cavities, such as the mouth, nose, eyes, rectum, or genitals.

Susceptible hostan uninfected person who could get sick.

Transmissionpassage or transfer.

Infectiouscontagious.

5 Preventing Infection

Transparency 5-1: The Chain of Infection


2. Describe the chain of infection

REMEMBER:If one of the links in the chain of infection is broken—by washing hands, for example—then the spread of infection is stopped.



Malnutritionpoor nutrition due to improper diet.

Dehydrationa condition that results from inadequate fluid in the body.

5Preventing Infection3. Explain why the elderly are at a higher risk for infection and identify symptoms of an infection

The elderly are at higher risk of infection due to • Weakened immune systems • Decreased circulation • Slow wound healing • Malnutrition • Dehydration


Factors affecting risk of infection in the elderly (cont’d.):• Limited mobility• Hospitalization • Difficulty swallowing • Incontinence • Feeding tubes and other tubing


Report these signs and symptoms of localized infection: • Pain• Redness • Pus• Swelling• Drainage (fluid from a wound or cavity) • Heat


Report these signs and symptoms of systemic infection: • Fever • Chills • Body aches• Headache • Drop in blood pressure • Nausea, vomiting• Weakness • Mental confusion



Centers for Disease Control and Prevention (CDC)a government agency under the Department of Health and Human Services (HHS) that issues information to protect the health of individuals and communities.

Isolate to keep something separate, or by itself.

Standard Precautions a method of infection control in which all blood, body fluids, non-intact skin, and mucous membranes are treated as if they were infected with an infectious disease.



Body fluids under Standard Precautions, includes saliva, sputum (mucus coughed up), urine, feces, semen, vaginal secretions, and pus or other wound drainage; does not include sweat.

Sharpsneedles or other sharp objects.

5Preventing Infection4. Describe the Centers for Disease Control and Prevention (CDC) and explain Standard Precautions

Think about this question:Why should Standard Precautions be practiced with every resident in your care?


Use these Standard Precautions measures with every resident: • Wash hands.• Wear gloves. • Remove gloves immediately when finished with a procedure. • Immediately wash skin surfaces. • Wear a disposable gown when appropriate. • Wear a mask and goggles when appropriate.


Standard Precautions measures (cont’d.): • Wear gloves when handling sharp objects. • Never attempt to cap a needle or syringe.• Avoid nicks and cuts. • Bag all contaminated supplies. • Clearly label body fluids. • Dispose of contaminated waste properly.



Hand hygienewashing hands with either plain or antiseptic soap and water and using alcohol-based hand rubs.

Hand antisepsiswashing hands with water and soap or other detergents that contain an antiseptic agent.

Antimicrobialdestroying or resisting pathogens.

5Preventing Infection5. Explain the term “hand hygiene” and identify when to wash hands

REMEMBER:Although alcohol-based rubs are useful, it is still very important to wash hands with soap and water and not to rely solely on alcohol-based rubs.


NAs should wash their hands at all of the following times: • Arrival at work • Any time they are visibly soiled• Before, between, and after all resident contact • After contact with body fluids, mucous membranes, non-intact

skin, dressings • After handling contaminated items• After contact with objects in resident’s room


Wash hands (cont’d.): • Before and after touching meal trays • Before and after feeding residents • Before putting on gloves and after removing gloves • Before getting clean linen • After touching garbage or trash • After picking up things from the floor • After using the toilet


Wash hands (cont’d.):• After blowing nose or sneezing into hand • Before and after eating • After smoking • After touching areas on the body • Before and after applying makeup• After any contact with pets/pet care items • Before leaving facility


REMEMBER:Handwashing is the single most important thing you can to do prevent the spread of disease.

Washing hands

Equipment: soap, paper towels

1. Turn on water at sink. Keep your clothes dry, because moisture breeds bacteria.

2. Angle your arms down, holding your hands lower than your elbows. This prevents water from running up your arm. Wet hands and wrists thoroughly.

Washing hands (cont’d.)

3. Apply skin cleanser or soap to your hands.

4. Rub hands together and fingers between each other to create a lather. Lather all surfaces of your fingers and hands, including your wrists. Use friction for at least 20 seconds. Friction helps clean.

5. Clean your nails by rubbing them in palm of other hand.


6. Being careful not to touch the sink, rinse thoroughly under running water. Rinse all surfaces of your hands and wrists. Run water down from wrists to fingertips. Do not run water over unwashed arms down to clean hands.

7. Use a clean, dry paper towel to dry all surfaces of your hands, wrists, and fingers. Do not wipe towel on unwashed forearms and then wipe clean hands. Dispose of towel without touching wastebasket. If your hands touch the sink or wastebasket, start over.


8. Use a clean, dry paper towel to turn off the faucet. Do not contaminate your hands by touching the surface of the sink or faucet.

9. Dispose of used paper towel(s) in wastebasket immediately after shutting off faucet.



Personal protective equipment (PPE)equipment that helps protect employees from serious workplace injuries or illnesses resulting from contact with workplace hazards.

Perineal carecare of the genitals and anal area.

Non-intact skinskin that is broken by abrasions, cuts, rashes, acne, pimples, or boils.

5Preventing Infection6. Discuss the use of personal protective equipment (PPE) in facilities

Gloves should be worn at the following times:• If you might touch blood or any body fluid • During mouth care or care of any mucous membrane • During perineal care • When providing personal care on non-intact skin• When providing personal care if NA has cuts on hands • When shaving a resident • When disposing of soiled linens, gowns, dressings, and pads


Gloves should be changed• Immediately before contact with mucous membranes or

broken skin • If gloves become soiled, worn, or damaged

Putting on gloves

1. Wash your hands.

2. If you are right-handed, slide one glove on your left hand (reverse if left-handed).

3. With gloved hand, slide the other hand into the second glove.

4. Interlace fingers. Smooth out folds and create a comfortable fit.

Putting on gloves (cont’d.)

5. Carefully look for tears, holes, or discolored spots. Replace the glove if needed.

6. If wearing a gown, pull the cuff of the gloves over the sleeve of gown.


Gloves should be removed • After use • Before caring for another resident • Before touching non-contaminated items or surfaces

Taking off gloves

1. Touch only the outside of one glove. Pull the first glove off by pulling down from the cuff.

2. As the glove comes off your hand, it should be turned inside out.

Taking off gloves (cont’d.)

3. With the fingertips of your gloved hand, hold the glove you just removed. With your ungloved hand, reach two fingers inside the remaining glove. Be careful not to touch any part of the outside of glove.

4. Pull down, turning this glove inside out and over the first glove as you remove it.

Taking off gloves (cont’d.)

5. You should now be holding one glove from its clean inner side. The other glove should be inside it.

6. Drop both gloves into the proper container.

7. Wash your hands.


REMEMBER:Gowns are worn during any procedure that is likely to cause body fluid splashes or sprays.

Putting on a gown

1. Wash your hands.

2. Open the gown. Hold out in front of you and allow gown to open. Do not shake it. Slip your arms into the sleeves and pull gown on.

Putting on a gown (cont’d.)

3. Tie the neck ties into a bow so they can be easily untied later.

4. Reach behind you. Pull the gown until it completely covers your clothing. Tie the back ties.

Putting on a gown (cont’d.)

5. Use a gown only once and then remove and discard it. When removing a gown, roll the dirty side in and away from the body. If your gown ever becomes wet or soiled, remove it. Check clothing and put on a new gown. The Occupational Safety and Health Administration (OSHA) requires non-permeable gowns—gowns that liquids cannot penetrate—when working in a bloody situation.

6. Put on your gloves after putting on gown.


Wear masks and goggles• If there is risk of splashing body fluids or blood. • Wear masks if respiratory illnesses are present.

Putting on mask and goggles

1. Wash your hands.

2. Pick up the mask by top strings or elastic strap. Be careful not to touch the mask where it touches your face.

Putting on mask and goggles (cont’d.)

3. Adjust the mask over your nose and mouth. Tie top strings first, then bottom strings. Masks must always be dry or they must be replaced. Never wear a mask hanging from only the bottom ties.

4. Put on the goggles.

5. Put on your gloves after putting on mask and goggles.



Sterilizationa measure that destroys all microorganisms, including pathogens.

Disinfectionprocess that kills pathogens, but not all microorganisms; it reduces the organism count to a level that is generally not considered infectious.

Disposableonly to be used once and then discarded.


7. List guidelines for handling equipment and linen

Remember these guidelines for equipment, linen, and clothing: • Prevent skin/mucous membrane contact. • Prevent contamination of clothing. • Prevent transfer of disease to other residents or

environments. • Do not use re-usable equipment until it has been cleaned

properly. • Dispose of all single-use equipment properly.


7. List guidelines for handling equipment and linen

Guidelines for equipment, linen, and clothing (cont’d.): • Clean and disinfect all environmental surfaces, beds, bedrails,

all bedside equipment, and all frequently touched surfaces (doorknobs are a good example).

• Handle, transport, and process soiled linens and clothing in a way that prevents skin and mucous membrane exposure, contamination of clothing (hold linen away from uniform), and transfer of disease to other residents and environments.

• Bag soiled linen at point of origin.• Sort soiled linen away from resident care areas.• Place wet linen in leak-proof bags.


8. Explain how to handle spills

Remember these guidelines for cleaning spills involving blood, body fluids, or glass: • Put on gloves (industrial strength). • Use proper product to absorb spill.• Scoop up absorbed spill and dispose of it in designated

container.• Apply disinfectant.• Use tools to pick up glass, never hands. • Properly bag waste.



Transmission-based (isolation) precautionsmethod of infection control used when caring for persons who are infected or suspected of being infected with a disease; also called isolation precautions.

Multidrug-resistant organisms (MDROs)microorganisms, mostly bacteria, that are resistant to one or more antimicrobial agents.


Transparency 5-2: Airborne Precautions


Transparency 5-3: Droplet Precautions


Transparency 5-4: Contact Precautions


9. Explain transmission-based precautions

Remember these guidelines for isolation: • Transmission-based precautions always used in addition to

Standard Precautions • Nurses will set up the isolation unit.• Use PPE as instructed. Do not wear PPE outside resident’s

room and perform hand hygiene following removal of PPE.• Do not share equipment between residents.


9. Explain transmission-based precautions

Guidelines for isolation (cont’d.): • Wear proper PPE and use disposable dishes, etc. as indicated

when serving food and drink.• Follow standard precautions in dealing with body waste

removal.• Wear proper PPE if required to take specimen.• Reassure residents that the disease, not the person, is being

isolated.



Bloodborne pathogensmicroorganisms found in human blood, body fluid, draining wounds, and mucous membranes that can cause infection and disease in humans.

HIVstands for human immunodeficiency virus, the virus that can cause AIDS.

Hepatitisinflammation of the liver caused by infection.

Jaundicea condition in which the skin, whites of the eyes, and mucous membranes appear yellow.

5Preventing Infection10. Define “bloodborne pathogens” and describe two major bloodborne diseases

Bloodborne diseases are transmitted by • Infected blood • Infected semen or vaginal secretions • Sexual contact • Needle sharing • Infected mothers• Contact with infected blood or certain other body fluids in

healthcare setting

5Preventing Infection10. Define “bloodborne pathogens” and describe two major bloodborne diseases

REMEMBER:Standard Precautions, handwashing, isolation, and PPE are all used to prevent the spread of bloodborne pathogens.



Occupational Safety and Health Administration (OSHA)a federal government agency that makes rules to protect workers from hazards on the job.

Bloodborne Pathogens Standardfederal law that requires that healthcare facilities protect employees from bloodborne health hazards.

Exposure control planplan designed to eliminate or reduce employee exposure to infectious material.


11. Explain OSHA’s Bloodborne Pathogen Standard

OSHA’s Bloodborne Pathogens Standard calls any of the following a “significant exposure”: • Needle stick • Mucous membrane contact • Cut from an object containing potentially infectious body fluid • Non-intact skin contact


11. Explain OSHA’s Bloodborne Pathogen Standard

Employers must follow these guidelines: • Written exposure control plan • Proper PPE • Biohazard containers • Hepatitis B vaccine• Warning labels • Log of injuries from contaminated sharps• In-service training



Tuberculosisan airborne disease carried on very small mucous droplets suspended in the air.

Latent TBtype of tuberculosis in which the person carries the disease but does not show symptoms and cannot infect others; also known as TB infection.

Active TBtype of tuberculosis in which the person shows symptoms of the disease and can spread TB to others; also known as TB disease.



Multidrug resistant-TB (MDR-TB)type of TB that can develop when a person with active TB does not take all the prescribed medication.

Resistantstate in which drugs no longer work to kill specific bacteria.

Phlegmthick mucus from the respiratory passage.


12. Define “tuberculosis” and list infection control guidelinesSigns and symptoms of TB include:• Fatigue • Loss of appetite • Weight loss • Slight fever and chills • Night sweats • Prolonged coughing • Coughing up blood • Chest pain • Shortness of breath • Trouble breathing


12. Define “tuberculosis” and list infection control guidelinesRemember these guidelines for infection control when tuberculosis is present:• Follow Standard Precautions and airborne precautions. • Wear mask and gown. • Handle sputum or phlegm carefully. • Ensure proper ventilation. • If resident is in AFB isolation room, open and close door

slowly. • Follow isolation procedures if ordered. • Help resident remember to take medications.



Multidrug-resistant organisms (MDROs)microorganisms, mostly bacteria, that are resistant to one or more antimicrobial agents.

Antimicrobial destroying or resisting pathogens.

MRSA stands for methicillin-resistant Staphylococcus aureus, an antibiotic-resistant infection often acquired by people in hospitals and other healthcare facilities who have weakened immune systems.



VRE vancomycin-resistant enterococcus, a genetically changed strain of enterococcus that originally developed in people who were exposed to the antibiotic vancomycin.

Clostridium difficile (C-diff, C. difficile)bacterial illness that causes diarrhea and can cause colitis.


13. Define the terms “MRSA,” “VRE,” and “C. Difficile”

MRSA is spread through• Direct contact • Indirect contact

REMEMBER:Handwashing is the single most important measure to control the spread of MRSA.


13. Define the terms “MRSA,” “VRE,” and “C. Difficile”

C. Difficile is spread through• Direct contact with infected residents• Contact with environmental surfaces contaminated with

C. Difficile spores

REMEMBER:C. Difficle is very difficult to kill. Handwashing will not kill the spores, but will wash them down the drain. Hand rubs may increase the risk of C. Difficile transmission because many feel a hand rub is all that is needed, but hand rubs do not kill C. Difficile spores. Proper handwashing is essential.

5Preventing Infection14. List employer and employee responsibilities for infection control

REMEMBER:All facilities have policies and procedures in place regarding infection control. Know and follow your facility’s policies.


Employers’ responsibilities regarding infection control include • Infection control procedures and exposure control plan• In-service education• Written procedures to follow• PPE for employees • Free hepatitis B vaccine


Employees’ responsibilities regarding infection control include• Follow standard precautions.• Follow facility’s policies and procedures.• Follow care plans and assignments.• Use PPE when appropriate.• Take advantage of free hepatitis B vaccine.• Immediately report exposure.• Participate in education programs.

5 preventing infection define the following terms: infection control the measures practiced in...

Documents

clean hands

rub hands

hands lower

wet hands

washing hands contd

personal care

gloves contd

dry paper towel