best practices for environmental cleaning module 1 – chain of transmission
TRANSCRIPT
Best Practices for Environmental Cleaning
Module 1 – Chain of Transmission
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Learning Objectives
At the end of this session you will be able to:
1. Explain the importance of environmental cleaning
2. Describe the general principles of transmission of infectious agents
3. Suggest some strategies to break the chain of transmission
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Background
• Healthcare Associated Infections (HAIs) occur as a result of health care interventions in any health care setting
• HAIs are a client/resident/patient safety issue and represent a significant adverse outcome of the healthcare system
• The environment around the client/patient/resident influences the incidence of infection
Cleaning and disinfection reduces the numbers of microorganisms in the healthcare environment
• The goal of cleaning is to keep the environment safe for clients/residents/patients, staff and visitors
Chain of Transmission
Infection prevention strategies are aimed
at “breaking the chain” at one of its links
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Infectious AgentInfectious Agent
The GermThe Germ
ReservoirReservoir
Hiding PlacesHiding Places
Portal of Portal of ExitExit
Way OutWay Out
Means of Means of TransmissionTransmission
Getting AroundGetting AroundPortal of EntryPortal of Entry
Way InWay In
Susceptible Susceptible HostHost
Next Sick Next Sick PersonPerson
Chain of Chain of TransmissionTransmission
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Chain of Chain of TransmissionTransmission
ReservoirReservoir
Hiding PlacesHiding Places
Portal of EntryPortal of Entry
Way InWay In
Infectious AgentInfectious Agent
The GermThe Germ
Susceptible Susceptible HostHost
Next Sick Next Sick PersonPerson
Means of Means of TransmissionTransmission
Getting AroundGetting Around
Portal of Portal of ExitExit
Way OutWay Out
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Infectious Agent – The Germ
• Germs are everywhere!
• Bacteria MRSA, VRE, C. difficile, Salmonella, Group A Streptococcus
• Viruses Influenza, Hepatitis B, HIV
• Parasites Giardia, Malaria
• Fungi Candida, Aspergillus
* The State of Queensland
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Chain of Chain of TransmissionTransmission
ReservoirReservoir
Hiding PlacesHiding Places
Portal of EntryPortal of Entry
Way InWay In
Infectious AgentInfectious Agent
The GermThe Germ
Susceptible Susceptible HostHost
Next Sick Next Sick PersonPerson
Means of Means of TransmissionTransmission
Getting AroundGetting Around
Portal of Portal of ExitExit
Way OutWay Out
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Reservoir – Hiding Places
Place where infectious agent can survive, but may or may not multiply:
People Cases and carriers
Food Environment (water, solutions) Animals
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You cannot tell by looking . . .
You cannot tell by looking . . .
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You cannot tell by looking . . .
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Chain of Chain of TransmissionTransmission
ReservoirReservoir
Hiding PlacesHiding Places
Portal of EntryPortal of Entry
Way InWay In
Infectious AgentInfectious Agent
The GermThe Germ
Susceptible Susceptible HostHost
Next Sick Next Sick PersonPerson
Means of Means of TransmissionTransmission
Getting AroundGetting Around
Portal of Portal of ExitExit
Way OutWay Out
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Portal of Exit – Way OUT
How an infectious agent gets out of reservoir
• Human portals of exit:
• Respiratory system
• Genital and urinary tracts
• Intestinal tract
• Skin/mucous membrane
• Trans-placental
• Blood
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Learning Checkpoint
Learning Checkpoint
Which of the following are reservoirs for germs?
a) An individual with a cold
b) Outdated cleaning solution
c) Visiting pets
d) All of the above
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Learning Checkpoint Answer
• The correct answer is d – All of the above are reservoirs for transmission of germs.
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Chain of Chain of TransmissionTransmission
ReservoirReservoir
Hiding PlacesHiding Places
Portal of EntryPortal of Entry
Way InWay In
Infectious AgentInfectious Agent
The GermThe Germ
Susceptible Susceptible HostHost
Next Sick Next Sick PersonPerson
Means of Means of TransmissionTransmission
Getting AroundGetting Around
Portal of Portal of ExitExit
Way OutWay Out
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Transmission – Getting Around
Direct Indirect
CONTACT
Transmission – Getting Around
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<2 metresDroplet
Transmission – Getting Around
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Airborne transmission
<2 metresDroplet
Transmission – Getting Around
23VEHICLE
Transmission – Getting Around
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Vectorborne
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Chain of Chain of TransmissionTransmission
ReservoirReservoir
Hiding PlacesHiding Places
Portal of EntryPortal of Entry
Way InWay In
Infectious AgentInfectious Agent
The GermThe Germ
Susceptible Susceptible HostHost
Next Sick Next Sick PersonPerson
Means of Means of TransmissionTransmission
Getting AroundGetting Around
Portal of Portal of ExitExit
Way OutWay Out
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Portal of Entry – Way IN
• Non-intact skin
• Mucous membranes
• Respiratory system
• Gastrointestinal system
• Genitourinary system
Aerosol image: http://staff.vbi.vt.edu/pathport/pathinfo_images/Mycobacterium_tuberculosis/AerosolTransmission.jpg
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Learning Checkpoint
Learning Checkpoint
What is the most common mode of transmission for infection?
a. Droplet
b. Airborne
c. Contact
d. Respiratory
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Learning Checkpoint Answer
• The correct answer is c – The majority of infections are spread through direct and indirect Contact
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Chain of Chain of TransmissionTransmission
ReservoirReservoir
Hiding PlacesHiding Places
Portal of EntryPortal of Entry
Way InWay In
Infectious AgentInfectious Agent
The GermThe Germ
Susceptible Susceptible HostHost
Next Sick Next Sick PersonPerson
Means of Means of TransmissionTransmission
Getting AroundGetting Around
Portal of Portal of ExitExit
Way OutWay Out
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Susceptible HostThe Next Sick Person
• Anyone who lacks immunity or has reduced resistance to a particular infectious agent
Host Characteristics
• Age• Disease history• Underlying illness• Lifestyle
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When you return to your job, what will you do differently as a result of this session?
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Thank You!Thank You!
Image Sources – Module 1
• Getty Images used in: Slides 9, 10, 11, 12, 20 & 22
Quiz question 7
• iStock photos used –
Slides 19 & Quiz question 7 – PersonSneezing-iStock_000003466751
Slide 24 – Mosquito_iStock_000018469709
• Microsoft Clipart used in: Slides 12, 15 & 27
All quiz answers
• All other images are © PHO 2013