COMMON TERMINOLOGIES IN INFECTION CONTROL

CONTAMINATION Bacteria present on surfaceCOLONIZATION : presence and multiplication of microorganisms in or on a host without tissue damage.Bacteria present on surface.

INFECTION : invasion and multiplication

of an infectious agent in the tissues of the host.

ENDOGENOUS INFECTION : The organisms derived from patients own flora.EXOGENOUS INFECTION : Organisms are derived from outside forces.

INCUBATION PERIOD : time of initial contact with the infectious agent to the appearance of the first symptoms.

COMMON TERMINOLOGIES IN INFECTION CONTROL cont’d

COMMON TERMINOLOGIES

IN INFECTION CONTROL cont’d

Asepsis : The freedom from disease causing

micro-organism.

Medical asepsis: Includes all practices intended to confine a specific microorganism to a specific area, limiting the number, growth, & transmission of microorganisms.

Surgical asepsis (sterile technique) : Refers to those practices that keep an area or object free of all microorganisms; it include all practices that destroy all microorganisms & spores.

COMMUNITY ACQUIRED INFECTION : infection present or incubating on admission

with no association to previous hospitalization

at the same facility

HOSPITAL ACQUIRED INFECTION : A

nosocomial infection can be defined as an

infection acquired in the hospital after 72 hours

of admission to hospital.

COMMON TERMINOLOGIES IN INFECTION CONTROL cont’d

HOSPITAL AQUIRED INFECTION ( NOSOCOMIAL INFECTION )

It is an infection meeting the following criteria :Not present or incubating on admission1. An infection temporarily associated with

admission to or a procedure done at health care facility .

2. An infection incubating at that time of admission that is related to previous hospitalization at the same facility or identified on admission following performance of the procedure during a previous admission

COMPONENTS OF INFECTION PROCESS

CAUSATIVE AGENTS

RESERVOIR OF THE AGENT

PORTAL OF EXIT

MODE OF TRANSMISSION

PORTAL OF ENTERY

SUSCEPTIBLE HOST

Any biological ,physical or chemical entity capable of causing disease is called an agent )The micro-organism that can cause infection).

MICRO-ORGANISMS: Organisms that can be seen only with the magnification of a microscope .

# Bacteria# Viruses# Fungi# Parasites

Some Micro-organisms are normally present on people’s skin & in Respiratory ,Intestinal , & Genital tract ; these micro-organisms are called NORMAL FLORA.

Other Micro-organisms are normally not found on or in the human body & are usually associated with disease ;these micro-organism are known as PATHOGENS.ALL MICRO-ORGANISMS, including normal flora ,can cause infection or disease if certain conditions exist:

Normal flora are introduced an area of the body in which they are not normally found .

Pathogens are introduced into the body . Micro-organisms are introduced into the body of a person

who is immunocomprimised & thus susceptible to infections to which he or she otherwise would not be susceptible .

It is a place in which an infectious agent can survive but may or may not multiply

# Human-Beings (most common).# Animals# Plants# Soil# Air# Water# Solutions & Instruments

It is the path by which an infectious agent leaves the source.

Respiratory tract (e.g., lung, nose). Genitourinary tract (e.g., vagina, penis). Mucous membranes (e.g., eyes, nose, mouth). Gastrointestinal tract (e.g., mouth ,anus). Blood-stream (open wound, needle puncture). Broken skin (e.g., puncture ,cut, surgical site,

rash). Trans-placental ( mothers –to- fetus ).

The mechanisms or the way in which the infectious agent moves from the reservoir to a susceptible host.

Transmission can occur by four modes: CONTACT TRANSMISSION :The infectious

agent can be transmitted directly from the reservoir to a susceptible host through touch (e.g.,staphyllococcus) ,sexual inter-course (e.g., gonorrhea, HIV), or droplets (e.g., influenza).

VEHICLE TRANSMISSION : The infectious agent can be transmitted indirectly from the reservoir to a susceptible host by material that maintains the life of the infectious agent .

Food (e.g, salmonella )

Blood (e.g, Hepatitis B , HIV)

Water (e.g, Cholera , Shigella)

Instruments & Others Items (e.g, Hepatitis B , HIV , Pseudomonas )

AIRBORNE TRANSMISSION : The infectious agent can be carried by air currents (e.g, Measles , Mycobacterium Tuberculosis , Varicella zoster ).

VECTOR TRANSMISSION: The infectious agent can be transmitted to a susceptible host through insects & other invertebrate animals (e.g, Mosquitoes can transmit Malaria & Yellow Fever ; fleas can transmit plague ) .

The route by which the infectious agent moves into (enters ) susceptible host. Respiratory tract (e.g., lungs).(e.g., lungs). Genitourinary tract (e.g., vagina, penis).(e.g., vagina, penis). Mucous membranes (e.g., eyes, nose, mouth).(e.g., eyes, nose, mouth). Gastrointestinal tract (e.g., mouth ,anus).(e.g., mouth ,anus). Blood-stream .. Broken skin (e.g., puncture ,cut, surgical site, (e.g., puncture ,cut, surgical site, rash).rash). Trans-placentalTrans-placental ( mothers –to- fetus ).( mothers –to- fetus ).

Host is any person who is at risk for infection. Characteristics that influence susceptibility & severity of disease are :

Age

Sex

Socio-Economic status

Disease history

Nutritional status

OccupationImmunization statusDiagnostic /Therapeutic proceduresMedicationsPregnancyTraumaHeredityEthnicity

How can we break the chain of infection?

Link InterventionAccurate and rapid identification of micro-organisms Early recognition of sign and symptoms of infection

1-Infectious or Causative Agent

How can we break the chain of infection?

Link InterventionEmployee health examinations and

screening Environmental sanitization including floors, walls, exam tables and beds Disinfection/Sterilization of equipment and instruments Standard Precautions Medical Asepsis Proper Hygiene - bathing and hand washing Clean gowns, linens and towels Clean wound dressings

2-Reservoirs

How can we break the chain of infection?

Link InterventionHand washing

Use of Personal Protective Equipment such as gloves, gowns, facemask, N95 . Clean dressings over wounds Medical Asepsis or Clean Technique Control of excretions and secretions Covering the mouth and nose when coughing or sneezing Proper trash and waste disposal Standard Precautions

3-Portal of Exit

How can we break the chain of infection?

Link InterventionHand washing

Standard Precautions Rooms with air flow control Safe Food handling Isolation Transmission-based precautions Sterilization of equipment and supplies Medical and Surgical Asepsis Use of Personal Protective Equipment such as gloves, gowns, facemask, N95 .Proper disposal of contaminated objects

4-Method or Mode of Transmission

How can we break the chain of infection?

Link InterventionSterile technique or

Surgical Asepsis (dressing, injections, catheterization). Medical Asepsis or Clean Technique Catheter Care Wound care Proper Disposal of needles or sharps Maintaining skin integrity Standard Precautions

5-Portal of Entry

How can we break the chain of infection?

Link Intervention

Treatment of Disease Recognition of clients at risk Immunization Exercise Proper NutritionPatient Education

6-Susceptible Host

PREVENTIVE PATIENT CARE PRACTICES

1. Hand washing

2. Aseptic technique

3. Standard precautions

4. Sterilization

5. Disinfection

6. Isolation Precaution

HAND WASHING:- It is the process for the removal of dirt and

transient microorganisms(E.g. E. COLI) from the hands. (it is considered the most effective infection control measure).

HAND ANTISEPSIS:-

It is a process of the removal or destruction of transient microorganisms.

SURGICAL HAND SCRUB :-

It is a process to remove or destroy the transient microorganisms and reduced resident flora, (E.g. Diphtherias )

Types of the Hand Washing♣ ROUTINE HAND WASHING or HYGIENIC

HAND WASHING:-

It is accomplished by vigorously rubbing together all surfaces of lathered hands followed by thorough rinsing under a stream of water.

This should take 10-15 seconds to complete.

The hands should be dried with a paper towel.

Types of the Hand Washing cont’d

♣ SURGICAL SCRUB:-

It is the process that begin with washing

hands and forearms thoroughly to remove

dirt and transient bacteria .

A nail cleaner should be used to clean

under the nails.

It should take about 5 minutes.

VARIOUS HAND DECONTAMINANTS

Soap solution:-

Soap have a detergent effect.

They remove transient microorganisms

physically but have no effect on the

resident microbial population.

VARIOUS HAND DECONTAMINANT cont’d

CHLOROHEXIDINE:-

It has a broad - spectrum activity . It binds to the stratum corneum, continuing

to destroy bacteria for at least six hours.

VARIOUS HAND DECONTAMINANTS cont’d

POVIDINE IODINE:-

It is often used in the operating theatre

because it destroys spores more

effectively than many other antiseptics.

VARIOUS HAND DECONTAMINANTS cont’d

ALCOHOL HAND-RUBS, GEL & WIPES:-

They have excellent bactericidal

activity against most gram – positive

and gram- negative bacteria but have

no effect on spores.

INDICATIONS FOR HAND WASHING

When coming on duty.

After removing gloves.

When hands are soiled including after sneezing, coughing, or blowing your nose.

Between patients’ contacts.

Before & after medication administration.

After personal use of the toilet.

Before performing invasive procedures.

INDICATIONS FOR HAND WASHING cont’d

Before taking care of particularly susceptible

patients, such as who are severely Immuno-

compromised & Newborns.

Before and after touching wounds.

Before & after eating.

After touching objects that are likely to be

contaminated with pathogenic micro-

organisms E.g. urine measuring devices,

secretion collection apparatus, etc....

INDICATIONS FOR HAND WASHING cont’d

After taking care of infected patients or

patients who are likely to be colonized

with microorganisms for special clinical

or epidemiologic significance. (E.g.

Multi-drug resistant bacteria-M.D.R.O).

ASEPTIC TECHNIQUEIt is an a method used to prevent

contamination of wounds and other

susceptible sites by organisms that

could cause infection.

This can be achieved by using sterile

equipment and fluids used for invasive

medical and nursing procedures.

STERELIZATION It is the complete elimination of all

viable microorganisms including viruses, fungi, and their spores both pathogenic and non- pathogenic.

DIS-INFECTION Disinfection implies the removal of all

life forms capable of causing disease.( all viable microorganisms except bacterial spores).

STANDARD PRECAUTIONS

The term standard precautions refers to a

system of infection control practices which

assume that every direct contact with blood

and body fluids is potentially infectious.

CONCEPT OF STANDARD PRECAUTIONS:

1. It should be implemented to all patients.

2. Standard precautions are not generally

intended to reduce cross contamination

among patients and they do not replace other

precautions.

ELEMENTS OF STANDARD PRECAUTIONS

Hand washingGlovesMasks, eyewear, face shieldsGowns and apronsCare of sharps and needlesCare of spills of blood and body fluidsCare of laboratory specimensDisposal of wasteDisposal of linenCare of resuscitation equipment

ISOLATION PRECAUTION These are guidelines created to

prevent transmission of microorganisms

in hospitals. They are Transmission Based Isolation

designated for care of patients with known

or suspected infectious disease that can

spread by one of the following routes:- AIR-BORNE: (e.g measels, Rubella & TB)

DROPLET: (e.g Diphteria & Pertusis)

CONTACT: (e.g Hepatitis A, herpes simplex).

ISOLATION

The separation of a person

with infectious disease from

contact with other human

beings, for the period of

communicability

BASIC PRINCIPLES FOR ALLCATEGORIES OF ISOLATION

1.Necessity of a single room 2.Hand washing 3. Use of protective barriers as per need 4.Disposal of waste in orange bags.

5.Disposal of linen in water- soluble linen bags.

6.Request for a isolation diet tray (with

disposable cutleries)