Infection Control

UNIT-F

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

• Specific Objectives:

• 2H06.01Analyze principles of infection control.

• 2H06.02 Maintain sterile technique and isolation.

Basic Principles (disease transmission)

Microbe Classifications

• Bacteria

• Protozoa

• Fungi

• Rickettsiae

• Viruses

Bacteria

ProtozoaProtozoa

FungiFungi

RickettsiaeRickettsiae

VirusesViruses

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

Microorganisms

• This consist of any organism that can be seen with the aid of a microscope

• Also known as microbe

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

Non-Pathogens

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

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

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.

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

Fungi• 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, athlete’s 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.

Ring Worm

Athlete’s Foot

Thrush

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.

Viruses

• Lives on living cells

• Smallest microorganisms

• Cannot reproduce unless they are inside another living cell.

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

Hepatitis B

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

Hepatitis C

• Caused by HCV virus• Transmitted by blood

and blood containing fluids.

• Referred to as ‘silent epidemic’.

• Sometimes don’t experience symptoms for decades after infection.

• No vaccination, unlike Hep B

OpportunisticInfections

• Infections that occur when bodies immune systems are weak

• Do not usually occur within individuals with good immune systems– Ex. Kaposi’s sarcoma or

neumocystis carinii

Mouth yeast infection

Kaposi’s sarcoma

Aerobic

• Organisms that need oxygen to live.

Escherichia coli

Anaerobic

• Lives without oxygen

• Facultative Bacteria

Endogenous• Infection or disease

originating within the body.

• Include metabolic disorders, congenital abnormalities, tumors, and infections caused by microorganisms.

Exogenous

• Infection or disease

originating outside of the body.

• Include pathogenic organisms that invade body, radiation, chemical agents, trauma, electric shock, & temperature extremes.

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.

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

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.

• 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.

HANDWASHING1. Standard precautions are used for

all patients.2. 2.Use continuously running H2O3. Use generous amt. of soap4. Apply vigorous contact/scrubbing5. Wash for 15-30 seconds6. 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.

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.

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

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

HBV/HIVAssume that every person’s blood

& body fluids are infectious.

Top 4 ways to prevent

the spread of disease.

1. Wash your hands often.

2. Get immunized

3. Practice standard precautions.

4. Disinfect regularly

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

2H06.02 Maintain sterile technique & isolation.

Sterilization - autoclave

pressure & steam

sterilization.

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.

Disinfection Methods

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.

Sterilized Article

• Used instruments should be put in a puncture resistant container

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.

Using Sterile Technique

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.

Opening Sterile Packages

1. Place in center of work area

2. Reaching around (not over it!), pinch 1st flap onoutside of wrapper.3. Repeat for side flaps4. Pull the 4th flap toward you grasping the turneddown corner.5. Establish a sterile field using a drape- pluck the backof the drape & allow it to open freely withouttouching anything.7. Lay drape across a clean, dry surface withoutreaching over it.8. Use sterile forceps to handle sterile supplies.

Drop Method

Putting on Sterile Surgical Gloves

 

• 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.

• 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.

 

• Donning & removing isolation garments *

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

Sterile Dressing Change

1. Gather the following: PPE Dressing Supplies Equipment2. 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

Applying the sterile dressing

1. Apply the sterile dressing.2. Remove your gloves and place them in a

plastic bag.3. Tape the new dressing in place.4. Double-bag the contaminated articles

closing each bag securely.5. Place these bags inside a red plastic bag

outside of the room.6. Wash your hands using the proper

technique. 7. Clean up the treatment room and complete

the charge tickets for materials used.8. Document the following in the patient's

record: Name of person performing the procedure Time of procedure Description of the wound

Example: Absence or presence of edema, discoloration, and/or drainage

Patient's reaction to dressing change.9. Report any unusual findings to the physician.

Isolation

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

Types of Isolation

• Airborne

• Droplet

• Contact Transmission

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 (Contact+airborne)

Airborne Precautions

• Room:• •Negative pressure• •Private• •Door kept closed• •Mask• •Orange ‘duckbill’

mask required to enter room

Droplet Precautions

•Designed to prevent droplet (larger particle) transmission of infectious agents when the patient talks, coughs, or sneezes

• •For documented or suspected:• •Adenovirus (droplet+contact)• •Group A steppharyngitis,

neumonia, scarlerfever (in infants, young children)

• •H. Influenzameningitis, epiglottitis• •Infleunza, Mumps, Rubella• •Meningococcal infections

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 inthe patient’s 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)