Infection
A condition that results with a microorganism (microbe) invades the body, multiplies and causes injury or disease
Microbes (list)
Bacteria
fungi
protozoa
Viruses
Nonpathogenic
Do NOT cause disease under normal conditions
Pathogenic
Causing or productive of disease
Pathogens
Microbes that are pathogenic
Local Infection
Restricted to a small area of the body
Systemic Infection
The entire body is affected
Communicable Infections
Able to spread from person to person
Centers for Disease Control and Prevention (CDC)
Charged with investigation and control of diseases especially Communicable and epidemic potential
CDC
Develops guidelines and recommendations safety precautions to protect healthcare workers from infection
Nosocomial Infection
Infections acquired in hospitals
Healthcare-Associated Infection (HAI)
Applies to infections associated with healthcare delivery in any healthcare setting, including home care
Healthcare Infection Control Practices Advisory Committee (HICPAC)
Advises the CDC on updating guidelines regarding the prevention of infections
Chain of Infection
Infections agent
Reservoir
Exit Pathway
Means of Transmission
Entry Pathway
Susceptible Host
Infections Agent or Causative Agent
Pathogenic microbe responsible for causing an infection
Reservoir
Source of an infections agent. Microbe can survive and grow or multiply
Reservoir Host
A person or animal infected with a pathogenic microbe
Viability
Ability of the microbe to survive on the object
Virulence
Degree to which the microbe is capable of causing disease
Exit Pathway
A way an infectious agent is able to leave a reservoir host....Secretions from eyes, nose or mouth; weeping wounds, tissue specimens; blood, feces and urine
Means of Transmission
Method used to travel from a reservoir to a susceptible individual. Airborne, Contact, Droplet, Vector and Vehicle
Airborne Transmission
Can remain infectious for long periods of time, can be inhaled
Airborne Infection Isolation Rooms (AIIRs)
Rooms that have special air handling and ventilation
National Institute for Occupational Safety and Health (NIOSH) certified N95
Individually fitted face mask to wear when a patient has an airborne infection
Contact Transmission
Most common means of transmitting infection
Direct Contact Transmission
Physical transfer on an infections agent to a susceptible host through close or intimate contact (Kissing)
Indirect Contact Transmission
When a susceptible host touches contaminated objects (bed linens clothing. needles gloves)
Fomites
Inanimate objects that can harbor material containing infectious agents
Droplet Transmission
Transfer of an infectious agent to the mucus membranes. Droplets travel less than 10 feet and do not remain suspended in the air
Vector Transmission
Transfer of an infectious agent carried by critters
Vehicle Transmission
Transfer of an infectious agent through contaminated food, water or drugs (Salmonella and Shigella)
Entry Pathway
The way an infectious agent is able to enter a susceptible host (orifices, mucous membranes, breaks in skin)
Susceptible Host
Someone with a decreased ability to resist infection. Factors...age, health and immune status
Immune
Received a vaccination against an infection or has developed antibodies against that virus
Ways to break the chain of of infection
Hand hygiene
Good nutrition, rest and stress reduction
Immunization against common pathogens
Insect and rodent control
Isolation procedures
Proper decontamination
Proper disposal of sharps and infectious waste
Use of PPE when indicated
Use of needle safet
Opportunist Microorganism
Primarily infects individuals with weakened immune systems (i.e. Acinetobacter Baumannii)
Joint Commission
Requires every healthcare institution to have an infection-control program
What are employees screened for?
TB (PPD), RPR (syphillis), diarrhea and skin diseases
OSHA and HBV
Employers required to offer HBV vaccine FREE to employees at risk of exposure
Situations that require hand hygiene procedures
Before and after each patient contact
Between unrelated procedures
Before putting on gloves and after taking them off
Before leaving the laboratory
Before going to lunch or on break
Before and after going to the restroom
Whenever hands become visibly or k
National Surveillance System for Healthcare Workers (NASH)
Works with healthcare facilities to collect info important in preventing occupational exposure and infection
Hand Hygiene
One of the most important means of preventing the spread of infection
Alcohol-Based Antiseptic Hand Cleaners
CDC/HICPAC okay-ed use as long as the hands are not visibly soiled. Must be allowed to evaporate to achieve proper antisepsis
Microbiocidal
Destructive to microbes
Hand-Washing Procedures
Use plain soap and water
Hand Antisepsis
Use an antimicrobial soap
Personal Protective Equipment (PPE)
Protective clothing and other items worn to protect mucous membranes, airways, skin and clothing from contact with infectious substances (i.e. gloves, gowns, lab coates, masks, respirators)
Putting On Protective Clothing
Gown, Mask, Gloves
Taking Off Protective Clothing
Gloves, Gown, Mask
Isolation Procedures
Requires doctor's order. Implemented either to prevent the spread of infection from a patient or to a patient whose immune system is compromised
Protective / Reverse Isolation
Used for patients who are highly susceptible to infections (i.e. burn patients, organ transplant, AIDS, neutropenic and chemo patients
Neutropenic
Having a low neutrophil count (a type of white blood cell)
Universal Precautions (UP)
Blood and certain body fluids of ALL individuals were considered potentially infectious. Required part of infection control plan
Body Substance Isolation (BSI)
Followed for every patient requiring gloves be worn when contacting ANY moist body substance
Standard Precautions
Precautions used in caring for all patients. Apply to blood, all body fluids except sweat, non-intact skin and mucous membranes.
Transmission-Based Precautions
Used for patients either suspected or known to be infected with certain pathogens transmitted by airborne, droplet, or contact routes.
Airborne Precautions
In addition to standard precautions for patients known or suspected to be infected with microorganisms transmitted by airborne droplet nuclei
Droplet Precautions
In addition to standard precautions for patients known or suspected to be infected with microorganisms transmitted by droplets when a patient talks, coughs, or sneezes or during suctiong
Contact Precautions
In addition to standard precautions when a patient is known or suspected to be infected or colonized with epidemiologically important microorganisms transmitted by direct contact with the patient or indirect contact with surfaces or patient-care items
Occupational Safety and Health Administration (OSHA)
Safe working conditions must be ensured by employers
Biosafety
Safe handling of biological substances that pose a risk to health
Biohazard
Anything harmful or potentially harmful to health
Parenteral Routes
Routes other than the digestive tract
General Laboratory Safety Rules
Never eat, drink, smoke, chew gum, put pencil or pens in mouth
Never place food or drinks in fridge used for storing reagents or specimens
Never apply cosmetics, contact lenses or rub eyes
Never wear long chains, large dangling earrings or loose bracelets
Safety Rules When in Patient Rooms and Other Patient Areas
Avoid running. Alarming to patients and may cause accident
Be careful entering and exiting patient rooms
Do not touch electrical equipment
Follow standard precautions when handling specimens
Properly dispose of used and contaminated specimen collection su
Percutaneous
Through the skin. Result or accidental needle sticks and injuries from other sharps
Permucosal
Through mucus membranes.
Blood-Borne Pathogen (BBP)
Any infectious microorganism present in blood and other body fluids and tissues (i.e. HBV, HCV, HIV, Cytomegalovirus {CMV} syphilis, malaria)
Hepatitis B (HBV)
Potentially life-threatening blood-borne pathogen that targets the liver. Most frequently occurring lab-associated infection
HBV
Best defense is vaccination. 1 now, 2nd in a month, 3rd in 6 months
HBV Exposure Hazards
Can be present in blood and other body fluids. Can survive up to a week in dried blood on work surfaces. Transmitted through needle sticks, sex and sharing needles
HBV Symptoms
Resemble Flu symptoms but generally last longer. Carriers have an increased risk of cirrhosis of the liver and liver cancer
Hepatitis C (HCV)
The most widespread chronic blood-bourne illness in the US. No Vaccine available
HCV Exposure Hazards
Primarily found in blood and serum. Infection primarily occurs after large or multiple exposures. Primary means of transmission sexual contact and needle sharing
HCV Symptoms
Similar to HBC. Lead to cirrhosis of the liver, liver cancer and transplantation
Human Immunodeficiency Virus (HIV)
Attacks the body's immune system causing AIDS by leaving the body susceptible to opportunistic infections
HIV Exposure Hazards
Found in body fluids and tissues. Primary risk exposure to blood
HIV Symptoms
Mild to severe flu-like symptoms. Hairy leukoplakia (white lesion on tongue). Karposi's sarcoma (bluish-red skin nodules)
OSHA Blood-Borne Pathogens Standard
Mandated by federal law. Meant to reduce, not eliminate occupational exposure to BBPs. Requires engineering controls and work practice controls
Engineering Controls
Devices that isolate or remove a BBP hazard
Work Practice Controls
Practices that change the way tasks are performed
BBP Exposure Routes
Skin is pierced by a contaminated needle or sharp object
Blood or body fluid splashes into eyes, nose or mouth
Blood or body fluid contacts a cut, scratch, or abrasion
Human bite breaks the skin
Needstick Exposure Procedure
Wash with soap and water minimum 30 seconds
Mucous Membrane Exposure
Flush site with water or sterile saline for minimum 10 minutes
Environmental Protection Agency (EPA) surface decontamination
Wash at end of each shift or when visibly dirty 1:10 bleach solution or other EPA approved disinfectant
Cleanup of Body Fluid Spills
Put on gloves FIRST, contain spill, cleanup materials discarded in a biohazard container
Biohazardous Waste Disposal
Disposal regulated by OSHA, EPA, and state and locan agencies
Electrical Safety
Avoid use of extension cords
Don't make repairs
Don't handle with wet hands
Don't overload circuits
Don't touch electrical equip. in patient rooms
Inspect cords and plugs for breaks and fraying
Know location of circuit breaker box
Unplug and do not use ma
Actions to Take if Electrical Shock Occurs
Shut off source of electricity
If it can't be shut off use a nonconducting material to remove the source of electricity from the victim
Call for medical assistance
Start CPR if indicated
Keep victim warm
Fire Tetrahedron
Oxygen
Heat
Fuel
Chemical Reaction
National Fire Protection Association (NFPA) 5 classes of fire
Class A, B, C, D, and K
Class A
Ordinary combustible materials (wood, paper). Requires water to cool or quench the fire to extinguish
Class B
Flammable liquids and vapors (paint, oil, gas). Block the source of oxygen or smothering the fuel to extinguish
Class C
Electrical. Nonconducting agents to extinguish
Class D
Combustible or reactive metals. Require dry powder agents or sand to extinguish
Class K
Occur with high-temperature cooking oils. Require agents to prevent splashing and cool and smother the fire
R.A.C.E.
R = Rescue individuals in danger
A = Alarm: activate the fire alarm
C = Confine the fire by closing all doors and windows
E = Extinguish the fire with fire extinguisher
P.A.S.S.
P = Pull the pin
A = Aim the nozzle
S = Squeeze the trigger
S = Sweep the nozzle
Radiation Safety Principles
Distance, shielding and time
Radiation Hazard Symbol
Posted where radioactive materials are used or on a patient's door signifying treatment with radioactive isotopes
Mixing Acid
Never add a liquid to an acid. ALWAYS add an acid to a liquid
General Rules for Chemical Safety
Always wear PPG
Always us proper chemical cleanup materials
Never store chemicals above eye level
Never add water to acid
Never indiscriminately mix chemicals together
Never store chemicals in unlabeled containers
Never pour chemicals into dirty container
Hazard Communication (HazCom) Standard
Developed by OSHA to protect employees who may be exposed to hazardous chemicals. A.K.A. the right to know law
Material Safety Data Sheets (MSDS)
Contains general information as well as precautionary and emergency information for the product
External Hemorrhage
Controlled by firmly applying direct pressure to wound using cloth or gauze
Avulsion
Tearing away or amputation of a body part
Shock
When there is insufficient return of blood flow to the hear, resulting in an inadequate supply of oxygen to all organs and tissues
Shock Symptoms
Pale, cold, clammy skin
Rapid, weak pulse
Increased, shallow breathing rate
Expressionless face and staring eyes
Shock First Aid
Maintain open airway for victim
Call for assistance
Keep victim lying down with head lower than body
Attempt to control bleeding or cause of shock if known
Keep victim warm until help arrives