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1190L NURSING SKILLS LAB Infection Control Justine Clegg, MS, LM, CPM, LMHC Chair/Professor Emeritus Miami Dade College Mi...
Infection control <ul><li>Goal of infection control is to prevent the spread of infectious diseases </li></ul><ul><li>Infe...
Maintain a safe environment <ul><li>Follow specific polices and procedures designed to reduce risk of transferring infecti...
Infection <ul><li>Infection can be: </li></ul><ul><li>Generalized or systemic (throughout the body) </li></ul><ul><li>Loca...
Microbiology <ul><li>Microbiology: the study of microorganisms </li></ul><ul><li>Microorganisms are one celled animals or ...
History of infection control <ul><li>1843 Oliver Wendell Holmes: contagious disease or communicable disease can be spread ...
Facts about microorganisms <ul><li>Not all are harmful </li></ul><ul><li>Normal flora (microorganisms) are found on skin, ...
Facts about microorganisms <ul><li>Some microorganisms are part of the normal flora but have no beneficial role </li></ul>...
Facts about microorganisms <ul><li>Antibiotics  are drugs which inhibit the growth of or destroy microorganisms </li></ul>...
Growth of microorganisms <ul><li>Aerobic  – require oxygen to live </li></ul><ul><li>Anerobic  – do not require oxygen to ...
Types of microbes <ul><li>Microbe  – a pathogenic microorganism </li></ul><ul><li>Classifications of plant and animal micr...
Bacteria <ul><li>One-celled plants  </li></ul><ul><li>Either pathogenic or non-pathogenic </li></ul><ul><li>Many produce  ...
Categories of Bacteria <ul><li>Bacteria are categorized according to shape </li></ul><ul><li>Each type causes certain cond...
Round/Ovoid Bacteria <ul><li>Round or ovoid bacteria are called  Cocci </li></ul><ul><li>Cocci are further defined by thei...
Infections caused by cocci <ul><li>Micrococci cause skin and wound infections </li></ul><ul><li>Diplococci cause gonorrhea...
Rod shaped bacteria <ul><li>Rod shaped bacteria are called  bacilli </li></ul><ul><li>Bacilli are further defined by their...
Spiral shaped bacteria <ul><li>Spiral shaped bacteria are defined by their appearance </li></ul><ul><ul><li>Vibrios – form...
Bacteria and locomotion <ul><li>Cocci are incapable of movement </li></ul><ul><li>Some rod and spiral shaped bacteria have...
Diagnosing bacterial infections <ul><li>Essential for proper treatment of infection </li></ul><ul><li>Gram staining: frequ...
Diagnosing bacterial infections <ul><li>Growing the microorganism in various culture media is also used for diagnosis </li...
Spores: the resting stage <ul><li>Some bacteria can grow spores </li></ul><ul><li>Spores are thick capsules which the bact...
Treating bacterial  infections <ul><li>Almost all bacteria can be destroyed with antibiotics </li></ul><ul><li>Some are an...
Viruses <ul><li>Smallest of the microbes </li></ul><ul><li>Need electron microscope to see them </li></ul><ul><li>Viruses ...
Viruses <ul><li>Over 300 viruses have been identified by researchers </li></ul><ul><li>Some appear to be harmless </li></u...
Fungi <ul><li>Fungi are a large group of simple plants. </li></ul><ul><li>Two forms of fungi are potential pathogens: yeas...
Fungi <ul><li>Many yeasts and molds are non-pathogenic </li></ul><ul><li>Penicillin (antibiotic) is produced from a mold <...
Fungal infections <ul><li>Cutaneous infections:  superficial infections of the skin or mucus membranes, including hair fol...
Rickettsia <ul><li>Smaller than bacteria, with rod or spherical shapes  </li></ul><ul><li>Called  obligate intracellular p...
Protozoa <ul><li>The only microorganism classified as an animal. </li></ul><ul><li>Plentiful in the environment – 45,000 d...
Protozoa <ul><li>Found in decayed materials, bird and animal feces, water contaminated with sewage waste, food washed in c...
Chain of infection <ul><li>Model of infectious disease transmission </li></ul><ul><li>Six elements must be present for an ...
Chain of infection 97 total slides Infectious  agent Reservoir Host Portal of exit Route of transmission Portal of entry S...
Chain of infection <ul><li>1.  Infectious agent : a pathogen must be present </li></ul><ul><li>2.  Reservoir host : the pa...
Chain of infection <ul><li>3.  Portal of exit : the pathogen must be able to escape from the reservoir host where it has b...
Chain of infection <ul><li>4.  Route of transmission : When the pathogen leaves the reservoir host through the portal of e...
Chain of infection <ul><li>5.  Portal of entry : The pathogen must have a way of entering the new host. Common ports of en...
Breaking the chain of infection <ul><li>Breaking at least one link stops the spread of infectious disease </li></ul><ul><l...
Breaking the chain of infection <ul><li>3. Portal of exit from the host </li></ul><ul><ul><li>Medical asepsis </li></ul></...
Breaking the chain of infection <ul><li>4.  Route of transmission </li></ul><ul><ul><li>Standard precautions </li></ul></u...
Breaking the chain of infection <ul><li>Portal of entry </li></ul><ul><ul><li>Wound care </li></ul></ul><ul><ul><li>Cathet...
Defense Mechanisms <ul><li>A number of defense mechanisms exist outside and in the body to break the chain, including decr...
Body’s natural defenses to eliminate/kill pathogens <ul><li>Cilia - in respiratory tract, catch and move pathogens out of ...
Scope of the problem <ul><li>Health care facilities or “sick care buildings” have higher concentration of microorganisms t...
Scope of the problem <ul><li>Industrial illness – a disease contracted by a health care professional during work </li></ul...
Regulatory Agencies <ul><li>Center for Disease Control and Prevention (CDC)  - Responsible for developing safe guidelines ...
Prevention: Medical Asepsis <ul><li>Medical asepsis (clean technique): procedures to decrease the number and spread of pat...
Prevention: Surgical Asepsis <ul><li>Surgical asepsis (sterile technique): procedures that completely eliminate the presen...
Breaking chain of infection <ul><li>Most important concept: breaking at least one link stops the infectious disease </li><...
Breaking chain of infection <ul><li>Best defenses: </li></ul><ul><ul><li>Decrease the sources of infecting microorganisms ...
Methods to decrease the source of microorganisms <ul><li>Perform proper hand washing </li></ul><ul><li>Decontaminate surfa...
Preventing transmission of microorganisms <ul><li>Wear PPE – personal protective equipment: caps, gloves, gowns masks, boo...
Maintaining resistance <ul><li>Provide and practice good hygiene </li></ul><ul><li>Ensure proper nutrition and fluid intak...
Standard Precautions <ul><li>Developed by the CDC </li></ul><ul><li>Follow at all times and apply to every patient </li></...
Handwashing <ul><li>Perform proper handwashing techniques: </li></ul><ul><ul><li>when coming on the clinical site </li></u...
Handwashing <ul><li>See Practical Skills Guide for Midwifery: </li></ul><ul><li>Procedure – step-by-step how to do it </li...
Personal Protective Equipment <ul><li>Abbreviated PPE </li></ul><ul><li>Includes gloves, masks, protective eyewear, gowns,...
Gloves <ul><li>Change gloves between tasks/procedures on the same client if there is contact with material that may contai...
Face Protection <ul><li>Face protection: Mask, Eye Protection and Face Shield </li></ul><ul><li>Hospital workers wear a ma...
Gowns <ul><li>Gowns may be cloth or paper </li></ul><ul><ul><li>Cloth gowns are reusable  </li></ul></ul><ul><ul><li>Paper...
Removing a Gown <ul><li>Remove a soiled gown as promptly as possible </li></ul><ul><li>Fold front of gown into itself, out...
Client care equipment <ul><li>Handle used/soiled client care equipment to prevent skin, mucous membranes and clothing from...
Environmental Control <ul><li>Follow procedures for the routine care, cleaning and disinfection of environmental surfaces,...
Occupational Health and Blood-Borne Pathogens <ul><li>Take care to prevent injuries when using and cleaning/disposing of “...
Occupational Health and Blood-Borne Pathogens <ul><li>Never recap used needles </li></ul><ul><li>Follow facility policies ...
Occupational Health and Blood-Borne Pathogens <ul><li>Use mouthpieces, resuscitation bags, or other ventilation devices as...
Self-inflating resuscitation bag (Ambu bag) 97 total slides
Using a flow inflating resuscitation bag on a baby 97 total slides
Environmental control <ul><li>Follow facility infection control procedures for cleaning the environment, jacuzzi tubs, etc...
Airborne Precautions <ul><li>Airborne droplets or dust particles containing infectious agents can remain suspended in the ...
Droplet Precautions <ul><li>Propelled short distances through the air </li></ul><ul><li>Deposited on host’s conjunctiva, n...
Contact Precautions <ul><li>Most important and frequent mode of transmission for nosocomial infections </li></ul><ul><ul><...
<ul><li>Direct Contact Transmission </li></ul><ul><li>Occurs when touching the infected client’s dry skin during client ca...
Double-bagging technique <ul><li>Used when disposing of medical waste from clients with infections (ex HIV) </li></ul><ul>...
Sterilization <ul><li>Chemical agents and physical methods used to destroy or inhibit growth of pathogens </li></ul><ul><l...
Disinfectants <ul><li>Chemical disinfectants can be harmful to the skin.  When using chemical disinfectants follow manufac...
Sterilization <ul><li>Agents/methods that totally destroy all microorganisms including viruses and spores </li></ul><ul><l...
Surgical Asepsis – Sterile Technique <ul><li>Aseptic: free from pathogenic microorganisms </li></ul><ul><li>Sterile Techni...
Maintaining a sterile field <ul><li>Field should be above the waist height </li></ul><ul><li>Do not bring contaminants int...
Blood borne diseases <ul><li>HBV and HIV: put health care workers at risk </li></ul><ul><li>Transmitted by infected blood,...
HBV <ul><li>When infected with HBV, the liver becomes inflamed and can be destroyed </li></ul><ul><li>Symptoms range from ...
HBV vaccine <ul><li>OSHA requires employers to provide the HBV vaccine free for employees with exposure risk </li></ul><ul...
HIV <ul><li>The Human Immunodeficiency virus that causes AIDS </li></ul><ul><li>HIV virus destroys cells in the host that ...
AIDS <ul><li>Most but not all HIV infected people will eventually develop AIDS and die from “opportunistic infections” suc...
HIV transmission <ul><li>HIV has been isolated from blood, semen, breast milk, vaginal secretions, saliva, tears, urine, c...
HIV transmission <ul><li>HIV is NOT transmitted through: </li></ul><ul><li>Sharing household facilities, food, eating uten...
HBV& HIV: Relative risk <ul><li>Most health care workers are afraid of getting HIV, but HIV is much harder to catch than H...
Tuberculosis <ul><li>Airborne pathogen mycobacterium tuberculosis primarily affects the lungs </li></ul><ul><li>Working wi...
Tuberculosis <ul><li>Screening for TB is a skin test </li></ul><ul><li>Positive test result means the person has been expo...
Drug-resistant organisms <ul><li>A fairly recent occurrence </li></ul><ul><li>Results from:  </li></ul><ul><ul><li>the ove...
Drug-resistant organisms <ul><li>Two drug resistant organisms encountered in health care: </li></ul><ul><ul><li>MRSA – Met...
Reporting accidental exposure <ul><li>Report any injury or accident involving exposure to blood or body fluids immediately...
OSHA Regulations <ul><li>Every facility must have an Exposure Control Plan: </li></ul><ul><ul><li>Predetermines employee e...
SUMMARY <ul><li>How do antibiotics work? </li></ul><ul><li>What is an opportunistic infection? </li></ul><ul><li>Define: A...
SUMMARY <ul><li>Explain the chain of infection and how to break it at each point </li></ul><ul><li>1. The infectious agent...
SUMMARY <ul><li>What are the body’s natural defense mechanisms? </li></ul><ul><li>Explain the concept of a sterile field a...
SUMMARY <ul><li>How is HIV transmitted?  How is it NOT? </li></ul><ul><li>What are the 3 major disease risks for health ca...
1190L NURSING SKILLS LAB Infection Control 97 total slides
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  1. 1. 1190L NURSING SKILLS LAB Infection Control Justine Clegg, MS, LM, CPM, LMHC Chair/Professor Emeritus Miami Dade College Midwifery Program 97 total slides
  2. 2. Infection control <ul><li>Goal of infection control is to prevent the spread of infectious diseases </li></ul><ul><li>Infectious disease is any disease caused by the growth of pathogens in the body </li></ul><ul><li>Pathogens are disease-causing microorganisms (germs) </li></ul><ul><li>Infectious diseases can cause unnecessary pain, suffering and death </li></ul>97 total slides
  3. 3. Maintain a safe environment <ul><li>Follow specific polices and procedures designed to reduce risk of transferring infectious diseases </li></ul><ul><li>Prevent pathogens from being transmitted: </li></ul><ul><ul><li>Patient to client, staff to client, client to staff, staff to staff </li></ul></ul><ul><ul><li>Improperly cleaned instruments and equipment </li></ul></ul>97 total slides
  4. 4. Infection <ul><li>Infection can be: </li></ul><ul><li>Generalized or systemic (throughout the body) </li></ul><ul><li>Localized (affecting one part of the body) </li></ul><ul><li>Signs and symptoms of infection: </li></ul><ul><li>Systemic: headaches, fever, fatigue, vomiting, diarrhea, increased pulse and respiration </li></ul><ul><li>Localized: redness, swelling, painful, warm to the touch </li></ul>97 total slides
  5. 5. Microbiology <ul><li>Microbiology: the study of microorganisms </li></ul><ul><li>Microorganisms are one celled animals or plants invisible to the eye, can only be seen with a microscope </li></ul><ul><li>1600s: Anton van Leeuwenhoek invented the microscope </li></ul><ul><li>1800s: Louis Pasteur developed germ theory. Stated that microorganisms, called bacteria, cause specific diseases in humans and animals </li></ul>97 total slides
  6. 6. History of infection control <ul><li>1843 Oliver Wendell Holmes: contagious disease or communicable disease can be spread directly or indirectly from one person to another through contaminated hands </li></ul><ul><li>Ignaz Philipp Semmelweis observed high mortality rate from MDs going from morgue to patients’ bedside without washing hands </li></ul><ul><li>1864 Joseph Lister: developed surgical aseptic technique to prevent wound contamination </li></ul>97 total slides
  7. 7. Facts about microorganisms <ul><li>Not all are harmful </li></ul><ul><li>Normal flora (microorganisms) are found on skin, in the intestines and vagina </li></ul><ul><li>Some are necessary to maintain normal bodily functions </li></ul><ul><ul><li>Escherichia coli (E. coli): </li></ul></ul><ul><ul><ul><li>Aids the digestive process in the colon </li></ul></ul></ul><ul><ul><ul><li>Can cause infection in the blood or urine; can cause spontaneous abortion </li></ul></ul></ul>97 total slides
  8. 8. Facts about microorganisms <ul><li>Some microorganisms are part of the normal flora but have no beneficial role </li></ul><ul><li>Normally they do no harm unless the person is susceptible to infection due to supression of the body’s immune response </li></ul><ul><li>The immune response: the body fights infection by producing antibodies (protective proteins that combat pathogens) </li></ul>97 total slides
  9. 9. Facts about microorganisms <ul><li>Antibiotics are drugs which inhibit the growth of or destroy microorganisms </li></ul><ul><li>They also suppress the body’s normal flora and create an imbalance that can decrease the body’s ability to resist other infections </li></ul><ul><li>Age, overall health, stress, nutrition and drugs can also weaken the body </li></ul><ul><li>Opportunistic infections take advantage of the body’s weakened state to grow </li></ul>97 total slides
  10. 10. Growth of microorganisms <ul><li>Aerobic – require oxygen to live </li></ul><ul><li>Anerobic – do not require oxygen to live </li></ul><ul><li>Many microorganisms thrive in warm, moist, dark environments like the human body which becomes a host to the microorganism </li></ul><ul><li>Symbiosis – the host benefits </li></ul><ul><li>Neutralism – no damage is done to the host </li></ul><ul><li>Parasitic – the host is damaged, the pathogen causing damage is called the parasite </li></ul>97 total slides
  11. 11. Types of microbes <ul><li>Microbe – a pathogenic microorganism </li></ul><ul><li>Classifications of plant and animal microbes: </li></ul><ul><ul><li>Bacteria </li></ul></ul><ul><ul><li>Viruses </li></ul></ul><ul><ul><li>Fungi </li></ul></ul><ul><ul><li>Rickettsia </li></ul></ul><ul><ul><li>Protozoa </li></ul></ul>97 total slides
  12. 12. Bacteria <ul><li>One-celled plants </li></ul><ul><li>Either pathogenic or non-pathogenic </li></ul><ul><li>Many produce toxins (poisonous substances) </li></ul><ul><li>Most bacteria are aerobic (need oxygen) and grow best in moderate temperatures </li></ul><ul><li>A group of bacteria growing in one place is called a colony </li></ul>97 total slides
  13. 13. Categories of Bacteria <ul><li>Bacteria are categorized according to shape </li></ul><ul><li>Each type causes certain conditions and diseases </li></ul><ul><li>Types of bacteria: </li></ul><ul><ul><li>Round or ovoid shape </li></ul></ul><ul><ul><li>Rod </li></ul></ul><ul><ul><li>Spiral </li></ul></ul>97 total slides
  14. 14. Round/Ovoid Bacteria <ul><li>Round or ovoid bacteria are called Cocci </li></ul><ul><li>Cocci are further defined by their appearance: </li></ul><ul><ul><li>Micrococci – appear singly </li></ul></ul><ul><ul><li>Diplococci – appear in pairs </li></ul></ul><ul><ul><li>Staphylococci – appear as irregular clusters </li></ul></ul><ul><ul><li>Streptococci – form chains </li></ul></ul>97 total slides
  15. 15. Infections caused by cocci <ul><li>Micrococci cause skin and wound infections </li></ul><ul><li>Diplococci cause gonorrhea, meningitis and some pneumonias </li></ul><ul><li>Staphylococci are pus-producing and can cause abscesses, boils, wound infections, UTIs and some pneumonias </li></ul><ul><li>Streptococci can cause rheumatic fever and strep throat </li></ul>97 total slides
  16. 16. Rod shaped bacteria <ul><li>Rod shaped bacteria are called bacilli </li></ul><ul><li>Bacilli are further defined by their appearance </li></ul><ul><ul><li>Bacilli – appear singly </li></ul></ul><ul><ul><li>Coccobacilli – when rods are somewhat oval </li></ul></ul><ul><ul><li>Diplobacilli – appear in pairs </li></ul></ul><ul><ul><li>Streptobacilli – attached end to end to form a chain </li></ul></ul><ul><li>Bacilli diseases: TB, tetanus, pertussis, typhoid fever, botulism and diphtheria </li></ul>97 total slides
  17. 17. Spiral shaped bacteria <ul><li>Spiral shaped bacteria are defined by their appearance </li></ul><ul><ul><li>Vibrios – form curved rods </li></ul></ul><ul><ul><li>Spirilla: organism is rigid </li></ul></ul><ul><ul><li>Spirochetes: organism is flexible </li></ul></ul><ul><li>Common diseases caused by spiral shaped bacteria are syphilis and cholera </li></ul>97 total slides
  18. 18. Bacteria and locomotion <ul><li>Cocci are incapable of movement </li></ul><ul><li>Some rod and spiral shaped bacteria have slender whip-like appendages called flagella (singular: flagellum ). </li></ul><ul><li>Flagella enable the bacteria to move. </li></ul>97 total slides
  19. 19. Diagnosing bacterial infections <ul><li>Essential for proper treatment of infection </li></ul><ul><li>Gram staining: frequently used lab method </li></ul><ul><li>Bacteria are stained with crystal violet </li></ul><ul><li>Type of cell wall determines how it reacts to staining. Three categories of reactions: </li></ul><ul><ul><li>Gram positive: cell wall retains the stain </li></ul></ul><ul><ul><li>Gram negative: cell wall loses the stain </li></ul></ul><ul><ul><li>Acid fast: cell wall retains the stain even when treated with acid </li></ul></ul>97 total slides
  20. 20. Diagnosing bacterial infections <ul><li>Growing the microorganism in various culture media is also used for diagnosis </li></ul><ul><li>Takes 24-72 hours for colonies to form </li></ul><ul><li>Can identify exact bacteria </li></ul><ul><li>Can choose a more precise antibiotic for a specific bacterium </li></ul>97 total slides
  21. 21. Spores: the resting stage <ul><li>Some bacteria can grow spores </li></ul><ul><li>Spores are thick capsules which the bacteria creates for self-protection </li></ul><ul><li>Spores are created when life-supporting conditions are not favorable </li></ul><ul><li>Bacteria is alive but dormant, difficult to kill, resistant to heat, drying and disinfectants </li></ul><ul><li>Can lie dormant for months or years until conditions are favorable for re-emergence </li></ul>97 total slides
  22. 22. Treating bacterial infections <ul><li>Almost all bacteria can be destroyed with antibiotics </li></ul><ul><li>Some are antibiotic-resistant, create threat to health care workers and patients </li></ul><ul><li>Extremely high temperatures must be used for sterilization to kill bacterial spores </li></ul>97 total slides
  23. 23. Viruses <ul><li>Smallest of the microbes </li></ul><ul><li>Need electron microscope to see them </li></ul><ul><li>Viruses are not whole cells, they depend on other living cells to provide food, nutrients and for reproduction </li></ul><ul><li>They are called obligate intracellular parasites because they can only live inside another living organism </li></ul>97 total slides
  24. 24. Viruses <ul><li>Over 300 viruses have been identified by researchers </li></ul><ul><li>Some appear to be harmless </li></ul><ul><li>Cause infections like influenza, pneumonia, chicken pox, croup, hepatitis B, AIDS, measles, mumps, polio, herpes, and warts </li></ul><ul><li>Transmitted through blood & body secretions </li></ul><ul><li>Difficult to treat because they are resistant to disinfectants and not killed by antibiotics </li></ul>97 total slides
  25. 25. Fungi <ul><li>Fungi are a large group of simple plants. </li></ul><ul><li>Two forms of fungi are potential pathogens: yeast and molds </li></ul><ul><ul><li>Yeasts are one celled </li></ul></ul><ul><ul><li>Molds are multi-celled </li></ul></ul><ul><li>Thrive in warm, moist, dark conditions </li></ul><ul><li>Cannot produce their own nutrients, must rely on living and dead organic materials </li></ul>97 total slides
  26. 26. Fungi <ul><li>Many yeasts and molds are non-pathogenic </li></ul><ul><li>Penicillin (antibiotic) is produced from a mold </li></ul><ul><li>Fungi can become pathogenic under the right conditions </li></ul><ul><li>Can create various opportunistic infections: </li></ul><ul><ul><li>Mildly annoying </li></ul></ul><ul><ul><li>Chronic and/or recurrent </li></ul></ul><ul><ul><li>Life-threatening </li></ul></ul>97 total slides
  27. 27. Fungal infections <ul><li>Cutaneous infections: superficial infections of the skin or mucus membranes, including hair follicles and scalp. Example: ringworm, athlete’s foot </li></ul><ul><li>Systemic infections: Example: histoplasmosis (respiratory disease) </li></ul><ul><ul><li>Difficult or impossible to treat or cure </li></ul></ul><ul><ul><li>Treatment requires medications toxic to humans </li></ul></ul>97 total slides
  28. 28. Rickettsia <ul><li>Smaller than bacteria, with rod or spherical shapes </li></ul><ul><li>Called obligate intracellular parasites - must live inside cell of another living organism </li></ul><ul><li>Rickettsia transmitted through bites of fleas, lice, ticks and mites </li></ul><ul><li>Diseases: several types of typhus and Rocky Mountain Spotted Fever </li></ul><ul><li>Typhus is the only rickettsial infection that can be transferred from 1 human to another </li></ul>97 total slides
  29. 29. Protozoa <ul><li>The only microorganism classified as an animal. </li></ul><ul><li>Plentiful in the environment – 45,000 different identified types of protozoa </li></ul><ul><li>Animal parasites reside in and out of the body </li></ul><ul><li>Seek locations that provide nutrients, warmth and moisture </li></ul><ul><li>Protozoa constantly present in intestines, skin, and mucus membranes of the nose and throat </li></ul>97 total slides
  30. 30. Protozoa <ul><li>Found in decayed materials, bird and animal feces, water contaminated with sewage waste, food washed in contaminated water or handled by unwashed hands, and insect bites </li></ul><ul><li>Common diseases caused by protozoa: dysentery, trichomonas, toxoplasmosis, pneumocystis pneumonia and malaria </li></ul>97 total slides
  31. 31. Chain of infection <ul><li>Model of infectious disease transmission </li></ul><ul><li>Six elements must be present for an infection to develop </li></ul><ul><li>1. The infectious agent </li></ul><ul><li>2. Reservoir host </li></ul><ul><li>3. Portal of exit from the host </li></ul><ul><li>4. Route of transmission </li></ul><ul><li>5. Port of entry </li></ul><ul><li>6. Susceptible host </li></ul>97 total slides
  32. 32. Chain of infection 97 total slides Infectious agent Reservoir Host Portal of exit Route of transmission Portal of entry Susceptible host
  33. 33. Chain of infection <ul><li>1. Infectious agent : a pathogen must be present </li></ul><ul><li>2. Reservoir host : the pathogen must have a place to live and grow – the human body, contaminated water or food, animals, insects, birds, dead or decaying organic material. </li></ul><ul><li>Humans who can transmit infection but how no signs of the disease are called carriers. Person may be unaware they are a carrier. </li></ul>97 total slides
  34. 34. Chain of infection <ul><li>3. Portal of exit : the pathogen must be able to escape from the reservoir host where it has been growing. </li></ul><ul><li>Examples of portals of exit are blood, urine, feces, breaks in the skin, wound drainage, and body secretions like saliva, mucus and reproductive fluids </li></ul>97 total slides
  35. 35. Chain of infection <ul><li>4. Route of transmission : When the pathogen leaves the reservoir host through the portal of exit, it must have a way of being transmitted to a new host. </li></ul><ul><li>Examples of routes of transmission are air, food, insects, and direct contact with an infected person </li></ul>97 total slides
  36. 36. Chain of infection <ul><li>5. Portal of entry : The pathogen must have a way of entering the new host. Common ports of entry are the mouth, nostrils, and breaks in the skin </li></ul><ul><li>6. Susceptible host : An individual who has a large number of pathogens invading the body or does not have adequate resistance to the invading pathogen will get the infectious disease </li></ul>97 total slides
  37. 37. Breaking the chain of infection <ul><li>Breaking at least one link stops the spread of infectious disease </li></ul><ul><li>1. The infectious agent </li></ul><ul><ul><li>early recognition of signs of infection </li></ul></ul><ul><ul><li>Rapid, accurate identification of organisms </li></ul></ul><ul><li>2. Reservoir host </li></ul><ul><ul><ul><li>Medical asepsis </li></ul></ul></ul><ul><ul><ul><li>Standard precautions </li></ul></ul></ul><ul><ul><ul><li>Good employee health </li></ul></ul></ul><ul><ul><ul><li>Environmental sanitation </li></ul></ul></ul><ul><ul><ul><li>Disinfectant/sterilization </li></ul></ul></ul>97 total slides
  38. 38. Breaking the chain of infection <ul><li>3. Portal of exit from the host </li></ul><ul><ul><li>Medical asepsis </li></ul></ul><ul><ul><li>Personal protective equipment </li></ul></ul><ul><ul><li>handwashing </li></ul></ul><ul><ul><li>Control of excretions and secretions </li></ul></ul><ul><ul><li>Trash and waste disposal </li></ul></ul><ul><ul><li>Standard precautions </li></ul></ul>97 total slides
  39. 39. Breaking the chain of infection <ul><li>4. Route of transmission </li></ul><ul><ul><li>Standard precautions </li></ul></ul><ul><ul><li>Handwashing </li></ul></ul><ul><ul><li>Sterilization </li></ul></ul><ul><ul><li>Medical asepsis </li></ul></ul><ul><ul><li>Air flow control </li></ul></ul><ul><ul><li>Food handling </li></ul></ul><ul><ul><li>Transmission-based precautions </li></ul></ul>97 total slides
  40. 40. Breaking the chain of infection <ul><li>Portal of entry </li></ul><ul><ul><li>Wound care </li></ul></ul><ul><ul><li>Catheter care </li></ul></ul><ul><ul><li>Medical asepsis </li></ul></ul><ul><ul><li>Standard precautions </li></ul></ul><ul><li>Susceptible Host </li></ul><ul><ul><li>Treating underlying diseases </li></ul></ul><ul><ul><li>Recognizing high-risk patients </li></ul></ul>97 total slides
  41. 41. Defense Mechanisms <ul><li>A number of defense mechanisms exist outside and in the body to break the chain, including decreasing the sources of microorganisms; preventing the transmission of microorganisms; and maximizing the host’s resistance to the microorganism </li></ul>97 total slides
  42. 42. Body’s natural defenses to eliminate/kill pathogens <ul><li>Cilia - in respiratory tract, catch and move pathogens out of the body </li></ul><ul><li>Coughing/sneezing, to propel pathogens outward </li></ul><ul><li>Tears - contain chemicals to kill bacteria </li></ul><ul><li>Hydrochloric acid in stomach </li></ul><ul><li>Rise in body temperature (fever) </li></ul><ul><li>Leukocyte (white blood cell) production increases, to destroy pathogens </li></ul>97 total slides
  43. 43. Scope of the problem <ul><li>Health care facilities or “sick care buildings” have higher concentration of microorganisms than a normal environment </li></ul><ul><ul><li>Patients with lowered levels of resistance due to illness </li></ul></ul><ul><ul><li>Health care personnel have frequent contact with body fluids </li></ul></ul><ul><li>Nosocomial infection – contracted by 5-10% of patients while receiving health care </li></ul><ul><ul><li>Results in 80,000 deaths per year </li></ul></ul>97 total slides
  44. 44. Scope of the problem <ul><li>Industrial illness – a disease contracted by a health care professional during work </li></ul><ul><li>Blood-borne pathogens such as Hepatitis B and HIV can be transmitted through needle sticks </li></ul><ul><li>800,000 needle sticks occur each year </li></ul><ul><li>Up to 500 health care workers die each year from Hepatitis B </li></ul><ul><li>Follow precautions when performing procedures </li></ul><ul><li>Dispose of all sharps in proper containers </li></ul>97 total slides
  45. 45. Regulatory Agencies <ul><li>Center for Disease Control and Prevention (CDC) - Responsible for developing safe guidelines to help prevent and control the spread of infectious diseases </li></ul><ul><li>Occupational Safety and Health Administration (OSHA) - Responsible for maintaining minimum health and safety standards for employees </li></ul>97 total slides
  46. 46. Prevention: Medical Asepsis <ul><li>Medical asepsis (clean technique): procedures to decrease the number and spread of pathogens </li></ul><ul><li>Hand washing, good personal hygiene, cleaning rooms between patient use, proper disposal of gloves after contact with body fluids or contaminated objects </li></ul>97 total slides
  47. 47. Prevention: Surgical Asepsis <ul><li>Surgical asepsis (sterile technique): procedures that completely eliminate the presence of pathogens from objects and areas </li></ul><ul><ul><li>Sterile caps, gowns, masks, and gloves </li></ul></ul><ul><ul><li>Sterilizing instruments </li></ul></ul><ul><ul><li>Maintaining sterile fields </li></ul></ul><ul><ul><li>Changing dressing </li></ul></ul><ul><ul><li>Disposing of contaminated materials </li></ul></ul>97 total slides
  48. 48. Breaking chain of infection <ul><li>Most important concept: breaking at least one link stops the infectious disease </li></ul><ul><li>Chain of infection summarized into 3 components: </li></ul><ul><ul><li>Source of infecting microorganisms (1 & 2) </li></ul></ul><ul><ul><li>Means of transmission for the micro-organisms (3, 4 & 5) </li></ul></ul><ul><ul><li>Susceptible host (6) </li></ul></ul>97 total slides
  49. 49. Breaking chain of infection <ul><li>Best defenses: </li></ul><ul><ul><li>Decrease the sources of infecting microorganisms (1 & 2) </li></ul></ul><ul><ul><li>Prevent means of transmission for the micro-organisms (3, 4 & 5) </li></ul></ul><ul><ul><li>Maximize the resistance of the host (6) </li></ul></ul>97 total slides
  50. 50. Methods to decrease the source of microorganisms <ul><li>Perform proper hand washing </li></ul><ul><li>Decontaminate surfaces and equipment with antiseptics, disinfectants and sterilization procedures </li></ul><ul><li>Avoid contact with patients and others when harboring infectious microorganisms </li></ul>97 total slides
  51. 51. Preventing transmission of microorganisms <ul><li>Wear PPE – personal protective equipment: caps, gloves, gowns masks, booties and eye protection </li></ul><ul><li>Follow isolation procedures when indicated </li></ul><ul><li>Take additional precautions when working with patients who have highly contagious diseases. Don’t ignore posted signs. </li></ul>97 total slides
  52. 52. Maintaining resistance <ul><li>Provide and practice good hygiene </li></ul><ul><li>Ensure proper nutrition and fluid intake </li></ul><ul><li>Get enough rest </li></ul><ul><li>Decrease stressors – physical and psychosocial - that weaken the immune response </li></ul><ul><li>What can you do in your life to increase resistance to disease-causing pathogens? </li></ul>97 total slides
  53. 53. Standard Precautions <ul><li>Developed by the CDC </li></ul><ul><li>Follow at all times and apply to every patient </li></ul><ul><li>To prevent contact with potentially infectious body fluids: blood, secretions, excretions, non-intact skin and mucous membranes </li></ul>97 total slides
  54. 54. Handwashing <ul><li>Perform proper handwashing techniques: </li></ul><ul><ul><li>when coming on the clinical site </li></ul></ul><ul><ul><li>when taking a break or leaving work </li></ul></ul><ul><ul><li>between client contacts </li></ul></ul><ul><ul><li>before gloving and after ungloving </li></ul></ul><ul><ul><li>before and after touching your face </li></ul></ul><ul><ul><li>after contact with any contaminants </li></ul></ul><ul><ul><li>before touching items considered clean </li></ul></ul>97 total slides
  55. 55. Handwashing <ul><li>See Practical Skills Guide for Midwifery: </li></ul><ul><li>Procedure – step-by-step how to do it </li></ul><ul><li>Explain why is it important to know </li></ul><ul><li>(1) the procedure – what to do </li></ul><ul><li>(2) the rationale – the reason you do it that way, why each step is important </li></ul>97 total slides
  56. 56. Personal Protective Equipment <ul><li>Abbreviated PPE </li></ul><ul><li>Includes gloves, masks, protective eyewear, gowns, caps and shoes </li></ul><ul><li>Use appropriate PPE in situations that could cause infection to you or your client </li></ul><ul><li>Use clean, non-sterile gloves when handling blood, body fluids, secretions, excretions, contaminated items, mucous membranes and non-intact skin </li></ul>97 total slides
  57. 57. Gloves <ul><li>Change gloves between tasks/procedures on the same client if there is contact with material that may contain a high concentration of microorganisms (ex: feces) </li></ul><ul><li>Remove gloves promptly after use, before touching non-contaminated items and environmental surfaces and before taking care of another patient </li></ul><ul><li>After removing gloves, wash your hands </li></ul>97 total slides
  58. 58. Face Protection <ul><li>Face protection: Mask, Eye Protection and Face Shield </li></ul><ul><li>Hospital workers wear a mask and eye protection or a face shield to protect mucous membranes of the eyes, nose and mouth during procedures that could involve splashes or sprays of blood, body fluids, secretions or excretions. </li></ul>97 total slides
  59. 59. Gowns <ul><li>Gowns may be cloth or paper </li></ul><ul><ul><li>Cloth gowns are reusable </li></ul></ul><ul><ul><li>Paper gowns are disposable </li></ul></ul><ul><li>Some clinical sites provide gowns to clients for physical exams </li></ul><ul><li>A clean, non-sterile gown protects skin and prevents soiling clothing during procedures that could involve splashes or sprays of blood, body fluids, secretions or excretions. </li></ul><ul><li>Follow the procedures on your clinical site(s) </li></ul>97 total slides
  60. 60. Removing a Gown <ul><li>Remove a soiled gown as promptly as possible </li></ul><ul><li>Fold front of gown into itself, outside in </li></ul><ul><li>Place cloth gowns in a closed receptacle marked with the biohazard symbol to be picked up, laundered and re-used </li></ul><ul><li>Place paper gowns in a closed waste can in a red plastic bag marked with the biohazard symbol </li></ul><ul><li>Wash hands promptly to avoid transferring microorganisms </li></ul>97 total slides
  61. 61. Client care equipment <ul><li>Handle used/soiled client care equipment to prevent skin, mucous membranes and clothing from exposure to blood, body fluids, secretions and excretions which could be transferred to other patients and environments </li></ul><ul><li>Reusable equipment must be properly cleaned and reprocessed before being used on another client </li></ul><ul><li>Discard single-use items appropriately </li></ul>97 total slides
  62. 62. Environmental Control <ul><li>Follow procedures for the routine care, cleaning and disinfection of environmental surfaces, beds, bedside equipment, and other frequently touched surfaces </li></ul><ul><li>For used linen that is soiled with blood, body fluids, secretions and excretions – fold with soiled surface in, handle to prevent exposing skin, mucous membranes and clothing which could transfer microorganisms to other environments, and place in designated biohazardous medical waste receptacle </li></ul>97 total slides
  63. 63. Occupational Health and Blood-Borne Pathogens <ul><li>Take care to prevent injuries when using and cleaning/disposing of “sharps” - needles, scalpels, and other sharp instruments </li></ul><ul><li>Place used disposable syringes, needles and scalpel blades in appropriate puncture-resistant containers </li></ul><ul><li>Containers should be located close by for convenient disposal </li></ul><ul><li>Placer reusable syringes and needles in a puncture resistant container for transport to be reprocessed (sterilized) </li></ul>97 total slides
  64. 64. Occupational Health and Blood-Borne Pathogens <ul><li>Never recap used needles </li></ul><ul><li>Follow facility policies on how to handle contaminated needles </li></ul><ul><li>If the facility allows recapping (for example, drawing up from a multi-dose vial), use either a one-handed “scoop” technique or a mechanical device to hold the needle sheath </li></ul><ul><li>Do not remove used needles from disposable syringes by hand </li></ul><ul><li>Do not bend, break or manipulate used needles </li></ul>97 total slides
  65. 65. Occupational Health and Blood-Borne Pathogens <ul><li>Use mouthpieces, resuscitation bags, or other ventilation devices as an alternative to mouth-to-mouth resuscitation methods. </li></ul><ul><li>Keep these devices available in areas where clients may need to be resuscitated (ie, birth rooms) </li></ul>97 total slides
  66. 66. Self-inflating resuscitation bag (Ambu bag) 97 total slides
  67. 67. Using a flow inflating resuscitation bag on a baby 97 total slides
  68. 68. Environmental control <ul><li>Follow facility infection control procedures for cleaning the environment, jacuzzi tubs, etc. </li></ul><ul><li>Use Transmission-Based Precautions: </li></ul><ul><ul><li>Airborne precautions </li></ul></ul><ul><ul><li>Droplet precautions </li></ul></ul><ul><ul><li>Contact precautions </li></ul></ul>97 total slides
  69. 69. Airborne Precautions <ul><li>Airborne droplets or dust particles containing infectious agents can remain suspended in the air for long periods of time </li></ul><ul><li>Air currents can blow them long distances </li></ul><ul><li>Can be emitted during talking, sneezing, coughing and whispering </li></ul><ul><li>Examples: Mycobaterium tuberculosis, Rubeola (measles) and Varicella (chicken pox) </li></ul>97 total slides
  70. 70. Droplet Precautions <ul><li>Propelled short distances through the air </li></ul><ul><li>Deposited on host’s conjunctiva, nasal mucosa or mouth </li></ul><ul><li>Can be emitted during talking, sneezing, coughing and during procedures like suctioning and bronchoscopy </li></ul><ul><li>Examples: streptococcal pharyngitis, mumps, influenza, rubella, some some pneumonias, meningitis and sepsis </li></ul>97 total slides
  71. 71. Contact Precautions <ul><li>Most important and frequent mode of transmission for nosocomial infections </li></ul><ul><ul><li>Nosocomial = originates/takes place in hospital or other health care facility </li></ul></ul><ul><ul><li>Nosocomial infection = the client gets it as a result of being in the health care facility </li></ul></ul><ul><li>Example: herpes (HSV), impetigo, scabies, some gastrointestinal, respiratory, skin and wound infections </li></ul><ul><li>Direct-contact & Indirect-contact transmission </li></ul>97 total slides
  72. 72. <ul><li>Direct Contact Transmission </li></ul><ul><li>Occurs when touching the infected client’s dry skin during client care activities like giving a massage </li></ul><ul><li>Can occur between two clients: a source of the infecting micro-organism and a susceptible host </li></ul><ul><li>Indirect contact transmission </li></ul><ul><li>Occurs when a contaminated object is touched. </li></ul><ul><li>For example, coming in contact with needles, instruments, environmental surfaces or client care items. </li></ul>97 total slides
  73. 73. Double-bagging technique <ul><li>Used when disposing of medical waste from clients with infections (ex HIV) </li></ul><ul><li>Health care worker “A”, wearing proper PPE, takes the contaminated bag from the area </li></ul><ul><li>“ A” slips it into another bag held by co-worker “B” </li></ul><ul><li>“ B” does not touch the contaminated bag </li></ul><ul><li>“ A” does not touch the clean bag </li></ul><ul><li>The bags are labeled according to the facility policy with hazardous waste or linen markers to alert to the need for special handling </li></ul>97 total slides
  74. 74. Sterilization <ul><li>Chemical agents and physical methods used to destroy or inhibit growth of pathogens </li></ul><ul><li>Bacteriostatic – inhibits growth </li></ul><ul><li>Bacteriocidal/germicidal – kills microorganisms </li></ul><ul><li>Antiseptics – bacteriostatic chemical agents, mild enough to use on skin: 70% isopropyl alcohol </li></ul><ul><li>Disinfectants – destroy most bacteria and viruses. Used for instruments that do not penetrate the skin and for cleaning the environment – floors, bathrooms, equipment </li></ul>97 total slides
  75. 75. Disinfectants <ul><li>Chemical disinfectants can be harmful to the skin. When using chemical disinfectants follow manufacturer’s directions for dilution and for antidoting any exposure </li></ul><ul><li>10% household bleach in water meets OSHA requirements, kills HBV, HIV and TB </li></ul><ul><li>Soaking for 20-30 minutes in 70% isopropyl alcohol acts as a disinfectant: used for some instruments, glass thermometers </li></ul><ul><li>Boiling instruments in water: cover and boil in “rolling water” for 20 mins. Rarely used today. </li></ul>97 total slides
  76. 76. Sterilization <ul><li>Agents/methods that totally destroy all microorganisms including viruses and spores </li></ul><ul><li>Include chemical agents, gas, radiation, dry or moist heat under pressure </li></ul><ul><li>Most common method used is the autoclave, which sterilizes by steam created by a pressurized heating system </li></ul><ul><li>Small units used in a medical office; large units used in hospitals </li></ul>97 total slides
  77. 77. Surgical Asepsis – Sterile Technique <ul><li>Aseptic: free from pathogenic microorganisms </li></ul><ul><li>Sterile Technique: refers to a group pf principles and procedures designed to eliminate pathogens </li></ul><ul><li>Sterile field: an area designated as free from microorganisms </li></ul><ul><li>Example: a sterile towel placed on a clean, dry surface – the towel becomes the sterile field </li></ul><ul><li>Consider the field as a 3-dimensional area </li></ul>97 total slides
  78. 78. Maintaining a sterile field <ul><li>Field should be above the waist height </li></ul><ul><li>Do not bring contaminants into the field </li></ul><ul><li>Actions that contaminate the field: touching it, allowing it to become wet, reaching across it, talking or coughing directly over the surface </li></ul><ul><li>Work to the side of the field </li></ul><ul><li>Sterile gloves come in sealed packages that must be opened at the edge of the sterile field and placed onto the field </li></ul><ul><li>See PSGM Skills Book to put on sterile gloves </li></ul>97 total slides
  79. 79. Blood borne diseases <ul><li>HBV and HIV: put health care workers at risk </li></ul><ul><li>Transmitted by infected blood, mucous, secretions, excretions, any moist body fluid (except sweat) </li></ul><ul><li>Routes of transmission: </li></ul><ul><ul><li>Parenteral – blood transfusion, needle sharing, stick by needle or other sharp instrument </li></ul></ul><ul><ul><li>Mucous membranes – eye or mouth </li></ul></ul><ul><ul><li>Sexual contact </li></ul></ul><ul><ul><li>Perinatal – from infected mother to her baby </li></ul></ul>97 total slides
  80. 80. HBV <ul><li>When infected with HBV, the liver becomes inflamed and can be destroyed </li></ul><ul><li>Symptoms range from mild to severe -jaundice (yellowing of the eyes, skin, mucous membranes), dark urine, extreme fatigue, loss of appetite, nausea, abdominal pain, joint pain, rash and fever </li></ul><ul><li>Prevention: HBV vaccine, use of PPE, preventing puncture injuries, disinfecting and sterilizing equipment and environments </li></ul>97 total slides
  81. 81. HBV vaccine <ul><li>OSHA requires employers to provide the HBV vaccine free for employees with exposure risk </li></ul><ul><li>A series of 3 doses given over 6 months </li></ul><ul><li>Induce protective antibody levels in 85 – 97% of healthy adults </li></ul><ul><li>Blood test can determine antibody levels </li></ul><ul><li>An employee has the right to refuse the HBV vaccine but must sign a form to release the facility from responsibility if the health care worker becomes infected </li></ul>97 total slides
  82. 82. HIV <ul><li>The Human Immunodeficiency virus that causes AIDS </li></ul><ul><li>HIV virus destroys cells in the host that are vital to the immune system function </li></ul><ul><li>Testing: tests for HIV antibodies </li></ul><ul><li>Most infected people test positive within 6-12 weeks up to 6 months from exposure </li></ul><ul><li>HIV positive = infected with the virus, can transmit to others even if non-symptomatic </li></ul><ul><li>AIDS = weakened immune system </li></ul>97 total slides
  83. 83. AIDS <ul><li>Most but not all HIV infected people will eventually develop AIDS and die from “opportunistic infections” such as PCP (Pneumocystis carinii pneumonia) </li></ul><ul><li>Signs and symptoms of AIDS: weakness, chronic fever, night sweats, swelling of lymph nodes, weight loss and diarrhea </li></ul><ul><li>No known vaccine or cure </li></ul><ul><li>Managed by treating symptoms with antiviral drugs and a healthy supportive lifestyle </li></ul>97 total slides
  84. 84. HIV transmission <ul><li>HIV has been isolated from blood, semen, breast milk, vaginal secretions, saliva, tears, urine, cerebrospinal fluid and amniotic fluid </li></ul><ul><li>Only blood, semen, vaginal secretions and breast milk have been proven to transmit HIV </li></ul><ul><li>Transmission not through casual contact: </li></ul><ul><ul><li>Parenteral – blood transfusion, needle stick </li></ul></ul><ul><ul><li>Mucous membranes – eye or mouth </li></ul></ul><ul><ul><li>Sexual intercourse </li></ul></ul><ul><ul><li>Perinatal – from infected mother to baby </li></ul></ul>97 total slides
  85. 85. HIV transmission <ul><li>HIV is NOT transmitted through: </li></ul><ul><li>Sharing household facilities, food, eating utensils, plates, drinking glasses or towels </li></ul><ul><li>Hugging and kissing on the cheek </li></ul><ul><li>Mosquitoes or other animals </li></ul><ul><li>Infection from exposure is determined by: </li></ul><ul><li>Amount of the virus transmitted </li></ul><ul><li>How many exposures </li></ul><ul><li>Overall health of the person </li></ul>97 total slides
  86. 86. HBV& HIV: Relative risk <ul><li>Most health care workers are afraid of getting HIV, but HIV is much harder to catch than HBV </li></ul><ul><li>The infection and death rate from HBV far exceeds HIV </li></ul><ul><li>Only 3-5 health care workers out of 1000 injured with a needle contaminated with HIV will become infected </li></ul>97 total slides
  87. 87. Tuberculosis <ul><li>Airborne pathogen mycobacterium tuberculosis primarily affects the lungs </li></ul><ul><li>Working with TB clients requires using special PPE, individually fitted masks, to avoid inhaling tiny droplets which carry the disease </li></ul><ul><li>Cases of TB have increased in recent years </li></ul><ul><li>Medication must be taken for 6 months </li></ul><ul><li>If clients don’t complete the course of treatment, a drug-resistant strain can mutate and re-infect the person </li></ul>97 total slides
  88. 88. Tuberculosis <ul><li>Screening for TB is a skin test </li></ul><ul><li>Positive test result means the person has been exposed to the disease </li></ul><ul><li>A chest x-ray confirms active disease </li></ul><ul><li>Signs and symptoms: lethargy, fever, night sweats, cough, weight loss, coughing up blood-tinged sputum, chest pain, and SOB. </li></ul><ul><li>Patients hospitalized with suspected TB are put in isolation for 2-3 weeks and begin antibiotic treatment </li></ul>97 total slides
  89. 89. Drug-resistant organisms <ul><li>A fairly recent occurrence </li></ul><ul><li>Results from: </li></ul><ul><ul><li>the overuse of antibiotics in the USA to treat minor conditions </li></ul></ul><ul><ul><li>Using wide-spectrum antibiotics instead of testing/prescribing for a specific pathogen </li></ul></ul><ul><ul><li>patients not completing an entire course of prescribed treatment of antibiotics </li></ul></ul><ul><li>These create conditions that encourage pathogens to become resistant to antibiotics </li></ul>97 total slides
  90. 90. Drug-resistant organisms <ul><li>Two drug resistant organisms encountered in health care: </li></ul><ul><ul><li>MRSA – Methicillin-resistant Staphylococcus aureas </li></ul></ul><ul><ul><li>VRE – Vancomycin-resistant Enterococcus </li></ul></ul><ul><li>Both are difficult to control and can cause serious, life threatening infections esp. in susceptible people (ex: premature babies) </li></ul><ul><li>Treatment is expensive and has severe side effects – liver, kidney & hearing damage </li></ul>97 total slides
  91. 91. Reporting accidental exposure <ul><li>Report any injury or accident involving exposure to blood or body fluids immediately to your clinical preceptor/supervisor </li></ul><ul><li>Complete a written incident or injury report </li></ul><ul><li>Reporting facilitates evaluation, appropriate treatment and follow-up </li></ul><ul><li>Failure to report can result in negative health consequences and is in violation of OSHA requirements </li></ul>97 total slides
  92. 92. OSHA Regulations <ul><li>Every facility must have an Exposure Control Plan: </li></ul><ul><ul><li>Predetermines employee exposure risk to blood-borne pathogens </li></ul></ul><ul><ul><li>Describes how employees at risk will be protected </li></ul></ul><ul><ul><li>Gives training and annual retraining and testing requirements for employees </li></ul></ul><ul><ul><li>Gives policies and procedures to follow in case of employee exposure </li></ul></ul>97 total slides
  93. 93. SUMMARY <ul><li>How do antibiotics work? </li></ul><ul><li>What is an opportunistic infection? </li></ul><ul><li>Define: Aerobic, Anerobic, host, Symbiosis, Neutralism and Parasitic </li></ul><ul><li>Differentiate plant and animal microbes: Bacteria, Viruses, Fungi, Rickettsia, Protozoa </li></ul>97 total slides
  94. 94. SUMMARY <ul><li>Explain the chain of infection and how to break it at each point </li></ul><ul><li>1. The infectious agent </li></ul><ul><li>2. Reservoir host </li></ul><ul><li>3. Portal of exit from the host </li></ul><ul><li>4. Route of transmission </li></ul><ul><li>5. Port of entry </li></ul><ul><li>6. Susceptible host </li></ul>97 total slides
  95. 95. SUMMARY <ul><li>What are the body’s natural defense mechanisms? </li></ul><ul><li>Explain the concept of a sterile field and how to avoid contaminating it </li></ul><ul><li>Describe standard precautions including handwashing, gloving, PPE </li></ul><ul><li>Explain the differences between antiseptics, disinfectants and sterilization </li></ul>97 total slides
  96. 96. SUMMARY <ul><li>How is HIV transmitted? How is it NOT? </li></ul><ul><li>What are the 3 major disease risks for health care workers </li></ul><ul><li>How do pathogens become drug-resistant? </li></ul><ul><li>What is the role of government agencies: CDC, OSHA </li></ul><ul><li>Explain environmental control and transmission precautions </li></ul>97 total slides
  97. 97. 1190L NURSING SKILLS LAB Infection Control 97 total slides
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