INFECTION PREVENTION AND CONTROL IN HEALTH AND SOCIAL CM5 JULY 2023.ppt

INFECTION PREVENTION AND
CONTROL IN HEALTH AND
SOCIAL CARE
Unit HSC CM5
Unit Code: L/507/1432
By:
Oguchi Martins Egbujor FHEA FCMI MBA
Oguchi Martins Egbujor FHEA FCMI MBA 1

The Aim
The aim of this unit is to provide learners with knowledge and
understanding of Infection Prevention and Control in health and social
care. The unit provides the learner with the skills required to minimise
the spread of infection.

The Learning Outcomes
LO1: Understand types of biological organisms that cause disease.
LO2: Understand the features of vector borne disease.
LO3: Understand transmission of disease.
LO4: Understand methods of micro-organism control.
LO5: Understand precautions to be taken to reduce the spread of
infection in a health or social care setting.
LO6: Be able to minimise the spread of infection.

The Learning Outcomes cont.
LO7: Understand how infectious disease can be controlled and
treated by medication.
LO8: Understand the requirements of RIDDOR and COSHH in relation to
infection prevention and control.
LO9: Understand the role and responsibilities of the health and social
care practitioner in relation to infection prevention and control.

LO1
Understand Types of Biological Organisms That Cause Disease.

LO1.1: Describe Types of Microbiological
Organisms That Cause Disease
Types of microbiological organisms:
1. Bacteria: structure, infectivity, life cycle e.g.: tuberculosis,
salmonella, staphylococcus, body flora.
2. Viruses: structure, size, life cycle, e.g.: influenza, measles, mumps,
HIV/AIDS.
3. Fungi: structure, life cycle, infectivity; e.g.: athlete’s foot, candida.
4. Protozoa: structure, life cycle, e.g.: plasmodium, schistosomiasis,
parasites.

Sources of Infection
Sources of (potential) infection include blood and other body fluids,
secretions or excretions (excluding sweat), non-intact skin or mucous
membranes and any equipment or items in the care environment that
could have become contaminated.
NHS England

Standard Infection Control Precaution (SICPs)
NHS England stated that “Standard Infection Control Precautions”
(SICPs) are to be used by all staff, in all care settings, at all times, for all
patients whether infection is known to be present or not, to ensure the
safety of those being cared for, staff and visitors in the care
environment.
https://www.england.nhs.uk/national-infection-prevention-and-
control-manual-nipcm-for-england/chapter-1-standard-infection-
control-precautions-sicps/#1-2

Types of Microbiological Organisms
• Bacteria
• Viruses
• Fungi
• Protozoa
https://phw.nhs.wales/services-and-teams/harp/infection-prevention-
and-control/nipcm/a-z-pathogens/

Microbiology
Microbiology is the study of all living organisms that are too small to be
visible with the naked eye. This includes bacteria, archaea, viruses,
fungi, prions, protozoa and algae, collectively known as 'microbes'.
These microbes play key roles in nutrient cycling, biodegradation or
biodeterioration, climate change, food spoilage, the cause and control
of disease, and biotechnology. Thanks to their versatility, microbes can
be put to work in many ways: making life-saving drugs, the
manufacture of biofuels, cleaning up pollution, and producing or
processing food and drink.
https://microbiologysociety.org/why-microbiology-matters/what-is-
microbiology.html

What Is Organism
An organism refers to a living thing that has an organized structure, can
react to stimuli, reproduce, grow, adapt, and maintain homeostasis. An
organism would, therefore, be any:
• Animal
• Plant
• Fungus
• Protist
• Bacterium
• Archaeon on earth
https://www.biologyonline.com/dictionary/organism

Microbiological Organisms
A microorganism or microbe is an organism that is microscopic. The
study of microorganisms is called microbiology. The term
microorganisms does not include viruses and prions, which are
generally classified as non-living. Microorganisms can be:
• Bacteria
• Fungi
• Archaea
• Protists
https://www.uib.no/en/geobio/56846/what-are-microorganisms

Bacteria
Bacteria
1. Structure
2. Infectivity
3. Life cycle
https://phw.nhs.wales/services-
and-teams/harp/infection-
prevention-and-control/nipcm/a-
z-pathogens/
Types of Bacteria
• Tuberculosis
• Salmonella
• Staphylococcus
• Body flora

Bacteria Diseases
• Cholera
• Diptheria
• Dysentery
• Bubonic plague
• Pneumonia
• Tuberculosis (TB)
• Typhoid
• Many more

Bacteria
Bacteria are microscopic
living organisms, usually one-
celled, that can be found
everywhere. They can be
dangerous, such as when
they cause infection, or
beneficial, as in the process
of fermentation (such as in
wine) and that of
decomposition.
• However, most bacteria serve a
useful purpose. They support
many forms of life, both plant
and animal, and they are used in
industrial and medicinal
processes. Bacteria can use most
organic and some inorganic
compounds as food, and some
can survive extreme conditions.
health.

Bacteria Structure
Bacterial cells are different from
plant and animal cells. Bacteria
are prokaryotes, which means
they have no nucleus. Bacteria
Cells include:
• Capsule
• Cell Wall
• Plasma Membrane
• Cytoplasm
• DNA
• Ribosomes
• Flagellum
• Pili
• https://www.medicalnewstoday.
com/articles/157973#structure

Where Do Bacteria Live
Bacteria can be found in soil,
water, plants, animals, radioactive
waste, deep in the earth’s crust,
arctic ice and glaciers, and hot
springs. There are bacteria in the
stratosphere, between 6 and 30
miles up in the atmosphere, and
in the ocean depths, down to
32,800 feet or 10,000 meters
deep.
• Anaerobes, or anaerobic
bacteria, can only grow where
there is no oxygen. In humans,
this is mostly in the
gastrointestinal tract. They can
also cause gas, gangrene,
tetanus, botulism, and most
dental infections.

Where Do Bacteria Live
Facultative anaerobes, or facultative anaerobic bacteria, can live either
with or without oxygen, but they prefer environments where there is
oxygen. They are mostly found in soil, water, vegetation and some
normal flora of humans and animals. Examples include Salmonella.

Bacteria Feeding
Bacteria feed in different ways.
Heterotrophic bacteria, or
heterotrophs, get their energy
through consuming organic carbon.
Most absorb dead organic material,
such as decomposing flesh. Some of
these parasitic bacteria kill their
host, while others help them. Those
that use chemosynthesis are known
as chemoautotrophs. These bacteria
are commonly found in ocean vents
and in the roots of legumes, such as
alfalfa, clover, peas, beans, lentils,
and peanuts.
Bacteria that use photosynthesis are
called photoautotrophs. Some types,
for example cyanobacteria, produce
oxygen. These probably played a vital
role in creating the oxygen in the
earth’s atmosphere. Others, such as
heliobacteria, do not produce
oxygen.

Viruses
Viruses:
1. Structure
2. Size
3. Life cycle
https://www.nhs.uk/search/result
s?q=influenza
Types of Viruses
• Influenza
• Measles
• Mumps
• HIV/AIDS

Viruses
Viral infections are illnesses you get from tiny organisms that use your
cells to make more copies of themselves (viruses). Viral infections
commonly cause respiratory and digestive illnesses, but viruses can
also infect most other parts of your body
https://my.clevelandclinic.org/health/diseases/24473-viral-infection

Viruses
A virus is an infectious microbe consisting of a segment of nucleic acid
(either DNA or RNA) surrounded by a protein coat. A virus cannot
replicate alone; instead, it must infect cells and use components of the
host cell to make copies of itself. Viruses can infect many organisms,
including humans. Example is Covid 19.
https://www.genome.gov/genetics-glossary/Virus

HIV and AIDS
Human immunodeficiency virus (HIV) is the virus that causes acquired
immune deficiency syndrome (AIDS). HIV weakens your immune
system by destroying your T-cells until you are unable to fight off even
minor illnesses. You can have HIV without any symptoms. Getting
tested and starting treatment early gives you the best chance of living a
long life.
https://my.clevelandclinic.org/health/diseases/4251-hiv-aids

Viruses and Bacteria
List of all know viruses and bacteria
• https://phw.nhs.wales/services-and-teams/harp/infection-
prevention-and-control/nipcm/a-z-pathogens/

Influenza
Influenza or ‘Flu’ is an acute viral infection affecting the respiratory
tract. There are three main types or ‘genera’ of viruses that affect
humans: Influenza virus A, Influenza virus B and Influenza virus C.
and-control/nipcm/glossary

Measles
Measles is a highly infectious acute viral disease resulting from
infection with measles virus. Initial symptoms include fever,
conjunctivitis, cough, runny nose and sneezing. This is followed by
small grey/white spots, called Koplik’s spots, on the inside of the mouth
1 to 2 days before rash onset which may last for 2 to 4 days. Measles
rash appears red and blotchy, developing 2 to 4 days after the onset of
fever, and spreading from the head to the body over the next 3 to 4
days.
and-control/nipcm/a-z-pathogens/

Mumps
Mumps is a disease caused by a paramyxovirus. The symptoms include
swelling of the parotid glands (Parotitis) which may be painful, causing
difficulty with swallowing. Parotitis may be preceded by several days of
non-specific symptoms such as fever, headache, malaise, nausea,
myalgia and anorexia; although asymptomatic mumps infection is
common, particularly in children. Mumps is a vaccine preventable
disease and is part of the normal childhood vaccination schedule.

Types of Viral Infections
• Respiratory infections.
• Digestive system infections.
• Viral hemorrhagic fevers.
• Sexually transmitted infections (STIs).
• Exanthematous (rash-causing) infections.
• Neurological infections.
• Congenital infections.

Symptoms of Viral Infection
Symptoms of a viral infection depend
on where you are infected, but some
common ones include:
Flu-like symptoms:
Upper respiratory symptoms:
Digestive symptoms:
Skin conditions:
• fever, head and body aches,
fatigue.
• sore throat, cough, sneezing.
• nausea, vomiting, diarrhea.
• rashes, sores, blisters, warts.

Examples of Viruses

Fungi
Fungi
1. Structure
2. Life cycle
3. Infectivity
Types of Fungi
• Athlete’s foot
• Candida

Fungi
A fungus is a tiny organism, such as mould or mildew. Fungi are
everywhere; in the air, water and on the human body. About half of
fungi are harmful. If one of the harmful fungi lands on your skin, it can
cause a fungal infection. You may develop a rash or feel itchy. most
fungal infections are not dangerous, and you can usually treat them
easily with creams. If you tend to get repeated fungal infections, talk to
your healthcare provider about how to prevent rashes from returning.
https://my.clevelandclinic.org/health/diseases/4276-skin-fungus

Protozoa
Protozoa
1. Structure
2. Life cycle
Types of Protozoa
• Plasmodium
• Schistosomiasis
• Parasites

Protozoa
Protozoa are single celled organisms. They come in many different
shapes and sizes ranging from an Amoeba which can change its shape
to Paramecium with its fixed shape and complex structure. They live in
a wide variety of moist habitats including fresh water, marine
environments and the soil.
https://microbiologysociety.org/why-microbiology-matters/what-is-
microbiology/protozoa.html

Protozoa
These infections arise in very different parts of the body. For example:
• Malaria infections start in the blood
• Giardia begins in the gut
• Toxoplasmosis can infect lymph nodes, the eye, and the brain.
https://www.verywellhealth.com/definition-of-protozoa-1958837#toc-
what-are-protozoa

Protozoa
Protozoa are one-celled animals found worldwide in most habitats.
Most species are free living, but all higher animals are infected with
one or more species of protozoa. Infections range from asymptomatic
to life threatening, depending on the species and strain of the parasite
and the resistance of the host.
https://www.ncbi.nlm.nih.gov/books/NBK8325

Infections

Microbiological Organisms

LO2
Understand the Features of Vector Borne Disease

LO2.1: Explain The Features of Vector Borne
Disease.
Vector Borne Disease:
1. Mosquitoes (malaria)
2. Body lice (typhus)
3. Ticks (Lyme disease)
4. Rabies vector species.

Vector-Borne Diseases
Vectors are living organisms that can transmit infectious pathogens
between humans, or from animals to humans. Many of these vectors
are bloodsucking insects, which ingest disease-producing
microorganisms during a blood meal from an infected host (human or
animal) and later transmit it into a new host, after the pathogen has
replicated. Often, once a vector becomes infectious, they are capable
of transmitting the pathogen for the rest of their life during each
subsequent bite/blood meal.
https://www.who.int/news-room/fact-sheets/detail/vector-borne-
diseases

Vector Borne Diseases
• Chikungunya.
• Dengue and severe dengue.
• Yellow fever.
• Zika virus.
• Malaria.
• Japanese encephalitis.
• Lymphatic filariasis.
• Leishmaniasis
• Crimean-Congo haemorrhagic
fever
• Chagas disease (American
trypanosomiasis)
• Onchocerciasis
• Trypanosomiasis, human African
(sleeping sickness)
• Plague
• Schistosomiasis

Vector Borne Diseases
Vector-borne diseases account for more than 17% of all infectious
diseases, causing more than 700 000 deaths annually. They can be
caused by either parasites, bacteria or viruses:
https://www.who.int/news-room/fact-sheets/detail/vector-borne-
diseases

Victor-Borne Diseases
Dengue
• Dengue is the most prevalent
viral infection transmitted by
Aedes mosquitoes. More than
3.9 billion people in over 129
countries are at risk of
contracting dengue, with an
estimated 96 million
symptomatic cases and an
estimated 40,000 deaths every
year.
Malaria
• Malaria is a parasitic infection
transmitted by Anopheline
mosquitoes. It causes an
estimated 219 million cases
globally, and results in more
than 400,000 deaths every year.
Most of the deaths occur in
children under the age of 5 years

Victor-Borne Diseases
Body Lice
• Typhus is an infection spread by
lice, fleas or mites. It's very rare
in the UK. It can be serious, but
most people make a full
recovery if treated quickly.
https://www.nhs.uk/conditions/ty
phus/
Ticks
• Lyme disease is a bacterial
infection that can be spread to
humans by infected ticks. It's
usually easier to treat if it's
diagnosed early.
https://www.nhs.uk/conditions/ly
me-disease/

Vector-Borne Diseases
Rabies
• Rabies is a rare but serious
infection that's usually caught
from a bite or scratch of an
infected animal. It's almost
always fatal once symptoms
appear, but vaccination and
early treatment can prevent it.
https://www.nhs.uk/conditions/ra
bies/
Yellow Fever
• Yellow fever is a serious infection
spread by mosquitoes. It's found
in certain areas of Africa and
South and Central America. You
should have a yellow fever
vaccination if you're travelling to
an area where there's a risk of
getting it.
https://www.nhs.uk/conditions/
yellow-fever/

LO3: Understand Transmission of Disease.
LO3.1: Describe how pathogenic micro-organisms are transmitted.
LO3.2: Explain why individuals may be more vulnerable to infection.
LO3.3: Describe the body’s defence mechanisms against infection.
LO3.4: Explain how to break the chain of infection.

What Is Pathogenic Organism
A pathogen is defined as an organism causing disease to its host, with
the severity of the disease symptoms referred to as virulence.
Pathogens comprise viruses and bacteria as well as unicellular and
multicellular eukaryotes. Pathogens can be divided into two main
categories:
1. Facultative Pathogens
2. Obligate pathogens
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5648414

Bacteria Pathogens
• Escherichia coli
• Salmonella
• Shigella
• Campylobacter
• Salmonella typhi
• Vibrio cholerae
• Pseudomonas
https://www.sciencedirect.com/topics/earth-and-planetary-
sciences/pathogenic-organism

LO3.1: Describe How Pathogenic Micro-organisms
Are Transmitted.
Transmitted:
1. Direct/indirect spread
2. Inhalation
3. Inoculation
4. Ingestion
5. Reservoirs
6. Fomites
7. Carriers

Virus Transmission
• Nose
• Mouth
• Eyes
• Anus
• Genitals
• Broken skin
• Coughing
• Sneezing
• Close contact
• Bite from Infected Animal
• Mosquito

Direct and Indirect Transmission
The spread of infectious agents from one person to another by contact.
When spread occurs through skin-to-skin contact, this is called direct
contact transmission. When spread occurs via a contaminated object,
this is called indirect contact transmission
and-control/nipcm/glossary

Inhalation
Inhalation occurs when germs are aerosolized in tiny particles that
survive on air currents over great distances and time and reach a
susceptible person
https://www.cdc.gov/infectioncontrol/spread/index.html

Inoculation In Microbiology
Inoculation is the act of inducing immunity by introducing infectious
agents into the body. In simple terms, inoculation in microbiology is the
process of introducing microbes into a culture media so that it
reproduces there. Commonly, it is used in the introduction of vaccines,
serum or any antigenic substance in the body so as to boost immunity
against a particular disease.
https://byjus.com/neet/inoculation

Inoculation
Auto-inoculation, or self-inoculation, occurs when a person transfers a
disease from one part of their body to another. Self-inoculation
frequently happens when someone scratches or rubs a sore and then
touches uninfected skin. Many diseases can be spread by self-
inoculation in this way, including chicken pox.
https://www.verywellhealth.com/what-is-selfinnoculation-3132792#

Ingestion
Ingestion is the process of taking food into the body through the
mouth. In vertebrates, the teeth, saliva, and tongue play important
roles in mastication (preparing the food into bolus). While the food is
being mechanically broken down, the enzymes in saliva begin to
chemically process the food as well.
https://bio.libretexts.org/Bookshelves/Introductory_and_General_Biol
ogy/General_Biology_1e_(OpenStax)/7%3A_Animal_Structure_and_Fu
nction/34%3A_Animal_Nutrition_and_the_Digestive_System/34.3%3A
_Digestive_System_Processes#

Reservoir
In microbiology, a reservoir is defined as the habitat in which an
infectious agent normally lives, grows, and multiplies. It can be any
person, animal, plant, soil or substance in which an infectious agent
normally lives and multiplies, and typically harbours the infectious
agent without injury to itself and serves as a source from which other
individuals can be infected. It is the source from which an agent is
transferred to a host. A host organism in which an infectious agent that
is pathogenic for some other species lives and multiplies typically
without damaging the host.
https://www.bing.com/search?q=reservoir+in+microbiology&qs=SS&p
q=reservoir

Infectious Disease Control
Infectious disease control and prevention relies on a thorough
understanding of the factors determining transmission. An immune
host is someone protected against a specific pathogen (because of
previous infection or vaccination) such that subsequent infection will
not take place or, if infection does occur, the severity of disease is
diminished. The duration and efficacy of immunity following
immunization by natural infection or vaccination varies depending
upon the infecting agent, quality of the vaccine, type of vaccine (i.e.,
live or inactivated virus, subunit, etc.), and ability of the host to
generate an immune response.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7150340/

Vehicle of Pathogenic Organism Transmission
• Contaminated food
• Water
• Blood
• Fleas
• Mites
• Ticks
• Rats
• Snails
• Dogs

LO3.2: Explain why individuals may be more
vulnerable to infection
Vulnerable To Infection:
1. Compromised immune status
2. Procedurally induced tissue damage

Compromised Immune Status
Being immunocompromised, your immune system's defenses are low,
affecting its ability to fight off infections and diseases. Depending on
why your immune system is compromised. Certain conditions, such as
HIV and AIDS, destroy immune cells, leaving your body vulnerable to
other attacks. Autoimmune conditions turn immune cells into double
agents that fight against your own healthy tissues. Common
autoimmune diseases include:
• Lupus
• Rheumatoid arthritis
• Type 1 diabetes
https://www.pennmedicine.org/updates/blogs/health-and-
wellness/2020/may/what-it-means-to-be-immunocompromised

Procedurally Induced Tissue Damage
The damage inflicted by pathogens on their hosts is the result of direct
and indirect collateral effects resulting from the activity of virulence
factors performing specific functions involved in pathogenesis. The
impact on the host of microbial damage depends very much on the
tissue involved. Damage to muscle in the shoulder or stomach wall, for
instance, may not be serious, but in the heart the very existence of the
host depends on a strong muscle contraction continuing to occur every
second or so, and here the effect of minor functional changes may be
catastrophic.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7158287/

Being Vulnerable To Infection
Hospital patients are more vulnerable to infection than a healthy
person, because of:
• Age (very young and the elderly) are at an increased risk.
• Medical conditions
• Low immune system
• Undergone surgery
• Device placed in a vein to give them fluids or medications OR a
• Tube placed in the bladder to drain urine.

Infectious Disease Transmission
Germs are a part of everyday life and are found in:
• Air
• Soil
• Water
• Bodies
Some germs are helpful, others are harmful. Many germs live in and on
our bodies without causing harm and some even help us to stay
healthy. Only a small portion of germs are known to cause infection
https://www.cdc.gov/infectioncontrol/spread

LO3.3: Describe the body’s defence mechanisms
against infection.
Defense Mechanisms:
1. Skin
2. Cilia acids and enzymes
3. Immune response
4. Role of white blood cells
5. Inflammatory response
6. Body temperature

Skin Defense Mechanism
Skin is a barrier that serves as one of the body's first lines of defense
against harmful microbes. Specialized immune cells within skin tissue
help to fight invading organisms. Yet the skin hosts diverse
communities of beneficial bacteria, collectively known as the skin
microbiota
https://www.nih.gov/news-events/nih-research-matters/skin-
microbes-immune-response#

Cilia Acids And Enzymes
Cilia propel a liquid layer of mucus that covers the airways. The mucus
layer traps pathogens (potentially infectious microorganisms) and other
particles, preventing them from reaching the lungs. Cilia, tiny muscular,
hair-like projections on the cells that line the airway, are one of the
respiratory system's defense mechanisms. Cilia propel a liquid layer of
mucus that covers the airways. The mucus layer traps pathogens
(potentially infectious microorganisms) and other particles, preventing
them from reaching the lungs.
https://www.msdmanuals.com/en-gb/home/lung-and-airway-
disorders/biology-of-the-lungs-and-airways/defense-mechanisms-of-
the-respiratory-system

Enzyme
An enzyme is a biological catalyst and is almost always a protein. It
speeds up the rate of a specific chemical reaction in the cell. The
enzyme is not destroyed during the reaction and is used over and over.
https://www.genome.gov/genetics-glossary/Enzyme

Immune Response
The Immune response is the body's ability to stay safe by affording
protection against harmful agents and involves lines of defense against
most microbes as well as specialized and highly specific response to a
particular offender.

The Role of White Blood Cells
One of the key functions of blood is protection. White blood cells are
immune system cells. They are like warriors waiting in your blood
stream to attack invaders such as bacteria and viruses. When fighting
an infection, your body produces more white blood cells. There are
several types of white blood cells, and they have different roles in
defending the body against bacterial, viral, fungal and parasitic
infections. When they locate an infection, these cells move to the site
under attack to destroy the invading pathogen and prevent illness.
https://www.blood.co.uk/news-and-campaigns/the-donor/latest-
stories/functions-of-blood-its-role-in-the-immune-system

Inflammatory Response
The inflammatory response (inflammation) occurs when tissues are
injured by bacteria, trauma, toxins, heat, or any other cause. The
damaged cells release chemicals including histamine, bradykinin, and
prostaglandins. These chemicals cause blood vessels to leak fluid into
the tissues, causing swelling. Pus is formed from a collection of dead
tissue, dead bacteria, and live and dead phagocytes
https://medlineplus.gov/ency/article/000821.htm

Body Temperature
Normal body temperature varies by person, age, activity, and time of
day. The average normal body temperature is generally accepted as
98.6°F (37°C). Some studies have shown that the "normal" body
temperature can have a wide range, from 97°F (36.1°C) to 99°F
(37.2°C). Mild fevers are a good indication that the immune system is
doing its job. But fevers are not just a byproduct of the immune
response. In fact, an elevated body temperature triggers cellular
mechanisms that ensure the immune system takes appropriate action
against the offending virus or bacteria
https://www.medicalnewstoday.com/articles/321889#

LO3.4: Explain How To Break The Chain of
Infection
Chain of Infection Controls:
Six Links –
• Causative agent
• Reservoir
• Portal of exit
• Mode of transmission
• Portal of entry
• Susceptible host.

Chain of Infection Control
No matter the germ, there are six points at which the chain can be
broken, and a germ can be stopped from infecting another person. The
six links include:
1. The infectious agent
2. Reservoir
3. Portal of exit
4. Mode of transmission
5. Portal of entry
6. Susceptible host

Breaking The Chain of Infection
• Infectious agent is the pathogen
(germ) that causes diseases
• Reservoir includes places in the
environment where the
pathogen lives (this includes
people, animals and insects,
medical equipment, and soil and
water
• Portal of exit is the way the
infectious agent leaves the
reservoir (through open wounds,
aerosols, and splatter of body
fluids including coughing,
sneezing, and saliva)
• Mode of transmission is the way
the infectious agent can be
passed on (through direct or
indirect contact, ingestion, or
inhalation)

Breaking The Chain of Infection
• Portal of entry is the way the
infectious agent can enter a new
host (through broken skin, the
respiratory tract, mucous
membranes, and catheters and
tubes)
https://infectionpreventionandyo
u.org/protect-your-
patients/break-the-chain-of-
infection
• Susceptible host can be any
person (the most vulnerable of
whom are receiving healthcare,
are immunocompromised, or
have invasive medical devices
including lines, devices, and
airways)

LO4.1: Explain Methods of Micro-organism
Control
• Sterilisation
• Disinfection
• Pasteurisation
• Sanitation
• Asepsis.

HouseKeeping Cleaning
In most clinical areas a daily clean with a detergent based fluid is
adequate. The aim is to remove organic matter and dust and to reduce
the bacterial load in the environment. Cleaning should be carried out in
line with the Revised NHS Healthcare Cleaning Manual. Housekeeping
staff should have received training and standards should be monitored
by senior staff. Equipment used by the Housekeeping Staff for cleaning
is colour coded in accordance with national guidance as outlined in the
revised NHS Healthcare Cleaning Manual (Appendix 1).

Decontamination
A general term used to describe the destruction or removal of
microbial contamination to render an item or the environment safe.
The term decontamination includes sterilisation, disinfection and
cleaning. Disinfection is used as part of the decontamination process
for moderate risk items. Disinfection methods include thermal and
chemical processes. Moist heat may be used for items such as crockery,
linen and bedpans e.g. automated processes in a machine.
https://www.england.nhs.uk/wp-content/uploads/2022/09/Appendix-
7-09.01.22.pdf

The Methods of Micro-organism Control
Sterilisation
• This is a process of removing or
killing all viable organisms
including spores. Dead
microorganisms and toxins
(pyrogens) may remain. Prions
will not be effectively destroyed
by this process
(NHS England, 2019)
Disinfection
• This is a process of removing or
killing most, but not all viable
organisms. The aim of
disinfection is to reduce the
number of micro-organisms to a
level at which they are not
harmful. Spores are not
destroyed

The Methods of Micro-organism Control
Pasteurization
• pasteurization, heat-treatment
process that destroys
pathogenic microorganisms in
certain foods and beverages. It is
named for the French scientist
• https://www.britannica.com/tec
hnology/pasteurization
Sanitisation
• Poor sanitation is linked to
transmission of diarrhoeal
diseases such as cholera and
dysentery, as well as typhoid,
intestinal worm infections and
polio. It exacerbates stunting
and contributes to the spread of
antimicrobial resistance.
https://www.who.int/news-
room/fact-
sheets/detail/sanitation

Sanitisation
Sanitation refers to the provision of facilities and services for the safe
disposal of human urine and faeces (WHO, 2018). However, the term
“sanitation” on a broader perspective also refers to the effective
maintenance of hygienic conditions through city level services. It has
been realized that integral and whole system sanitation solutions need
to take an integrated approach, thereby addressing other sanitation
sectors such as solid waste management, stormwater management,
water supply and access to toilets.

Asepsis
Aseptic technique means using practices and procedures to prevent
contamination from pathogens. It involves applying the strictest rules
to minimize the risk of infection. Healthcare workers use aseptic
technique in surgery rooms, clinics, outpatient care centres, and other
health care settings.
https://www.healthline.com/health/aseptic-technique

LO5: Understand Precautions To Be Taken To
Reduce The Spread of Infection In a Health or
Social Care Setting
• LO5.1. Explain the importance of personal hygiene and attire in
relation to infection control.
• LO5.2. Explain the correct hand washing technique.
• LO5.3. Explain the use of personal protective equipment.
• LO5.4. Explain the process of safe waste disposal for:
1. body fluids
2. linen
3. sharps and equipment.

LO5.1: Explain The Importance of Personal
Hygiene and Attire In Relation To Infection
Control
• Hair
• Nails
• Jewellery
• Badges
• Uniform
• Sleeves
• Ties
• Cleanliness

LO5.2::
Explain The Correct Handwashing Technique
Refer to World Health Organization guidelines:
Wash hands with non-antimicrobial liquid soap and water if:
• Hands are visibly soiled or dirty
• Caring for patients with vomiting or diarrhoeal illnesses
• Caring for a patient with a suspected or known gastrointestinal
infection, eg norovirus or a spore-forming organism such as
clostridioides difficile.
In all other circumstances, use alcohol-based handrubs (ABHRs) for
routine hand hygiene during care.

Performing Hand Hygiene
(See NIPCM Appendix 1-2)
Where running water is unavailable, or hand hygiene facilities are
lacking, staff may use hand wipes followed by ABHR and should wash
their hands at the first opportunity.
Perform hand hygiene:
• Before touching a patient.
• Before clean or aseptic procedures.
• After body fluid exposure risk
• After touching a patient; and
• After touching a patient’s immediate surroundings.

Correct Handwashing
Washing your hands is one of the easiest ways to protect yourself and
others from illnesses such as food poisoning and viruses such as flu and
coronavirus (COVID-19).
https://www.nhs.uk/live-well/best-way-to-wash-your-hands/

LO5.3: Explain The Use of Personal Protective
Equipment
• Legislation
• Policy and procedures
• Types
• Selection
• Maintenance
• Removal
• Disposal

Personal Protective Equipment
Under Health and Safety At Work (HASAW) Act 1974 as amended,
Personal Protective Equipment (PPE) Regulations 1992 made a
requirement for employers to provide adequate and appropriate
equipment for their employees to protect them from harm.
See appendices 5a and b: https://www.england.nhs.uk/wp-
content/uploads/2022/09/national-infection-prevention-and-control-
manual-appendix-5a.pdf
https://www.england.nhs.uk/wp-content/uploads/2022/09/nipc-
manual-appendix-6-Donning-and-doffing.pdf

Personal Protective Equipment (PPE)
Before undertaking any procedure, staff should assess any likely
exposure to blood and/or other body fluids, non-intact skin or mucous
membranes and wear personal protective equipment (PPE) that
protects adequately against the risks associated with the procedure.
The principles of PPE use set out below are important to ensure that
PPE is used correctly to ensure patient and staff safety
https://www.england.nhs.uk/wp-content/uploads/2022/09/national-
infection-prevention-and-control-manual-appendix-5b.pdf

Principles of PPE
• ALL PPE MUST BE: Located close to the point of use. PPE for
healthcare professionals providing care in the community and
domiciliary care providers must be transported in a clean receptacle
• Stored to prevent contamination in a clean, dry area until required
(expiry dates must be adhered to)
• Single-use only unless specified by the manufacturer
• Changed immediately after each patient and/or after completing a
procedure or task
• Disposed of after use into the correct waste stream, eg domestic
waste, offensive (non-infectious) or clinical waste
• Discarded if damaged or contaminated.

LO5.4: Explain The Process of Safe Waste
Disposal
The Process of Safe Waste Disposal for:
• Body fluids
• Linen
• Sharps and equipment.

Blood and Body Fluid Spillages
If an organisation locally approves a product for use in the
management of blood and body fluid spills, the organisation is
responsible for ensuring safe systems of work, including the completion
of a risk assessment approved through local governance procedures.
Organisations must confirm the efficacy and suitability of the product
(i.e., that it conforms with the relevant standards and is appropriate for
the intended use) with the product manufacturer.

Blood and Body Fluid
A locally approved product which
conforms to the following may be
used for the management of
blood and body fluid spills:
• EN17126
• EN13727
• EN14348
• EN14476
• EN13697
• EN14885
• EN13706
• EN1650
• EN1276
• EN13624.

Cleaning Linen
• Should be stored in a clean, designated area, preferably an enclosed
cupboard
• If clean linen is not stored in a cupboard, then the trolley used for
storage must be designated for this purpose and completely covered
with an impervious covering/or door that is able to withstand
decontamination
https://www.england.nhs.uk/wp-content/uploads/2022/09/nipc-
manual-Appendix-8-linen.pdf

Cleaning Linen
Do not:
• Rinse, shake or sort linen on removal from beds/trolleys
• Place used linen on the floor or any other surfaces eg a locker/table
top
• Re-handle used linen once bagged
• Overfill laundry receptacles (not more than 2/3 full); or
• Place inappropriate items in the laundry receptacle eg used
equipment/needles.

Disposal of Sharp Instruments
The Health and Safety (Sharp Instruments in Healthcare) Regulations
2013 outline the regulatory requirements for employers and
contractors in the healthcare sector in relation to: arrangements for the
safe use and disposal of sharps; provision of information and training to
employees; investigations and actions required in response to work
related sharps injuries.

Disposal of Sharp Instruments
Health and Safety (Sharp Instruments in Healthcare) Regulations 2013
are concerned with reducing and eliminating the number of ‘sharps’
related injuries which occur within healthcare. Its basic guidance is:
• Avoid unnecessary use of sharps
• If use of medical sharps cannot be avoided, source and use a ‘safer
sharp’ device
• If a safer sharp device is not available then safe procedures for
working with and disposal must be in place eg sticky mats, sharps
bins, safety procedures and training.

Handling Sharp Instruments
Sharps handling must be assessed, kept to a minimum and eliminated,
if possible, with the use of approved safety devices.
• Manufacturers’ instructions for safe use and disposal must be
followed
• Needles must not be re-sheathed/recapped or disassembled after use
• Sharps must not be passed directly hand to hand
• Used sharps must be discarded at the point of use by the person
generating the waste
• Always dispose of needles and syringes as 1 unit
• If a safety device is being used safety mechanisms must be deployed
before disposal.

The Process of Safe Waste Disposal
• Legislation
• Policy
• Procedures
• Responsibilities
• Clinical/non-clinical
• Colour codes
• Used linen
• Soiled linen
• Sharps containers;
• Re-sheathing;
• Disposal of personal protective
equipment;
• Health and Safety Executive
regulations.

Process of Safe Waste Disposal
Health Technical Memorandum (HTM 07-01) on best practice for waste
management and ways to improve the environment and carbon
impacts of managing waste. HTM 07-01 (2023 version) replaces the
previous 2013 edition and details the environmental benefits of the
safe management and disposal of healthcare waste, It also presents
opportunities for cost savings, safer working practices and reducing
carbon emissions related to the management of waste.
(NIPCM 7 March 2023)

Healthcare Waste
Clinical waste means waste from a healthcare activity (including
veterinary healthcare) that:
contains viable micro-organisms or their toxins which are known or
reliably believed to cause disease in humans or other living organisms.
For example, if a patient is known or suspected to be infected, or
colonised, by an infectious agent. Clinical judgement should be applied
in the assessment of waste and should consider the infection status of
a patient and the item of waste produced.

Healthcare Waste
Clinical waste means waste from a
healthcare activity (including
veterinary healthcare) that:
contains or is contaminated with a
medicine that contains a
biologically active pharmaceutical
agent, or
Is a sharp, or a body fluid or other
biological material (including
human and animal tissue)
containing or contaminated with a
dangerous substance within the
meaning of Regulation (EC) No
1272/2008 of the European
Parliament and of the Council on
classification, labelling and
packaging of substances and
mixtures, as amended from time
to time.

LO6: Able To Minimise The Spread of Infection
LO6.1: Use the correct hand washing technique.
LO6.2: Use personal protective equipment.
LO6.3: Dispose of waste safely.

LO7: Understand How Infectious Disease Can
Be Controlled And Treated By Medicine
LO7.1: Evaluate the use of drugs to control and treat infectious
disease.
LO7.2: Explain how antimicrobial resistance occurs.

LO7.1: Evaluate The Use Of Drug To Control
And Treat Infectious Diseases
Drugs:
• Anti-viral
• Antibiotics
• Anti-fungal
• Anti-parasitic

Anti-Viral Treatment
• Antiviral drugs can ease symptoms and shorten how long you are sick
with viral infections like the flu and Ebola. They can rid your body of
these viruses.
• Viral infections like HIV, hepatitis and herpes are chronic: Antivirals
cannot get rid of the virus, which stays in your body. However,
antiviral medicines can make the virus latent (inactive) so that you
have few, if any, symptoms. Symptoms that develop while you take
antivirals may be less severe or go away faster.
https://my.clevelandclinic.org/health/drugs/21531-antivirals

Antibiotic Treatment
Antibiotics are medicines that fight infections caused by bacteria in
humans and animals by either killing the bacteria or making it difficult
for the bacteria to grow and multiply. Bacteria are germs. They live in
the environment and all over the inside and outside of our bodies.
Antibiotics DO NOT work on viruses, such as those that cause:
Colds and runny noses, even if the mucus is thick, yellow, or green
• Most sore throats (except strep throat)
• Flu
• Most cases of chest colds (bronchitis)
https://www.cdc.gov/antibiotic-use/q-a.html

Antifungal Treatment
Antifungal medicines are used to treat fungal infections, which most
commonly affect your skin, hair and nails. One can get some antifungal
medicines from a pharmacy without needing a GP prescription.
Fungal infections commonly treated with antifungals include:
• Ringworm
• Athlete's foot
• Fungal nail infection
• Vaginal thrush
• Some types of severe dandruff
https://www.nhs.uk/conditions/antifungal-medicines/

Anti-Parasitic Treatment
In general, children and adults who have an infection that results from
a parasite need antiparasitic medication. But the side effects of each
drug vary, and some side effects are severe. Your provider will consider
the risks and benefits of antiparasitic medications and recommend the
most appropriate treatment for you.
https://my.clevelandclinic.org/health/drugs/22945-antiparasitic-drugs
https://go.drugbank.com/categories/DBCAT000522

LO7.2: Explain How Antimicrobial Resistance
Occurs
Antimicrobial resistance:
• Consider past and current case studies, e.g. MRSA;
• Drug resistance
• Over prescribing
• Non-compliance of patients
• Infection prevention and control practices
• Mutation of microorganisms, e.g. influenza strains.

Antimicrobial Resistance (AMR)
The World Health Organisation stated that “Antimicrobial Resistance”
(AMR) occurs when bacteria, viruses, fungi and parasites change over
time and no longer respond to medicines making infections harder to
treat and increasing the risk of disease spread, severe illness and death.
As a result of drug resistance, antibiotics and other antimicrobial
medicines become ineffective and infections become increasingly
difficult or impossible to treat.
https://www.who.int/news-room/fact-sheets/detail/antimicrobial-
resistance

Antimicrobial Resistance (AMR)
WHO has declared that AMR is one of the top 10 global public health
threats facing humanity.
• Misuse and overuse of antimicrobials are the main drivers in the
development of drug-resistant pathogens.
• Lack of clean water and sanitation and inadequate infection
prevention and control promotes the spread of microbes, some of
which can be resistant to antimicrobial treatment.
• The cost of AMR to the economy is significant. In addition to death
and disability, prolonged illness results in longer hospital stays, the
need for more expensive medicines and financial challenges for those
impacted.

Antimicrobial Resistance
Antimicrobial resistance happens when microorganisms (such as
bacteria, fungi, viruses, and parasites) develop the ability to continue to
grow, even when they are exposed to antimicrobial medicines that are
meant to kill them or limit their growth (such as antibiotics, antifungals,
antivirals, antimalarials, and anthelmintics).
As a result, the medicines become ineffective and infections persist in
the body, increasing the risk of spread to others. While antimicrobial
resistance refers to all microbes that resist treatments designed to
destroy them, antibiotic resistance specifically deals with bacteria that
are resistant to antibiotics.
https://www.uicc.org/what-we-do/areas-focus/antimicrobial-
resistance-amr?gclid

MRSA
MRSA is a type of bacteria that usually lives harmlessly on the skin. But
if it gets inside the body, it can cause a serious infection that needs
immediate treatment with antibiotics. If the infection spreads to your
blood or lungs, or another part of your body, symptoms may include:
• high temperature
• difficulty breathing
• chills
• dizziness
• Confusion
https://www.nhs.uk/conditions/mrsa/

Drug Resistance Tuberculosis
Drug Resistance Disease means that the drug can no longer kill the
bacteria or virus.
Tuberculosis (TB) is a disease caused by bacteria that are spread from
person to person through the air. TB usually affects the lungs, but it can
also affect other parts of the body, such as the brain, the kidneys, or
the spine. In most cases, TB is treatable and curable; however, people
with TB can die if they do not get proper treatment. Sometimes drug-
resistant TB occurs when bacteria become resistant to the drugs used
to treat TB.
https://www.cdc.gov/tb/topic/drtb/default.htm

Drug-Resistant Tuberculosis
Drug-resistant TB can occur when the drugs used to treat TB are
misused or mismanaged. Examples of misuse or mismanagement
include:
• People do not complete a full course of TB treatment
• Health care providers prescribe the wrong treatment (the wrong dose
or length of time)
• Drugs for proper treatment are not available
• Drugs are of poor quality

Infection Prevention and Control (SICPs)
There are 10 elements of Standards Infection Control Preventions:
• Patient placement/assessment of infection risk.
• Hand hygiene.
• Respiratory and cough hygiene.
• Personal protective equipment.
• Safe management of the care environment.
• Safe management of care equipment.
• Safe management of healthcare linen.
• Safe management of blood and body fluids.

Mutation of Microorganisms
A mutation is a permanent alteration in the sequence of nitrogenous
bases of a DNA molecule. The result of a mutation is generally a change
in the end‐product specified by that gene. In some cases, a mutation
can be beneficial if a new metabolic activity arises in a microorganism,
or it can be detrimental if a metabolic activity is lost.
https://www.cliffsnotes.com/study-
guides/biology/microbiology/microbial-genetics/mutation
https://www.bing.com/videos/search?q=mutation+of+microorganisms
&&view=detail&mid=B7625485FA9DC51FA15AB7625485FA9DC51FA15
A&&FORM=VRDGAR&ru=

Mutation of Microorganisms
Genomes of bacteria exist on a single double-stranded circular DNA
molecule that contains approximately 4000 kb of DNA and are
regulated by operons. A mutation is a change in the nucleotide
sequence and can create new cellular functionalities or lead to the
dysfunction of others. Mutations can occur spontaneously or be caused
by exposure to mutation-inducing agents
https://www.ncbi.nlm.nih.gov/books/NBK459274/

LO8: Understand The Requirements of
RIDDOR And COSHH In Relation To Infection
Prevention And Control
LO8.1: Explain the requirements of RIDDOR in relation to
LO8.2: Explain the requirements of COSHH in relation to

LO8.1: Explain The Requirements Of RIDDOR
In Relation To Infection Prevention And
Control
Requirements of RIDDOR:
• Responsibilities
• Reporting requirements
• Record keeping
• Risk assessment
• Procedures
• Training

Risk Assessment Recording
Organisations must record if they have five (5) or more employees.
They must record assessments however, even if you have fewer than 5,
it makes sense to write down what steps you have taken to identify the
risks. Make a list of the actions you have taken to control the risks to
workers’ and residents’ health.
https://www.hse.gov.uk/coshh/basics/assessment.htm

Reporting and Recording
Recording is documenting data of an individual's health information
that is traceable, secure, and permanent for communication. In
contrast, reporting refers to exchanging health care data in either oral
or written form. Accurate timing and proper documentation are the
two vital components of reporting and recording.
https://www.jove.com/science-education/13540/data-reporting-and-
recording

The Requirements of RIDDOR In Relation To
Infection Prevention and Control
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations
(RIDDOR) 2013:
• Deaths and Injuries
• Over-seven-day incapacitation of a worker
• Over-three-day incapacitation of a worker
• Non-Fatal accidents to non-workers (Public)
• Occupational Diseases
• Dangerous Occurrences

RIDDOR 2013
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations
2013 is organisational responsibility under Health and Safety at Work
Act 1974. The law under regulations 2013 demands as below:
• Reporting and recording of Injuries at workplace
• Reporting and recording of Diseases at workplace
• Reporting and recording of Dangerous Occurrences at workplace
https://www.hse.gov.uk/riddor/reportable-incidents.htm
https://www.legislation.gov.uk/uksi/2013/1471/contents/made

RIDDOR
• All deaths to workers and non-workers, with the exception of
suicides, must be reported if they arise from a work-related accident,
including an act of physical violence to a worker and/or public.
• The list of 'specified injuries' in RIDDOR 2013 replaces the previous
list of 'major injuries' in RIDDOR 1995. Specified injuries are
(regulation 4):
• If someone has died or has been injured because of a work-related
accident this may have to be reported. Not all accidents need to be
reported.
• https://www.hse.gov.uk/riddor/reportable-incidents.htm

LO8.2: Explain The Requirements Of COSHH In
Relation To Infection Prevention And Control
Requirements of COSHH:
• Risk assessment
• Training
• Monitoring
• Health surveillance
• Emergency plans
• Substances hazardous to health

COSHH
This is the Control of Substances Hazardous to Health Regulations
(COSHH). The law requires you to adequately control exposure to
materials in the workplace that cause ill health. Many materials or
substances used or created at work could harm your health. These
substances could be dusts, gases or fumes that you breathe in, or
liquids, gels or powders that come into contact with your eyes or skin.
There could also be harmful micro-organisms present that can cause
infection, an allergic reaction or are toxic.
https://www.hse.gov.uk/coshh/basics/index.htm

Hazardous Substances
• Dust
• Gas
• Fume
• Liquid
• Gel
• Powder
• Harmful Micro-organisms

COSHH Risk Assessment
COSHH assessment concentrates on the hazards and risks from
hazardous substances in your workplace. You as a worker must
remember that health hazards are not limited to substances labelled as
'hazardous'. Some harmful substances can be produced by the process
organisations use at workplace, for example:
• Wood dust from sanding
• Silica dust from tile cutting
• Fumes from welding
https://www.hse.gov.uk/coshh/basics/assessment.htm

Risk Assessment Management
Risk assessment will help you decide if an organisation needs health
surveillance. The management should:
• Look around workplace to decide what may harm the worker’s health
• Decide if they are taking reasonable steps to reduce risk and prevent
harm
• Think about reasonably practicable improvements you can make or
controls that can be put in place to reduce risk.
https://www.hse.gov.uk/health-surveillance/overview.htm

Health Surveillance
Health surveillance is a scheme of repeated health checks which are
used to identify ill health caused by work. Health and safety law
requires health surveillance when your workers remain exposed to
health risks even after you have put controls in place.
https://www.hse.gov.uk/health-surveillance/overview.htm

Health Surveillance
Health surveillance and monitoring is advised in healthcare sector
where certain risks and hazards exist in the workplace to ensure that
workplace risks are effectively managed and monitored to provide a
safe working environment and protect the ongoing health of your
employees, residents and others.
https://www.staywelloh.co.uk/services/medical-
surveillance/?utm_source=pc&utm_medium=google-ads&gclid

LO9: Understand The Role And
Responsibilities Of The Health and Social
Practitioner In Relation To Infection
Prevention and Control
LO9.1: Analyse the role and responsibilities of the health and social
care practitioner in relation to infection prevention and control.

LO9.1: Analyse The Role And Responsibilities
Of The Health and Social Practitioner In
Relation To Infection Prevention And Control
Roles and responsibilities of health and social care practitioners:
• Applying policies and procedures
• Reporting problems
• Maintaining own knowledge and skills

INFECTION PREVENTION AND CONTROL IN HEALTH AND SOCIAL CM5 JULY 2023.ppt

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