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1 Infection Control

INFECTION CONTROL

A MODULE

PURPOSE

This module is designed to provide health care professionals with education on

accepted infection control practices.

OBJECTIVES

After completing the Infection Control module, you will be able to:

· Describe how infections spread

· Explain Standard Precautions

· Name common infections transmitted by blood and other body fluids

· List types of protective work practices

· Explain and list the types of Personal Protective Equipment

· Explain the steps involved in exposure reporting and follow up

· Name other types of precautions apart from Standard Precautions

Researchers at one hospital found that only 48 percent of staff in the intensive care units washed their hands before examining patients even though they knew they were being watched as part of a research project. staff members and visitors. including patients. and wound drainage. yeasts and fungi. Although invisible. You must take time and make the effort required to consistently adhere to infection control procedures – because these procedures are crucial for protecting your patients and yourself from infection. can harbor a variety of infectious microorganisms such as bacteria. such as MRSA and VRE. A. these microorganisms may be present in blood and other body fluids and secretions such as saliva. Infection control practices are easy to ignore because they can be so elementary. the risk of acquiring an infection in healthcare facilities has increased in recent years for both patients and staff. viruses. healthcare facilities have several sources of infectious microorganisms including:  People  Contaminated objects People. sputum. They are also present in excrement and are often on the . three elements are required:  A source of infectious microorganisms (germs)  A susceptible host  A means of transmission for the microorganism. nasal and vaginal discharge. HOW INFECTION SPREADS For infection to spread. you must recognize that these threats underscore the fundamental truth that using proper infection control practices is one of your most important job responsibilities. I. 2 Infection Control GENERAL INFECTION CONTROL PRACTICES Because of viruses such as HIV and the new drug-resistant super bacteria. As a healthcare worker. SOURCES Unfortunately. parasites.

HOST To become a host. medical equipment. especially the hands. healthcare facilities have many different kind of patients that can become hosts. breathing tubes and other medically induced pathways into the body that can allow infections to enter. A person doesn’t have to look or feel sick to be a source of infection. A person exposed to an infectious organism will not necessarily become a host because some people are immune to or able to resist the infection. invasive medical devices and dirty laundry. Unfortunately. Patients can even infect themselves when microorganisms within their body multiply out of control. catheters. Entrance may be gained through:  Inhalation  The mouth. C. People particularly susceptible to infection include:  Elderly patients  Newborns  Persons with weak or undeveloped immune systems  Persons with cancer. nicks. TRANSMISSION To be transmitted. Some objects especially prone to contamination include floors. B. bedpans. a person must be susceptible to the infectious organism. The longer a patient is in the hospital. Contaminated objects can also be sources of infection. nose or other opening into the body  A break in the host’s skin caused by cuts. multiple health problems or chronic diseases that require steroid therapy  Patients with surgical incisions. the greater is his or her chance of acquiring an infection. skin abrasions or dermatitis . eyes. 3 Infection Control skin’s surface. microorganisms must enter the host’s body. trash cans.

Direct contact transmission can also occur between two patients. 3. . or they may be carried by air currents and infect people further away. nose or mouth. sneezes or talks. or during the performance of certain procedures such as bronchoscopy. which then contacts a susceptible host. The microorganisms can then be inhaled by a susceptible host in the same room. The infectious microorganisms are carried by microscopic droplet nuclei or even dust particles that remain suspended in the air for long periods of time. 4 Infection Control There are five main routes of transmission:  Contact  Droplet  Airborne  Common vehicle  Vectorborne. Direct contact transmission—occurs when microorganisms are physically transferred from the source person’s body surface to the host’s body surface. The infectious droplets are propelled a short distance through the air and land in the host’s eyes. Indirect contact transmission—is when a source of infection contaminates an intermediate object. Airborne Transmission—can occur over greater distances than droplet transmission. This can happen when contaminated gloves are not changed between patients or when a healthcare worker is stuck with a contaminated needle. or performs other patient care activities that required direct personal contact. 2. The droplets may be generated when the source person coughs. Contact Transmission—the most common route. 1. Droplets do not remain suspended in the air. This can happen when a healthcare worker turns or bathes a patient. can be either direct or indirect. Droplet Transmission Occurs when a source person produces tiny droplets containing infectious microorganisms.

surefire method of determining which patients may be carrying an infectious disease.  Body Substance Isolation—which reduces the risk of transmitting pathogens from moist body substances. rats and other vermin transmit microorganisms. Common vehicle transmission and vectorborne transmission are both rare in U. effective infection control programs have two levels: Standard Precautions and Transmission-Based Precautions. A. Hepatitis B (HBV). Vectorborne Transmission—occurs when mosquitoes. The Exposure Control Plan is located in the Infection Control Policy and Procedure Manual. Hepatitis C (HCV) and syphilis. University Hospital has an Exposure Control Plan which outlines the methods that are in place to minimize employee risk. water. Standard Precautions combine the major features of:  Universal Precautions—which reduce the risk of transmitting bloodborne pathogens.S. Since there is no quick. METHODS OF INFECTION CONTROL According to the Centers for Disease Control. 5 Infection Control 4. STANDARD PRECAUTIONS The Occupational Safety and Health Administration (OSHA) requires that employers protect employees with exposure to blood and body fluids from potential infection by organisms such as HIV. 5. among others. Standard Precautions require that you treat all patients as though they may be infected. flies. . Common Vehicle Transmission —occurs when microorganisms are transmitted by contaminated items such as food. medications and equipment. II. These methods include the use of standard precautions. healthcare facilities. exposure reporting and follow up and offering of the Hepatitis B vaccine.

1. hepatitis C and HIV. mucous membranes and contaminated items – whether or not gloves are worn . PROTECTIVE WORK PRACTICES You can decrease the spread of infection by using common sense and by practicing good hygiene. you must use Standard Precautions every time you anticipate contact with blood. non-intact skin. secretions and excretions. Standard Precautions cover all healthcare workers whether they give direct patient care or work in support areas. secretions and excretions. nonintact skin and mucous membranes. The sooner you wash infectious material off you hands. Wash Your Hands Handwashing is the single most important precaution for preventing the spread of infection. University Hospital has developed policies using Standard Precautions. Standard Precautions outline a system of safeguards to help you protect yourself from infections such as hepatitis B. the less likely your chance of infection. Handwashing keeps you from transferring contamination from your hands to other areas of your body or other surfaces you may contact later. including:  Protective work practices  Use of personal protective equipment  Protective Housekeeping  Protection through the hepatitis B vaccination  Exposure reporting. Always wash your hands:  After touching blood. while also protecting your patients from infectious organisms that are often transmitted from patient to patient by healthcare workers. 6 Infection Control In other words. all body fluids. B. like maintenance and housekeeping. Hands should be washed for 10-15 seconds. all body fluids.

cleaning them or disposing of them. smoke. recap or break needles after use  Dispose of contaminated sharps in appropriate puncture-resistant containers immediately after use. Practice Good Hygiene  Minimize splashing. fluid-resistant gowns or aprons. lotions may promoted the growth of harmful microorganisms. spraying or spattering when performing procedures involving blood or other potentially infectious materials  Do not eat. . in some situations. However. Never top-off lotion or soap containers because this can promote the growth of harmful bacteria. 3. drink. personal protective equipment (PPE) protects you from infectious hazards. 4. Petroleum-based lubricants may deteriorate latex gloves and some tubing. Personal Protective Equipment When worn properly.  Never bend. smoke. smoking. PPE includes gloves. Clean containers before refilling or use disposables. Be sure to wash your hands thoroughly before you apply lotion. cough. sneeze or use the toilet. or handle contact lenses where there is a reasonable chance you might be exposed to blood or body fluids  Do not keep food and drink in places where blood or other potentially infectious materials are present. Use hand lotion after washing hands to prevent drying and chapping. apply cosmetics or lip balms. Handle Sharps With Care Be careful to prevent injuries from needles and other sharp instruments when using them. applying makeup.  Always activate safety mechanism on sharp devices after use and before discarding. handling contact lenses or using the restroom  After you eat. drinking. 2. 7 Infection Control  Immediately after gloves are removed and between patient contacts  Before eating.

torn. You should wear as much or as little PPE needed to keep blood or other potentially infectious materials from getting on your clothing. you should wear cotton glove liners. punctured or damaged in any way. to not touch the outside of the glove.  Use disposable gloves only once on a single patient—and then discard. For example: If you anticipate skin exposure only to your hands. 8 Infection Control faceshields. Types of PPE: a. It damaged in any way—throw them out. protective eyewear and masks.  Be careful when removing contaminated gloves. . and then discard.  Utility gloves may be cleaned or decontaminated for reuse only if they are not damaged. or if you are allergic to disposable gloves. No glove offers 100 percent effective protection. PPE must be appropriate for the task you are doing. mouth or nose is likely. powderless gloves or hypoallergenic gloves – consult your manager or supervisor.  Remove disposable gloves as soon as possible if they are contaminated.  Before putting on gloves. resuscitation bags or other ventilation devices. you only need to wear gloves. Never wash or decontaminate them for reuse. b. wash your hands thoroughly. Always wash your hands after removing gloves. Face Protection Fluid resistant masks and eye protection (splash guards or goggles) are to be worn if splashing to the face. skin or mucous membranes. If you have dermatitis that is caused or aggravated by wearing gloves. Cover any hand cuts with bandages in case a glove leaks or tears. Gloves Gloves are the most common type of PPE: You should use disposable gloves for medical procedures and heavy duty utility gloves for some housekeeping activities.

Wash hands after PPE removed. use mechanical emergency respiratory devices and pocket masks designed to isolate you from contact with potentially infectious substances. such as autoclaves.e. avoid unprotected mouth-to-mouth resuscitation. Fluid-Resistant Gowns  Are to be worn if splashing or soiling of clothing is likely  Remove clothing as soon as possible if soiled with blood or body fluids d. during and after use  Clean and maintain PPE properly  Repair or discard any equipment that is flawed or damaged  Replace PPE as soon as possible if it becomes penetrated by blood or other potentially infectious materials  Always remove PPE before leaving the work area and place it in a designated receptacle for disposal. blood or other fluids which could contain infectious materials. C. Carefully follow University Hospital’s policies and procedures regarding housekeeping. Follow these general rules: . laundering or processing  Remove PPE carefully to avoid contamination of clothing and skin. gloves before other PPE. Instead. PROTECTIVE HOUSEKEEPING Good housekeeping protects everyone and is everyone’s responsibility. General Rules For PPE Use  Always inspect your protective equipment before. Protection During Resuscitation Since a patient may expel saliva. 5. Hospitals also provides equipment necessary to eliminate infectious hazards at their source. 9 Infection Control N95 Respirators are required for protection against tuberculosis c. sharps disposal containers and needles with safety mechanisms attached.  Remove PPE in the proper order i.

REGULATED MEDICAL WASTE All items contaminated with blood or body fluids are characterized as regulated medical waste and are to be disposed of in red bags. Waste from patients on isolation must also be deposited into red bags.  Transport specimens in closed containers. mucous membrane. . Contamination of body or clothing with blood and body fluid is likely. 10 Infection Control  Handle used patient care equipment soiled with blood or other potentially infectious materials with care. Do not let the equipment touch your skin. Do not place linen on the floor. Single-use items must be discarded. windowsill.  Do not let sharps container overfill  To prevent contamination. away from your body. other patients or items in the environment.Sharp objects are to be disposed of into sharp containers.  Keep clean linen carts covered when not in use. In the event that clothing should become contaminated.  Promptly contact Environmental Services to clean major blood and body fluid spills.  Shake down waste containers and carry waste bags by the top.  Clean reusable equipment appropriately before using it for the care of another patient. Without sorting or rinsing. D. place soiled linen in leakproof bags in the area where it was used. handle soiled linen as little as possible and with minimum agitation. clothing. Wear gloves and handle the containers carefully. Note: Items that are not contaminated with blood or body fluids are to be disposed of in clear bags. furniture. it should be removed promptly. etc. REMEMBER: Hepatitis B virus can become active again even after existing dry on surfaces for between seven to thirty days.

needlestick and contamination of nonintact skin (burns. HEPATITIS C (HCV) is transmitted via:  Sexual contact with a infected partner  Nonsexual household contact  Needle sharing  Blood transfusion (now very rare)  Perinatally  Occupational exposure as described above OTHER TYPES OF PRECAUTIONS To prevent the spread of certain highly infectious or drug-resistant organisms. a second level of precautions. HUMAN IMMUNODEFICIENCY VIRUS (HIV) the virus that causes AIDS is transmitted by:  Sexual contact with an infected partner  Sharing needles with an infected person  Perinatally from mother to baby  Occupationally through mucous membrane (eye. cuts. 11 Infection Control COMMON BLOODBORNE PATHOGENS 1. must be used in addition to Standard Precautions. cuts. needlestick and contamination of nonintact skin (burns. Transmission-Based Precautions. wounds. mouth) splashes. acne lesions. 2. acne lesions. nose. etc). nose. etc). HEPATITIS B (HBV) is transmitted by:  Sexual contact with an infected partner  Sharing needles with an infected person  Perinatally from mother to baby  Occupationally through mucous membrane (eyes. mouth) splashes. 3. wounds. Categories of Transmission-Based Precautions include: .

Hepatitis A etc. . and requiring anyone enter these rooms to wear appropriate respiratory protection. Transmission-Based Precautions may involve some of the following special infection control measures:  Placing the patient in a private room or cohorting patients by grouping those who are actively infected with the same microorganisms  Keeping the patient’s room door closed  Wearing masks when entering the patient’s room  Moving the patient from the room only for essential purposes  Having the patient wear a mask outside the room  Wearing gloves when entering the patient’s room  Placing patients with infectious TB in rooms with proper ventilation. such as negative air-pressure rooms.) Sometimes several of these special categories are combined or one category is individualized to meet the needs of the particular patient.difficile. Depending upon the particular category. C. Rotavirus. 12 Infection Control  Airborne ( TB.)  Contact (MRSA. rubella etc.)  Droplet (RSV. chickenpox. Meningitis etc. measles. VRE.