LECTURER: SIR DAÑOS

BSN 4 | FIRST SEM | BATCH 2022 | TOPIC: 4: INFECTION CONTROL & PREVENTION
implementation of the infection
control program in every HC
HISTORY
facility
− By the 1960s, HAIs (Hospital
Acquired/Based Infections) control INFECTION
efforts have been established in
− Disease or condition of the body that
scattered hospitals throughout the US
occurs when harmful germs get in the
− The number of hospitals with high control
body and grow in number
programs increased substantially in the
− Harmful germs to people include
1970s bacteria, fungi, viruses, and parasites
− High control programs were established
− As HC workers, there lies a huge
in virtually every US hospital by the early
responsibility to protect oneself, one’s
90s
family, and patients from danger
− All due to Dr Ignaz Semmelweis, a 19th
because:
century Hungarian doctor who was
a. Work environment encourages
known as the pioneer of handwashing
infection
• Discovered the wonders of the
b. Patients are susceptible to
now basic hygienic practice as a
diseases (pediatrics, elderly,
way to stop the spread of sickly)
infection in 1847 during an
c. Healthcare is always facing new
experiment in a Vienna hospital’s dangers
maternity ward
− The emergence of life-threatening COLONIZATION, INFECTION, AND DISEASE
infections (SARS) and re-emerging
diseases (e.g plague, TB) have − Colonization: describes microorganisms
highlighted the need for efficient present without host inference or
infection prevention and control in all interaction
healthcare settings and capacity − Infection: indicates host interaction with
building for HC workers so they can the organism
implement them • Example: patient colonized with
• A breach in infection control Staphylococcus aureus may have
practices facilitates transmission staphylococci on skin without any
of infection from patients to HC skin interruption/irritation
workers, other patients, and − Infectious disease: the infected host
attendants displays a decline in wellness caused by
• Important for all HC workers, the infection
patients, their family members,
friends and close contacts to INFECTION CONTROL AND PREVENTION
adhere to the infection control
Guidelines followed by HC settings are based
guidelines strictly
on the ff organizations:
• Responsibility of hospital
administrators to ensure − World Health Organization

MYLES, ELOISA, WELLA 1


BSN 4 | FIRST SEM | BATCH 2022 |
− Centers for Disease Control and
Prevention (publications, guidelines, and
website)
• Federal agency responsible for
monitoring endemic and
epidemic disease,
recommending strategies to
decrease disease incidence, and
developing guidelines to reduce
risk to patients and HC workers
− Occupational Safety and Health
Administration (OSHA)
− Local agencies (such as DOH)
− Hospital and facility infection control
specialists and facility policies
CHAIN OF INFECTION
− Represents how one infection is passed
on from one living being/host to another
− As long as the links of the chain are
joined together, an infection may be
passed on from one to the other
− There are 6 links involved:
1. Infectious agent (The Bug)
• Microorganisms include bacteria,
viruses, fungi, and protozoa
• Harmful germ that causes
infection
2. Reservoir (Hiding Places)
• The place where microorganisms
survive, multiply, and await
transfer to a susceptible host
• Where harmful germs live, grow,
and increase in number
• May be a person, animal, dirt,
water, or other places in the
environment
• When it is a person, reservoir areas
include blood, skin, GI tract
(mouth, stomach, intestines),
MYLES, ELOISA, WELLA
LECTURER: SIR DAÑOS
TOPIC: 4: INFECTION CONTROL & PREVENTION
respiratory tract (nose, throat,
lungs)
• As reservoirs, all humans belong in
one of three groups:
✓ Infected: have harmful
germs that are making
them sick; can infect others
✓ Not infected: people who
are well, and are not being
used as hiding places for
harmful germs
✓ Carriers: those who are
carrying harmful germs
living in their body but it
doesn't make them sick;
doesn’t show symptoms of
infection but can still infect
others
3. Portal of Exit (Way Out)
• Includes sites such as the blood,
skin, and mucous membranes,
respiratory tract, genitourinary
tract, GI tract, and transplacental
• Any way that harmful germs can
escape the reservoir where
they’ve been living
• Includes the nose and mouth
where harmful germs can live in
mucus droplets or saliva, GI tract
where germs can live in stool or
vomit, or skin as it allows harmful
germs to live through direct
contact, through blood or passed
from other liquids from inside the
body
4. Mode of Transmission (Getting Around)
• how harmful germs get around
from place to place
• #1 mode of transmission is through
the hands
• May travel through:
2
 LECTURER: SIR DAÑOS
BSN 4 | FIRST SEM | BATCH 2022 | TOPIC: 4: INFECTION CONTROL & PREVENTION
✓ direct or indirect contact ✓ Not having proper
with body fluids from the vaccinations
infected reservoir (blood, ✓ Open cuts or skin
sputum, pus, wound fluid, breakdown
saliva, urine/stool)
✓ Droplet (large particles
BREAKING THE CHAIN OF INFECTION
released when infected
person sneezes, talks,
- Rapid identification
laughs, or sings)
- Prompt treatment
✓ Airborne (droplets Infectious - Environmental sanitation
suspended in air) agent - Decontamination/
✓ Vehicles (blood, water, disinfection
food, etc) - Hand hygiene
✓ Vector (flies, mosquitos,
- Promotion of good health
fleas, ticks, etc)
- Proper hygiene
5. Portal of Entry (Getting In) - Environmental sanitation
• Any body opening on a person Reservoir
- decontamination/
who doesn’t have an infection disinfection
that allows harmful germs to get in
- Waste management
the body
• Germs can usually get in the same - Wear PPEs
way they get out (portals of entry - Proper hygiene
are the same with portals of exit) - Environmental sanitation
Portal of Exit - decontamination/
• Nose and mouth when the person
Disinfection
breathes in harmful germs, GI
tract when person consumes Waste management
contaminated food/drink, breaks
in skin that allow entry (open sores, - Hand hygiene at all times
cuts, needlestick) - Airflow control
6. Susceptible Host (Next Sick Person) Mode of - Proper food handling
• Person who does not have an Transmission - Isolation precaution
infection now, but is at risk for - decontamination/
disinfection
being the next person to get
infected from the harmful germs
• Body cannot fight off an infection - Aseptic technique
Portal of - Wound care
• Reasons for being unable to fight Entry - Hand hygiene
off infection include:
- Protective equipment
✓ Age
✓ Stress - Treatment of disease
Susceptible - Immunization vaccination
✓ Fatigue
Host - Adequate nutrition and
✓ Poor nutrition
✓ Chronic illness rest

MYLES, ELOISA, WELLA 3


BSN 4 | FIRST SEM | BATCH 2022 |
Convalescence
Additional ways of breaking the chain of
infection:
− Washing hands frequently
− Covering coughs and sneezes with tissue
− Disposing of used tissue in bin
immediately
− Practicing social distancing
− Using PPE appropriately
− Cleaning frequently touched surfaces
COURSE OF INFECTION BY STAGE
Incubation Period
− Interval between entrance of pathogen
into body and appearance of first
symptoms
− Ex: for chicken pox: 14-16 days after
exposure; common colds: 1-2 days after
exposure
Prodromal Stage
− Interval from onset of nonspecific signs
and symptoms (such as low-grade fever
or malaise) to more specific symptoms
− During this time microorganisms grow
and multiply
− Patient may be capable of spreading
disease to others
− Ex: in herpes simplex, it begins with
tingling and itching at the site before the
lesion appears
Illness Stage
− Interval when patient manifests signs and
symptoms specific to type of infection
− Ex: strep throat is manifested by sore
throat, pain and swelling; mumps is
manifested by high fever, parotid and
salivary gland swelling
MYLES, ELOISA, WELLA
LECTURER: SIR DAÑOS
TOPIC: 4: INFECTION CONTROL & PREVENTION
− Interval when acute symptoms of
infection disappear
− Length of recovery depends on severity
of infection and patients host resistance
− Recovery may take several weeks to
months
HEALTHCARE ASSOCIATED INFECTIONS (HAIs)
− Patients in HC settings (hospitals and
long-term care facilities) have an
increased risk of acquiring infections
− HAIs result from delivery of healthcare
services in a HC facility
− Occurs as a result from invasive
procedures, antibiotic administration,
presence of multi-drug resistant
organisms (MDROs), and breaks in
infection prevention and control
activities
− Number of HC employees having direct
contact with a patient, type and number
of invasive procedures, therapy
received, and length of hospitalization
influence the risk of infection
− Major sites for HAIs:
• Surgical or traumatic wounds
• Urinary and respiratory tracts
• Bloodstream
− If hospital infection control team fails to
provide the proper protocols to the HC
team, HC settings can become sources
of infection
NOSOCOMIAL INFECTION
− Result from delivery of health services in
a healthcare setting, where clients are at
increased risk
4

BSN 4 | FIRST SEM | BATCH 2022 |
− HAIs lead to increased HC costs,
extended hospital stay and prolonged
recovery time
− Most are transmitted by HC workers and
clients as a result of direct contact
− Infection that occurs more than 48-72
hours after admission and within 10 days
after discharge are considered
nosocomial
Clients in a healthcare setting are at risk for
acquiring or developing infections because of
the:
− Lower resistance to infectious
microorganisms
− Exposure to an increased number and
more types of disease-causing organisms
− Performance of invasive procedures
FACTORS INFLUENCING INFECTION PREVENTION AND
CONTROL
− Age - an infant has immature defenses
against infection and is incapable of
producing the necessary
immunoglobulins and WBCs
− Nutritional Status - directly influences
susceptibility to infection; a reduction in
the intake of proteins and other nutrients
(carbohydrates and fat) reduces the
body’s defenses against infection and
impairs wound healing
− Stress - body responds to physical or
emotional stress by the general
adaptation syndrome.
• During the alarm stage - body
metabolic rate increases as the
body uses energy stores
− Disease Process - patients with diseases
of the immune system are particularly at
risk for infection (Leukemia, HIV, etc.)
MYLES, ELOISA, WELLA
LECTURER: SIR DAÑOS
TOPIC: 4: INFECTION CONTROL & PREVENTION
ORGANISMS OF HEALTH ASSOCIATED INFETIONS
POTENTIAL
− Clostridioides difficile
• Most common cause of HAIs
− Methicillin-resistant S. aureus (MRSA)
• Healthcare-associated MRSA
• Community-associated MRSA
− Vancomycin-resistant enterococcus
(VRE)
− Multidrug-resistant organisms (MDROs)
PREVENTION OF INFECTION
HAI BLOODSTREAM INFECTIONS (CLABSI)
− Bundle approach
1. Hand hygiene
2. Maximal barrier precaution
3. Chlorhexidine skin antisepsis
4. Optimal catheter site selection
5. Daily review of line necessity with
prompt removal of unnecessary
lines
COMMUNITY-ACQUIRED INFECTIONS
− Collaborate effort of CDC, state, and
local public health departments
− Methods
1. Sanitation techniques
2. Regulated health practices
3. food preparation
4. immunization program
BURDENS OF HCAIS
− Need for hospitalization - extra days of
confinement
− Income loss
− Pain and suffering
− Disfigurement/disability
− Litigation - Malpractice
5
 LECTURER: SIR DAÑOS
BSN 4 | FIRST SEM | BATCH 2022 | TOPIC: 4: INFECTION CONTROL & PREVENTION
− Reputation − Staphylococcus aureus
− Death − Viruses (rotavirus)

SOURCES OF AGENTS OF HCAIS “All staff have a responsibility to reduce the risk
for healthcare associated infection.”
− Exogenous - hands, instruments,
catheters, respiratory instruments, “All staff have a responsibility to remind staff
transfusion, IV system, linen and air members of the need to perform hand hygiene
− Endogenous - oropharynx, respiratory, and educate patients and watchers.”
gastrointestinal and skin
“All staff have a responsibility to procure hand
hygiene products in CSR if supplies have run out
Contaminated surfaces increase cross- and need restocking.”
transmission
CDC estimates nearly 2 million patients in the US
Abstract: the risk of hand and glove get an infection in hospitals, 90 of these patients
contamination after contact die as a result of infection.

Resident Flora - normal bacteria; difficult to

remove with a single washing, and rarely causes
infection. Infection arises when there is a break
in the skin
Examples
− Coagulate negative staphylococcus
− Staphylococcus epidermidis
− Corynebacterium and Ditheroids
− Propionibacterium spp.
− Acinbobacter spp.
− Klebsiella enterobacter group
Transient Flora - skin contaminants, colonized
superficial layers of the skin, and mostly
associated with hospital-acquired infections.
Acquired through contact with objects and the
environment, and can be easily removed by
handwashing
Examples
− Gram negative bacilli (E. coli, Klebsiella &
pseudomonas)
− Salmonella spp.
MEDICAL ASEPSIS
Aseptic technique refers to the practice or
procedures that help reduce the risk for
infection.
2 types: medical and surgical
Basic medical aseptic techniques break the
chain of infection.
− Never store wet equipment; clean and
dry all equipment after use because this
can only encourage growth of
organisms if not dried properly.
− All cleaning solutions should be prepared
fresh, as this may affect the potency or
effectiveness of the solution.
General rules:
− Start from the highest point and work
towards the lowest point.
− Work from the cleanest to the dirtiest

MYLES, ELOISA, WELLA 6


BSN 4 | FIRST SEM | BATCH 2022 |
BASIC PRINCIPLES OF ENVIRONMENTAL CLEANING
− Ensure all equipment is clean and dry
before starting procedure
− All cleaning solutions should be prepared
fresh
− Plan work route and when necessary,
remove furniture and equipment
− Wear goggles, mask, and gloves when
preparing cleaning solutions when there
is likelihood of splashing, inhalation of
noxious gas or skin irritating solutions
− Always use clean hazard-warning signs
and position at the start of the task where
they are most effective, and people will
know that cleaning is in progress.
Remove, clean, and return to the
storage area when the task is
completed, and the floor is dry.
− When cleaning or using cleaning
equipment, items must be checked for
damage or wear which would impair
future use or endanger the safety of any
individual. If damaged, do not use.
Report to supervisor, label as faulty and
remove from use.
− Never mix cleaning agents, as poisonous
gases could result. Always ventilate any
area where chemicals are used.
− All equipment should be left clean, dry,
and tidy in the storage area after use.
Never store wet equipment.
WATER DISPOSAL GUIDELINES
− Waste should be collected daily or
frequently as needed
− Trash bag should be replaced
immediately of the same type
− A supply of fresh bags should be readily
available where waste is produced
− Use PPE when handling waste
MYLES, ELOISA, WELLA
LECTURER: SIR DAÑOS
TOPIC: 4: INFECTION CONTROL & PREVENTION
− Wash waste containers regularly
− Equipment used to hold waste should not
be used for any other purpose
− Never use hands to compress waste into
the containers
− Hold plastic bags at the top and keep
bags from touching or brushing against
the body
− Do proper hand hygiene after removing
gloves when handling waste
HEALTH AND SAFETY
− Check pictures, hangings and clocks are
secure
− Do not climb on furniture or overreach
− Never mix cleaning agents, as poisonous
gases could result
− Careful in manual handling when
moving furniture
− Work in small sections to prevent
overstretching
− When mopping a corridor, mop half first,
leaving a clearly identified dry area for
patients/visitors/staff to walk on
− Do not over wet the floor
− If mopping stairs, ensure area is
cordoned-off and warning signs are
displayed
− Cover electric sockets with masking tape
− Avoid splashes of disinfectant on
furniture, curtains or floor
− Report any damage of surfaces to your
supervisor
− All equipment should be left clean, dry,
and tidy in the storage area after use
DISINFECTION AND STERILIZATION
The use of both physical and chemical
processes that disrupt the internal functioning of
microorganisms by destroying cell proteins.
7
 LECTURER: SIR DAÑOS
BSN 4 | FIRST SEM | BATCH 2022 | TOPIC: 4: INFECTION CONTROL & PREVENTION
Disinfection Rule:
preoperative when using diathermy
preparation of as it can cause
1. Clean first before you disinfect
skin. diathermy burns.
(decontaminate)
2. Make sure you do rule #1

Phenolics 2% (Lysol)
GUIDELINES IN DISINFECTION

Sodium Hypochlorite 1% (Bleach) ANTIBAC Recommended Precautions

Use
Recommended Precautions
Use Only - Protective clothing
environmental should be worn while
disinfection, handling as it can be
Disinfection of - Should be used in well-
mycobacterial absorbed through the
material ventilated areas;
laboratory skin and cause
contaminated causes irritation of the
discard jars. respiratory irritation in
with blood and skin, eyes, and lungs if
higher concentrations
body fluids. used in poorly
- Must not be used in
ventilated areas.
equipment meeting skin
- Protective clothing
and mucous
required while handling
membranes or should
and using when
not be used on food
undiluted.
preparation surfaces.
- Do not mix with strong
acids to avoid release
of chlorine gas.
- Corrosive to metal. Virusolve

Recommended Precautions
Alcohol Use

Recommended Precautions For disinfection - Eye irritant, may cause

Use of hard non-reversible damage
surfaces, if not immediately
medical rinsed off. Avoid
Smooth metal - Flammable, toxic, to be
devices and prolonged contact, use
surface, table used in well-ventilated
instruments gloves and goggles.
top surfaces on area, avoid inhalation,
- Skin irritant, launder
which bleach use for small surface
contaminated clothing
cannot be used. only
before reuse.
In combination - Keep away from heat
- Use in a well-ventilated
with skin source, electrical
area.
emollients can equipment, flames and
be used for hot surfaces.
disinfection of - Allow it to dry
hands, completely, particularly

MYLES, ELOISA, WELLA 8


BSN 4 | FIRST SEM | BATCH 2022 |
CATEGORIES FOR STERILIZATION, DISINFECTION, AND
CLEANING
Items that enter the tissue or vascular
system present a high risk of infection if
they are contaminated with
CRITICAL
microorganisms. These must be sterile.
- Surgical instruments
- Cardiac or intravascular catheters
- Urinary catheters
- Implants
Items that come in contact with mucous
membranes or non-intact skin also
present risks. These items must be free
from all microorganisms except
SEMI CRITICAL
bacterial spores. Semi-critical items must
be high-level disinfected or sterilized.
- Respiratory and anesthesia
equipment
- Endoscopes
- Endotracheal tubes
- GI endoscopes
- Diaphragm fitting rings
Items that come in contact with intact
skin, but not mucous membranes must
be clean. These must be disinfected.
NON-CRITICAL
- Bedpans
- BP cuffs & stethoscopes
- Bed rails
- Linens
- Bedside trays and patient furniture
- Food utensils
STERILIZATION
This is the basic requirement of quality patient
care today.
Efficacy of Autoclaving
− Air tightness of the sterilizer
− Atmospheric pressure
MYLES, ELOISA, WELLA
LECTURER: SIR DAÑOS
TOPIC: 4: INFECTION CONTROL & PREVENTION
• Low pressure = air leak = uneven
heating (spot dry condition)
− Quality of steam: 100% saturated steam
and water in the system (Steam
separator - remove water from steam at
required velocity)
• Decreased steam quality =
trapped air = wet packs = good
bacterial growth for items
Monitoring Sterilization Process
- External indicator
- Internal indicator
- Biologic indicator
Maintenance, Handling and Inspection
- Low traffic area
- 30 minutes cooling
- Torn and wet packaging are considered
contaminated and should be
reprocessed
STORAGE AND SHELF-LIFE
Shelf-life is event-related and depends on
quality of the packaging material, storage
conditions, and the conditions during transport
and amount of handling.
− Sterility maintenance covers
− Close or cover cabinets
− Open shelving
• 2” from outside walls
• 8” to 10” from floor
• 18” from ceiling
• No bent, crunched, compressed
punctures or near location that
could become wet
− Protective environment
− Design and traffic pattern: 3-Zone
Concept
− Ventilation, filtered air, temperature and
humidity
9
 LECTURER: SIR DAÑOS
BSN 4 | FIRST SEM | BATCH 2022 | TOPIC: 4: INFECTION CONTROL & PREVENTION
• Positive pressure system Surfaces
• contaminated with
• Filter air 20 changes/hour patient specimen should be
• Temp. 18-24 degrees centigrade carefully cleaned and disinfected
• Humidity 50-55% • Sink must be scrubbed daily
• Ideally 1-degree centigrade • Walls, windows, shelves, etc.
cooler than the outer area. should be cleaned periodically
− Double gloving − Basic infection Control Personnel
− Environmental cleaning Education
− Environmental sampling
− Principles of Draping must be observed
CDC PRECAUTIONS TO PREVENT TRANSMISSION OF
in all areas
INFECTIOUS AGENTS
OPERATING ROOM/DELIVERY ROOM INFECTION
Two tiers:
PREVENTION
a. Standard precautions
Surgical Site Infection and Bundling Prevention
b. Transmission-based precautions
− Classification of Wound and Risk
Infection
• Clean < 2% Standard Precautions:
• Clean-contaminated < 10% − Which applies to all clients and patients
• Contaminated ~ 20% in all health care settings regardless of
• Dirty ~ 40% the suspected or confirmed presence of
− Bundles of Care in SSI infectious agents
• Clippers, no razors − Guidelines include:
• Prophylactic antibiotics • Consider every person as
• Normothermia potentially infectious and
• Glucose control susceptible
• Oxygen control • Handwashing as most important
procedure
NICU/NURSERY INFECTION PREVENTION • Wear gloves before touching any
wet or performing invasive
− Physical Area maintained clean procedures
− Administrative Arrangements • Use antiseptic for cleansing skin
• Staff health and mucous membranes
• Dress code • Use safe work practices
− General housekeeping − Standard precautions apply to:
• Dust should not be dispensed in • Blood
the air • All body fluids, secretions and
• Cabinets and work surfaces must excretions except sweat,
be cleaned daily regardless of whether they
• Friction cleaning contain visible blood
• Non-intact skin

MYLES, ELOISA, WELLA 10


BSN 4 | FIRST SEM | BATCH 2022 |
• Mucous membranes
STANDARD PRECAUTION: KEY COMPONENTS
− Handwashing
• After touching blood, body fluids,
excretion, and contaminated
items
• Immediately after removing
gloves
• Between patient contact
− Gloves
• For contact with blood, body
fluids, secretions,
contaminated items
• For contact with mucous
membranes and non-intact skin
− Mask, goggles, face masks
• When contact with
membranes of eyes, nose, and
mouth when contact with blood
and body fluids is likely
− Gowns
• Protect skin from blood or body
fluid contact
• Prevent soil in of clothing during
procedures that may involve
contact with blood or body fluids
− Linens
• Handle in a manner that prevents
transfer of microorganisms to
others and to the environment
LECTURER: SIR DAÑOS
TOPIC: 4: INFECTION CONTROL & PREVENTION
• Clean reusable equipment prior
to reuse
− Environmental Cleaning
• Routinely care, clean, and
disinfect equipment and
furnishings in patient care areas
• Make sure to use appropriate PPE
− Sharps
• Should be properly dispose din
punctured proof containers with
antibac 1000ppm (ward) and 500
ppm (special areas/infectious)
• Should never use hand to pick-up
and sharps
− Patient placement
• Place patients who contaminate
the environment or cannot
maintain appropriate hygiene in
of private rooms
PERSONAL PROTECTIVE EQUIPMENT
PPE GUIDELINES AND SAFE PRACTICE

• Wear gloves if visibly − PPE is used in addition to normal uniforms.

contaminated
• Placing infectious soiled linens in a
yellow cellophane
− Patient Care Equipment
• Handle soiled equipment in a
manner to prevent contact with
skin or mucous membranes and to
prevent contamination
clothing or the environment
Uniforms are not considered personal
protective equipment.
− PPE will not protect against sharp injuries,
avoidance or caution in the use of sharps
where possible.
− PPE is identified as single use and must
not be kept for reuse.
of

MYLES, ELOISA, WELLA 11


BSN 4 | FIRST SEM | BATCH 2022 |
− The need for protective equipment shall
be task related approach, not disease
specific.
− Selection of protective equipment
should be selected on the basis of an
assessment of the risks of transmissions of
microorganisms to the patient and the
risk of contamination of health care
practitioners clothing and skin by the
patient’s blood, body fluids, secretions
and excretions.
− PPE protects intact skin. Cuts, abrasions,
exposed fresh unhealed body piercings
must be covered with waterproof plaster
or other suitable dressing in addition to
PPE.
− Keep hands away from face and never
adjust PPE with contaminated gloves.
− Limit surfaces touched. Do not touch
environmental surfaces except as
necessary during patient care.
− Change gloves when torn or heavily
contaminated
− All hospital personnel shall wear
enclosed footwear, preferably resistant
to spills of hazardous substances
RULES IN WEARING GLOVES
− Gloves should be worn once and then
thrown away
− When you wear gloves, always work from
(or touch) a clean area before you
touch the contaminated area
− Change gloves if your hands are going
to move from a body part that is
contaminated, to a body part that is not
contaminated
− Change gloves to right away if they get
dirty or tear
MYLES, ELOISA, WELLA
LECTURER: SIR DAÑOS
TOPIC: 4: INFECTION CONTROL & PREVENTION
− Take gloves off carefully and do not
touch your skin or clothes with the dirty
sides of the gloves
− Do not touch anything with your dirty
gloves that anyone may touch without
gloves, like a doorknob
− The fit should be comfortable - not to
loose or not too tight
− Important: the use of gloves does not
preclude the need for hand washing
Respiratory hygiene/cough etiquette: Instruct
symptomatic persons and healthcare workers
to cover their mouths and noses when
coughing or sneezing, use and dispose of
tissues, perform hand hygiene after hands have
been in contact with the respiratory secretions,
and wear surgical mask if tolerated or maintain
spatial separation, more than three feet is
possible.
TO HELP STOP THE SPREAD OF GERMS
− Cover your mouth and nose with a tissue
when you cough or sneeze
− Put your used tissue in the waste basket
− If you don't have a tissue, cough or
sneeze into your upper sleeve or elbow,
not your hands
− You may be asked to put on a face mask
to protect others
− Wash your hands often with soap and
water for 20 seconds
ELEMENTS OF RESPIRATORY HYGIENE/COUGH
ETIQUETTE
− Healthcare personnel are advised to
observe droplet precautions and hand
hygiene when examining and caring for
12
 LECTURER: SIR DAÑOS
BSN 4 | FIRST SEM | BATCH 2022 | TOPIC: 4: INFECTION CONTROL & PREVENTION
patients with signs and symptoms of − For the droplet (green) precaution,
respiratory infection we do hand hygiene, we wear masks
− Healthcare personnel with respiratory with goggles or face shield if
infection are advised to avoid patient necessary, so that is case-to-case
contact when they are actively basis.
coughing and producing respiratory − For the airborne (blue) precaution,
secretions we wear our mask, then after, we
need to make sure that we close the
door to avoid spreading of
BLOOD AND BODY FLUID RISK ASSESSMENT
microorganisms.
A. HIGH RISK
- Blood, all body fluids
DISEASE SPECIFIC ISOLATION PRECAUTIONS
contaminated with blood,
cerebrospinal, peritoneal, a. Contact precaution
pericardial, synovial, amniotic • MRSA
fluids, breast milk, semen, vagina • VRE
secretions, and all unfixed tissues • Adenovirus
organs and parts of the body • Diarrhea
B. MINIMAL RISK • C. Difficile
- Urine, feces, saliva, sputum, tears, • Rotavirus
sweat, and vomit • E Coli 0157
• Enterovirus
• Salmonella
TRANSMISSION BASED PRECAUTION
• Shigella
a. Yellow - Contact • Hepatitis A
b. Green - Droplet • Herpes Zoster (shingles, localized)
c. Blue - Airborne • Herpes simplex, Parainfluenza
(mask if coughing)
• RSV (mask if productive cough)
• Lice
• Scabies
• Chicken pox (symptomatic, until
all lesions crusted and dried)

− For every precaution, we must first do b. Droplet precaution

the hand hygiene. • Pertussis
− For the contact precaution, after • Influenza A or B
doing the hand hygiene, we wear • MRSA (respiratory infection)
gloves and wear a gown if necessary, • Neissera meningitides (suspected
and we just do after care to all or confirmed)
equipment touched to the patient. • Coxsackle

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BSN 4 | FIRST SEM | BATCH 2022 |
• Bacterial meningitis (for 24 hours
after effective antibiotic therapy)
• RSV (droplet and contact)
• Mumps
• Rubella
LECTURER: SIR DAÑOS
TOPIC: 4: INFECTION CONTROL & PREVENTION
PRIORITY: protect self and patients from
cross contamination. Use antibac 5000
ppm and disinfectants when cleaning.
Make sure to include aircon in deep
cleaning.

c. Airborne precaution DISCHARGE OR TRANSFER TO REGULAR ROOM

• Chicken pox
− All equipment used to be disinfected
• Disseminated herpes zoster
with disinfectants, sprayed, and air-dried
• Measles
− BP cuffs - Return to nurses station for
• N95 mask:
cleaning
✓ TB
− You will be notified by NOD if patient is
✓ SARS
for transfer and discharge for timely
✓ Avian influenza
decontamination, cleaning, and
disinfection
ISOLATION PRECAUTION − Aircon maintenance should be notified
for them to facilitate aircon cleaning
Cases that require private room isolation:

− PTB CASES THAT REQUIRE REVERSE ISOLATION

− Mumps
− Rubella − Cancer patients who will undergo
− Chicken pox chemotherapy
− Measles − Preterm, neonates, newborn, or children
− Pertussis below 1 year old
− 2nd and 3rd degree burn patients
Strict isolation: − Leukemia, aplastic anemia, similarly
severe prolonged neutropenia
− Meningococcemia, tetanus, rabies, − All patients confined in ICU and NICU
AH1N1 or SARS, leprosy, active PTB

MANAGING PATIENTS ON REVERSE ISOLATION

ISOLATION ROOM OCCUPANCY
− All must wear mask before entering
− Soiled linens - Place inside a yellow − Wash hands
cellophane prior to dispensing to linen − Limit visitors
department − Close the door and never leave the door
− Body fluid spillage - Soak in paper towel open
or absorbent material and placed in − When leaving, remove PPE outside and
yellow trash can then spray with antibac discard in yellow trash
solution and air dry
− Use appropriate personal protective
equipment before going inside the room.

MYLES, ELOISA, WELLA 14

 LECTURER: SIR DAÑOS
BSN 4 | FIRST SEM | BATCH 2022 | TOPIC: 4: INFECTION CONTROL & PREVENTION
NEEDLE STICK INJURY

− Encourage bleeding under running

water
− Do not suck blood from wound
− Thoroughly wash wound with soap and
water followed by a 70% alcohol
− Do not scrub
− Dry and apply waterproof dressing
− Report incident to the supervisor on duty
and infection control nurse
− Fill out a needle stick or sharps injury
report form
− Consult with the ICC chairperson and
work out an appropriate action in
accordance to the hospital infection
control plan on needle stick injuries

HOME-BASED CARE OF INFECTIOUS DISEASE

− Reduction of risk to patients

• Care of equipment
• Patient education
− Reduction of risk to household members
• Prevention of transmission
• Education
• Fever and comfort
− Healthcare workers should follow
standard precautions in the home setting
− Patient and family education
• Establish an environment that
facilitates hand hygiene and
aseptic technique
• Family caregivers should receive
annual influenza vaccine
• Equipment care
• Common sense cleanliness
• Food preparation and personal
hygiene
• Establishment of reasonable
barriers to protect family members

MYLES, ELOISA, WELLA 15