CRITERION MEDICINE COMMUNITY AND PUBLIC HEALTH

Concern Individual Community

Focus Treating Disease Preventing disease and promoting good health
Responsibility Patient is freed of responsibility Community members participate in finding solution
Basic sciences Anatomy, physiology, Biostatistics, epidemiology, behavioral science, managerial
biochemistry, pathology, sciences and environmental health
pharmacology, and
microbiology
Priority Helping one patient, no matter Dealing with conditions that will benefit a large number of
how expensive it may be individuals in the community
Cost High: Medical bill and expenses Low: per capita cost is much less
Technology Sophisticated Local and simple
Commercialization More Less

 Public Health
- “the art and the science of preventing disease, prolonging life and promoting health through organized efforts of the
society.” -Acheson
-concerned with all aspects of health and well- being. Many activities such as health programs, are aimed at specific
demographics

 Community
-A group of individuals who share common interests and characteristics
-Living in the same geographical area and have a common cultural and historical heritage.
-Bound to each other by social, religious, ethnic, occupational, or other characteristics that they have in common.
-Usually follow some shared rules.
-Units that accomplish basic needs for sustenance, social interaction, and symbolic collective identity

 Health- state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

Chain of Infection
-The chain of infection requires a continuous link between six components. You have to understand the chain of infection
and ways to disrupt this chain to protect your patients.

1. Infectious Agent Infectious agents

-consist of bacteria, fungi, parasites, and viruses.
-Breaking the Chain: Early detection and treatment of infectious agents

2.
Reservoir
- must be a place where the infectious agent can live and possibly multiply.
-Humans and animals make ideal reservoirs.
- Equipment and other soiled objects often called fomites will serve as reservoirs particularly if they contain
blood or other body fluids.
- Some microorganisms form spores or become inactive when conditions are not ideal such as in dried blood
-They wait patiently until a suitable reservoir is available.
Breaking the Chain: Disinfecting the work area kills the infectious agent and eliminates the reservoir

3. Portal of Exit
-The infectious agent must have a way to exit the reservoir to continue the chain of infection.
-When the reservoir is a human or an animal this can be through the nose, mouth, and mucous membranes and
in blood or other body fluids.
-Phlebotomists provide a portal of exit when they collect blood.
4. Means of Transmission
-Once the infectious agent has left the reservoir it must have a way to reach a susceptible host.
-For phlebotomists the means of transmission can be an accidental needle stick.
Means of transmission include:
o Direct contact: unprotected host touches or is touched by the reservoir
o Droplet: the host inhales material from the reservoir such as aerosol droplets from an infected person
o Airborne: inhalation of dried aerosol nuclei circulating on air currents or attached to dust particles
o Vehicle: ingestion of contaminated food or water
o Vector: parasites such as malaria transmitted by a mosquito bite

5. Portal of Entry
- After the infectious agent has been transmitted to a new reservoir it must have a means to enter the reservoir.
- The portal of entry can be the same as the portal of exit.
- This includes the nose, mouth, mucous membranes, and opens wounds.
- Medical and surgical procedures provide a very convenient portal of entry for infectious agents.

6. Susceptible Host
- This can be another patient or the health-care provider.
-Patients are ideal susceptible hosts because their immune systems that normally provide defense against
infection are already involved with the patient’s illness.
- Patients receiving chemotherapy and immunocompromised patients are very susceptible hosts.
- The immune system is still developing in newborns and infants and begins to weaken as people age, making
these groups of patients more susceptible to infection.
-The immune system also is depressed by stress, fatigue, and lack of proper nutrition. These factors contribute to
the susceptibility of the health-care provider.