In your own words define: Normal flora-what is it and what does it do? Pathogen-what is it and what does it do?

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1 Bell Work: Based on yesterday s lesson In your own words define: Normal flora-what is it and what does it do? Pathogen-what is it and what does it do?

2 Chain of Infection and Isolation Precautions

3 Standard 15) Correlate the function of normal flora with homeostasis and relate deviation to disease states. Evaluate specific measures to prevent deviation that are aligned with accepted standards of care. 16) Assess the differences between healthcareassociated infections and non-healthcare associated infections using examples drawn from mock patient documents or case studies. Support explanations with relevant surveillance statistics, preventive measures, and methodologies concerning outbreak detection, management, and education.

4 Objectives By the end of class, students will be able to: Identify and review the steps in the Chain of Infection and practice the most effective way of breaking it through proper handwashing. Identify Transmission-Based Precautions by creating a graphic organizer and apply that knowledge by practicing proper PPE.

5 Draw this diagram to use as a graphic organizer: Chain of Infection

6 Chain of Infection: Causative agent Reservoir Portal of exit Mode of transmission Portal of entry Susceptible host

7 Causative Agent = Pathogen Disease-producing microorganism What are the 5 pathogens we discussed yesterday? Write these down in your diagram. Present in blood or body fluids, called bloodborne pathogens Pathogens need an environment that enables them to survive, grow, and multiply The human body is a perfect environment

8 Reservoir Human, animal, or insect that is infected with disease From our previous lesson, what is an example of an insect carrying a disease? Other reservoirs may be water, food, and contaminated objects Host may be symptomatic or asymptomatic What does asymptomatic mean? Reservoir host is contagious even though he or she may not appear ill Write down some examples in your diagram.

9 Portal of Exit Pathogen must be able to exit reservoir host Any body opening lined with mucous membranes: eyes, nose, throat, vagina, rectum, penis Injury or surgical site What is an example of a possible injury or surgical site? Blood, body fluids: vaginal secretions, semen, urine, feces

10 Mode of Transmission Direct contact person-to-person contact or skinto-skin contact Handshaking, kissing, and sexual contact Indirect contact fomites, ticks, fleas, lice, and countertops Research and share out: What is a fomite? Indirect contact includes airborne and droplet infection sneezing, coughing, and talking

11 Portal of Entry Pathogen must find entry into new host Any opening in the body lined with mucous membranes: nose, mouth, throat, vagina, penis, rectum Wounds to the skin Is the portal of entry similar to the portal of exit? Can they be same?

12 Susceptible Host Weakened immune system Poor hygiene Inadequate nutrition Stress Chronic disease Poor environmental conditions Poor environmental conditions Elderly Very young; neonatal, preemies Certain medications Smoking Alcohol abuse Why are those who smoke and drink alcohol considered susceptible hosts?

13 Chain of Infection Video and Activity Write down all the ways you see the chain of infection spread. List as many as you can!! What is the single most important way to break the chain of infection and STOP the spread of pathogens??

14 In your small group, work together and decide which links in the chain are each of the following: Yeast infection Handshake Open wound Mucous membranes Sneeze Nose Elderly lady Person with flu Mouth Pencil Table top Cold virus Infant girl Person with hepatitis Bloody nose Blood Door knob Person with AIDS Sexual intercourse Needle Used Kleenex Can any of these be more than one link in the chain?

15 Draw this graphic organizer on a new sheet of paper. Label the top left corner: Standard Write: Precautions and PPE in the center block or circle. Make sure to describe each and give examples.

16 Review of Standard Precautions Apparel: Personal Protective Equipment (PPE) Gloves Eye glasses or shields Face mask or shields Gowns Caps footies

17 Treat all patients as if potentially infectious and all surfaces as if contaminated. This applies to people you know and family members who are patients and their rooms.

18 Infectious and Communicable Diseases An infectious disease results from an invasion of microorganisms. A communicable disease is a type of infectious disease that can be transmitted from one person to another person. Not all infectious diseases are communicable - cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. What might be another example?

19 Classification of Infections and Diseases Endogenous begins inside the body Exogenous caused by something outside the body Nosocomial acquired by an individual within a health care facility AKA healthcare-associated infection (we will go over these in further detail later) Opportunistic occur when the body s defenses are weak Name an example of someone who has a weakened immune system.

20 Communicable Diseases Some communicable diseases are spread through direct contact. Others may be spread through indirect contact.

21 Transmission of Communicable Diseases Not all communicable diseases are transmitted the same way. There are many different types of communicable diseases, and health care workers must become familiar with the mode of transmission for each disease. We specifically want to address how to prevent nosocomial infections from spreading through specific addendums to normal standard precautions.

22 Transmission-Based Precautions Transmission-based precautions are used only with patients who have been diagnosed with highly communicable diseases. Three types: Airborne Droplet Contact

23 Transmission-Based Precautions:

24 Airborne Precautions Airborne precautions are used for patients with disease that are spread through tiny airborne droplets. Precautions: Isolation room Respiratory protection (N95 mask, also called TB mask) Negative pressure Examples of diseases: Tuberculosis Chicken pox Shingles Measles Which do we have a vaccine for?

25 Droplet Precautions Droplet precautions are used for patients with diseases that are spread through large airborne droplets. Precautions: Isolation room Standard surgical masks Examples of diseases: Pneumonia Influenza Whooping cough Mumps Do we have vaccines for any of these?

26 Contact Precautions Contact precautions are used for patients with diseases that are spread through direct and indirect contact. Precautions: Isolation room Gowns and gloves Equipment precautions Examples of diseases: MRSA, VRE, antibiotic resistant Wound infections Diarhhea related Skin related: lice, scabies What type of pathogen are lice?

27 Transmission-Based Garments When health care workers enter isolation rooms, they must wear transmission-based garments. Health care workers must wear appropriate garments based on the disease of the patient. Proper PPE! Usually, there is a combination of precautions taken depending on what you will be doing to or with the patient.

28 Isolation Units Patients with communicable diseases are often placed into private rooms for isolation. This practice helps prevent the spread of communicable diseases to health care workers and other patients.

29 Meals in an Isolation Unit Most facilities require that disposable food trays and eating utensils are used in isolation units. Leftover food and beverages should never be taken out of an isolation unit. Liquids and soft foods should be flushed down the toilet. Solid foods should be placed in biohazardous waste bags.

30 Working in an Isolation Unit Most of the procedures that take place in isolation units require two health care workers. Items that are taken from isolation rooms are doublebagged to prevent the spread of dangerous pathogens.

31 Activity with a partner: Review the handwashing rubric. We will use glo-germ to imitate pathogens on our hands and practice proper handwashing. You will first practice with a partner and simulate the steps from the rubric, speaking out loud to each what you are doing. After you practice, evaluate each other again without using your rubric. Once you and your partner are done, come to the sink and perform proper hand-washing with the glo-germ /03/Chain-of-Infection-Fact-Sheet.pdf You may refer to this fact sheet to review the various links of the chain of infection.

32 Exit Ticket 1. Who would be a susceptible host? 2. What is an example of a reservoir? 3. When would a patient need to be placed in Airborne Isolation? 4. What is the single most important way to prevent the spread of disease and infection?

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