INFECTION CONTROL RSPT 1410 SPREAD OF INFECTION Requires 3 elements for infection to spread: 1. of pathogen 2. Susceptible 3. of transmission 2 SOURCE Primary source in hospital : patients, personnel, visitors : equipment, linens, meds Patients can be their own source called infection 3 1
HOST Colonization mere of microorganisms infection results when organisms cause cell or tissue damage whether infection occurs depends on: host s resistance (varies greatly) organism s 4 HOST Nosocomial infection acquired in endogenous or external Iatrogenic induced by doctor, therapist, nurse caused by treatment or diagnostic procedure 5 TRANSMISSION 5 major routes of transmission Contact transmission Droplet transmission Vehicle transmission Airborne transmission Vectorborne transmission 6 2
CONTACT TRANSMISSION Most frequent route for nosocomial infection Direct body surface-to-body surface sex, hands Indirect contaminated object è fomite - contaminated object 7 DROPLET TRANSMISSION Discharge of large contaminated liquid droplets into the air cough, sneeze, talking travel up to feet contact mucous membranes, conjunctiva 8 VEHICLE TRANSMISSION Host exposure to contaminated food or water Salmonella Hepatitis A Shigellosis Cholera 9 3
AIRBORNE TRANSMISSION Spread by contaminated: dust particles ( ) fungal infections droplet nuclei residue of evaporated very small, can stay suspended for a long time TB, measles 10 VECTORBORNE TRANSMISSION Occurs when an animal, insect transfers an infectious agent from 1 host to another flea mosquito tick mice 11 SPREAD OF INFECTION TO LUNGS Aspiration oropharyngeal, gastric Inhalation droplet, dust Blood ( ) 12 4
INTERRUPTING ROUTES OF TRANSMISSION Equipment processing Equipment handling Barrier methods & isolation precautions actually placing barriers between source and host 13 HANDWASHING Single best method to prevent spread of infection!! Wash after every patient contact 14 GLOVES 3 reasons to wear protect caregiver from contamination when contacting patient protect patient from colonized caregiver during invasive procedures reduce risk of cross-contamination 15 5
GLOVES for invasive procedures, for noninvasive procedures change between patient contact & after direct contact with patient s blood, body fluids, secretions, excretions, non-intact skin after removing gloves 16 MASKS, GOGGLES, FACE SHIELDS Barrier protection for eyes, nose, mouth Worn during any procedure that can generate or of: blood body fluids secretions excretions 17 MASKS, GOGGLES, FACE SHIELDS Mask whenever contacting infected patients who are, Surgical masks for large droplets High-efficiency particulate filter masks for droplet nuclei 18 6
GOWNS, APRONS, SHOE COVERS Splash protection 19 PATIENT PLACEMENT precautions Private rooms for serious infection Appropriate ventilation systems - negative vs. positive Cohorting 20 PATIENT PLACEMENT Transporting limited, if possible mask, gown, etc. on patient Equipment double-bagged needles - Sharps containers, not 21 7
ISOLATION PRECAUTIONS - 1 ST LEVEL Standard (Universal) apply to blood, body fluids, secretions, excretions, mucous membranes, non-intact skin ê general risk of infection from both recognized & unrecognized sources handwashing, gloves, eye protection 22 ISOLATION PRECAUTIONS - 2 ND LEVEL Transmission-Based use with documented or suspected severe, contagious infections use in addition to precautions 3 types: 23 1- AIRBORNE PRECAUTIONS ê droplet nuclei & dust particle transmission Special air handling & ventilation Universal precautions, ventilated room, door closed Legionellosis, varicella, measles TB requires special mask 24 8
2- DROPLET PRECAUTIONS ê droplet transmission Hemophilus influenza, Strep pneumonia, epigottitis, Diphtheria, Pertussis, mumps, rubella Universal precautions, private room, door can be open, no special ventilation 25 3- CONTACT PRECAUTION ê risk of transmission by direct or indirect contact Hepatitis, VD, AIDS, Staph infection, enteric infection Universal precautions, private room, gown, no special ventilation 26 27 9