Chapter 12 Preventing Infection Infection is a major safety and health hazard. Minor infections cause acute illnesses and some infections are serious and can cause death. Microbe/microorganism is a small living plant or animal that can be seen only with a microscope. Pathogen: microbes that are harmful and can cause infection and disease Nonpathogen: microbes that usually do not cause infection or disease. 1. What is an infection: is a disease resulting from the invasion and growth of microbes in the body. A. Type of microbes that can cause infections: Virus: Bacteria: living organisms, that multiplies fast Fungus (yeast): living animal, grows on other living animals Rickettsia: Parasite (protozoa): one cell animals. Can infect the blood, brain, intestines and other body areas (tape worms) B. Requirements for Microbes to live and grow: -host (reservoir) - - -warmth -food C. How infection is spread: chain of infection 1.Source - pathogen 2. -- (human/animal) where the microbe grows and multiplies. Great host: low immune system, tired, stress, poor nutrition, young/old 3. - how pathogen leaves the host - mouth, nose, urine or feces, cut 4.Method of transmission - from host to a new host by a method of food, objects such as a cup, used tissue and soiled hands.( Airborne, droplet, contact) 5.Portal of entry - entrance to the new host/reservoir through an opening such as the mouth, cut, nose and eyes. 6. : new host- starts the chain/cycle again D. Signs and Symptoms (S&S) of infection: pg 202 box 12-1 fever, increase pulse, increase respirations, pain, redness, warm to touch, drainage, malaise Local infection: Systemic infection: involved the whole body E. Prevention of Infection: things you can do to prevent Hand washing Cleaning equipment Proper disposable of equipment Using PPE (personal protective equipment) Breaking the infection chain/cycle
F. Natural Body s defenses against infection: 1. External: intact mucous membranes 2. Internal: digestive juices antibodies 2. Terms: Virus: microorganism smaller than a bacteria, which cannot grow or reproduce apart from a living cell. Virus can not be treated with antibiotics Normal flora: microbes that usually live and grow in certain areas of the body, but when moved, becomes a pathogen. * E.coli- lives in the Large intestine Nosocomial Infection: infection acquired during a stay in a health care setting. *Best way to prevent is by HAND WASHING. Drug resistant Organisms (bacteria): A. MRSA (Methicillin-Resistant Staphylococcus Aurea): bacteria. Found in or on the nose and skin. It can cause pneumonia, wound infections. B. VRE (Vancomycin-resistant Entercoccus): bacteria. Found in intestines and present in feces. Can be transmitted to the urinary tract and cause UTI *antibiotics resistant------it is hard to kill them. Best way to prevent spreading is by washing hands! C. C-diff (Clostridium difficile) bacterial illness that causes diarrhea and can cause colitis. C. Diff is very difficult to kill. Handwashing will not kill the spores, but will wash them down the drain. Hand rubs may increase the risk of C. Difficile transmission because many feel a hand rub is all that is needed, but hand rubs do not kill C. Diff spores. Proper hand washing is essential. 3. Asepsis: being free of disease-producing microbes/germs. Microbes are everywhere A. Aseptic practices: Measure of thing that we do to help reduce or destroy microbes focus on home care Box Pg 204 -washing hands -take out -wash cooking/eating utensils with hot water and soap -cover nose/mouth when coughing -good personal hygiene -wash fruit/vegetables -boil objects for at least (sterile technique) B. Clean- basic cleanliness C. Medical asepsis (clean technique): the practice or process to remove or destroy pathogens Disinfection: used on objects Disinfect supplies/equipment: -soap & hot water: utensils -detergent: laundry -vinegar: 1 part vinegar to 3 part water. Only good for 24 hours -bleach: 1 part bleach to 10 parts water. Only good for 24 hours
-Lysol -ammonia Germicides: disinfectants apply. destroying pathogens -Alcohol -Iodine/betadine -Hydrogen peroxide D. Sterile technique (Surgical asepsis): the practice that keep items free of all microbes (pathogens/ non-pathogens/spores). Sterilization: destroys all pathogens and non-pathogens including spores. -boiling hot water for 15 minutes -autoclave: high pressurized heat -radiation -chemicals: acid -excessive heat Sterile field: is a working area free from all pathogens/non-pathogens/spores Guidelines to follow when assisting a nurse with sterile field Box 12-8 (principles for sterile technique) Pg 227 CNA s never by yourself. You can only assist a nurse 4. Terms: Contamination: process of becoming unclean. Cross-contamination: is the moving of pathogens from one area to another. Reverse Isolation: devices that protect others from your infection When you clean items you must clean CLEANEST TO & IMMEDIATELY 5. PRECAUTIONS: A. Universal Precautions/ Standard Precautions: is a process you used for all people to protect yourself! (because every person has body fluids) a. Every time you come in contact or could come in contact with: blood, all body fluids, secretions or excretions, non intact skin, and mucous membranes *secretions: comes from glands/duct: tears, saliva *excretions: urine/feces *non-intact skin: open wound *mucous membranes: drainage from nose, sputum, ears, vagina, eyes b. Practices for Standard precautions: pg 211 box 12-4 - : before/after tasks -gloves: change gloves between tasks -Personal Protective Equipment (PPE): gloves, mask, gown, eye protection, etc. - as needed. Hold bag away from you. -follow exposure control plans
B Transmission Based Precautions:. When a person is diagnosed or suspected of a highly contagious infection. Three ways the infection is passed from one person to another. Page 212 BOX 12-5 1. 2. 3. Contact Precautions 1. Airborne Precautions: Transmitted through the air. When a person coughs/sneezes, the microbes leave the body through particles of saliva or sputum. They spray through the air, they dry out and remain in the air for a long time (much like particles of dust caught in a shaft of sunlight). Like dust in the air we breathe and on the surfaces we touch. -measles -chickenpox -tuberculosis (TB) Practice: standard precautions, private room, wear respiratory mask (TB respirator). 2. Droplet Precautions: Transmitted by direct exposure to droplets released from mouth/nose like talking, coughing, and sneezing. Necessary to wear a mask within 3 feet of the infected person. -meningitis -pneumonia -pertussis (whooping cough) -influenza -mumps -rubella -scarlet fever Standard Practice: standard precautions, private room, wear mask if working 3 ft from person.
3. Contact Precautions: Direct contact: touching the person. Indirect contact: touching surfaces or items. -MRSA (Methicillin-Resistant Staphylococcus Aurea): bacteria. -VRE (Vancomycin-resistant Entercoccus): bacteria. -C-diff (Clostridium difficile) bacterial -RSV (Respiratory syncytial virus) a virus that causes infections of the lungs and respiratory tract. Babies or under 2 years syncytial (sin-sish-ul) Standard Practice: standard precautions, wear gown & gloves on entering room. Gloves must be change after having contact with infected area. Wash hand C. Isolation Precaution: Rules for isolation precautions Pg 213 box 12-6 To contain or a barrier needed to prevent escape of pathogens. - - - - Reverse isolation: worker wears PPE to protect the patient from you (illness). All PPE needs to be on before entering the room and removed before leaving the room. 6. Bloodborne Pathogens Standard: When you can come into contact with blood you practice (bloodborne Pathogens Standards) viruses exit the body through blood and are transmitted to others by blood. OSHA has set up guidelines that must be followed in every facility to protect the work from HBV and HIV. Pg box 12-7 -staff at risk for exposure must receive information and training. -employer must have a written exposure control plan -never store food, where blood is stored. -never recap a used needle, discard in sharps container -always use gloves and then wash hands 7. Bio-hazardous waste: is items contaminated with person s blood, body fluids, secretions, excretions and dangerous substance. Pg 220 Material Safety Data Sheet on all hazardous waste Bagging items pg 220 Collecting specimens pg 220 Transporting person pg 222 Double bag when outside of the bag is soiled.
8. Personal and environmental Measures: Personal Measures -keep current on personal vaccination and immunizations (flu shot, HBV, measles, mumps) -eat well and get enough sleep -Use PPE equipment -personal hygiene -regular health screening (TB) Environmental Measures: -proper use and cleaning of equipment -follow principles of cross contamination -use appropriate bio-hazard disposal techniques 9. OSHA: Federal agency that regulates worker safety OSHA guidelines relate to health care Exposure control plan PPE Equipment safety Waste Housekeeping Laundry 10. The Center of Disease Control (CDC) a government agency under the Department of Health and Human Services (HHS) that issues information to protect the health of individuals and communities. CDC investigates and researches microorganisms and develops infection control guideline that are then regulated by OSHA.