INFECTION CONTROL OBJECTIVES... Define nosocomial infection Identify infection control programs Demonstrate aseptic hand washing Demonstrate donning gloves OBJECTIVES, cont. Describe gowning, masking & double bagging Explain technique for entering & exiting isolation areas Identify potential routes of infection Describe various isolation procedures & reasons for their use 1
What is a pathogen? Microorganism that can cause disease NOSOCOMIAL Hospital acquired infection Urinary tract is most frequent + + al INFECTION CONTROL PROGRAMS Surveillance Reporting Isolation procedures Education Management: community & health care facility acquired infections 2
CORNERSTONES OF INFECTION CONTROL Hand washing PPE Waste management CHAIN OF INFECTION Source Mode of transmission Susceptible host MODE OF TRANSMISSION Direct contact Airborne (droplets) Indirect contact Medical instruments Fomites Inanimate objects Vectors Vehicle 3
What is a fomite? FOMITE-PHOBIA BREAKING THE CHAIN OF INFECTION HANDWASHING 4
PROPER WASTE DISPOSAL Other chain-breakers Housekeeping / laundry service Isolation precautions Vector control Disposable equipment / supplies Control host susceptibility Universal Precautions Blood & certain body fluids of all individuals are considered potentially infections. Infection control turned from prevention of patient-to-patient transmission to prevention of patient-to-personnel transmission. 5
BODY SUBSTANCE ISOLATION All body substances may carry infectious agents Barrier precautions STANDARD PRECAUTIONS Combination of: universal precautions body substance isolation All blood & body fluids considered infectious regardless of diagnosis suspicion of transmissible disease Requires gloves to be worn when contacting any moist body substance Number one strategy for successful nosocomial infection control ISOLATION Precautions based on route of transmission: airborne droplet Contact direct or indirect 6
CDC Guidelines for Isolation Precautions in Hospitals First tier Standard precautions Identifies precautions to be used in caring for all hospital patients regardless of diagnosis or presumed infection status Second tier Transmission-based precautions Identifies precautions to be used for patients suspected or known to be infected with pathogens PSYCHOLOGICAL IMPACT OF ISOLATION Category-specific and disease-specific isolation systems have been replaced with transmission-based precautions 7
Airborne transmission Droplet transmission Airborne Pathogens within droplet nuclei can remain viable while suspended in the air or in dust particles for long periods TB, rubeola, varicella TB also known as AFB: acid-fast bacilli N category, 95% efficiency (N95) respirator mask required in specified patient care areas Droplet Pathogens do not travel more than 3 feet & do not remain suspended in the air Transfer of pathogen to the mucous membranes Coughing, sneezing, or talking Suctioning & throat swab collection Enteric Precautions Old category Emesis Stool Gastric contents Drainage / Secretion Precautions Old category Contact transmission Surgical wounds Skin infections Catheters IV infusion sites 8
CONTACT ISOLATION Highly transmissible infections: influenza pneumonia major skin infections with drainage antibiotic-resistant microorganisms What is protective, reverse isolation? Protects susceptible host who is immuno-compromised Transplant patients AIDS patients Chemotherapy patients Burn patients PATIENT AREAS AT HIGH RISK FOR INFECTION Nursery Burn Unit ICU Dialysis 9
ISOLATION ALERTS Read information posted outside the room Follow procedures Check with nursing personnel if unsure STOP OSHA - EXPOSURE TO BLOOD-BORNE PATHOGENS IMMEDIATE POST- EXPOSURE PROCEDURES Decontaminate skin puncture site Flush mucus membranes 10
POST-EXPOSURE MEDICAL EVALUATION Exposed worker Source, must consent to testing Counseling Treatment Follow-up How does the laboratory contribute to infection control? Maintaining surveillance records Reporting infectious agents Evaluating effectiveness of sterilization or decontamination procedures What infections are most prevalent in the laboratory setting? 11
What is a disinfectant? What is an antiseptic? 12