C Dec/Jan
• Ravina
A/B (November)
•
•
•
•
•
•
•
•
Srujal
Nicole
Prachi
Celina
Katie
Jaxmaureen
Taylor M
Shinera
• Sergio
• Alexa
• Nick
•
•
•
•
•
•
•
•
Sagar
Allison
Dana
Sabrina
Rishi
Jessica
Pierce
James
• Christian
• Michal
• Kristen
•
•
•
•
Avani
Juhi
Masaumi
Eduardo
D Jan/Feb
•
•
•
•
•
•
•
Edward
Dan
Danielle
Taylor L
Erin
Jessica
Neil
• Hubert
• Bailey
• Rachel
Tentative CNA clinical Groups
Preventing Infection
Unit 5
• Infection control involves preventing &
controlling the spread of disease in a
healthcare facility.
• All care team members must work to
prevent the spread of disease.
• All facilities have infection control
policies.
Infection control
• Microorganisms (also
called microbes) are tiny
living things that can only
be viewed through a
microscope.
• Pathogens are harmful
organisms that invade the
body & multiply.
• Pathogens cause infections.
Microorganisms
• Systemic infections
• Infection in the bloodstream  spread throughout
body.
• Generalized symptoms: fever, chills, confusion.
• Localized infections
• Located in specific part of body.
• Causes symptoms at site of infection.
• Healthcare-associated infections (HAIs) are
acquired in healthcare settings, as a result of Tx for
other conditions. (AKA: nosocomial infections.)
Infections
• Medical asepsis – process of removing all
pathogens.
• “Clean” – not contaminated with
pathogens
• “Dirty” – contaminated with pathogens
• Surgical asepsis – process of removing all
micoorganisms, not just pathogens.
• Also called “sterile technique”
2 kinds of asepsis
1. ____Measures practiced in agencies
to prevent & control the spread of
infection.
2. ____A harmful microbe.
3. ____Infections that are the result of
treatment for other conditions.
4. ____Tiny living things that cannot be
seen s a microscope.
5. ____Occurs when pathogens invade
the body & multiply.
6. ____Infection that is confined to a
specific part of the body.
Matching
A. Healthcareassociated
infection
B. Infection
C. Infection control
D. Localized
infection
E. Microorganism or
microbe
F. Pathogen
7. ____The state of being free of all
microbes, not just pathogens.
8. ____The process of removing
pathogens, or the state of being free
of pathogens.
9. ____When pathogens are in the
bloodstream & spread throughout the
body.
10. ____In healthcare, objects that have
not been contaminated with
pathogens.
11. ____In healthcare, objects that have
been contaminated with pathogens.
Matching
A. Clean
B. Dirty
C. Medical asepsis
D. Surgical asepsis
E. Systemic
infection
Causative agent
Susceptible host
Reservoir
Portal of entry
Portal of exit
Mode of
transmission
Chain of infection is a way of describing
how disease is transmitted from one living
being to another.
Chain of infection
Causative agent
Susceptible host
Reservoir
Portal of entry
Portal of exit
Mode of
transmission
Causative agent (pathogen): can be bacteria,
fungi, viruses, or protozoa. May be normal flora
in one part of body, pathogenic in another.
Chain of infection
Causative agent
Susceptible host
Reservoir
Portal of entry
Portal of exit
Mode of
transmission
Reservoir is the place where the pathogen
lives & grows (usually warm, dark, moist
place).
Chain of infection
Causative agent
Susceptible host
Reservoir
Portal of entry
Portal of exit
Mode of
transmission
Portal of exit is any opening in the body
that allows pathogens to leave (mouth, eyes,
wound in skin).
Chain of infection
Causative agent
Susceptible host
Reservoir
Portal of entry
Portal of exit
Mode of
transmission
Mode of transmission describes how the
pathogen travels from one person to next person
(can be by direct contact or indirect contact).
Chain of infection
Causative agent
Susceptible host
Reservoir
Portal of entry
Portal of exit
Mode of
transmission
Portal of entry is any body opening that
allows a pathogen to enter (mouth, eyes,
nose, mucous membrane, or break in skin).
Chain of infection
Causative agent
Susceptible host
Reservoir
Portal of entry
Portal of exit
Mode of
transmission
Susceptible host is any uninfected person
who could get sick.
Chain of infection
Causative agent
Susceptible host
Reservoir
Portal of entry
Portal of exit
Mode of
transmission
Infection prevention practices &
vaccinations break links in the chain of
infection to stop the transmission of
infection.
Chain of infection
1. ____opening on an infected person
that lets pathogens leave.
2. ____opening on uninfected person
that lets pathogens enter.
3. ____pathogen, microbe that causes
disease.
4. ____place were pathogen lives &
grows.
5. ____uninfected person who could
get sick.
6. ____how pathogens travel from one
person to another.
Matching
A. Causative agent
B. Reservoir
C. Portal of exit
D. Mode of
transmission
E. Portal of entry
F. Susceptible host
Elderly are at high risk for
infection.
•
•
•
•
•
Immune systems are weaker.
Chronic illnesses
Decreased circulation
Slow wound healing
Malnutrition due to
difficulties chewing &/or
swallowing,  appetite &
thirst, weakness, medications
• Limited mobility
• Frequent hospitalizations.
Risk of infection
Infection is more dangerous
for the elderly.
• Simple illnesses can turn
life-threatening
• Recovery takes longer.
• Prevention is the key.
Risk of infection
S & S of local infection.
• Fever
• Body aches
• Pus
• Drainage
• Swelling
• Heat
Signs & symptoms of infection
S & S of systemic infection.
•
•
•
•
•
•
•
•
•
Pain
Body aches
Chills
Nausea
Vomiting
Weakness
Headache
Confusion
 blood pressure
Signs & symptoms of infection
1. ____ The elderly have a higher risk for
infection than younger people.
2. _____It is normal for a person’s immune
system to grow weaker as he or she ages.
3. _____ Blood circulation increases as a person
ages.
4. ____ Limited mobility increases the risk of
pressure sores as a person ages.
5. _____Nutrition & fluid intake play no part in
helping prevent infection.
True or false
6. ____ The elderly are less likely than younger
people to have HAIs.
7. _____Infections are less dangerous in the
elderly than in young people.
8. _____ CNAs play an important role in
protecting elderly residents from infections.
9. ____ Redness & swelling are common
symptoms of systemic infections.
10._____Fever, chills, & confusion are symptoms
of systemic infection.
True or false
• The CDC (Centers for Disease Control &
Prevention) is a government agency that
promotes public health of Americans.
• Recommended new infection control
system in 1996 to reduce risk of infectious
disease in health care settings.
• 2 tiers of precautions
• Standard precautions
• Transmissions-based (isolation) precautions
Infection control precautions
• Standard precautions means to treat all blood, body
fluids, & non-intact skin & mucous membranes as if
they were infected with an infectious disease.
• For standard precautions, “body fluids” include saliva,
sputum (coughed up mucous), urine, feces, semen,
vaginal secretions, pus or wound drainage. They do
NOT include sweat.
• Remember standard precautions should ALWAYS be
practiced with everyone.
• Transmission based precautions are based on how an
infection is transmitted & are used in addition to
standard precautions.
Standard precautions
• Always practice standard precautions c every
person in your care.
• Wash hands a & p gloving.
• Do not touch clean objects while wearing gloves.
• Wear gloves q time you may come into contact
with blood or body fluids
• Includes mouth care, toileting, cleaning up spills
or containers that have held body fluids.
Standard precautions
• Remove gloves immediately when finished c
procedure
• Immediately wash all skin surfaces that have
been contaminated c blood or body fluids
• Wear gloves & use caution when handling
sharps (needles, blades, anything that can cut or
pierce skin). Discard these objects in a
puncture-resistant biohazard container.
Standard precautions
• Never cap a needle or syringe. Dispose of them
in a biohazardous waste container.
• Avoid nicks & cuts when shaving residents.
• Carefully bag all contaminated supplies &
dispose of them according to facility policy.
• Clearly label body fluids that are saved for a lab
specimen. Keep them in a container with a lid &
transport them in a biohazard specimen bag.
• Dispose of contaminated liquid waste in sewer
system. Avoid splashing.
Standard precautions
1. ____ Standard precautions means treating
all blood, body fluids, non-intact skin, &
mucous membranes as if they were infected.
2. _____Standard precautions relate to all
body fluids except saliva.
3. _____ You can usually tell if someone is
infectious by looking at him.
4. _____ The CDC is a government agency
that issues information to protect the health
of individuals & communities.
True or false
5. ____You should wash your hands before
putting on gloves.
6. _____Syringes should be re-capped p use.
7. _____Giving mouth care will require you to
wear gloves.
8. _____It is a good idea to wear a mask &
goggles to empty a bedpan.
9. _____When cleaning a urinal, you don’t
need to wear gloves.
True or false
10. Standard precautions should be practiced
A. Only on people who look like they have a
bloodborne disease.
B. On every single person in your care.
C. Only on people who request that you follow
them.
D. Only people who have tuberculosis.
Multiple choice
11. Standard precautions include the following
measures
A. Using your used or soiled gloves to gather clean
equipment.
B. Wearing gloves if there is a possibility of
contact with blood, body fluids, mucous
membranes, or broken skin.
C. Touching body fluids with your bare hands.
D. Putting caps on used needles.
Multiple choice
12. Which of the following is true of transmissionbased, or isolation precautions?
A. You do not need to practice standard precautions if
you practice transmission-based precautions.
B. They are exactly the same as standard precautions.
C. They are practiced in addition to standard
precautions.
D. They are never practiced at the same time that
standard precautions are used.
Multiple choice
• CDC definition of hand hygiene includes both:
• handwashing with either plain or antimicrobial
soap & water
• using alcohol-based hand rubs (gel, rinse, or
foam).
• Alcohol-based hand rubs are not a substitute for
handwashing.
• Always use soap & water for visibly soiled
hands.
Hand hygiene
• Consider removing rings while working. They may
increase the risk of contamination.
• Keep fingernails short, smooth, & clean.
• Artificial nails harbor bacteria & risk
contamination.
• Always wash hands a & p handling food.
• A & p applying makeup.
• P contact c pets or pet care items.
• A you start work & a you leave.
Hand hygiene
1. You will come in contact c microbes
A.
B.
C.
D.
Only in public areas of the facility.
Only during direct contact c residents.
Only during personal care procedures.
Q time you touch something.
Multiple choice
1. You will come in contact c microbes
A.
B.
C.
D.
Only in public areas of the facility.
Only during direct contact with residents.
Only during person care procedures.
Every time you touch something.
2. Why is it a bad idea to wear artificial nails to work?
A.
B.
C.
D.
Residents may not like them.
They may be lost.
They harbor bacteria.
They may be damaged by frequent handwashing.
Multiple choice
3. Alcohol-based hand rubs are used
A.
B.
C.
D.
With water for maximum effectiveness.
When agency runs out of antimicrobial soap.
To prevent dry, cracked skin.
In addition to washing c soap & water.
4. The CDC defines hand hygiene as
A. Handwashing c soap & water & using alcohol-based
hand rubs.
B. Using only alcohol-based hand rubs.
C. Rinsing ands c water.
D. Not washing hands more often than once per day.
Multiple choice
• Protects employees from contact with
workplace hazards.
• It is the employers responsibility to
provide appropriate PPE to wear
• Includes gloves, gowns, masks, face
shields, & goggles.
Personal protective
equipment (PPE)
• GLOVES
• Any time you will be in contact with blood or
body fluids
• Oral care & shaving
• Personal care on non-intact skin
• Disposing of soiled bed linens or clothing
• Any time you have open sores or cuts on your
hands (1st cover area c bandage or gauze)
• Use them only once & discard.
Personal protective
equipment (PPE)
• Gowns
•
•
•
•
Protect clothing & exposed skin
Should fully cover torso
Should fit snugly at wrists
Remove it if wet or soiled, check clothing
& put on a clean gown
Personal protective
equipment (PPE)
• Masks & goggles
• Masks are worn c residents who have respiratory
illnesses (TB requires special masks)
• Must fit snugly over nose & mouth to prevent
fluid penetration
• Goggles protect eyes. Glasses are inadequate.
• Should fit snugly over & around eyes or glasses
Personal protective
equipment (PPE)
• Face Shields
•
•
•
•
Substitutes for a mask & goggles
Should cover forehead & extend below chin
Wraps around sides of face
Always follow company policy
Personal protective
equipment (PPE)
• Utility rooms
• There are separate utility rooms for “clean” &
“dirty” supplies.
• Always wash hands a entering the clean utility
room & a leaving the dirty utility room.
Handling equipment & linen
• Cleaning equipment
• General cleaning removes microbes, but doesn’t
kill them. This is adequate for supplies that only
touch intact skin (BP cuff)
• Sterilization destroys ALL microbes using steam
under pressure, chemicals, or dry heat. Used for
items that come in contact c normally sterile areas.
• Disinfection kills all pathogens, but not all
microbes, using chemicals or pasteurization.
Handling equipment & linen
• Handling equipment & cleaning
•
•
•
•
•
Always avoid contact c portals of entry/exit
Avoid contaminating your clothing
Don’t transfer disease between residents
Dispose of disposable equipment after use
Don’t reuse equipment shared between residents
until it has been cleaned
• Clean all environmental surfaces, freq touched
surfaces, beds, rails, & freq touched surfaces
Handling equipment & linen
• Handling linen
• Handled soiled linens & clothing to avoid
contact with skin & mucous membranes
• Hold linen away from uniform
• Don’t shake linens of clothes
• Roll dirty linens so soiled area is on inside
• Bag soiled linen at point of origin
• Sort soiled linen away from patient care areas.
• Place wet linen in leak-proof bags
Handling equipment & linen
• Always wear gloves
• Absorb spill according to policy
• Scoop up absorbed spill & dispose according
to policy
• Apply disinfectant & wait 10 minutes
• Use proper cleaning solution
• Do not pick up pieces of broken glass. Use
dustpan & broom or other tools.
• Use biohazard containers according to policy.
Handling spills
1. ____ A measure that
destroys all microbes,
including pathogens.
2. ____ A process that kills
pathogens, but not all
microbes.
3. ____ Only to be used once
& then discarded.
Matching
A. Disinfection
B. Disposable
C. Sterilization
4. ____You do not need to wear gloves to clean up a
small spill.
5. ____Place a disinfectant directly on the spilled
fluid a absorbing & removing the fluid
6. ____It’s okay to use your hands to pick up large
pieces of glass & use a broom & dustpan for
smaller pieces.
7. ____Waste containing body fluids may be
disposed of in the trash can in the cafeteria.
8. ____An absorbing powder may be used to absorb a
spill before removing it.
True of false
• CDC has established 2nd level of precautions
(beyond standard precautions )for persons
who are infected or suspected of being
infected.
• Transmission-based precautions will always
be listed on the care plan & assignment sheet.
Transmission-based
(isolation) precautions
• 3 categories of transmission-based precautions
• Airborne precautions
• Droplet precautions
• Contact precautions
• Category depends on the disease & how it spreads
• May be used in combination for diseases c
multiple routes of transmission
Transmission-based
(isolation) precautions
• Multidrug resistant organisms (MDROs) may
require additional isolation procedures
•
•
•
•
•
•
MRSA –methacillin-resistant staph aureus
VRE – vancomycin-resistant enterococcus
C-diff – clostridium difficile
Scabies
Lice
Influenza (during outbreak)
Transmission-based
(isolation) precautions
• Used for diseases transmitted through
expelled air
• Pathogens are so small they remain floating
for a long time
• May require you to wear a special mask (N95 or HEPA mask) to avoid infection
• Includes: tuberculosis, measles, chickenpox
Airborne precautions
• Used for diseases transmitted by coughing,
sneezing, talking, laughing, or suctioning
• Pathogens don’t stay suspended in air, usually
don’t travel more than 3 feet
• Require face mask during care & restricted
visits from uninfected people
• Infected residents must wear masks when out
of their room
• Includes: mumps, influenza, scarlet fever
Droplet precautions
• Used when there is a risk of transmitting an
infection by touching an infected object or
person
• Includes wearing PPE & resident isolation
• Requires washing c antimicrobial soap & not
touching infected surfaces c ungloved hands or
uninfected surfaces c contaminated gloves
• Examples: hepatitis, VRE, MRSA, lice, scabies
Contact precautions
• PPE may be outside room, or inside room
• Used PPE should be disposed ofin appropriate
container a leaving resident’s room
• Hand sanitizer or handwashing area should be
available where PPE is removed
• Don’t share supplies between residents. Use
disposable supplies whenever possible, or
dedicated supplies that don’t leave the
resident’s room
Isolation guidelines
• Wear PPE when serving food & drink. Do not
leave uncovered food in resident’s room.
Remove tray to designated area.
• Body waste must be disposed of to minimize
splashing & spraying. Gown & goggles may
be indicated.
• Do not contaminate outside of specimen
containers.
• Do not avoid resident or rush through tasks.
Isolation guidelines
• Indicate “A” for airborne, “D” for droplet, “C” for
contact.
1. ___Transmission occurs c skin to skin contact
during bathing & transfers.
2. ___Used when there is risk from touching an
infected object or person
3. ___Used to guard against tuberculosis &
measles.
4. ___Helps prevent the spread of lice & bacterial
conjunctivitis (“pink eye”).
Transmission-based precautions
• Indicate “A” for airborne, “D” for droplet, “C” for
contact.
5. ___Covering mouth & nose when coughing or
sneezing & washing hands afterward.
6. ___Used when microbes don’t stay suspended in
air, traveling not more than 3 feet.
7. ___Microbes are transmitted by coughing,
sneezing, laughing, talking, or suctioning.
8. ___Helps prevent the spread of illnesses
transmitted through air.
Transmission-based precautions
• Indicate “A” for airborne, “D” for droplet, “C”
for contact.
9. ___Helps prevent the spread of mumps.
10.___May require the use of a special mask,
such as N-95 or HEPA.
Transmission-based precautions
11. Transmission-based precautions are used
A.
B.
C.
D.
Every day on the job
In addition to standard precautions
Instead of standard precautions
When treating all residents c terminal illnesses
12. Dedicated equipment is
A.
B.
C.
D.
Used by multiple residents.
Donated to a resident by another resident.
Disposable.
Only used by one resident.
Multiple choice
13. Which is true of wearing PPE while caring for
residents in isolation
A. CNAs will have to decide for themselves which PPE
they must wear while caring for residents in isolation.
B. CNAs should remove PPE a exiting a resident’s
room.
C. CNAs will always wear the same PPE while
caring for all residents in isolation.
D. CNAs should remove PPE p exiting a resident’s
room.
Multiple choice
14. When a resident is in isolation,
A. The person should be avoided until isolation is
completed.
B. CNAs must perform all tasks requested of
them, even if they are outside the scope of
practice.
C. The resident still has the same basic human
needs.
D. CNAs should leave uneaten food in the room
for 24 hours to see if the resident will eat it.
Multiple choice
• Bloodborne pathogens are microbes found in
human blood that cause disease in humans.
• The same organisms are found in body fluids,
draining wounds, & mucous membranes.
• They are transmitted by infected blood
entering the bloodstream, or infected body
fluids coming in contact c mucous membranes.
• They are also transmitted by shared needles,
through the placenta, & during birth.
Bloodborne pathogens
• Employers are required by law to help
prevent exposure to bloodborne diseases.
• They must follow federal standards established
for health agencies by OSHA (Occupational
Safety & Health Administration)
• They must have a written exposure control
plan that tells employees what to do if exposed
to infectious material.
• Plan must be accessible to all employees.
• Employees must receive training.
Bloodborne pathogens
• Employers must provide needed PPE, free of
charge, to all employees, residents, & visitors.
• Puncture-resistant, leakproof, & well marked
biohazard containers must be available for
disposal of biohazardous waste & sharps.
• Free hepatitis B vaccination must be provided
for all employees after hire.
• Warning labels must be affixed to waste
containers & refrigerators/freezers that contain
potentially infectious material.
Bloodborne pathogens
• HIV -Weakens the immune system so that
people can’t fight infection, can develop AIDS
• Hepatitis – inflammation of the liver caused by
viral infection.
• Hepatitis – initially resembles flu-symptoms
(fever, fatigue, nausea, vomiting), then jaundice
(yellow skin, mucous membranes, & eyes).
Can cause permanent liver damage.
HIV
• Hepatitis A –Transmitted by fecal-oral
contamination.
• Hepatitis B (HBV)– bloodborne or needle
transmission. Vaccine is available – TAKE IT!
• HBV – short-term illness leads to loss of appetite,
diarrhea, vomiting, jaundice, pain in muscles,
joints, & stomach
• HBV – long-term illness leads to liver cancer,
cirrhosis, death.
• Hepatitis C, D, E – less common, no vaccine
HIV & Hepatitis
1. Bloodborne diseases can be transmitted by
A.
B.
C.
D.
Infected blood entering the bloodstream.
Hugging an infected person.
Being in the same room c an infected person.
Talking to an infected person.
2. Your employer must offer a free vaccine for
A.
B.
C.
D.
HIV/AIDS
Hepatitis B
Hepatitis A
All bloodborne diseases
Multiple choice
3. How does HIV affect the body?
A.
B.
C.
D.
It cuts off blood supply to the brain.
It causes hearing impairment.
It causes diabetes in otherwise healthy people.
It weakens the immune system.
4. Which is true of Hepatitis B?
A.
B.
C.
D.
HBV is caused by fecal oral contamination.
There is no vaccine for HBV.
HBV is caused by jaundice.
HBV can be transmitted in blood.
Multiple choice