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
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What is a pathogen?
• Microorganism that can cause disease
NOSOCOMIAL
Hospital acquired infection
Urinary tract is most frequent
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INFECTION CONTROL
PROGRAMS
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Surveillance
Reporting
Isolation procedures
Education
Management: community &
health care facility acquired
infections
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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
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What is a fomite?
“FOMITE-PHOBIA”
BREAKING THE
CHAIN OF INFECTION
HANDWASHING
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PROPER WASTE
DISPOSAL
Other “chain-breakers”…
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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.
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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
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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
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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
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Old category
Emesis
Stool
Gastric contents
Drainage / Secretion
Precautions
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Old category
Contact transmission
Surgical wounds
Skin infections
Catheters
IV infusion sites
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CONTACT ISOLATION
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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
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ISOLATION ALERTS
• Read information posted outside the
room
• Follow procedures
• Check with nursing personnel if unsure
STOP
OSHA - EXPOSURE TO
BLOOD-BORNE PATHOGENS
IMMEDIATE POSTEXPOSURE PROCEDURES
• Decontaminate skin puncture
site
• Flush mucus membranes
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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?
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• What is a disinfectant?
• What is an antiseptic?
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