 Small

living organism
Not visible to the naked eye
 Found
everywhere
 Part of your normal flora
 Some microorganisms cause infection—called
pathogens or germs
 At times a microorganism that is beneficial in
one area can cause problems in another area
 Microorganisms like:



Warm environment
Darkness
Source of food and moisture
 Bacteria


One-celled, multiply rapidly
Cocci



Diplococci, Streptococci, Staphlococci
Bacilli
Spirilla
 Antibiotics

Some strains of bacteria have become antibiotic
resistant
 Illnesses:

Strep throat, pneumonia, pertussis, tetanus, UTI,
gonorrhea, syphilis
 Protozoa


Found in decayed materials, bird feces,
contaminated water, insect bites
Malaria, trichomonas, African sleeping sicknes
 Fungi

Plant like organisms that live on dead organic
matter



Yest and Molds
Athletes foot, thrush, yeast infections, ring worm
Antifungal
 Rikettsia

Parasitic organisms

Found on fleas, lice, ticks, mice
 Viruses




Smallest microorganism
Can’t reproduce unless in another living sell
Spread by body secretions
Difficult to kill
 Diseases:

Cold, measles, chicken pox, warts, herpes, polio,
influenza, mumps
 Able
to mutate and change genetic
information

SARS



West Nile Virus





Variant of the common cold
Flu like symptoms to respiratory failure and death
Mosquito are the carriers
Mild fevers to death
Monkeypox
Ebola
H5N1 Virus (Bird Flu)


Contact with infected poultry or surfaces
Death rate is 50-60%
 Hepatitis

Destroys and scars liver cells
 Hepatitis



immunodeficiency syndrome (AIDS)
Caused by human immunodeficiency virus (HIV)
No cure or vaccine
Suppresses the immune system


C
Serious liver damage
 Acquired

B
Individuals are not able to fight off infections
Important to take precautions
 Helminths



Multicellular parasitic organisms
Transmitted through eggs or larvae in
contaminated foods, contaminated meat or
infected insects
Some can penetrate the skin to enter the body
 Types:




Hookworms
Trichinella spiralis
Entrobiasis
Tape worm (taenio solium)
 Pathogenic
microorganisms cause infections
in different ways



Produce toxins
Cause allergic reactions
Attack and destroy living cells
 Classifications:

Endogenous: originated within the body


Exogenous: originated outside the body



Tumors, metabolic disorders, congenital abnormalities
Trauma, radiation, chemical agents
Nonsocomial: Infections from a health care
facility
Opportunistic: infections that occur when body
defenses are weakened
 Factors
spread






Causative agent: pathogen that can cause a disease
Reservoir: area where the agent can live
Portal of exit: way to escape the reservoir
Mode of transportation: way for the causative
agent to be transmitted to another host
Portal of entry: Way to get into the host
Susceptible host: individual who can contact the
disease
 Ending

must exist for disease to occur and
the chain:
If any part is eliminated, the spread will be
stopped
 Ways
to maintain cleanliness and eliminate
or prevent contamination




3

Hand washing
Disposable gloves
Proper cleaning of instruments and equipment
Thorough cleaning of the environment
Levels
Antisepsis: prevent or inhibit growth


Disinfection: destroys or kills



Alcohol, betadine
spores and viruses may not die with disinfection
Bleach solutions
Sterilization: destroys all

Autoclaving
 Use
of microorganisms or biological agents as
weapons
 CDC has identified major bioterrorism threats






Small pox
Anthrax
Plague
Botulism
Talaremia
Filovirus
 Bioterrorism

act of 2002
Requires development of a plan against bioterrorism
to increase security in the US
 Blood



Born pathogen Standards
1991 by OSHA
Must be followed by all health care facilities
Regulations









Develop a written exposure control plan
Identify all employees who have potential exposure
Provide Hep B vaccinations
Provide personal protective equipment
Provide hand washing supplies and areas
Ensure work site is clean
Dispose of infectious materials properly
Label biohazard wastes and post signs
Provide training
 Safety



and prevention Act
Passed in 2000
CDC estimated 600,000-800,000 needle sticks a
year
Requires employees to:





Identify and use effective and safer medical devices
Incorporate changes in annual update of exposure
control plan
Get input from nonmanagerial employees
Maintain a sharps injury log
Make sure every employee uses standard precautions
at all times to prevent contact of body fluids
 Major
aspect of standard precautions
 Most important for aseptic technique
 Prevents spread of pathogens and protects
worker
 Regular Hand washing

Plain soap and water—routine cleaning
 Antiseptic

Antimicrobial soap and water—invasive procedures
 Antiseptic

Hand washing
Hand rubs
Waterless hand washing using alcohol-based hand
cleaners
When you arrive and before leaving
 Before and after every patient contact
 Before and after putting on gloves
 If gloves rip
 Before and after handling a specimen


Basics






Use soap
Warm water
Use friction to clean all surfaces
Point fingertips downwards
Use paper towels to dry off and shut off
Clean nails
 Waterless


hand cleaners
Proven safe
Recommended when the hands are not visibly
dirty
 Gloves



When ever in contact with blood, body fluids,
secretions, or specimens they should be worn
Change after contact with patients
Wash hands after removing
 Gowns/Masks/Eyeware/Faceshields

Worn during procedures that are likely to cause
splashing or spraying
 Use
care while handling sharp objects
 Needles



Place in a leakproof, puncture resistant
container labeled with a red biohazard symbol
Surgical blades, razors, and other sharp objects
must also be discarded in the sharps container
Dispose of sharps appropriately according to law
 Spills



or splashes
Wiped up immediately
Gloves need to be warn
Disinfect per protocol
 Wear
gloves while handling waste and soiled
linen
 Follow policy
 Infectious wastes must be placed in special
biohazard bags
 Soiled linen should be placed in laundry bags


Gloves should be worn
Bags containing contaminated linen need to be
labeled
 Reporting

cuts and injuries
Required to report
 Various
methods are used to achieve
infection control
 Different methods lead to different levels of
aseptic control



Antisepsis: prevents or inhibits growth of
pathogens, but not effective against spores and
viruses
Disinfection: destroys or kills pathogenic
organisms, but not always effective against
spores and viruses
Sterilization: destroys all microorganisms both
pathogenic and non pathogenic as well as spores
and viruses
 Uses
steam under pressure
or gas
 Most efficient method of
sterilization
 Process:


Items are washed first with soapy water to remove
any residue
Items are wrapped for autoclaving




Special wrapping technique to ensure no open edges to
allow contamination
Autoclave is properly loaded
Indicator allows you to know when items are
sterilized—time period can vary
Care of items after autoclaving
 Chemicals
used for aseptic control
 Disinfects, but doesn’t sterilize
 Used for instruments that don’t
penetrate the body
 Preparation


Items are cleaned and debris is removed
Chemical solution is used
 Requirements:



Large enough container to fit all items
Items must be separate from one another
Tight fitting lid to prevent contamination
 Solution
must be changed according to
manufacture's instructions
 Sound
waves are used to
produce bubbles, when the
bubble strikes the item being
cleaned it explodes removing
the dirt and residue
 Aseptic Control
 Special cleaning solutions are used in the unit,
some are permanent solution tanks
 Instruments, impression trays, glass products,
jewelry can be cleaned
 Permanent tanks need to be drained and
cleaned according to manufacturers
instructions
 Different
methods provide different levels of
aseptic control
 Method used depends on equipment available
and level of aseptic control required
 Read manufacture's instructions before using
any equipment
 Make sure all items to be sterilized or
disinfected are clean, rinsed, and dry before
they are processed
 Handle items carefully after processing to
maintaining level of aseptic control
 Many
procedures require sterile techniques
to protect patient from infection
 Surgical Asepsis: Procedures that keep an
object or area free from living organisms
 Sterile: Free from all organisms, including
spores and viruses
 Contaminated: organisms and pathogens are
present on an article or area
 Correct techniques MUST be followed to
maintain sterility and prevent contamination
 Clean



free working area
Sterile + non-sterile=unsterile
Sterile+ sterile=sterile
Sterile+ wet surface= unsterile
 Handling



Sterile supplies
Touching skin or clothing=unsterile
Below the waste=unsterile
Hold items away and in front of the body
 Sterile
field: area used for placement of
sterile supplies
 Keep
the sterile field in constant view
 Never reach over the top of a sterile field
 Never turn your back to a sterile field
 Avoid coughing, sneezing or talking over a
sterile field
 Keep sterile fields clean and dry
 2-inch area around sterile field =unsterile
 Check all items before use
 Use appropriate methods for removing articles


Drop
Mitten
 Worn
while doing sterile procedures
 Make sure sterile tray is open and all sterile
items are ready before putting gloves on
 Observe correct technique
 When gloves are on hands hold away from
the body and above waist
 Handle only sterile objects while wearing
sterile gloves
 Change gloves if contamination occurs
 Proper
authorization
 Use an infectious waste bag for contaminated
dressings
 Wear disposable gloves while removing a
dressing
 Note type, color and amount of drainage on
dressings
 Put on sterile gloves to cleanse area and apply
new dressing
 Cleanse wound with proper technique
 If contamination occurs, start over
http://www.youtube.com/watch?v=uyNm47QK
W_c&feature=related
 Many

different diseases in the healthcare field
Some diseases are communicable or caused by an
organism that is easily transmitted


Epidemic
 Occurs when the communicable disease spreads rapidly
from person to person
 Affects a large number of people at the same time
Pandemic
 Exists when the outbreak of the disease occurs over a
wide geographical area
 Affects high proportion of the population
 Travel is a concern
 Required



for communicable diseases
Tuberculosis
Wound infections
Pertussis
 Standard
precautions do not eliminate the
need for specific transmission based isolation
precautions

Transmission based provides extra protection
against the spread of specific diseases or
pathogens
 Type
of transmission-based isolation depends
on what the causative organism is and how it is
transmitted

Personal Protective Equipment (PPE)

Gowns, gloves, face shields, masks
 Terms:

Contaminated/Dirty



Items that contain disease-producing organisms
Must not be touched unless your protected
Clean


Items that don’t contain organisms
Effort needs to be given to prevent contamination to
clean parts
 Standard:


Used for all patients
Gloves, gowns, face masks when needed
Private room if patient is infectious
 Airborne
precautions: patients with known or
suspected infections transmitted by droplets in
the air


Varicella, tuberculosis, herpes zoster, measles
Use standard precautions as well as respiratory
precautions




Private room with door closed
Air in room should be filtered or discharged outdoors
Everyone must wear a respiratory filtering mask (HEPA)
Patient should not be transported from room, if
necessary mask needs to be worn
 Droplet

Patients with known or suspected infections with
pathogens transmitted by large droplet particles




Influenza, meningitis, pneumonia, mumps, diphtheria
Standard precautions
Patient should be in private room or with patient of
the same infection
Mask when working within 3 feet
 Contact



Precautions
Patients with suspected infection with rapidly
spreading microorganisms that can be transmitted
by direct or indirect contact


Precautions
GI diseases, respiratory, skin,wound infections, pediculosis
Standard precautions
Private room, gloves, gown if contact
Equipment should be left in room
 Protective

Method to protect patients from certain organisms
present in the environment



Immunocompromised
 Burns, malnourished, chemotherapy, radiation, bone
marrow transplant, immune system failure
Precautions depend on patient’s condition
Frequent disinfecting
 Exact


or Reverse Isolation
procedures vary depending on facility
Type of units provided vary
Supplies or isolation equipment vary
 Learn
specific facility precautions, but basic
principles remain the same.
 100




points
25 matching
9 T/F
9 multiple choice
5 Short answer/Essay
 Chain
of infection
 Needle contamination
 Reverse isolation
 Hand washing
 Protective Equipment
 Airborne/Standard/Contact/Droplet
 Aseptic/Sterile/Disinfection
 Study worksheets and past tests