Chapter 16
Infection Control and Standard Precautions
© 2017 Cengage
© 2017
Learning.
Cengage
AllLearning.
Rights Reserved.
All RightsMay
Reserved.
not be scanned,
May not be
copied
scanned, copied
or duplicated,
or or
duplicated,
posted toor
a publicly
posted to
accessible
a publiclywebsite,
accessible
in whole
website,
or in
in part.
whole or in part.
Flora
• Microorganisms that live in a specific
environment
• Resident flora
– Normal flora that are always present
• Transient flora
– Occur in periods of limited duration
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Pathogenicity and Virulence
• Disease-producing microorganisms are
called pathogens
• Pathogenicity refers to the ability of a
microorganism to produce disease
• Virulence refers to the frequency with
which a pathogen causes disease
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Pathogens
•
•
•
•
•
•
Bacteria
Viruses
Fungi
Protozoa
Rickettsia
Helminths
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Bacteria
• Small, one-celled microorganisms
• Lack a true nucleus or mechanism to
provide metabolism
– Need an environment that will provide food for survival
• Multiply by simple cell division
• Spores
• Cause a wide range of illnesses
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Viruses (1 of 2)
• Can live only inside cells
• Cannot get nourishment or reproduce
outside the cell
• Damage the cell they inhabit
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Viruses (2 of 2)
• Contain a core of DNA or RNA surrounded
by a protein coating
• Some have another coating called an
envelope, which protects them from an
attack by the immune system
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Fungi
• Microscopic plants
• Diseases they produce are referred to as
mycoses
• Obtain food from living organisms or
organic matter
• Seen more frequently in individuals that are
immunologically impaired
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Protozoa
• Single-celled parasitic organisms
• Have ability to move
• Obtain food from dead or decaying organic
matter
• Spread by ingestion of contaminated food
or water or through insect bites
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Rickettsia
• Intercellular parasites
• Need to be in living cells to reproduce
• Spread through bites of fleas, ticks, mites,
and lice
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Helminths
• Parasitic worms
• Pinworms and tapeworms most common
• Acquired by eating uncooked or
inadequately cooked meat, or contaminated
food or water
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Chain of Infection
1. Infectious agent
2. Reservoir or source
3. Portal of exit from reservoir or source
4. Mode of transmission
5. Portal of entry to host
6. Susceptible host
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Agent
•
•
•
•
Entity that is causing disease
Biological
Chemical
Physical
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Reservoir (1 of 3)
• Place where the agent can survive
• Promotes growth of pathogens must contain
the proper nutrients, maintain temperature,
moisture, pH, proper amount of light
• Most common reservoir is fomites
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Reservoir (2 of 3)
• Portal of Exit
• Mode of Transmission
–
–
–
–
–
Contact transmission
Droplet transmission
Airborne transmission
Vehicle transmission
Vector-borne transmission
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Reservoir (3 of 3)
• Portal of Entry
–
–
–
–
–
–
Skin
Respiratory tract
Genitourinary
GI
Circulatory
Transplacental
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Host
•
•
•
•
Organism that can be affected by an agent
Susceptible host
Compromised host
Characteristics that influence susceptibility
to and severity of infections
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Breaking the Chain of Infection
• Health care professionals (HCP) must focus
on breaking the chain of infection
• Proper infection control
• Specific strategies
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Between Agent and Reservoir
• Cleansing
• Disinfection
• Sterilization
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Between Reservoir and Portal of Exit
•
•
•
•
Proper hygiene
Clean supplies
Clean linens
Clean equipment
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Between Portal of Exit and Mode of
Transmission
• Maintain clean dressings on all injuries and
wounds
• People should cover their mouth when
coughing or sneezing
• Gloves must be worn at all times
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Between Modes of Transmission and
Portal of Entry
• HCP should wash hands between patients
• Barrier protection
• Gloves, masks, gown, goggles
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Between Host and Agent
• Eliminate infection before it begins
• Proper nutrition, exercise, UTD
immunizations
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Stages of the Infectious Process
• Localized and systemic infections
–
–
–
–
Incubation
Prodromal
Illness
Convalescence
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Changes Occurring
in Infectious Disease
• Factors that have led to a reduction in
infectious diseases
• Factors that have led to an increase of
microbes and their global spread
• Emerging threats
• Recent scientific and medical progress
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Nosocomial Infections or HAI
• Acquired in a health care facility
• Most common categories:
–
–
–
–
Urinary tract
Surgical wounds
Pneumonia
Septicemia
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Bioterrorism
• Use of microbes to cause illness and spread
fear
–
–
–
–
–
Inhalational anthrax
Smallpox
Pneumonic plague
Tularemia
Botulism
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Standard Precautions (1 of 2)
•
•
•
•
Hand washing
Gloves
Mask, eye protection, and face shield
Gown
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Standard Precautions (2 of 2)
• Client care equipment
• Linens
• Occupational health and blood-borne
pathogens
• Client placement
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
Isolation
•
•
•
•
Airborne precautions
Contact precautions
Droplet precautions
Reverse isolation
© 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.