Textbook for Nursing Assistants
Chapter 7: Communicable Disease and Infection Control
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What Are Communicable Diseases?
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Communicable Diseases
• Communicable diseases are diseases that can be spread from
one person to another
– You must learn to protect yourself, your family members,
and your patients or residents from catching a
communicable disease
– You must also learn about the causes of communicable
disease, and the ways communicable diseases are spread
from one person to another. After all, it is hard to protect
yourself and others from communicable disease if you do
not know what causes it or how it is spread!
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What Is a Microbe?
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What Is a Microbe?
• A microbe, also called a microorganism, is a living thing
that cannot be seen with the naked eye
• Most microbes cause no harm and are actually essential
for healthy living: called normal (resident) flora
• Some microbes, however, can cause illness and are
known as pathogens
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Opportunistic Microbes
• Sometimes microbes can be considered normal flora in one
part of the body and pathogens in another
• These types of microbes are called opportunistic microbes
• For example:
– Escherichia coli. When E. coli finds its way out of the
intestine and into another part of the body where it is not
normal flora, such as the bladder, it can cause an infection
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Classification of Microbes
MICROBES
Bacteria
Viruses
Fungi
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Parasites
Microbes: Bacteria
• Bacteria cause many of the infections you will encounter in the health
care setting
• The ability of bacteria to adapt to all sorts of environments is proof of
this life form’s ability to survive
• Scientists classify and name bacteria in many different ways
–
By their shape
–
By the way they arrange themselves in a colony
–
By the way they stain (i.e., how they react to the dye scientists
use to make microbes more visible under a microscope)
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Microbes - Bacteria - Classification
Classification on the basis of shape
Round bacteria are
called cocci
Rod-shaped
bacteria are called
bacilli
Spiral-shaped or
curved bacteria are
called spirilla
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Microbes - Bacteria - Classification
By the way they arrange themselves in a
colony
Pairs of bacteria
(indicated by the
prefix diplo-)
Chains of bacteria
(indicated by the
prefix strepto-)
Grape-like clusters of
bacteria (indicated by
the prefix staphylo-)
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Microbes - Bacteria - Classification
By their basic requirements for survival
Aerobic: need
oxygen to live
Anaerobic: die if
oxygen is present
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Microbes - Bacteria - Endospores
– Some types of bacteria can surround themselves
with a hard shell, called an endospore, and enter a
state of inactivity
– Once the inactive bacterium’s best growing
conditions become available, the bacterium will
become active again
– Because of their protective endospores, these types
of bacteria are very difficult to kill using the standard
techniques
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Antibiotics
• An antibiotic is a drug that is able to kill bacteria or make it difficult
for them to reproduce and grow
• Two types of bacteria, methicillin-resistant Staphylococcus aureus
(MRSA) and vancomycin-resistant enterococci (VRE), have become
resistant to two of the most powerful antibiotics we have invented to
date (methicillin and vancomycin)
• Although antibiotics have given us more options for treating infectious
disease than we had in the past, they do not work against all
pathogens all of the time
• The best policy is clearly to avoid infection in the first place
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Microbes - Bacteria - Illnesses
• Illnesses caused by bacteria:
–
Tetanus (lockjaw)
–
Botulism (food poisoning)
–
Strep throat
–
Some bladder infections
–
Some skin infections
–
Rocky Mountain spotted fever
–
Typhus
–
Some types of pneumonia
–
Some infections of the reproductive and urinary systems
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Microbes - Viruses
• Viruses are the smallest of all microbes
• They can only be seen using a special kind of microscope,
called an electron microscope
• Many illnesses are caused by viruses, such as
– The common cold
– Fever blisters
– Chicken pox
– Hepatitis
– AIDS
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Microbes - Fungi
• Fungi are a group of plant-like organisms that scientists
have classified together because of certain
characteristics, including the make-up of their cell walls
• Examples of illnesses caused by fungi are
– Ringworm
– Athlete’s foot
– Thrush
– Candidiasis
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Microbes - Parasites
• Parasites live in or on a host, such as a plant or animal, and
use that host for food and protection
• Examples of parasites are
– Helminths
– Protozoa
• Examples of illnesses caused by parasites are
– Scabies
– Pediculosis (lice)
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Communicable Disease and the
Chain of Infection
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Chain of Infection
• For a person to get a communicable infection, six key
conditions must be met
• These six key elements are known as the chain of
infection
• Eliminating any one of the six key elements breaks the
chain and prevents the spread of infection
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Chain of Infection
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Breaking the Chain of Infection
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Infection Control in the
Health Care Setting
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Infection Control in the Health Care Setting
• Maintaining cleanliness in health care facilities is essential,
because exposure to pathogens is increased in these settings
• Most of the people in health care facilities are there because
they are not in good overall health and their potential to
become infected is increased
• A nosocomial infection is an infection received while in a
hospital or other health care setting
• All health care facilities follow basic practices that are designed
to decrease the chance that an infection will be spread from
one person to another. These practices are called infection
control
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Methods of Infection Control
• There are four major methods of infection control
– Medical asepsis
– Surgical asepsis
– Barrier methods
– Isolation (transmission-based) precautions
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Medical Asepsis
• Medical asepsis involves physically removing or killing
pathogens, and is primarily achieved through processes
involving soap, water, antiseptics, disinfectants, or heat.
• There are four techniques that make up the practice of
medical asepsis:
– Sanitization
– Antisepsis
– Disinfection
– Sterilization
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Medical Asepsis: Sanitization
• Sanitization is the word we use to describe practices associated
with basic cleanliness, such as:
– Handwashing
– Cleansing of eating utensils and other surfaces with soap
and water
– Providing clean linens and clothing
• Sanitization practices physically remove pathogens, thereby
preventing their spread
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Medical Asepsis: Antisepsis
• Antisepsis takes sanitation one step further, by actually killing
microbes or stopping them from growing
• An antiseptic is a chemical that is capable of killing a pathogen,
or preventing it from growing
• Antiseptics can be used on the skin or other surfaces to kill
pathogens
• Examples of antiseptics:
– Rubbing alcohol
– Iodine
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Medical Asepsis: Disinfection
• Disinfection involves the use of stronger chemicals to
kill pathogens
• The chemicals used for disinfection are too strong to be
used on the skin
• Disinfectants are used to clean non-living objects that
come in contact with body fluids or substances, such as
bedpans, urinals, and tray tables
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Medical Asepsis: Sterilization
• Sterilization is the most thorough method of killing microbes
• Sterilization is used on objects that must be completely free of
any microbe, such as surgical instruments, hypodermic
needles, or intravenous (IV) catheters
• Equipment is sterilized either by placing items in an autoclave
or by soaking the items in chemicals that destroy all microbes
• Boiling is not an effective method of sterilization
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Medical Asepsis: Sanitization – Handwashing
• In the health care setting, handwashing takes on a special
importance because the chance of picking up a pathogen and
passing it on to someone else is greater than in normal,
everyday life
• Although the specifics of how handwashing is performed vary
from setting to setting, one aspect of handwashing always
remains the same - it must be performed thoroughly, properly,
and consistently
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Medical Asepsis: Sanitization – Handwashing
• At the minimum, wash your hands:
– When you first arrive at your facility
– Before entering a resident’s room or a “clean”
supply room
– Before obtaining clean linen from a linen cart
– Before handling a patient’s or resident’s meal
tray
– Before you go on break and before you leave
your shift
– Before and after drinking, eating, or smoking
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Medical Asepsis: Sanitization Handwashing
– Before and after inserting contact lenses
– After using the bathroom
– After coughing, sneezing, or blowing your nose
– After touching anything that may be considered
dirty
– After picking an object up from the floor
– After removing disposable gloves, including
those times when you are replacing a torn glove
– After handling your hair or applying make-up or
lip gloss
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Handwashing: Using an Alcohol-Based Rub
• Alcohol-based hand rubs have several advantages:
– Using an alcohol-based hand rub is quicker than
washing your hands at the sink
– Alcohol-based hand rubs are gentler on the skin than
soap and water
– Alcohol-based hand rubs are used without water, so
they can be used anywhere
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Handwashing: Using an Alcohol-Based
Hand Rub
• It is very simple to use an alcohol-based hand rub
– The label on the product will tell you how much
product to use
– Apply this amount to one of your palms and rub your
hands together, covering your hands and fingers
(front and back) with the product
– Continue rubbing your hands together until your skin
is dry. That's all there is to it!
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Surgical Asepsis
• Surgical asepsis is used for procedures that involve entering a
person’s body
• Examples of procedures that require surgical asepsis include:
– Surgical procedures
– Injections
– The insertion of intravenous (IV) catheters
– The insertion of urinary catheters
• In most states, performing procedures that require surgical
asepsis is not within a nursing assistant’s scope of practice
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Barrier Methods
• A barrier is an object that physically prevents microbes from
reaching a health care provider’s skin or mucous membranes
• Examples of barriers used in infection control, called personal
protective equipment (PPE), include:
– Disposable gloves
– Gowns
– Masks
– Protective eyewear
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Barrier Methods: Gloves
• Gloves are the most commonly used barrier method
• Gloves are worn in the following situations:
– When there is a possibility that you will come in contact
with body fluids or substances
– When you are performing or assisting with perineal care
– When you have a cut or abrasion on your hands
– When you are shaving a patient or resident
– When you are performing care on a patient or resident
who has an open wound or other break in the skin
– When you are performing oral care
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Barrier Methods: Gloves
• To effectively prevent contamination of your hands
–
gloves must be intact
–
they must fit properly
• The most common error made by people who wear gloves for barrier
protection is becoming too comfortable with the fact that they are
protecting themselves, and forgetting to protect others! If you are
wearing gloves and you touch a surface that is contaminated, then
your gloves become contaminated. If you then touch something else,
that surface becomes contaminated too.
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Barrier Methods: Gowns
• A gown (fabric or paper) should be used when it is likely
that your uniform will be soiled with body fluids or
substances
• The use of the gown prevents contamination of your
uniform
• Each gown is worn only once
• Any gown, fabric or paper, is considered contaminated if
it becomes wet
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Barrier Methods: Masks
• Masks prevent you from breathing in microbes through your
nose or mouth, and are worn when there is a chance that you
will be exposed to pathogens that are transmitted through the
air or in droplets of saliva
• Surgical masks are most commonly used, but if you are caring
for a person with TB, you may be required to wear a special
high-filtration mask
• All masks are used only once
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Barrier Methods: Protective Eyewear
• Goggles, face shields, and other types of protective
eyewear are used to protect your eyes from substances
that may splash
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Isolation (Transmission-Based) Precautions
• Isolation (transmission-based) precautions are
guidelines, based on a pathogen’s method of
transmission, that we follow to contain the pathogen
and limit others’ exposure to it as much as possible
– Standard precautions are specifically used to protect
health care workers from pathogens that are
transmitted in blood. Since you may not know if a
person has this type of infection, standard
precautions are used for everyone
– Isolation precautions include precautions that are
used when a person is known to have a disease that
is transmitted a certain way, for example, via the
air, in droplets, or by direct contact.
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Isolation (Transmission-Based) Precautions
• Airborne precautions are used when caring for
people infected with pathogens that can be
transmitted through the air
• Droplet precautions are used when caring for
people with diseases caused by pathogens that are
transmitted by direct exposure to droplets released
from the mouth or nose (for example, when the
person coughs, sneezes, or talks)
• Contact precautions are used when caring for
people with diseases caused by pathogens that are
transmitted directly (by touching the person), or
indirectly (by touching fomites)
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North Hills Hospital Isolation Signs
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End of Presentation
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