INFECTION CONTROL

 Infection control practices are directed at controlling or eliminating sources of

infection in the health care agency or home

 Infection – it is the invasion and multiplication of microorganisms in tissues that

results in cellular damage. The M.O. are called INFECTIOUS AGENTS.

 Pathogens – microorganisms that cause disease in humans

 Pathogenicity – the ability of m.o. to produce a disease
 Virulence

 Communicable disease - these are the diseases that are produced by communicable
agents.
 COMMUNICABLE AGENTS – agents capable of transmitting direct or indirect
contamination either through vehicle, vector or airborne route.

STAGES OF INFECTIOUS PROCESS

1. Incubation Period – Entry of microorganisms --- onset of S/Sx
2. Prodromal Period – onset of non-specific symptoms – appearance of
specific S/Sx
3. Illness Period – specific S/Sx become evident
4. Convalescent Period – S/Sx are reduced – normal state

CHAIN OF INFECTION
1. Reservoir
2. Portal of exit from the reservoir
3. Mode of Transmission
4. Portal of Entry
5. Susceptible Host
6. Infectious agent

ELEMENTS OF INFECTION
 Infectious agent or Pathogen VIRULENCE

 Reservoir - any person, plant, animal, substance or location that provide nourishment
for MO and enables further disposal of the organism

 People - the most source of infection for others and for themselves

 CARRIER – no manifestations of the disease

 Portal of exit from reservoir- respiratory tract, GI tract, reproductive tract, blood,
and tissue

MODE OF TRANSMISSION
1. Direct contact (kissing, biting, touching, coitus) (droplet transmission)
 2. Indirect contact
a. Vector borne Transmission (animal or flying, crawling insect)
b. Vehicle Transmission (Fomites)

3. Airborne Transmission (dust)

Droplet nuclei - residue of evaporated droplets emitted by infectious
person

 Portal of entry-way to gain entry to the host-skin, GI tract, Placenta, blood

 Susceptible host - at risk for infection; defense mechanism cannot withstand the
invasion of pathogen “COMPROMISED HOST”

FACTORS THAT INCREASES THE HOST’S SUSCEPTIBILITY TO INFECTION

 Damaged or inadequate Primary defenses
 Debilitation and stress
 Invasive procedure that provide route of access for microorganism (e.g. Foley
catheterization)
 Therapy that causes immunosuppression (corticosteroids, chemotherapy)

AGENTS AND METHODS USED IN BREAKING THE CHAIN OF INFECTION

 Antiseptic
 Disinfectants
- Bactericidal and Bacteriostatic effects
 Sterilization through gas (ethylene oxide gas), moist heat(autoclave) , boiling water
and radiation (UV light).
 Proper hygiene
 Proper disposal of discharges and contaminated objects
 Proper handwashing
 Covering mouth and nose
 Proper wearing and disposal of PPE (gloves, masks, and gowns)
 Balanced nutrition and exercise
 Intact immune system
 Medical and surgical asepsis

 Asepsis – the freedom from infection or infectious materials

 Medical Asepsis – includes the practice to confine specific m.o. to a specific
area, limiting the number, growth and transmission of the M.O.
 Surgical asepsis – refers to the practice that keep an area or object free from
all microorganisms. It includes practices that destroy all m.o. and spores

 Medical Asepsis  Hand washing is number

 Reduces number of one
pathogens
 Referred to as the clean  Surgical Asepsis
technique  Eliminates all pathogens
 Used in the administration  Referred to as the sterile
of enemas, tube feedings, technique
medications, daily hygiene
  Used in dressing changes,
catheterization, surgical
procedures

 Isolation – refers to the measures designed to prevent spread of infections and M.O.
to individuals

 Standard precautions (barrier) – used with all patients

 Primary strategy for nosocomial infections
 Most important way to reduce pathogens
 Apply to blood and body fluids, secretions, and excretions, except sweat and
non-intact skin and mucous membranes

 Handwashing - Done immediately after having contact with blood or body

fluids
 Wash hands as soon as gloves are removed, between patient contacts,
between and after procedures or tasks with patient
 Gloves
 Use clean and non-sterile gloves when touching blood products, body fluids,
excretions, contaminated materials and secretions.
 Put on gloves just before touching mucous membranes or non-intact skin
 Change gloves between tasks or procedure; and remove promptly after use,
before touching items or the environment.

 Mask, eye protection, face shield

 Used to protect mucous membranes of eyes, nose, mouth, during procedures
and patient care activities likely to generate splashes or sprays.

 Gowns
 Use to protect the skin and prevent from soiling of clothing during the
procedures and patient activities that generate splashes and sprays should
be removed promptly, and wash hands after leaving patient’s environment

ENVIRONMENTAL CONTROL
 Do not recap used sharps, bend, brake or remove needles
 Do not manipulate used needles in two hands; use a one hand scoop technique
 Placed used sharps in a puncture resistant container
 Use mouthpieces, resuscitation bags, or other devices for mouth-to-mouth
resuscitation.

 Patient placement
 Private room if patient has poor hygiene habits, contaminates the
environment, or can’t assist in maintaining infection control

 Transport
 Use barriers
 Notify personnel of impending arrival and precautions needed
 Inform patient of ways to assist in prevention of transmission
  Transmission – based precautions apply to patients with documented infections with
highly transmissible or epidemiologically important pathogens.

Airborne precautions*
 Used with pathogens that are transmitted by airborne route
 Private room with monitored negative air pressure with 6-12 air changes per
hour
 Keep door closed in patient’s room
 Can cohort or place patient with another patient with the same organism, but
no other organism.
 Place mask in patient if being transported
 Example: measles, tuberculosis, varicella, shingles

Droplet precautions
 Used with pathogens that are transmitted by infectious droplets
 Involves contact of conjunctive or mucous membranes of nose or mouth;
happens during coughing, sneezing, talking, or during procedures such as
suctioning or bronchoscopy.
 Private room or with patient with same infection but no other infection
 Maintain spatial separation of three feet between infected patient and visitors
 Door may remain open
 Place masks on patient when being transported
 Examples: streptococcal pharyngitis, pneumonia, meningitis.

Contact Precautions
 Needed with patients that need contact care (skin-to-skin), or occurs between two
patients or occurs by contact with contaminated inanimate objects in patient’s
environment
 Private room or with patient of the same infection but no other infections
 Clean, non sterile gloves when entering room
 Change gloves after patient contact and fecal material or wound change or drainage
 Remove gloves before leaving patient’s environment and wash with antimicrobial
agents
 Wear gown when entering room if clothing will have contact with patient or
environmental surfaces and remove gown before leaving room
 Use dedicated equipment or clean an disinfect between patients
 Example of diseases: pediculosis, scabies

HANDWASHING

Special Consideration

It is the single most important measure used to prevent the spread of infection.
Hands should washed before entering and upon leaving isolation rooms, as well as between
care procedures for different clients.

Supplies:

Sink with running water

Liquid soap
Trashcan or linen hamper
Towels
Hand lotion

Preparation
• Nails should be short
• Remove all jewelry
• Check for breaks in the skin

Performance

If you are washing your hands where the client can observe you, introduce yourself and
explain to the client what you are going to do and why it is necessary

1. Crank out towels from dispenser before beginning hand washing.

2. Turn on the water and adjust it to a comfortably warm temperature and medium
force. Take care not to contaminate your uniform or get it wet by leaning against the
sink.
3. Wet your hands with water, pointing fingers toward the bottom of the sink.
4. Apply small amount of liquid soap. If a bar soap must be used, hold it in your palm
during the entire procedure and rinse it well before running it to the dish.
5. WASH YOUR HANDS
a. Use 10 circular strokes for the palm while applying friction.
b. Wash the back of the hands with 10 circular strokes
c. Wash the fingers with 10 circular motions, rub the palm together, slide back one
hand up to the palm of the other while encircling fingers with the opposite hand and
circle the hand and around the wrist alternating hands and interlace the fingers of
one hand with those of the other and friction rub back and forth 10 times to clean the
spaces between the fingers. Repeat as needed for the length of scrub.
6. Rinse the wrist and hands keeping the fingers pointed downward. Avoid touching any
part of the sink.
7. Dry the wrist and hands thoroughly beginning at the wrist and working down the
hand, pat rather than rub.
8. With a dry towel close the control being careful not to touch the handles with bare
hand.
9. Apply hand lotion.

Hands should be washed for 2 minutes, 1 minute, 30 seconds or 15 seconds depending on

the amount guidelines:

> 15 secs = between patients with minimal contact and with no presence of infection
on body fluids
> 30 secs = before an invasive sterile procedure
> 30 secs = After patient care, when wearing gloves, when contact with known
contaminants or body fluids have occurred
> 2 mins = Non-gloved contact with blood or body fluids covered under universal
precautions
Powerpoint prepared by:
NCM100 Clinical Instructor
Angela G. Pineda, RN

Transferred by:
MLR “luna”, AUFSN