Infection Control Flashcards
Infection Control
-Procedures that decrease the spread of infection
Health-care associated infection (HAIs)
aka nosocomial infection acquired during delivery of care in a healthcare setting
Infection Control aims to:
-Eliminate source of infection agents
-Create Barriers of transmission
-monitor and evaluate effectiveness of control
-For transmission of infection- 3 conditions necessary
Source
Susceptible Host: Portal of entry
Route or mode of Transmission
Source of Infection
-Humans, equipment, linens, bedside tables, or any inanimate objects.
Susceptible Host:
-Person who is exposed to an infection and becomes an asymptomatic carrier or develops the disease.
Route or mode of Transmission:
Categorized as Contact or noncontact.
-Contact (Directly or indirectly)
-Droplets (respiratory droplets) -Airborne -Vehicle (Transmitted by food) -Vector borne (Insects)
Direct:
When a pathogen is transmitted directly from one person to another
-Indirect:
- More common than direct-Through an inanimate object or another person-Unwashed hands-Examples, MRSA, Scabies, VRE
Droplet Transmission
-Droplets from airways larger than 5UM and usually within 3 feet (Do not stay suspended in air)
-Coughing, sneezing, talking, and other respiratory procedures
-These Droplets do not remain suspended in the air and cannot be cleared with a ventilation system
-Extra precautions are wearing a mask
-Examples of droplet transmitted diseases are influenza, and rubella
Airborne Transmission
-Spread of evaporated droplets nuclei smaller than 5UMs which contain infectious microorganisms.
-Stay suspended in the air for long periods at a time
-Require special handling through air filtration and ventilation
-Needs use national institute for occupational safety and health (NIOSH) approved N-95 mask or PAPR
-Examples of airborne transmitted diseases are (MTV) Measles, Tuberculosis, and Varicella.
Other Transmissions
-Vehicle: Transmitted through contaminated food and water, and medications. Example would be salmonella.
Vector Borne: Microorganisms transmitted by vectors such as mosquitoes, flies, incests, or vermin. Example would be Lyme disease.
Strategies for infection control
-Decreasing host susceptibility
-vaccinations Hep B vaccination, varicella, rubella, measles, influenza vaccine, pertussis
-Antimicrobial agents and antiseptics ( Hand sanitizer)
-Post Exposure chemoprophylaxis (medication after exposure to:)
Whopping cough, meningococcal meningitis anthrax, influenza virus, HIV, group A streptococci
General sanitation measures
-Sanitary laundry management, food prep, and housekeeping
-Specialized equipment processing
-Interrupting Routes
-Specialized equipment processing
-Baterical: Kills bacteria
-Bacteriostatic, inhibits growth of bacteria -Sporicidal, Distroies spores -Virucidal, Destroy Viruses
-Interrupting Routes
-Specialized equipment handling
-Barrier/ Isolation precautions -Single patient use: disposable equipment
-Disinfection and Sterilization “Cleaning”
-Cleaning: Removes gross contaminations such as dirt, organic material, secretions, or other visible materials from the surface, 1st step of any equipment
-Should be done in dirty utility room area -Disassemble equipment and check for worn parts -If not immersed in water, wipe with 70% ethyl alcohol -Dry Completely -Move to clean area to reassemble
-Disinfection and Sterilization “Disinfection”
-Destroy vegetative from bacteria and most viruses, including HIV
-Does not kill spores
-Pasteurization
-most common
-Application of moist heat at temp below boiling -Immerse in water bath at 70*C for more than 30 minutes -Filtered Dryers help prevent recontamination.
-Chemical Disinfection
-Alcohol, bleach, chlorine, glutaraldehyde, iodophors, phenolics, ammonic compounds, acetic acid. Peracetic acid, hydrogen peroxide
-Glutaraldehyde
-Otherwise known as Cidex
-Broad spectrum (Of what it can kill) -Does not damage metal, lenses, rubber, or plastic -Can disinfect in 20 minute and sterilize in 6-10 hours -Can be reused for 14-30 days after mixed -Must rinse with sterile water after soaking
-Sterilization
-Complete destruction of all forms of microbial life
-Two Types , physical and chemical
-Physical methods of Sterilization
-Steam
-Autoclaving: Steam under pressure -easiest and most efficient -Is PSI at 121*C -Not recommended for heat sensitive equipment -Incineration -Boiling
-Ionizing Radiation
-Chemical Methodof Sterilization
-Ethylene Oxide (ETO)
-Colorless, dry, toxic gas -Harmless to rubber and plastic -Active at ambient temps -combines with water to form ethylene glycol (BAD) -Biologic indicator tape like agent used to verify conditions met
-Personal Protective Equipment (PPE)
-Gloves
-Sterile whenever performing invasive procedures -Changed between patients (and after any direct contact with infected material.) -Wash hand before and after removing gloves. -WEARING GLOVES IS NEVER A SUBSTITUTE FOR WASHING HANDS -Mask, Face shields, goggles -Gowns, aprons hair coverings, shoe coverings
-Standard Precautions
Universal precautions and body substance isolation
-Blood, all body fluids, secretions, and excreations (except sweat) , Non-intact skin, and mucus membranes. -Hand hygiene, after touching bodily fluids, between patients, after removing gloves -Wear gloves when touching patients/ Contaminated items and surfaces -Mask, eye protection, face shields, during procedures that are likely to generate splashes or sprays of body fluid or blood -Gowns, to prevent soiling of clothing during procedures that may generate splashes or sprays of body fluid or blood.
-Contact Procedures
-Reduce transmission by direct or indirect
-Separation of more than 3 feet between infected/ colonized patient in multi patient rooms, single patient rooms are preferred -Gowns and gloves for all interactions that may involve contact with the patient or contaminated area -Examples include MRSA,VRE, herpes simplex, herpes zoster -Contact precautions PLUS is used with clostridium difficile(C-DIFF) and includes hand washing, not alcohol based rubs.
-Droplet Precautions
-Addition of mask (As well as other contact procedures items gloves, gowns, ect.)
-Single patient rooms is preferred -Examples include, influenza, meningococcal disease, diphtheria, rubella, mumps, ect.
Airborne Precautions
-N-95 mask or higher respirator
-Private rooms with negative air pressure with at least 6 to 12 air exchange per hour, and the door must remain closed
-Examples include, tuberculosis, smallpox, measles, SARs
Hand Hygiene
The single most important part of standard precautions and in the reduction of transmitting of microorganisms
-Importance cannot be stressed enough
-Handwashing with soap and water for 15-20 seconds
-Use alcohol based products , preferred over soap and water in the absence of visible soilings , except when dealing with C-Diff
-Through wetting hands, then adding soap
-Washing around the wrist and forearms
-Washing between fingers and in the back of hands
-Scrubbing palms
-Washing around cuticles and nails
-Rinsing
-Drying hands with clean towel
-Turning off water (with towel)
-Always done before and after each patient.
Respiratory Equipment handling -Large volume nebulizers
-Worst offender of spreading pathogens
-Moist Environments are easily contaminated -Minimize infection risk (Label and date equipment) -Filled with sterile water -Condensate drained away from patient
Respiratory Equipment handling-Small Volume nebulizers
-Can produce bacterial aerosol
-Minimize infection risk (label/date) -Single patient use -Use only sterile fluids for nebulization/ use aseptic to fill
Respiratory Equipment handling -Ventilator and Ventilator circuits
-HEPA (high Efficiency Particulate air/ aerosols) filters
-Inline suction catheters -Minimize risk -Drain condensate away from Patient -Use sterile water in humidifiers -Change HME’s when observed evidence of gross contamination -Use single patient use supplies instead of cleaning
