Infection Control: Evangeline H, SKP

INFECTION CONTROL
Evangeline H, SKp
Essential terms and facts about infections
Microorganism are everywhere in the environment : on the

skin, in the GI tract, in the air, in the soil and on clothes.
Those who produce disease are called pathogens.
Infection invasion and physiological response of the body to
pathogenic organism that multiply and overcome the flora
normally present.
If the infection can be passed on readily to others it is reffered to
as a communicable disease or infectious disease.
Etiology is the study of couses.
Etiology of infectious disease is the identification of invading
microorganisms.
More medical terms
Asepsis refers to absence of all disease-producing microroganisms.

Sterilization is the absence of all organisms including bacteria, viruses, spores
and fungi.
Medical asepsis or clean technique is those practices that limit the number
of microorganisms and their growth and spread. Aseptic measures are
protective measures in that are meant to prevent infections or the spread of
infections.
Surgical asepsis or sterile technique is intended to keep all microorganisms
from a specific area. Includes practices that destroy all microroganismsand
their spores. Ex. : sterile wound dressing technique
Spore is a round or oval stucture , with a tough resistant capsule. This structure
is formed in response to adverse conditions and is highly resistant to
destruction.
Infections
Infections occur when pathogenic organisms of sufficient

numbers and virulance invade a susceptible host.
Virulance microrganisms vary in their abilities to produce

disease.
Microorganisms also vary in the severity of the diseases they

produce and their degree of communicability.
Nosocomial infections are those infections contracted in

hospitals.
Couses of nosocomial infections :

1.
2.
3.
4.
Dx or in terapeutic procedures (iatrogenic)

caused by phycisian.
The presence in the hospital of resistant
strains of such mictoorganisms as serratia
marcescens.
The use of antibiotics.
Changes in diet and activity of patients
because they are hospitalized.
Comom sources of infection in the

hospitals
Microroganisms
Source
Mode of
transmision
Infection or
disease
Bacteria
S.Aureus
Colon, Nares, skin, hair,
Contact, vehicles,
airborne, autogenous
S., b-hemolitic group D
Colon, vagina of adult

females
Naso-oro-pharynx
Colon
Colon
Colon, perineum
Contact, vehicles,
autogenous
Autogenous
Contact, vehicles
Contact, autogenous
Direct, airborne
S.Viridans
Toxigenic e.coli
Bacteroides species
Serratia species
Infected eounds,
pneumonia, abcesses,
food poisoning
UTI, wound
Bacterial endocarditis
Enteritis
Peritonitis, abcess
Pneumonia, UTI, etc
Continued.
Microroganisms
Source
Mode of
transmision
Infection or
disease
Fungi and yeasts

Candida albicans
Viruses
Herpes viruses
Hepatitis A
Hepatitis B
Mouth, colon, genital

tract, skin
Contact,vehicles,outogen
ous
Dermatitis
Lessions of mucous
membrane, genital tract,
skin
Feces, blood, urine
Contact, vehicles,
outogenous
STD, cold sores
Contact, vehicles
Infetious hepatitis
Feces, blood, body

excretions and fluids
Contac, vehicles,
airborne, possibly vectors
Serum hepatitis,
infectious hepatitis
Six factors are involved in the infection

process :
1.
2.
3.
4.
5.
6.
Etiologic agent
Source of the pathogen or reservoir
Method of escape from the source / exit
Method of transmission
Method of entry
Susceptibility of the person (host) to the
pathogen.
The extent to which any org., or parasite is capable of producing a

disease depends on these factors :
1. Number of organisms
2. Virulence and potency of organism
3. Source of the organisms
4. Their ability to enter the body
5. Their ability to establish themselves within the body.
Etiologic agent
The reservoir of the pathogen must have certain characteristics for

Source
of the pathogen or reservoir
the organisms to live and grow. Some of these are :
Food
Water
Oxygen (aerob S.aureus, anaerob - C.tetani)
Temperature
pH
Light
Antibiosis
Method of escape from the source / exit
1.
2.
3.
4.
5.
6.
Respiratory tract sneeze, cough, talk,

breathe
GI tract feces, drainage, vomitus
Urinary tract - urine
Reproductive tract male- urine, femalevaginal discharge
Blood
Tissues infected wounds
Method of transmission
1.
2.
3.
4.
5.
Contact direct contact, indirect contact

Vehicles food, water, medications, blood from infected
person.
Airborne droplets from infected person/carrier,
contaminated dust, mics. Sheed in to env., from hair,
skin, wounds or perineal area.
Vectors contaminated or infected mosquitos, fleas,
flies, etc
Auotgenous infection from the patients usual microbal
flora.
Method of entry
The skin serves as a barrier to
infections : however any break in the
sin can readily serve as a portal of
entry. Microorganisms can enter the
body through the same routes they use
to leave the body.
Course of infection
Incubation period is the time between the entry of the
pathogen into body and the onset of the symptom of
the infection.
Period of ilness the prodormal stage and full illness
stage.
Convalescent period the symptoms disapear and
there is a return to health.
Nursing assesment
Susceptibility
1.
2.
3.
4.
5.
6.
7.
Stress
Nutritional status
Fatigue
Sex
Heredity
Age
Medical treatment and health habits
Clinical signs
Clinical signs of localized infection are :
1. Swellling
2. Redness
3. Pain or tenderness
4. Heat at the infected area
5. Loss of function of the body part affected
Systemic infection
1.
2.
3.
4.
5.
6.
Fever
Lassitude, malaise
Anorexia, nausea
Headache
Lymph node enlargement and terderness
Vomiting and diarrhea
The nurses resposibilites for preventing infection include :
Teaching individual preventive measures

Strengthening the bodys barriers againts
infection immunization, nutirition, adequate
rest and sleep, normal stress level.
Encourages hygiene hand washing,
perineal care, reguler bathing, brushing teeth
regularly, blowing the nose, coughing, nail
care.
Standard precautions
Hand washing and antisepsis (hand hygiene)

Use of PPE when handling blood, body substances,
excretions and secretions.
Approriate handling of patient care patient and soiled
linen.
Prevention of needlestick/sharp injuries.
Environmental cleaning and spills-management
Approriate handling of waste.
Hand washing and antisepsis
Can minimize microorganisms

Acquired on the hands during daily duties.
Where is contact with the lood, body fluids,
secretions, excretions and known and
unknown contaminated equipment or
surfaces.
Wash or decontaminate hands :
After handling any blood, body fluids, secretions,

excretions and contaminated items.
Between contact with different patients.
Between tasks and procedures on the same patient
to prevent cross contamination between different
body site.
Immediately after removing gloves
Using plain soap, antimicrobial agent (alcoholic hand
rub or waterless antieptic agent).
Use of PPE
Using
PPE provides physical barrier between

mo and the wearer. It offers protection by
helping to prevent mo from :
Contaminating eyes, hands, clothing, hair and

shoes.
Being transmitted to other patients and staff
PPE includes :
Gloves
Goggles
Mask
Apron
Gown
Boot/shoe
cover
Cap/hair cover
PPE should be used by :
Health care worker who provide direct care to

patients and who work in situation where they may
have contact with blood, body fluids, excretions,
secretions.
Support staff including medical aides, cleaners, and
laundry.
Laboratory staff, who handle patients specimens
Family members who provide care to patients and
are in the situation.
Principles for use PPE
PPE should be chosen according to the risk of

exposure.
Avoid any contact between contaminated (used)
PPE and surfaces, clothing or people outside the
patient care area.
Discard the used PPE in approriate disposal bags
and dsipose of as per the policy of the hospital.
Do not share PPE
Change PPE completely and thoroughly wash hands
each time you leave a patient to attend to another
patient or another duty.
It is important to use PPE effectively,

correctly and at all times where
contact with patients blood, body
fluids. Excretions and secretions
may occur.
Gloves
Wear
gloves (clesn, non sterile) when

touching blood, body fluids, secretions,
excretions or mucous membranes.
Change gloves between contact with
different patient.
Change gloves between tasks/procedures on
the same patient to prevent cross
contamination between different body sites.
Cont
Remove gloves immediately after use and before

attending to another patient.
Wash hands immediately after removing gloves.
Disposible gloves should not be reused but should
be dsiposed of according to the health care facility
protocol.
Use a plain soap, antimicrobial agent or waterless
antiseptic agent.
Masks
Wear a masks to protect mucous membrane of the

mouth and nose when undertaking procedures that
are likely to generate splashes of blood, body fluids,
secretions and excretions.
Wear surgical maks rather than cotton material or
gauze masks.
Do not reuse disposible masks. They shoul be
disposed of according to rhe health care facility
protocol.
Protective eye
wear/goggles/visors/face shield
Wear
them to protect mucous membrane of

the eyes when conducting prod.
If
If
possible discard appropriately after used.
they are reuseable, decontaminate them

according to the manufacturers instructions.
Gowns and plastic aprons

Wear
a gown (clean, non-sterile) to protect

the skin and prevent soiling of clothing during
procedures that are likely to generate
splashes of blood, body fluids secretions or
excetions. Impermeable gowns are
preferable.
Remove a soiled or wet gown as soon as
possible.
Cont
A plastic
apron may be worn on top of the
gown.
Launder gowns and apron appropriately if
thay are reusuable, according to the hospital
guidelines.
Do not reuse disposable gowns and aprons.
Boots/shoe cover
Wear
caps/boots/shoecover if necessary.
Launder them if reusable, according to the
hospital guidelines.
Do not reuse the disposible ones.
Clean and desinfect reuse boots.
Patient care equipment

Handle
Ensure
spoiled patient care.
all reusable equiment is cleaned and

reprocessed appropriately before being used
another patient.
Linen
Handle,
transport and process used

linens that is soiled with blood, etc with
care to ensure that there is no leaking
of fluid.
Prevention of needle stick/sharps

injuries
Place used sharps items in a puncture-resistant

container with a lid that closes and is located close to
the area in which the item is used.
Take extra care when cleaning sharps items.
Never recap or bend needles.
Sharps must be appropriate disinfect pr destroyed as
per the national santdards or guidelines.
Additional precautions
Airborne precautions
droplet < 5 micron, TB, chicken pox, etc.
1.
2.
3.
4.
5.
Implement standard precautions

Place pt in a single room that has a monitored
negative airflow pressure.
Keep doors closed
Use N 95 mask
Limit movement and transport the patient. If it is
necessary masking the patient.
Droplet precautions
Droplet
> 5 micron, pneumonias, pertussis,

diptheria, mump sneezing, influenza,
meningitis.
Coughing, sneezing, talking or when
healthcare workers undertake the
procedures such as tracheal suctioning.
Cont
Implement
standard precautions.
Place pt in a single room or in a room with
another pt infected by the same pathogen.
Wear surgical mask when working within 1-2
m of the patient.
Masking the patient if transport is necessary.
Contact precautions
Implement
standard precautions.
Place pt in a single room or in a room with
another pt infected by the same pathogen.
Wear clean non sterile gloves and gowns
when entering the room
Masking the patient if transport is necessary.
Protect yourself
Prevention
better than cure

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INFECTION CONTROL

Essential terms and facts about infections

Microorganism are everywhere in the environment : on the

More medical terms

Asepsis refers to absence of all disease-producing microroganisms.

Infections occur when pathogenic organisms of sufficient

Virulance microrganisms vary in their abilities to produce

Microorganisms also vary in the severity of the diseases they

Nosocomial infections are those infections contracted in

Couses of nosocomial infections :

Dx or in terapeutic procedures (iatrogenic)

Comom sources of infection in the

Colon, Nares, skin, hair,

S., b-hemolitic group D

Colon, vagina of adult

Fungi and yeasts

Mouth, colon, genital

STD, cold sores

Feces, blood, body

Six factors are involved in the infection

The extent to which any org., or parasite is capable of producing a

The reservoir of the pathogen must have certain characteristics for

Method of escape from the source / exit

Respiratory tract sneeze, cough, talk,

Contact direct contact, indirect contact

The nurses resposibilites for preventing infection include :

Teaching individual preventive measures

Hand washing and antisepsis (hand hygiene)

Hand washing and antisepsis

Can minimize microorganisms

Wash or decontaminate hands :

After handling any blood, body fluids, secretions,

PPE provides physical barrier between

Contaminating eyes, hands, clothing, hair and

Being transmitted to other patients and staff

PPE should be used by :

Health care worker who provide direct care to

Principles for use PPE

PPE should be chosen according to the risk of

It is important to use PPE effectively,

gloves (clesn, non sterile) when

Remove gloves immediately after use and before

Wear a masks to protect mucous membrane of the

them to protect mucous membrane of

possible discard appropriately after used.

they are reuseable, decontaminate them

Gowns and plastic aprons

a gown (clean, non-sterile) to protect

apron may be worn on top of the

Patient care equipment

spoiled patient care.

all reusable equiment is cleaned and

transport and process used

Prevention of needle stick/sharps

Place used sharps items in a puncture-resistant

Implement standard precautions

> 5 micron, pneumonias, pertussis,

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