Infection Control Principles/Universal Precautions
Transmission of Infection
Patients who have an infection could be the source of an infection for you; you could be the source of an infection for your patient
The chain of infection
The pathogen is the causative agent
Protozoa are parasites that live off cell nutrients and cause malaria and amebic dysentery
Rickets are transmitted by insects and cause Rocky Mountain spotted fever and Typhus
Fungi cause Thrush and Athlete’s Foot
Bacteria cause a multitude of diseases; such as Diphtheria, Gonorrhea, Typhoid Fever, Tuberculosis, Cholera, and wound infections
Viruses cause Polio, Influenza, AIDS, Measles, Mumps, and the common cold
The Reservoir is the environment where pathogens can survive
The human reservoir can be a person infected with the disease or a carrier who shows no signs of the infection
Animals
Non-animal reservoirs, such as street dust, lint, or soil
Mode of escape is the exit route for Pathogens
Human: Intestinal Tract, Respiratory Tract, Genitourinary Tract, lesions, breaks in the skin, or through the blood
Animal bites
Mode of transmission is the way Pathogens spread from one place to another
Direct contact with the infected person
Direct contact with the infectious material; such as nose and throat secretions, blood, urine, feces, saliva, semen, vaginal fluids
Indirect contact with objects contaminated with the secretions; such as dressings, food, needles, or shape instruments
Vectors; such as animals, insects, fleas, and ticks
Mode of entry is the way into the body
Corresponds to the modes of escape
Mouth, breaks in the skin or mucous membranes, Respiratory Tract, Genitourinary Tract, lesions, breaks in the skin, or through the bloodstream
The susceptible host is where Pathogens can grow and survive
Pathogens entering may not necessarily cause disease
Resistance to disease is based on age, immunity, fatigue, general health, medications, nutrition, and drug and alcohol abuse
Individuals at risk include those with impaired resistance due to chronic or acute illness, injury, surgery, burns, radiation therapy, chemotherapy, stress, infants, children, pregnant women, and the elderly
Asepsis
Asepsis means the absence of Pathogens (disease-causing microorganisms)
Asepsis involves two types of actions
Those that kill or retard the growth of germs
Those that prevent contact with Pathogen
Aseptic practices for the environment kill or retard the growth of germs
Disinfect ion is the process that kills all Pathogens with chemicals
Products for disinfect ion include 1:10 bleach solution, 70% Isopropyl Alcohol, 3% Hydrogen Peroxide, and some commercial products
Universal Precautions
Consider all patients infectious and capable of spreading an infection
Consider all blood, bodily fluids, and tissue contaminated
Wear gloves when there is a danger of contact with blood or bodily fluids
Wear gloves when giving enemas, emptying drainage bottles, etc.
Gloves are not necessary for casual contact with patients
Properly dispose of all soiled disposables in a double plastic bag, securely closing the bag before disposing
Check with your local health department about trash disposal regulations
Wash hands after removing gloves and after contact with bodily fluids, blood, or materials contaminated with them
Wear protective clothing when there is a chance that blood or other bodily fluids could splash
Use disposable resuscitation aids for CPR
Flush patient’s waste down the toilet
Consider all used needles and other sharp instruments contaminated
Do not recap needles, bend or remove the needles, or handle them carelessly
Dispose of all sharp objects in sharps disposal unit, coffee can with lid, or bleach bottle
Infection Control Procedures
Hand washing
Hand washing with soap and water is the single most effective way to prevent the spread of infection
Hands are constantly in touch with contaminated surfaces so they are principle vehicles for transmitting infection
Purpose of hand washing is to prevent the transfer of disease-producing organisms from person-to-person or place-to-place
When to wash hands
Before and after every significant patient contact
After using a toilet, blowing your nose, covering a sneeze or cough, or combing you hair
After handling soiled items; such as linens, clothing, bedpans, urinals, or garbage
Before and after gloves are used
Before and after touching wounds or performing wound care
After contact with blood or other bodily fluids
Upon arrival at work and before leaving
Any time you think that you may have had contact with infectious material
PPE – Personal Protective Equipment
Wear appropriate protective clothing any time there is a chance that bodily fluids will splash, spatter, or soil your clothes
Use gowns or aprons
Disposable masks protect your mouth and nose
Goggles protect your eyes
You must wear gloves when there is any possibility that your hands will come in contact with blood or other bodily fluids that could be contaminated with pathogens
You will contact bodily fluids during procedures such as:
Giving an enema
Emptying drainage bottles
Cleaning the genital area
Performing a Venipuncture
Performing Tracheotomy care
When you handle utensils or supplies that are soiled with bodily fluids
When you change linens soiled with bodily fluids
When you clean up spills of bodily fluids
Remember these important principles
Always keep clean and dirty linen separate
Carry soiled linens away from your clothes
Avoid shaking or fanning linens
Don’t place any linen on the floor
To launder linens
Wash in family machine on hot cycle with detergent
Presoak linens soiled with blood or bodily fluids in cold water and wash separately
Add one cup of bleach to linens and white garments
Handling of Wastes and Disposables
Disposal of needles and other sharps immediately in a puncture-resistant, hard plastic or metal container with a tightly secured lid
Commercial containers are available from a pharmacy or equipment company
Or use a bleach bottle or coffee can
Procedure for disposal of a used syringe
Immediately after completing the injection, carefully discard the syringe and needle into the container
Make sure the opening is large enough for disposal of the entire syringe and needle
Never recap the syringe or break the needle off
Seal the container securely
Check with the health department about disposal of container
Disposal of patient wastes
Flush feces, urine, blood, and emesis down the toilet
Be careful not to splash
Disposal of bandages, dressings, catheters, gloves, incontinence pads, and other similar items
Wrap in a plastic bag, brown paper bag, or newspaper
Place in a plastic bag with the patient’s regular garbage
Or double bag immediately and discard with the regular garbage
The Patient with an infection
Hepatitis B
Also called HBV
Transmitted when blood, blood products, or bodily fluids contaminated with HBV infect the bloodstream of another person
Almost 100% preventable with a vaccine
AIDS
Acquired Immune Deficiency Syndrome caused by the human immunodeficiency virus (HIV)
No cure or vaccine available
AIDS virus lives in bodily fluids and is most commonly spread
By sexual contact with a HIV infected person
By sharing needles with a HIV infected person
From a HIV infected mother to the infant before or during birth
You cannot get AIDS
By donating blood
Through casual contact; such as sitting next to, caring for, or shaking hands with a HIV infected person
Through doorknobs, toilet seats, animals, air, drinking fountains, food, etc.
AIDS and Hepatitis B
Spread to healthcare workers
Through accidental sticks and cuts from infected needles or sharp instruments
Through contact with damaged skin
Through splashes of bodily fluids into the eyes, mouth, or nose
To protect yourself
Practice Universal Precautions
Practice safe sex
Abstain from illegal IV drug use and needle sharing