Nursing AssistantCHAPTER 7: COMMUNICABLE DISEASE AND INFECTION CONTROL

What is a Microbe?

Microbe, also called microorganisms Cannot be seen with the naked eye

Most consist of just one cell

Found in air, soil, water, food, bodies of plants and animals

Most cause no harm and are essential for healthy living

Normal (resident) flora

Pathogens Microbes that cause illness

Normal flora can become pathogenic

Opportunistic microbes

What is a Microbe?

Bacteria Most consists of only one cell

Group together to form colonies

Classified by:

Shape

Arrangement in a colony

The way they stain

Gram stain

What is a Microbe?

Bacteria Aerobic

Need oxygen to live

Anerobic

Die if oxygen is present

Most common cause of infection in the health care setting

Strep throat

Urinary tract infections

Skin infections

Pneumonia

STD’s

What is a Microbe?

Viruses Smallest of all microbes

Only be seen with an electron microscope

Not complete cells Small bundles of proteins

Cannot reproduce on their own Need a host cell

Many illnesses caused by viruses Common cold

Fever blisters

Chicken pox

Hepatitis

HIV/AIDS

What is a Microbe?

Fungi Plant-like organisms

Not all are microscopic

Some are capable of causing illness

Ringworm

Athlete’s foot

Thrush

Candidiasis

What is a Microbe?

Parasites Live in or on a host

Host used for food and protection

Transmitted through physical contact

Examples:

Scabies

Pediculosis

Some parasites transmitted through blood or feces

What is a Microbe?

Parasites Helminths

Worm like organisms

Pinworms, tapeworms, roundworms

Transmission method varies

Usually eating or inhaling the worm eggs

Grow in digestive tract

Larvae or eggs passed in the feces

Protozoa

Take in food

Animal like

Malaria, amoebic dysentery

Defenses Against Communicable Disease

The Immune System The bodies defense system that protects us from infection

Nonspecific Defense Mechanisms Main one is intact skin

Free from cuts, scrapes, and wounds

Prevent pathogens from entering the body

Mucous membranes

Traps pathogens

Stomach acid

Kills many microbes in what we eat

Defenses Against Communicable Disease

Tears

Kill microorganisms

Coughing and sneezing

Expels pathogens from the body

Defenses Against Communicable Disease

Signs of infection Fever

Rapid pulse, rapid respirations, changes in blood pressure

Pain or difficulty breathing

Redness, swelling, or pain

Foul-smelling or cloudy urine

Painful or difficult urination

Diarrhea or foul smelling feces

Nausea or vomiting

Defenses Against Communicable Disease

Signs of infection Lack of appetite

Skin rashes

Fatigue

Increased confusion or disorientation

Unusual discharge or drainage

Defenses Against Communicable Disease

Specific Defense Mechanisms Antibodies

Specialized proteins

Developed from exposure to a microbe or vaccination

Antibiotics Drug that is able to kill bacteria or make it difficult for them produce

Penicillin was first antibiotic

Bacteria have used ability to change and develop resistance to antibiotics

Defenses Against Communicable Disease

Multidrug resistant organisms (MDROs)

Methicillin-resistant Staphylococcus aureus (MRSA)

Vancomycin-resistant enterococcus (VRE)

Easily spread from person to person

Usually via the hands of health care workers

Very common bacteria

When normal flora is destroyed others can take over Clostridium Difficile (C.Diff)

Yellow, “seedy” diarrhea

Unique smell

Highly contagious

Not killed by alcohol based hand sanitizers

Communicable Disease and the Chain of Infection

Infection is an illness caused by a pathogen

Infections can be local or systemic

Many, but not all, are communicable

Contagious = easily transmitted through casual contact

Communicable Disease and the Chain of Infection

Chain of infection A pathogen must be present

A reservoir must be present

A place suitable for pathogens survival

Humans, animals, food, water, milk, and objects

A portal of exit must be available

How the pathogen leaves the reservoir

A method of transmission must be available

Direct transmission

Close contact between a infected and noninfected person

Communicable Disease and the Chain of Infection

Indirect transmission

Fomites

Vector

Mosquito

Portal of entry must be available

Susceptible host

Very young or very old

Poor general health

As long as ONE link in the chain is broken, an infection cannot exist

Communicable Disease and the Chain of Infection

Infection Control in the Health Care Setting

Health care-associated infections (HAIs) Infections people get while they are in the hospital or other health

care setting

Patient can get while receiving care

HCW can get while providing care

Nosocomial infection

Infection acquired by patients or residents while in a health care facility

Infection control

Basic practices that are designed to decrease the chance of infection

Four major methods

medical asepsis, surgical asepsis, barrier methods, isolation precautions

Infection Control in the Health Care Setting

Medical Asepsis Involves physically removing or killing pathogens

Soap, water, antiseptics, heat

Goal is to remove pathogenic microbes from surfaces, equipment, and hands

Four Techniques:

Sanitization

Basic cleanliness

Handwashing

Clean linens

Infection Control in the Health Care Setting

Antisepsis

Killing microbes or stopping them from growing

Antiseptic is a chemical that is capable of killing microbes

Rubbing alcohol

Iodine

Disinfection

Use of stronger chemicals to kill pathogens

Too strong to be used on skin

Used to clean objects

Infection Control in the Health Care Setting

Sterilization

Most thorough method of killing microbes

Used on objects that need to be free of microbes

Surgical instruments, needles, etc

Many sterile items are disposable

Autoclave to sterilize reuseable items

Objects must be sanitized first

Must be free of organic material

Infection Control in the Health Care Setting

Sterilization

Most thorough method of killing microbes

Used on objects that need to be free of microbes

Surgical instruments, needles, etc

Many sterile items are disposable

Autoclave to sterilize reuseable items

Objects must be sanitized first

Must be free of organic material

Infection Control in the Health Care Setting

Handwashing The form of medical asepsis that is most common

Single most important method of preventing the spread of infection (according to the CDC)

When to wash

When you first arrive at your facility

Before entering a patient’s room

Before entering a “clean” supply room

Before obtaining clean linen from a linen cart

Before handling a patient’s meal tray

Before you go on break and before you leave your shift

Infection Control in the Health Care Setting

Before and after drinking, eating, or smoking

Before and after inserting contact lenses

After using the bathroom (sometimes before!!)

After coughing, sneexing, or blowing your nose

After touching anything that may be considered dirty

After picking something up off the floor

After removing glove

After handling your hair or applying make-up or lip wear

Not a good idea to wear rings or bracelets on the job

Make sure watch is “cleanable”

Infection Control in the Health Care Setting

In October of 2002 the CDC issued guidelines for the use of alcohol based hand rubs

Advantages of alcohol hand rubs

Using an alcohol based hand rub is quicker than washing your hands at the sink

Alcohol based rubs are gentler on the skin than soap and water

Can be used anywhere

Remember if hands are visibly soiled, you must wash with soap and water

Infection Control in the Health Care Setting

Surgical Asepsis Used for procedures that involve entering a person’s body

These procedures disrupt the body’s natural protective barriers

Infection Control in the Health Care Setting

Barrier Methods PPE (Personal Protective Equipment)

Gloves

When there is a possibility that you will come in contact with bodily fluids or substances

When you are performing or assisting with mouth 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 who has broken skin

When handling soiled linen or clothing

When cleaning equipment that may come in contact with body fluids or substances

Infection Control in the Health Care Setting

Barrier Methods Gowns

Fabric, paper, or plastic

Use when your uniform could likely be soiled with bodily fluids or substances

Worn only once

Masks

Protecting you

Surgical mask

N-95 Respirator

Protecting the patient

Surgical mask

Infection Control in the Health Care Setting

Barrier Methods Protective Eyewear

Goggles, glasses, face shields

Wear when things can spray or splatter