RET 1024 Mod 3.0 Infection Control A

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Introduction to Respiratory Therapy

Module 3.0Infection Control


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Infection Control

Nosocomial Infection;

An infection acquired after hospitalization

- AKA: hospital-acquired infection


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Nosocomial Infection;

Account for an estimated 2 million

infections and 90,000 excess deaths

annually


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Infection Control

Nosocomial Infection

Infections acquired by those in the intensive care unit (ICU)

account for >20% of all HAIs (CDC 2007) Immunocompromised by disease and/or treatment

Major trauma

Respiratory failure

Myocardial infarction

CHF

Overdose


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Infection Control


Approximately 25% of patients undergoing mechanicalventilation develop pneumonia as a complication


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Approximately 30% of patients who develop ventilator-acquired pneumonia (VAP) will die


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Nosocomial Infection Historically, non-disposable respiratory equipment was

identified as a major cause of respiratory infection


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Today, procedures have evolved, and with the advent of

single-patient use equipment, infections associated with

respiratory equipment have decreased significantly


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Infection Control


Healthcare workers must remain vigilant to protect their

patients and themselves against infection; to do so, requires

strict adherence to infection control procedures


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Infection Control

Infection control procedures aim to:

Eliminate the sources of infectious agents

Create barriers to their transmission

Monitor and evaluate the effectiveness of control


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Spread of Infection

Infection occurs when a pathogen overcomes

the barrier of the host

Pathogen; a microorganism capable of producing a

disease

Host; an organism in which another, usually

parasitic, is nourished and harbored


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Spread of Infection

Three elements needed to spread an Infection

Source of pathogens

Route of transmission

Susceptible host


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Source of Pathogens

People Patients, personnel, visitors

Acute disease with symptoms

Incubation period (exposed, but no symptoms yet)

Colonized by pathogens without symptoms Autogenous infection (originating from within the

body)


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Source of Pathogens

Contaminated objects

Equipment

Linen

Medication


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Transmission Route

Contact

Droplet

Airborne

Common vehicle

Vectorborne

NOTE: Some organisms may be spread by multiple routes


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Contact Transmission

Direct Contact

Body-surface-to-body-surface contact (person-to-person)

Indirect Contact

Contaminated object (fomite) to host contact

Clothing (uniforms, lab coats, isolation gowns)

Equipment Dressings

Instruments

Shared toys
http://umdas.med.miami.edu/media/handhygiene_new.swfhttp://umdas.med.miami.edu/media/handhygiene_new.swf


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Droplet Transmission

Contaminated respiratory droplets

Discharged into the air (up to 10 feet) during:

Coughing, sneezing, talking

Suctioning, bronchoscopy, intubation, cough

induction

Deposited on the hosts mucosal surfaces

Nasal mucosa

Mouth


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Contaminated respiratory droplets

Currently Health Care Infection Control practices

Advisory Committee (HICPAC) guidelines state it

may be prudent to don a mask when within 6 feet of

the patient or upon entry into the room of a patientwho is on droplet isolation


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Haemophilus Influenzae

Pneumonia / Epiglotitis

Influenza virus

Rubella (German measles)


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Airborne Transmission

Contaminated droplet nuclei

Residue of evaporated water droplets containinginfectious microorganisms

Can remain suspended in air for long periods

Respirable particles of less than 5 m

Dust particles

Act as fomites


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Airborne Transmission

Mycobacterium tuberculosis (TB)

Rubeola (Measles)

Varicella-zoster (Chicken Pox)

Note:Special air handling and ventilation, as well as

respiratory protection are required

Mycobacterium Tuberculosis


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Common Vehicle Transmission

Pathogens in water and food

Food

Salmonellosis

Hepatitis A

Water

Shigellosis

Cholera

Medications (e.g., heparin solution)


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Vector borne Transmission

Animals or insects transfer pathogens

Malaria

West Nile Virus

Rabies

Note: Vectorborne transmission are of little

significance in hospital-acquired infections


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Spread of Infection to the Lungs

Pathogens enter the lungs via:

Aspiration of contaminated - Oropharyngeal secretions

Gastric secretions

Inhaled droplets, droplet nuclei, or dust particles

containing pathogens (fomites) Hematogenous

Via the blood


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Host

Host infection dependent upon:

Virulence of the organism

Resistance of the host

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RET 1024 Mod 3.0 Infection Control A