Infection Control Elementa

Infection control element 3 1

Gippsland Employment Skills Training Inc.

G S E S T


CHCOHS302A

Participate in safety procedures for direct care work


Element 3

• Identify sources of infection and apply accepted practice to minimise risk of infection to themselves clients and others


Infection Control

•Identify infection risks

•Standard Precautions for infection control

•Additional Precautions for infection control

•Infection Control work protocols

•Other sources of infection risk for workers


Objectives

On completion of this session and with further reading and practice the participant will demonstrate their knowledge and understanding of how to:

• Identify infection risks, • Assess and minimize risks of infection to

themselves, clients and others


Introduction

The primary concern for all health care workers should be the continuing improvement in quality of care for all clients.An infection control strategy that promotes prevention of infection from client to workers and from workers to clients and others, is a fundamental objective of quality care.


10 most common ways of spreading infection


What are Infectious Agents?

• Bacteria• Viruses• Fungi

MouldsYeasts

• Protozoa• Metazoa


Bacteria• Unicellular simple organisms• Reproduce by direct division of the cell into 2

equal parts• Do not require a host – just ideal conditions• Identified by shape (morphology)

cocci – are roundbacilli – are rod shapedspirochaetes – are spiral shapedvibrios – are comma shaped


Bacteria examples

• Staphylococcus aureus• Streptococci• Salmonella• Clostridium tetani• Clostridium botulini• Clostridium perfringens• Escherichia coli• Pseudomonas aeroginosa



Other Bacteria

• Rickettsiais• Chlamydias

These are specialised forms of bacteria that fit into a category of their own.– Smaller than bacteria – larger than viruses.– Require a living host for replication and

survival


Viruses

• Smallest from of microorganisms• Can be seen only with an electron

microscope• Require a living host for survival and

replication• Difficult to treat because they are not

susceptible to antibiotics.


Virus Examples

• HIV• Hepatitis A-G• Influenza• Herpes• Varicella• Mumps• Measles


HIV transmission

HIV is primarily transmitted through:

BloodSemenVaginal fluids


HIV Risks

Unprotected sexual intercourse with an HIV infected person


HIV risks

During injecting drug use, with contaminated needlesSharing needles with an HIV infected person


HIV risks

From an HIV infected mother to her babyDuring pregnancyBirthBreastfeeding


HIV Risks

Transfusion of HIV infected blood or blood productsIn Australia all blood/products are tested (Since April 1985)Not all countries test blood/products.


HIV risks

• Occupational Risk from:Needle stick injuriesFor Needle stick injuries – follow workplace protocols


Fungi- Two forms

• 1. Moulds– Histoplasmosis – spreads from contaminated

soil– tinea:

– Tinea pedis – athletes foot– Tinea corprois – ringworm– Tinea capitus – ringworm of the scalp– Tinea unguinum – nail fungus


Fungi

• 2. Yeasts– Candidiasis – causes (Skin and Mouth),

vaginitis and endocarditis– Thrush – monilia

Fungi are usually opportunistic – “ usually become pathogenic when the host’s normal flora can no longer counterbalance the colony’s growth” (Hosley et al, 1997)


Protozoa

• Giardia


Identifying risk of Infection

• Need to identify:• Source of the infecting organism• A susceptible host• A means of transmission of the

organism


Source of infecting agents

• People with acute diseases• People incubating diseases• People who carry diseases but have no

apparent symptoms• Own flora• Contamination from inanimate objects


Susceptibility to the infection risk

• Depends on:• A receptive host site• The quantity of micro-organisms

transmitted• The duration of the contact• The virulence of the organism• And whether the host’s health is already

compromised (in some cases)


Susceptible Hosts

• Resistance to infection varies depending on age, and health condition.

• Nutrition status, drug therapy and other illnesses may compromise a persons immune status.

• Some people resist infection, some become carriers and others get the disease.


Situations that make us more susceptible

• Trauma• Surgical procedures• Anaesthetics• Invasive indwelling devices• Therapeutic procedures• Diagnostic procedures• Poor nutritional status


transmission

• Contact• Droplet• Air• Vehicle• vector


Transmission of infection

• Contact transmission is either: • direct - physical transfer from a carrier to

a susceptible host• Indirect contact – contact of a susceptible

host with a contaminated object i.e. cutlery sharps


Transmission of infections

Direct


Transmission of Infections

Indirect



• Droplet – coughing, sneezing, talking some invasive procedures

• Droplets containing micro-organisms come in contact with eyes, nose mouth of susceptible person.

• It is limited by the force of the expulsion, not air movement and close contact usually within 1 meter or less



Droplet


Transmission of infection

• Airborne – occurs via moisture or dust particles that contain micro-organisms

• They can be widely dispersed by air currents, and can remain airborne for long periods of time

• Before being inhaled by a susceptible host



Airborne diseases

• include: • Chickenpox• Common cold• Diphtheria• Haemophilus influenzae type b (Hib)• Influenza• Measles


Airborne diseases

• Meningitis (bacterial)• Meningococcal disease• Mumps• Parvovirus infection (human parvovirus

infection, parvovirus B19 infection, slapped cheek, slapped face, erythema

infectiosum, fifth disease)


Airborne diseases

• Pneumococcal pneumonia• Rubella• Streptococcal sore throat• Tuberculosis (TB)• Whooping cough (pertussis)


Vehicle transmission

• Transmitted by contaminated food• Contaminated water• Contaminated body fluids


Vector transmission

• Mosquitoes• Flies• Mites• fleas• Rats or other vermin


Infection Control

Is achieved by:

• Conducting regular risk assessment based on current standards

• Putting in place OH&S standards & procedures & ensuring compliance


Identifying Infection risks

• Blood – fresh/dried• Body fluids – all other except sweat• Syringe/sharps injuries• Contaminated work surfaces• Contaminated clothing/linen• Non intact skin• Unprotected mucous membranes


Standard Precautions

Standard precautions are the primary strategy for successful control of spread of infection in

health care and direct care settings


Standard or Universal precautions

• Are used in every situation of direct careWhere contact with any “body fluids or wastes” is likely

• Where the carer has non-intact skin

• When cleaning body fluid spills/wastes


Standard precautions• Hand hygiene• Personal hygiene• Gloves• Protective clothing• Protective masks/eyewear• Disposal of infectious waste• Use of aseptic techniques• Recommended disposal of sharps• Good housekeeping


Care of linen

• Always keep clean linen separate from soiled linen- two separate trolleys

• Know the protocol for soiled linen• Don’t overfill soiled linen bags• Never drag soiled linen bags along floors• Never put any linen on the floor – always

take a skip with you for soiled linen


Hand hygiene

• Handwashing• Using anti bacterial gels


Rubbing in Hand Hygiene

• The human body harbours bacteria• Our body habits spread harmful

bacteria• Hand washing removes some

bacteria• Sanitising with antiseptic hand-rubs

kills 99% of harmful bacteria


When do we perform hand hygiene strategies?

• Before starting work• Between each task change• Before and after attending to clients• Before and after eating• Before and after using the toilet• Before and after smoking• All the time


Hand washing

Fully wash hands:• Before starting work• When they are visibly dirty• After eating• After the toilet• After smoking


Sanitise your hands

• Before and after attending to a client• Before and after using gloves• Between each task• At any time that it is indicated


Applying hand sanitiser

Approved method of applying hand rub

• Apply antiseptic hand rub from the bottle• Rub onto all hand surfaces• It needs 15 seconds to dry to be effective• Moisturise hands three times each shift

with a compatible moisturiser


Rubbing it in

Apply Hand Rub Rub palms together Intertwine fingers

Rub backs of hands Rub around thumbs Rub into palms


Conclusion

• Good hand hygiene is required by Law• Good hand hygiene protects me• Good hand hygiene protects my clients• Good hand hygiene prevents spread of

infections• Good hand hygiene makes sense


Handwashing technique

• Remove jewellery• (that you shouldn’t be

wearing)


Handwashing techniques

1. Wet hands with warm water



2. Apply liquid soap



3. Wash all surfaces backs of hands

wrists


Handwashing steps

• between fingers• Under nails



4. Rub hands together for 15 seconds


Handwashing steps

5. Rinse thoroughlyTurn taps off with

clean towel


Handwashing steps

• Dry hands• Dispose of handtowel

appropriately



Additional Precautions

Are additional to standard precautionsWhen to use:For a client who is immuno compromisedSuspected of being highly infectiousWhen there is a need for protection from cytotoxic substancesOr protection from the use of immunosuppressing medication


Additional precautions

• Are added on to standard precautionsAdditional or extra precautions may include:• Isolation of the client• Use of gowns, plastic aprons, gloves • Immediate disposal of aprons and gloves• Handwashing after removal• Separate linen disposal (double bagged)



• Are added on to standard precautionsAdditional or extra precautions may include:• Special ventilation• STOP sign on door – consult staff before

entering• Antiseptic handcleaners for routine

handwashing• Immune staff to care for client



• Are added on to standard precautionsAdditional or extra precautions may include:• Additional room cleaning• Dedicated client equipment• Restricting movement of client• Clear documentation of client care plan• Extra sterilisation or cleaning of used

equipment


Hazard identification

• Is achieved by:• Medical officer notification• Pathology findings• A sufficiently detailed client history taken

on admission


Hazard Identification

• Accurate assessment and diagnosis at onset of symptoms

• Basic understanding of infection control principles by staff

• Implementation of facility or program policy in relation to client screening


Exposure and prevention control

• Is achieved by:• Vaccination and immunisation programs• The use of safety devices• Adoption of safe work practice including

standard and additional precautions


Care of a deceased person

• Use standard precautions• Ensure body fluids are contained• If additional precautions were in place

before deaths – they still apply after death when handling the deceased

• Viewing, handling, touching of the deceased by relatives is permitted unless special conditions apply


Other sources of Infection risk for workers

• Accidents• Negative immunization status• Contaminated food


Infection control work protocols

• Risk assessment• Observe standard precautions• Observe warning signs• Observe basic hygiene• Report incidents • Report hazards


Conclusion

• All body fluids should be treated as if potentially containing an infection

• Infection control is everyone's responsibility:

• Infection control starts with you• It affects those you care for &• Your workmates &

The health of the wider community

Health & Medicine

Infection Control Elementa