COMMON TERMINOLOGIES IN INFECTION CONTROL CONTAMINATION Bacteria present

COMMON TERMINOLOGIES IN INFECTION CONTROL ØCONTAMINATION Bacteria present on surface ØCOLONIZATION : presence and multiplication of microorganisms in or on a host without tissue damage. Bacteria present on surface. ØINFECTION : invasion and multiplication of an infectious agent in the tissues of the host.

COMMON TERMINOLOGIES IN INFECTION CONTROL cont’d ENDOGENOUS INFECTION : The organisms derived from patients own flora. EXOGENOUS INFECTION : Organisms are derived from outside forces. INCUBATION PERIOD : time of initial contact with the infectious agent to the appearance of the first symptoms.

COMMON TERMINOLOGIES IN INFECTION CONTROL cont’d Asepsis : The freedom from disease causing microorganism. Medical asepsis: Includes all practices intended to confine a specific microorganism to a specific area, limiting the number, growth, & transmission of microorganisms. Surgical asepsis (sterile technique) : Refers to those practices that keep an area or object free of all microorganisms; it include all practices that destroy all microorganisms & spores.

COMMON TERMINOLOGIES IN INFECTION CONTROL cont’d COMMUNITY ACQUIRED INFECTION : infection present or incubating on admission with no association to previous hospitalization at the same facility HOSPITAL ACQUIRED INFECTION : A nosocomial infection can be defined as an infection acquired in the hospital after 72 hours of admission to hospital.

HOSPITAL AQUIRED INFECTION ( NOSOCOMIAL INFECTION ) It is an infection meeting the following criteria : Not present or incubating on admission 1. An infection temporarily associated with admission to or a procedure done at health care facility. 2. An infection incubating at that time of admission that is related to previous hospitalization at the same facility or identified on admission following performance of the procedure during a previous admission

COMPONENTS OF INFECTION PROCESS CAUSATIVE AGENTS RESERVOIR OF THE AGENT PORTAL OF EXIT MODE OF TRANSMISSION PORTAL OF ENTERY SUSCEPTIBLE HOST

Ø Ø Any biological , physical or chemical entity capable of causing disease is called an agent (The micro-organism that can cause infection). MICRO-ORGANISMS: Organisms that can be seen only with the magnification of a microscope. # Bacteria # Viruses # Fungi # Parasites

v v Some Micro-organisms are normally present on people’s skin & in Respiratory , Intestinal , & Genital tract ; these micro-organisms are called NORMAL FLORA. Other Micro-organisms are normally not found on or in the human body & are usually associated with disease ; these micro-organism are known as PATHOGENS. ALL MICRO-ORGANISMS, including normal flora , can cause infection or disease if certain conditions exist : Normal flora are introduced an area of the body in which they are not normally found. Pathogens are introduced into the body. Micro-organisms are introduced into the body of a person who is immunocomprimised & thus susceptible to infections to which he or she otherwise would not be susceptible.

It is a place in which an infectious agent can survive but may or may not multiply # Human-Beings (most common). # Animals # Plants # Soil # Air # Water # Solutions & Instruments Ø

Ø q q q q It is the path by which an infectious agent leaves the source. Respiratory tract (e. g. , lung, nose). Genitourinary tract (e. g. , vagina, penis). Mucous membranes (e. g. , eyes, nose, mouth). Gastrointestinal tract (e. g. , mouth , anus). Blood-stream (open wound, needle puncture). Broken skin (e. g. , puncture , cut, surgical site, rash). Trans-placental ( mothers –to- fetus ).

Ø Ø Ø The mechanisms or the way in which the infectious agent moves from the reservoir to a susceptible host. Transmission can occur by four modes: CONTACT TRANSMISSION : The infectious agent can be transmitted directly from the reservoir to a susceptible host through touch (e. g. , staphyllococcus) , sexual inter-course (e. g. , gonorrhea, HIV), or droplets (e. g. , influenza).

VEHICLE TRANSMISSION : The infectious agent can be transmitted indirectly from the reservoir to a susceptible host by material that maintains the life of the infectious agent. Food (e. g, salmonella ) Ë Blood (e. g, Hepatitis B , HIV) Water (e. g, Cholera , Shigella) Instruments & Others Items (e. g, Hepatitis B , HIV , Pseudomonas )

Ë AIRBORNE TRANSMISSION : The infectious agent can be carried by air currents (e. g, Measles , Mycobacterium Tuberculosis , Varicella zoster ). Ë VECTOR TRANSMISSION: The infectious agent can be transmitted to a susceptible host through insects & other invertebrate animals (e. g, Mosquitoes can transmit Malaria & Yellow Fever ; fleas can transmit plague ).

Ø The route by which the infectious agent moves into (enters ) susceptible host. Respiratory tract (e. g. , lungs). Genitourinary tract (e. g. , vagina, penis). Mucous membranes (e. g. , eyes, nose, mouth). Gastrointestinal tract (e. g. , mouth , anus). Blood-stream. Broken skin (e. g. , puncture , cut, surgical site, rash). Trans-placental ( mothers –to- fetus ).

Host is any person who is at risk for infection. Characteristics that influence susceptibility & severity of disease are : Age Sex Socio-Economic status Disease history Nutritional status

Occupation Immunization status Diagnostic /Therapeutic procedures Medications Pregnancy Trauma Heredity Ethnicity

How can we break the chain of infection? Link 1 -Infectious or Causative Agent Intervention üAccurate and rapid identification of micro-organisms üEarly recognition of sign and symptoms of infection

How can we break the chain of infection? Link Intervention 2 -Reservoirs üEmployee health examinations and screening üEnvironmental sanitization including floors, walls, exam tables and beds üDisinfection/Sterilization of equipment and instruments üStandard Precautions üMedical Asepsis üProper Hygiene - bathing and hand washing üClean gowns, linens and towels üClean wound dressings

How can we break the chain of infection? Link Intervention 3 -Portal of Exit üHand washing üUse of Personal Protective Equipment such as gloves, gowns, facemask, N 95. üClean dressings over wounds üMedical Asepsis or Clean Technique üControl of excretions and secretions üCovering the mouth and nose when coughing or sneezing üProper trash and waste disposal üStandard Precautions

How can we break the chain of infection? Link Intervention 4 -Method or Mode of Transmission üHand washing üStandard Precautions üRooms with air flow control üSafe Food handling üIsolation üTransmission-based precautions üSterilization of equipment and supplies üMedical and Surgical Asepsis üUse of Personal Protective Equipment such as gloves, gowns, facemask, N 95. üProper disposal of contaminated objects

How can we break the chain of infection? Link Intervention 5 -Portal of Entry üSterile technique or Surgical Asepsis (dressing, injections, catheterization). üMedical Asepsis or Clean Technique üCatheter Care üWound care üProper Disposal of needles or sharps üMaintaining skin integrity üStandard Precautions

How can we break the chain of infection? Link 6 -Susceptible Host Intervention üTreatment of Disease üRecognition of clients at risk üImmunization üExercise üProper Nutrition üPatient Education

PREVENTIVE PATIENT CARE PRACTICES 1. Hand washing 2. Aseptic technique 3. Standard precautions 4. Sterilization 5. Disinfection 6. Isolation Precaution

HAND WASHING: n It is the process for the removal of dirt and transient microorganisms(E. g. E. COLI) from the hands. (it is considered the most effective infection control measure). HAND ANTISEPSIS: - Ø It is a process of the removal or destruction of transient microorganisms. SURGICAL HAND SCRUB : - Ø It is a process to remove or destroy the transient microorganisms and reduced resident flora, (E. g. Diphtherias )

Types of the Hand Washing ♣ ROUTINE HAND WASHING or HAND WASHING: - HYGIENIC PIt is accomplished by vigorously rubbing together all surfaces of lathered hands followed by thorough rinsing under a stream of water. PThis should take complete. 10 -15 seconds to PThe hands should be dried with a paper towel.

Types of the Hand Washing cont’d ♣ SURGICAL SCRUB: PIt is the process that begin with washing hands and forearms thoroughly to remove dirt and transient bacteria. PA nail cleaner should be used to clean under the nails. PIt should take about 5 minutes.

VARIOUS HAND DECONTAMINANTS Soap solution: OSoap have a detergent effect. OThey remove transient microorganisms physically but have no effect on the resident microbial population.

VARIOUS HAND DECONTAMINANT cont’d v CHLOROHEXIDINE: O It has a broad - spectrum activity. O It binds to the stratum corneum, continuing to destroy bacteria for at least six hours.

VARIOUS HAND DECONTAMINANTS cont’d v POVIDINE IODINE: OIt is often used in the operating theatre because it destroys spores more effectively than many other antiseptics.

VARIOUS HAND DECONTAMINANTS cont’d v ALCOHOL HAND-RUBS, GEL & WIPES: - OThey have excellent bactericidal activity against most gram – positive and gramnegative bacteria but have no effect on spores.

INDICATIONS FOR HAND WASHING Ø When coming on duty. Ø After removing gloves. Ø When hands are soiled including after sneezing, coughing, or blowing your nose. Ø Between patients’ contacts. Ø Before & after medication administration. Ø After personal use of the toilet. Ø Before performing invasive procedures.

INDICATIONS FOR HAND WASHING cont’d 6 Before taking care of particularly susceptible patients, such as who are severely Immunocompromised & Newborns. 6 Before and after touching wounds. 6 Before & after eating. 6 After touching objects that are likely to be contaminated with pathogenic micro-organisms E. g. urine measuring devices, secretion collection apparatus, etc. . .

INDICATIONS FOR HAND WASHING cont’d 6 After taking care of infected patients or patients who are likely to be colonized with microorganisms for special clinical or epidemiologic significance. (E. g. Multi-drug resistant bacteria-M. D. R. O).

ASEPTIC TECHNIQUE FIt is an a method used to prevent contamination of wounds and other susceptible sites by organisms that could cause infection. FThis can be achieved by using sterile equipment and fluids used for invasive medical and nursing procedures.

STERELIZATION "It is the complete elimination of all viable microorganisms including viruses, fungi, and their spores both pathogenic and non- pathogenic. DIS-INFECTION "Disinfection implies the removal of all life forms capable of causing disease. ( all viable microorganisms except bacterial spores).

STANDARD PRECAUTIONS The term standard precautions refers to a system of infection control practices which assume that every direct contact with blood and body fluids is potentially infectious. CONCEPT OF STANDARD PRECAUTIONS: 1. It should be implemented to all patients. 2. Standard precautions are not generally intended to reduce cross contamination among patients and they do not replace other precautions.

ELEMENTS OF STANDARD PRECAUTIONS 'Hand washing 'Gloves 'Masks, eyewear, face shields 'Gowns and aprons 'Care of sharps and needles 'Care of spills of blood and body fluids 'Care of laboratory specimens 'Disposal of waste 'Disposal of linen 'Care of resuscitation equipment

ISOLATION PRECAUTION Ø These are guidelines created to prevent transmission of microorganisms in hospitals. Ø They are Transmission Based Isolation designated for care of patients with known or suspected infectious disease that can spread by one of the following routes: - ! AIR-BORNE: (e. g measels, Rubella & TB) ! DROPLET: (e. g Diphteria & Pertusis) ! CONTACT: (e. g Hepatitis A, herpes simplex).

ISOLATION q. The separation of a person with infectious disease from contact with other human beings, for the period of communicability

BASIC PRINCIPLES FOR ALL CATEGORIES OF ISOLATION 1. Necessity of a single room 2. Hand washing 3. Use of protective barriers as per need 4. Disposal of waste in orange bags. 5. Disposal of linen in water- soluble linen bags. 6. Request for a isolation diet tray (with disposable cutleries)