Principles of

Infection Control


Infectious Disease.
There are many types of germs (viruses,
bacteria, parasites, fungi) that cause many
types of illnesses including the common cold
or flu, foodbourne illness, Lyme disease, or
plague.
These germs can spread easily from one person
to another and have wide-reaching effects.
Salmonella infections are responsible for an estimated
1.4 million illnesses each year.
In 2008, infectious diseases cost the U.S. $120 billion
per year.
More than 160,000 people in the U.S. die yearly from
an infectious disease.
Costs in US
$30 billion for intestinal infections
$17 billion for influenza
$5 billion for non AIDS STD
$1 billion for salmonella
$720 million for Hepatitis B.


TOTAL > 120 billion per year (the cost
of treatment and lost productivity
associated with illnesses)
Spread of Infection
Source
Host
Transmission Route
Contact transmission body surface to body
surface
Droplet Transmission - travel 3 feet
Airborne Transmission - droplet nuclei ( 5m)
Common Vehicle Transmission - food or water
Vectorborne Transmission - animals (mosquito)
H1N1
April December 2009
Cases ~55 million
Hospitalizations ~246,000
Deaths ~11,160
Cost
Congress appropriated $7.65 billion to
fight pandemic flu in June
Related costs for time away from work
and school


Current Flu Statistics - CDC
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klyFluActivityMap.htm

Public Health Perspective
Flu.gov
YouTube - Put Your Hands Together
Impact on
Schools
Employers
Health care
www.purell.com
Infection Control Strategies in
Clinical Settings.
Decreasing Host Susceptibility
Immunizations
Eliminating the Source of Pathogens
Cleaning
Removal of all foreign material from objects
Disinfection
Inactivation of most pathogenic organisms,
including spores
Sterilization
Complete destruction of all forms of microbial
life
Isolation Precautions
Protect caregiver and patient
Universal Precautions
Treat all human blood and certain body fluids
such as blood, semen, vaginal secretions and
any fluid with visible blood as infectious.
When body fluids may be encountered, use
appropriate barriers, including gloves, mask,
eye protection, gowns, and booties.
Wash hands before and after each patient.
Body Substance Isolation
approach all body fluids and substances as if
they are infectious.
Transmission-Based Precautions
Airborne precautions
Negative-pressure room, mask
Droplet precautions
3 feet, mask
Contact precautions
Gloves, gowns
Contamination from clean
procedures in healthcare setting
Taking a pulse
Taking blood pressure readings
Taking a temperature
Touching a patients hand, shoulder or
groin
Studies have presented dramatic evidence
that microbes have an impressive ability to
survive on the hands, sometimes for hours,
if hands are not cleaned. All of the studies
clearly demonstrate that contaminated
hands can be vehicles for the spread of
microbes.
Use of gloves
You should use gloves when hands
may become contaminated with
blood, body fluids, excretions, or
secretions
or when touching mucous
membranes or non-intact skin,
or contaminated surfaces or
objects.

Most common problems with glove use are
failure to:
Wear gloves when touching open wounds or
mucous membranes, such as the mouth and
respiratory tract.
Wear gloves when touching items that are likely to
be contaminated, such as urinary catheters and
endotracheal tubes.
Change gloves between patients.
Remove gloves after patient-care.

How to correctly apply
Put on new gloves before contact with non-
intact skin or mucous membranes
Wear gloves during contact with bodily
fluids or contaminated items
Remove gloves after caring for a patient -
do not wear the same gloves for more than
one patient
Do not reuse or wash gloves
Dont forget hand hygiene after removing
gloves. Gloves are not a replacement
for hand hygiene

Additional protection
Wear a mask and eye protection, or
a face shield, during procedures
that are likely to generate splashes
or sprays of blood, bodily fluids,
secretions, and excretions.
Use of gowns
Wear a gown during procedures that are
likely to generate splashes or sprays of
blood, bodily fluids, secretions, or
excretions.
Secure gown appropriately.
Remove a soiled gown as soon as possible,
and practice hand hygiene after removing
the gown.

Handwashing
Antimicrobial soap and water
Used when hands are visibly soiled
Used when indicated by Hospital
Infectious Control Guidelines (units -
NICU, transplant)
Alcohol based hand rubs
Handwashing survey results
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/stories/washup/2010_handwashing
_behavior_survey.pdf
Alcohol Based Rubs Instructions
Apply adequate amount
(approximately 3ml)
Rub hands together so that contact
is made with all parts of hands and
fingers
Rub for at least 15 seconds to
ensure adequate antimicrobial
activity
Sharps handling and disposal
Care with opening prep razors
Importance of immediate disposal
into sharps container-do not recover
any sharps
If sharps container is full, do not
use regular trash
Disposal of full sharps containers
thru
Hazardous Materials
Includes
mercury in sphygmomanometers (BP
measuring systems)
bleach
isopropyl alcohol
Check for hazardous materials and
how to handle them
References

CDC.gov
Flu.gov
Infectious Disease Society of American clinical practice
guidelines -
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Washup.org