PRINCIPLES OF MEDICAL LABORATORY SCIENCE 2

College of Allied Health Sciences

Bachelor of Science in Medical Laboratory Science
Second Semester, A.Y. 2022-2023

[TRANS] PMLS UNIT 2: INFECTION CONTROL & SAFETY

nose, or mouth; exudates
OUTLINE from wounds; tissue
specimens; blood from
I Components of the Chains of Infection venipuncture and skin
II Breaking the Chain of Infection puncture sites; and
III Hazards in the Healthcare Setting excretions of feces and
urine.
 Means of Transmission  The means of
transmission is the
COMPONENTS OF THE CHAIN OF INFECTION method an infectious
 Infection agent uses to travel from
- Stated that disease was the result of excess a reservoir to a
substance within the body (blood, phlegm, black susceptible individual.
bile, and yellow bile). It was thought that the  Entry Pathway  An entry pathway is a way
removal of the excess would restore balance. for an infectious agent to
o Types: enter a susceptible host
 Communicable which includes body
- Infection that can spread from orifices (openings); the
person to person mucous membranes of
 Healthcare-associated the eyes, nose, or mouth;
Infection/Nosocomial Infection and breaks in the skin
- Caused by infected personnel,  Susceptible Host  Someone who is prone
patients, visitors, food, drug, or to infection, especially
equipment while a patient is in the the elderly, newborn
hospital or other healthcare babies, patients who are
facilities immune-suppressed or
 Localized Infection unvaccinated, and those
- Result from improper site suffering from acute or
preparation, contamination of the site chronic illness.
prior to specimen collection, or
choosing a site where inflammation
 Viability
or infection is present.
- Ability of the microbe to survive or live on the
- An infection that affects only one
obect
body part
 Virulence
 Systemic Infection
- Degree to which the microbe is capable of
- Systemic means affecting the entire
body, rather than a single organ or causing disease
body part.  Immune
 Pathogenic Organisms - A healthy person who has received a vaccination
against a specific virus or who has recovered
- Causing or capable of causing disease
from being infected with it has developed
 Non-Pathogenic Organisms
antibodies against that virus
- Do not cause disease under normal conditions
COMPONENTS OF THE CHAIN OF REACTION
MEANS OF TRANSMISSION
 Airborne Transmission
Component Description
- Involves dispersal of infectious agents that can
 Infectious Agent  Pathogenic microbes remain infective for long periods of time in particles
(Causative) responsible for causing that are typically less than 5 μm in diameter and
an infection such as virus, can be inhaled, such as droplet nuclei.
bacteria, fungus,
 Contact Transmission
protozoa, and rickettsia
o Direct Contact
 Reservoir  Source of the agent of - Physical transfer of an infectious agent to a
infection or place where susceptible host through close or intimate
the microbe can survive, contact such as touching or kissing.
grow, or multiply, which o Indirect Contact
could be in humans, - When a susceptible host touches contaminated
animals, food, water, soil, objects such as patient bed linens, clothing,
and contaminated articles dressings, and eating utensils.
and equipment.  Droplet Transmission
 Exit Pathway  A way or a manner for an - The transfer of an infectious agent to the mucous
infectious agent to leave membranes of the mouth, nose, or conjunctiva of
a reservoir host, which the eyes of a susceptible individual via infectious
could be through droplets generated by coughing, sneezing, or
secretions from the eyes,
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talking as well as through procedures such as
suctioning or throat swab collection.  Evaluation and Treatment
- Provides for the evaluation and treatment of
 Vector Transmission employees who are exposed to infections on the
- Transfer of an infectious agent carried by an job. This includes Occupational Safety and
insect, arthropod, or animal. Health Administration (OSHA)-mandated
 Airborne Transmission confidential medical evaluation, treatment,
- Transmission of an infectious agent through counseling, and follow-up of employees who have
contaminated food, water, or drugs. been exposed to blood borne pathogens (BBPs).
 Surveillance
BREAKING THE CHAIN OF INFECTION - This involves closely watching patients and
 Effective hand hygiene procedures employees at risk of acquiring infections as
 Good nutrition, adequate rest, and reduction of stress well as collecting, evaluating, and distributing data
 Immunization against common pathogens on infections contracted by patients and
 Proper decontamination of surfaces and instruments employees. Infection control measures are
 Proper disposal of sharps and infectious waste updated and new policies instituted based on this
information.
 Use of gloves and other personal protective equipment
(PPE) when indicated INFECTION CONTROL METHODS
 Use of needle safety devices during blood collection  Hand Hygiene
 Infection control programs - Hand hygiene is one of the most important means
of preventing the spread of infection if it is
 Insect and rodent control
performed properly and when required.
 Isolation procedures
o CDC/HICPAC Guidelines:
INFECTION CONTROL PROGRAMS - CDC/HICPAC guidelines recommend the use
 Employee Screening of alcohol-based antiseptic hand cleaners
- Screening tests are used to determine if an that contain a minimum of 60% alcohol in
employee was exposed to certain infectious place of handwashing if the hands are not
diseases. Screening for infectious diseases visibly soiled. Available as gels, foams, and
typically takes place prior to or upon employment rinses, these products have been shown to
and on a regular basis throughout employment. have superior microbicidal (destructive to
 Employee Immunization microbes) activity.
- Immunizations help keep employees from o Hand Washing
contracting and spreading infectious diseases that - There are different methods of handwashing,
are vaccine preventable depending on the degree of contamination
and the level of antimicrobial activity required.
Type of Vaccine Vaccine Recommendations o Routine Hand Washing
 Hepatitis B (HBV)  Three-dose series and - Uses plain soap and water to mechanically
serologic evidence of remove soil and transient bacteria
immunity (first dose; o Hand Antisepsis
second dose 1 month - Uses antimicrobial soap to remove, kill, or inhibit
after first dose; third dose transient microorganisms.
5 months after second o Two-minute Scrub
dose; anti-HBs test 1–2 - Uses an antimicrobial soap or equivalent to
months after third dose) remove or destroy transient microorganisms
 Influenza (Flu)  One dose annually and reduce levels of normal flora prior to surgical
 MMR (Measles, mumps,  Two doses of MMR (one procedures.
rubella) dose; second dose 28
days later) if no proof of  Personal Protective Equipment
prior vaccination or - Protective clothing and other items worn by an
serologic immunity to individual to protect mucous membranes, airways,
measles or mumps skin, and clothing from contact with infectious
 One dose of MMR if no substances. PPE provides a barrier against
proof of prior vaccination infection. Used properly, it protects those wearing
or serologic immunity to it. Disposed of properly, it prevents the spread of
rubella. infection to others.
 Recommendations are
now the same for those  CDC - Centers for Disease Control and Prevention
born before 1957  HICPAC - Healthcare Infection Control Practices Advisory
 Meningococcal  One dose for those Committee
routinely exposed to
isolates of N. meningitidis Donning Doffing
 Tdap (Tetanus,  One dose if not previously  Gown  Gloves
diphtheria, pertussis) vaccinated TD booster  Mask  Goggles
every 10 years after first  Goggles  Gown
dose  Gloves  Mask
 Varicella (Chickenpox)  Two doses 4 weeks apart
if no proof of vaccination PROPER ROUTINE HANDWASHING TECHNIQUE
or serologic immunity 1. Stand back so that you do not touch the sink.
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2. Turn on the faucet, and wet hands under warm
running water.
3. Apply soap, and work up a lather.
4. Scrub all surfaces, including between the fingers and
around the knuckles.
5. Rub your hands together vigorously.
6. Rinse your hands in a downward motion from wrists to
fingertips  Sharp objects in the laboratory - needles, lancets, and
7. Dry hands with a clean paper towel. broken glassware
8. Use a clean paper towel to turn off the faucet unless it  Sharps must be disposed in puncture-resistant
is foot or motion activated. containers
CHEMICAL HAZARDS
5 MOMENTS APPROACH FOR HAND HYGIENE BY
THE WHO
 Before touching a patient,
 Before clean/aseptic procedures,
 After body fluid exposure risk,
 After touching a patient, and
 After touching patient surroundings
 Chemical Spill
HAZARDS IN THE HEALTHCARE SETTING o Flush the area with large amounts of water for at
 Biologic hazards least 15 minutes and then seek medical attention
 Sharp hazards o Proper use of emergency showers and eye wash
 Chemical hazards stations
 Radioactive hazards  Chemical Handling
o Acid should always be added to water
 Electrical hazards
o Wear goggles and prepare reagents under a fume
 Fire/Explosive hazards
hood
BIOLOGIC HAZARDS  Chemical Labeling
o National Fire Protection Association(NFPA_
o Symbol on doors, cabinets, containers

 In 1987, the CDC instituted Universal Precautions (UP).

o All patients are considered to be possible carriers of
blood-borne pathogens
 Body Substance Isolation (BSI) guidelines are not limited
to blood-borne pathogens; they consider all body fluids and
moist body substances to be potentially infectious.
 In 1996 the CDC and HICPAC combined the major features
of UP and BSI guidelines and called the new guidelines
Standard Precautions.
o Hand hygiene
o Gloves
o Mask, eye protection, and face shield
o Gown
o Patient care equipment
o Environmental control
o Linen MATERIAL SAFETY DATA SHEETS (MSDS)
o Occupational health and blood-borne pathogens  OSHA Federal Hazard Communication Standard
o Patient placement  Information contained in an MSDS includes the
following:
BIOLOGICAL WASTE DISPOSAL o Physical and chemical characteristics
 All biological waste, except urine, must be placed in o Fire and explosion potential
appropriate containers labelled with the biohazard o Reactivity potential
symbol. o Health hazards and emergency first aid procedures
 The waste is then decontaminated following o Methods for safe handling and disposal
institutional policy: incineration, autoclaving, or o Primary routes of entry
pickup by a certified hazardous waste company o Exposure limits and carcinogenic potential
 Urine may be discarded by pouring it into a laboratory
sink. (Disinfection of the sink using a 1:5 or 1:10 RADIOACTIVE HAZARD
dilution of sodium hypochlorite should be performed
daily.)
SHARPS


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 Class K  High-temperature
cooking oils, grease, or
fats

TYPES AND APPLICATIONS OF FIRE

EXTINGUISHERS

Class Type
 Class A  Water
 Procedures using radioisotopes
 Class B  Foam, dry chemical, or
 Persons working in a radioactive environment are required
carbon dioxide
to wear measuring devices to determine the amount of
radiation they are accumulating  Class C  Dry chemical, carbon
dioxide, or halon
ELECTRICAL HAZARD
 Class ABC  Dry chemical reagents
 Class K  Potassium-based
alkaline liquid

PHYSICAL HAZARD

 Laboratory personnel should continually observe for any

dangerous conditions such as frayed cords and
overloaded circuits
 All electrical equipment must be grounded with three-
pronged plugs
FIRE/EXPLOSIVE HAZARD
 Avoid running in rooms and hallways, watch for wet floors,
and bend the knees when lifting heavy objects, keep long
hair pulled back, avoid dangling jewelry, and maintain a
clean, organized work area.
 Closed-toe shoes that provide maximum support are
essential for safety and comfort.

 When a fire is discovered, all employees are expected to

take the actions in the acronym RACE:
o Rescue—rescue anyone in immediate danger
o Alarm—activate the institutional fire alarm
system
o Contain—close all doors to potentially affected
areas
o Extinguish—extinguish the fire, if possible;
evacuate
 The acronym PASS can be used to remember the steps in
the operation:
o Pull pin.
o Aim at the base of the fire
o Squeeze handles.
o Sweep nozzle side to side.

CLASSIFICATIONS OF FIRE
Class
 Class A  Ordinary combustible
solid materials, such as
paper, wood, plastic, and
fabric
 Class B  Flammable liquids/gases
 Class C  Electrical equipment
 Class D  Combustible/reactive
metals

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