Implement and Monitor Infection
Control policies and procedures
The best method of infection
control is prevention, which is
successful when the chain of
infection is successfully broken
HYGIENE
Is the science of preventive medicine and
the preservation of health.
Client grooming is a part of good hygiene
and important to achieve positive self-
image.
Nature of Infection
Infection – is the invasion of the body by
pathogens.
Asymptomatic infection – if the
microorganism fails to cause serious injury
to cell or tissues.
Communicable disease – infectious disease
which can be transmitted directly from one
person to another
Chain of Infection
Pathogen
Susceptible
Host Reservoir
Portal of
Entry Portal of
Mode Exit
of
Transmission
Why Isolation?.. because transmission is
easier to control than the source / host!
Infectious Agent
Bacteria : Escherichia coli, Mycobacterium
tuberculosis
Viruses: Hepatitis B virus, Human
Immunodeficiency virus
Fungi: Aspergillus organisms (dermatitis)
Protozoa: Plasmodium falcifarum (malaria)
Pathogens on the skin
Resident pathogens
Transient pathogens
Factors affecting the ability of
organism to cause disease
Number of organisms
Virulence – ability to produce disease
Ability to enter and survive the host
Susceptibility of the host
Course of Infection by Stage
Incubation period – entrance to 1st
symptoms
Prodromal Stage – onset of nonspecific
ssx to more specific sx
Illness Stage – specific ssx
Convalescence –acute sx of infection
disappear
Concept of Asepsis
Asepsis –absence of germs of pathogens
Aseptic technique – efforts to keep client as free
from hospital microorganisms as possible
• Medical asepsis- clean technique
- to reduce the number of microorganisms and prevent their
spread
Ex: handwashing, changing linen daily
• Surgical asepsis – sterile technique
– to eliminate microorganisms
– Ex: sterilization
Control or elimination of infectious
agents
Cleansing – removal of all foreign
materials such as soil and organic material
from objects.
What is Infection Control?
Identifying and reducing the risk of
infections developing or spreading
Nosocomial Infections
Develops when a patient is staying at a
healthcare facility AND was not present
when the patient was admitted to the
facility
At least 5% of patients hospitalized each
year in the United States develop
nosocomial infections. Many are
preventable
Standard Precautions
Guidelines for preventing exposure to blood, body
fluids, secretions, excretions (except sweat), broken
skin, or mucous membranes
Based on the concept that body fluids from ANY patient
can be infectious
Should be used on every patient
Use necessary PPE for protection
– CDC guidelines requires us to use category-specific isolation
(ex – TB isolation) in addtion to Standard Precautions when a
patient is known or suspected to have an infection
Antibiotic Resistant
Microorganisms
normal flora gone bad!
Problem exists because of overuse and
inappropriate use
Resistant to multiple antibiotics
Reduced options for treatment
Require isolation precautions
Examples: MRSA, VRE, MDR TB
Solutions: more appropriate antibiotic use,
better infection control and prevention
CONTACT ISOLATION
used to prevent transmission of
microorganisms spread by
direct/indirect contact with the source
examples:
– MRSA
– VRE
– C. diff
– contagious skin infections… Lice & Scabies
CONTACT ISOLATION
BASIC COMPONENTS:
– gloves
– fluid impervious gown
– HANDWASHING
HAND WASHING
Proper hand washing is the single most important ay to prevent
and reduce infections
Wash and rinse hands for 15 seconds, using a dry paper towel to
turn off faucet
Avagard alcohol based hand wash is also available in all patient
care areas
Hands should be washed:
– Before and after patient contact
– Before putting on gloves and after taking them off
– After touching blood and body substances (or contaminated patient-care
equipment), broken skin, or mucous membranes (even if you wear
gloves)
– Between different procedures on the same patient
DROPLET ISOLATION
used to prevent transmission of microorganisms
spread by large, moist droplets inhaled by or
landing on the mucous membranes of the
susceptible host
examples:
– Influenza
– Neisseria meningitidis
– some pneumonias
– vaccine preventable diseases:
• rubella, mumps, pertussis
DROPLET ISOLATION
BASIC COMPONENTS
– surgical mask within 3 foot zone
– HANDWASHING
AIRBORNE ISOLATION
used to prevent transmission of
microorganisms spread on very small
particles that drift on air currents (droplet
nuclei, dust)
examples:
– pulmonary Tuberculosis
– varicella
– measles
Shingles vs. Chicken Pox
Both are caused by the
varicella virus
Shingles remain along
nerve roots and appear on
a single dermatome
Shingles involving
multiple dermatomes or an
immunocompromised
patient (WBC <4.0)
consider this to be
systemic and isolate just
like chicken pox (airborne)
AIRBORNE ISOLATION
BASIC COMPONENTS:
– negative air pressure isolation room
– door remains closed
– fit-tested N95 respirator
– Call Engineering (ext. 2060) with room # to
check negative pressure.
– yes… HANDWASHING!
Key Points About PPE
Don before contact with the patient,
generally before entering the room
Use carefully – don’t spread contamination
Remove and discard carefully, either at the
doorway or immediately outside patient
room; remove respirator outside room
Immediately perform hand hygiene
Sequence for Donning PPE
Gown first
Mask or respirator
Goggles or face shield
Gloves
How to Safely Use PPE
Keep gloved hands away from face
Avoid touching or adjusting other PPE
Remove gloves if they become torn;
perform hand hygiene before donning new
gloves
Limit surfaces and items touched
“Contaminated” and “Clean”
Areas of PPE
Contaminated – outside front
• Areas of PPE that have or are likely to have been in
contact with body sites, materials, or environmental
surfaces where the infectious organism may reside
Clean – inside, outside back, ties on head
and back
• Areas of PPE that are not likely to have been in
contact with the infectious organism
Sequence for Removing PPE
Gloves
Face shield or goggles
Gown
Mask or respirator
Where to Remove PPE
At doorway, before leaving patient room or
in anteroom*
Remove respirator outside room, after door
has been closed*
* Ensure that hand hygiene facilities are available at
the point needed, e.g., sink or alcohol-based hand
rub
Removing Isolation Gown
Unfasten ties
Peel gown away from
neck and shoulder
Turn contaminated
outside toward the
inside
Fold or roll into a
bundle
Discard
Removing a Mask
Untie the bottom, then
top, tie
Remove from face
Discard
Removing a Particulate Respirator
Lift the bottom
elastic over your
head first
Then lift off the top
elastic
Discard
Hand Hygiene
Perform hand hygiene immediately after
removing PPE.
• If hands become visibly contaminated during PPE
removal, wash hands before continuing to remove PPE
Wash hands with soap and water or use an
alcohol-based hand rub
* Ensure that hand hygiene facilities are available at
the point needed, e.g., sink or alcohol-based hand
rub
Handling Patient Care
Equipment
Handle patient care equipment soiled with blood, other
body fluids, secretions, or excretions in a way that
prevents contact with skin and mucous membranes
Handle patient care equipment in a way that prevents
contamination of clothing and the spread of
microorganisms to other patients
Appropriately dispose of single use equipment (suction
canisters, etc)
Clean and disinfect reusable equipment. Place clean
instruments in biohazard bag for transport to Central
Sterile Supply and re-sterilization
In addition, contact precautions
require that you:
Don’t share non-critical equipment (such as
stethoscopes and thermometers) between patients
If a piece of equipment is used with a patient in
contact isolation, then the equipment must be properly
cleaned and disinfected prior to use on another patient
Place a patient on airborne, contact, or droplet
precautions in a private room, if possible
If a private room is not available, the patient may be
placed with another patient who has the same (but no
other) infection
What to do if exposed to blood /
body fluids
Puncture wounds should be washed immediately and the
wound should be caused to bleed
If skin contamination should occur, wash the area
immediately
Splashes to the nose or mouth should be flushed with
water
Eye splashes require irrigation with clean water, saline,
or a sterile irritant
Most importantly: Complete a GBMC Employee
Incident Report. Report exposure to charge nurse
and Agency immediately
ROLE OF CAREGIVER
Assist to follow up client’s hygiene practices
Encourage them to do as much of their daily care as
possibly by themselves
Assist client to select their own clothing
Promote independence and self esteem
Encourage use of deodorant, perfume, aftershame
lotion, and cosmetics
Be patient and encouraging.
What are the Daily Hygiene Needs
of the Client?
Bathing Nail care
Dressing Perineal care
Back care Dressing and
Oral hygiene undressing
Shaving
Shampooing
Hair care
InfoWeb…….
Finished!
Please complete the Infection Control post-
test and print out the certificate of
completion for your agency
