Chain of Infection &
Standard
Precautions
Learning Objectives,
• To explain the chain of infection
• To reinforce the importance of strict hand hygiene in
reducing cross infection
• To refresh knowledge of methods of hand decontamination
• To refresh knowledge about PPE
Chain of Infection
Certain conditions must be met in order for a microbe or infectious disease to
be spread from person to person. This process, called the chain of infection
It can only occur when all six links in the chain are intact. By breaking this chain
at any of the links, the spread of infection is stopped
Links in the chain
• Infectious Agent
• Reservoir
• Portal of Exit
• Mode of Transmission
• Portal of Entry
• Susceptible Host
Routine hygienic practices, standard precautions, and transmission-based
precautions are used to break the chain of transmission.
Standard
Precautions
• Standard Precautions are a set of infection control practices used in
healthcare settings to prevent the transmission of infectious agents from
both recognized and unrecognized sources.
Standard Precautions -
components
1. Hand hygiene
2. Appropriate use of PPE
3. Sharps safety
4. Safe handling of clinical waste
5. Correct decontamination of used equipment
6. Maintaining a safe environment
Hand Hygiene
What’s on your hand ?
• Resident organisms: live naturally within the skin
normal flora. Not easily transferred.
• Transient organisms: are picked up easily from the
environment or during patient contact. Easily transferred
from your hands to others
• Good hand hygiene is the simplest most effective method of preventing cross
infection
• Decontamination of hands before and after contact and after removing
gloves
When Do We Contaminate Hands?
Moving &
Toileting Handling
handling
patients clinical notes
patients
Touching Touching
Obtaining Making beds
patient your face
specimens
surface
Cleaning Handling urine
equipments bottles & bed
pans
What To Look For In Your Area,
• Wash hand basins should be clean and intact and accessible within
the clinical area
• Elbow operated or non touch mixer taps
• Availability of liquid soap
• Good supply of disposable hand towels
• Warm water
What Products to Use,
Liquid Soap and Warm Water
Alcohol Gel (Do not use hand rubs more than 5-8 times without Washing your hands)
Antibacterial Solutions
Principles of Hand Hygiene
• Hand jewelry should never be worn in the clinical area
• Remove long sleeves (i.e. white coats, cardigans) before hand washing
• Nails
Keep fingernails short
No nail varnish
No false nails
• Ensure all areas of the hands and wrists are covered
• Technique is as important as frequency
• Ensure hands are dried properly with disposable paper towels – take care
not to contaminate hands when disposing of paper towels
• Use a hand moisturizer
What Can You Do?
Think:
• What have I just done?
• What am I going to do?
Be a good role model
Encourage others Discuss availability and
maintenance of facilities in your area with line
manager
Follow the 5 Moments
7 steps to effective hand hygiene
• Remember to wash your hands for at least
15 seconds
• The time it takes is less important than
making sure you clean all areas of your
hands
• Theses areas are most often missed while
washing:
Thumbs
Fingertips
Between fingers
Care of the hands
• When off duty apply hand cream to protect and
nourish the skin
• Keep the nails short and clean and free of nail polish
• Whilst on duty ensure that any areas of broken skin
are protected with a waterproof dressing
Patient Hand Hygiene
• Increase Patient Awareness of importance of Hand
Hygiene
• Encourage Patients to Wash Hands
After Toileting
Before Mealtimes
Before Touching Lines, Wounds, Feeding
Tubes
Personal protective equipment
(PPE)
Select appropriate personal protective equipment
(PPE) on the basis of an assessment of the risk of
transmission of organisms to the patient and the
risk of contamination of health care workers
clothing or skin by patient’s blood, body fluids,
secretions and excretions
Gloves
These should be used to protect hands from
contamination with organic matter and infectious
organisms
Wearing gloves correctly will reduce the risks of
transmission of micro-organisms to both patients and
staff
Gloves should be worn as single-use items. Put gloves
on immediately before an episode of patient care and
remove them as soon as the activity is completed.
Change gloves between different patients or between
Gloves must be disposed of as clinical waste and hands should always
be decontaminated following the removal of gloves.
Aprons & Gowns
Disposable plastic aprons should be worn whenever there
is a risk that clothing or uniform may become exposed to
blood, body fluids, secretions or excretions with the
exception of sweat
Full body, fluid repellent gowns should be worn where
there is a risk of extensive splashing of blood or body fluids
onto the health care worker.
Aprons are single use and should be worn for one
procedure or episode of patient care and then disposed of
as clinical waste
Eye Protection & Masks
These should always be worn when there is any possibility of
splashing of blood or body fluids onto the face
Donning and Doffing PPE
Donning and doffing is the practice of putting on and removing personal protective
equipment.
Donning refers to putting on personal protective equipment.
Doffing refers to removing personal protective equipment.
Remember!
Always move slowly – it is a step by step task
Do not rush when donning PPE
Have your hair tied back/out of the way
Avoid touching PPE once donned
Avoid touching face, exposed skin
Do not rush when doffing PPE
Use appropriate waste receptacle (preferably hands-free) and discard
carefully
Safe Work Practices
Use the following safe work practices to protect yourself and limit the spread of
contamination:
Keep your hands away from your face and limit the surfaces you touch.
Change gloves when torn or heavily contaminated.
Regularly perform hand hygiene. An alcohol based hand rub (ABHR) is the preferred
method to clean hands. If hands look or feel soiled, use soap and water to clean
hands.
Donning & Doffing Sequence
Donning Sequence
1. Proper hand hygiene
2. Inspection of PPE - tears, rips, soiling - anything that is found to be
soiled/damaged/defective must be removed from use, properly
disposed of or labeled accordingly
3. Gown
4. surgical mask
5. Goggles/face shield
6. Gloves
7. Inspection again. Check for gaps/tears during donning and that PPE
remains intact during range of motion - moving your arms, legs and neck
Doffing Sequence
1. Gloves
2. Gown
3. Goggles/face shield
4. Surgical mask
Thank You !
