Infection Control

FUNDAMENTALS OF PHLEBOTOMY AND BODY FLUID COLLECTIONS

Michelle Brown, MS, MLS(ASCP)CMSBBCM
Assistant Professor
Clinical and Diagnostic Sciences
michellebrown@uab.edu
OBJECTIVES

• Define infection and describe what is meant by the terms local,

systemic, communicable, and nosocomial.

• Identify the components of the chain of infection and give examples of

each, and describe infection control procedures to break the chain.

• Define blood borne pathogen, list examples, and describe the means
of transmission of blood borne pathogens in a healthcare setting.

• Describe proper procedures for hand washing, and donning and

removing protective clothing.

• Describe standard precautions outline by the Centers for Disease

Control and Prevention.
INFECTIONS

• Microbes that are capable of causing disease are called pathogens

• The majority of microbes are nonpathogenic meaning they do not

cause disease under normal conditions.

• If a pathogen invades the body and multiplies, the resulting condition

is called an infection.

• 4 broad categories of infection

• Local – restricted to a small area of the body
• Systemic – the entire body is effected
• Communicable – spread from person to person
• Nosocomial – hospital-acquired infections (HAIs)
CHAIN OF INFECTION

• Infection transmission requires

• Source of pathogenic microbes
• Means of transmission
• Susceptible host
CHAIN OF INFECTION - SOURCE

• Patients
• Personnel
• Visitors
• Equipment
• Food or water
• Person’s own normal flora

• Factors effecting transmission

• Amount of pathogen
• Viability – ability of pathogen to survive on the source
• Virulence – the degree to which an organism is capable of causing disease
CHAIN OF INFECTION – MEANS OF TRANSMISSION

• Contact transmission – most frequent mode

• Direct – direct, physical transfer of a pathogen such as touching or
kissing
• Indirect – host contact with a contaminated object such as gloves,
needles, medical equipment
• Droplet transmission – infectious microbe is transferred to the
mucous membranes of nose or mouth
• Sneezing
• Coughing
• Suctioning procedures
• Airborne transmission – evaporated droplets generated by sneezing or
coughing, they remain suspended in the air for long periods of time
• Special air handling is required for patients who have infections with
airborne transmission
• Mycobacterium tuberculosis, rubeola virus, varicella virus are common
CHAIN OF INFECTION – MEANS OF TRANSMISSION

• Vector transmission – microbe is transferred by an insect or animal

• Female Anopheles mosquito - Plasmodium sp – malaria
• Rodent fleas – Yersinia pestis – plague

• Vehicle transmission – microbe transferred through food, water, or

drugs
• Raw chicken - Salmonella
• Poor drinking water – Shigella
CHAIN OF INFECTION – SUSCEPTIBLE HOST

• Can be anyone, susceptibility affected by

• Age
• Health
• Immune status
BREAKING THE CHAIN OF INFECTION

• Ways to prevent transmission

• Handwashing
• Gloves
• Gowns
• Masks
• Isolation procedures
• Decontamination of surfaces and instruments
HANDWASHING

• Wet your hands with running water.

• Apply liquid, bar or powder soap.
• Lather well.
• Rub your hands vigorously for at least 15 seconds. Remember to scrub
all surfaces, including the backs of your hands, wrists, between your
fingers and under your fingernails.
• Rinse well.
• Dry your hands with a clean or disposable towel or air dryer.
• If possible, use your towel to turn off the faucet.

Keep in mind that antibacterial soap is no more effective at killing germs

than is regular soap. Using antibacterial soap may even lead to the
development of bacteria that are resistant to the product's
antimicrobial agents — making it harder to kill these germs in the
future.
BLOODBORNE PATHOGENS

• Infectious microbes in blood, tissues, or body fluids

• You are at particular risk of percutaneous contact (needle stick)when
performing phlebotomy

• Bloodborne Pathogens
• Hepatitis B and C
• HIV
• Human T cell Lymphotropic Virus I and II
• Syphilis
BLOODBORNE PATHOGENS

• Transmission of blood borne pathogens

• Nonintact skin – direct contact of the pathogen with visible and

nonvisible preexisting cuts, including chapped hands and
dermatitis

• Percutaneous – through the skin, needle sticks, broken glass,

human bites, transfusion

• Mucous membrane – contact with nasal oral or conjuctival

mucosa by droplets, aerosols, or splashes - or touching eyes,
nose, or mouth with contaminated hands
GLOVES

• Putting on gloves
• Pull gloves on tightly
• Stretch ends over the cuffs of the gown

• Removing gloves
• Pull gloves off from the open end
• Turn one inside out and place in other fist
• Remove other glove turning it inside out
• Avoid touching the outside surface of the gloves
STANDARD PRECAUTIONS

• Precautions used in caring for all patients because of the difficulty in

determining individuals with various infections

• Hand washing – use alcohol based sanitizer unless visibly contaminated,

then use soap and water
• Gloves – wear gloves when handling blood, body fluids, or tissue or
items contaminated with blood or body fluids
• Gowns – wear fluid resistant gowns when contamination of clothing is
likely
• Face protection – wear face shield when there is a possibility of aerosol
formation
• Sharps – Dispose of needles and sharps in a puncture proof container.
Do not recap needles
• Respiratory hygiene – cover your cough with a tissue or cough into your
elbow if you do not have a tissue
REFLECTION – YOU HAVE LEARNED

• The meaning of the terms local, systemic, communicable, and

nosocomial.

• The components of the chain of infection and can give examples of

each, and you can describe infection control procedures to break the
chain.

• What constitutes a blood borne pathogen, you can give examples, and
the means of transmission of blood borne pathogens in a healthcare
setting.

• Proper procedures for hand washing, and donning and removing

protective clothing.

• Standard precautions outline by the Centers for Disease Control and

Prevention.