THE CHAIN OF INFECTION

1.the various ways infection can be transmitted 2. the ways the infection chain can be broken

THERE ARE SIX LINKS

IN THE CHAIN OF

INFECTION

1ST - THE INFECTIOUS AGENT

-any disease-causing microorganism (pathogen)

2ND - THE RESERVOIR -the organism in which the infectious microbes reside

What are Carrier Hosts

Hosts that do not show any outward signs or symptoms of a disease but are still capable of transmitting the disease are known as carriers.

3RD - THE PORTAL OF EXIT -route of escape of the pathogen from the reservoir.
Examples: respiratory secretions, blood exposure, breaks in skin

4TH - THE ROUTE OF TRANSMISSION

-method by which the pathogen gets from the reservoir to the new host

Transmission may occur through:

direct contact

air

insects

5TH - THE PORTAL OF ENTRY

-route through which the pathogen enters its new host

Respiratory System

Gastrointestinal System

Urinary & Reproductive Tracts

Breaks in Protective Skin Barrier

6TH - THE SUSCEPTIBLE HOST

-the organism that accepts the pathogen

The support of pathogen life & its reproduction depend on the degree of the hosts resistance.

Organisms with strong immune systems are better able to fend off pathogens.

Organisms with weakened immune systems are more vulnerable to the support & reproduction of pathogens.

How to interrupt the chain of infection:

-The essential part of patient care & self-protection.

1. PATHOGEN IDENTIFICATION

-identification of infectious agent & appropriate treatment

2. ASEPSIS & HYGIENE

-potential hosts & carriers must practice asepsis & maintain proper personal hygiene

3. CONTROL PORTALS OF EXIT

-healthcare personnel must practice standard precautions:

(Control body secretions & wash hands according to protocol.)

4. PREVENT A ROUTE OF TRANSMISSION

-prevent direct or indirect contact by:

1. Proper handwashing 2. Disinfection & sterilization techniques 3. Isolation of infected patients 4. Not working when contagious

5. PROTECT PORTAL OF ENTRY

-Health professionals must make sure that ports of entry are not subjected to pathogens.

(nose, mouth, eyes, urinary tract, open wounds, etc.)

6. RECOGNITION OF SUSCEPTIBLE HOST

-health professionals must recognize & protect high-risk patients

Cancer Patients

AIDS Patients
Transplant Patients Infant & Elderly Patients

Remember--breaking the chain of infection is the responsibility of each health professional.

Resident Flora DEFINITION OF TERMS a given area in one part of the body, Collective vegetation in yet can produce infection Infection Invasion of body tissue by microorganisms and their growth. (infectious agent) Virulence Ability to produce disease. Microorganism also vary in the severity of the diseases they produce and their degree of communicability. Pathogenicity Ability to produce disease Oppotrunititic Pathogen Causes disease only in susceptible individual. Asepsis Freedom of disease causing microorganisms

DEFINITION OF TERMS

Medical Asepsis

Includes all practices intended to confine a specific microorganisms to a specific area, limiting number, growth and transmission of microorganisms Refers to those practices that keep an area or object free all microorganism Is the state of infection and can take many forms, including septic shock Classified as infections that are associated with delivery of health care services in a health care facility

Surgical Asepsis or Sterile Tech.

Sepsis

Nosocomial infections

DEFINITION OF TERMS

Septicemia

Transport of an infection or the products of infection through out the body or by blood A person or an animal, who is without signs of illness but who harbor pathogens within his body that can be transferred to another. A person or an animal known or believed to have been exposed to a disease Microorganism picked up by the skin as a result of normal activities that can be removed readily Process by which all microorganisms including their spores are destroyed

Carrier

Contact

Transient Flora

Sterilization

DEFINITION OF TERMS

Disinfectant

A substance, usually intended for use on inanimate objects that destroy pathogen but generally not the spores A substance usually intended for use in persons that inhibits the growth of pathogen but not necessarily destroy them A chemical that kills microorganisms An agent that prevents bacterial multiplication but does not kill all forms of organism Causes dse. Only in susceptible individual

Antiseptic

Bactercidal

Bacteriostatic

Opportunistic pathogen

TYPES OF MICROORGANISMS CAUSING INFECTIONS

Bacteria

Most common
Consists primarily of nucleic acid and therefore must enter living cells to reproduce Yeasts and molds Live on other living organisms

Viruses

Fungi

Parasite

TYPES OF INFECTION

Colonization strains of microorganisms become resident flora. May not cause dse.
Local infx limited to specific body part Systemic spread and damage diff parts of the body

Bacterima Septicemia

Acute infx. short term Chronic infx slowly , very long period of time

STAGES OF INFECTIOUS PROCESS

Incubation period Entry of microorganism to the onset of signs & symptoms Onset of nonspecific signs & symptoms to appearance of signs and symptoms Specific signs and symptoms develop and became evident

Prodromal Period

Illness Period

Convalescent Period

Signs and symptoms start to abate until the client returns to normal state of health.

FACTORS INFLUENCING HOSTS SUSCEPTIBILITY

Skin & mucus membrane pH levels WBC Age Immunization General health status

PRINCIPLES UNDERLYING MEDICAL & SURGICAL ASEPSIS

Patient is the source of pathogenic microorganism Pt.s microorganisms leave through specific routes There are always microorganisms in the environment Microorganisms can be transmitted though direct / indirect contact

PRINCIPLES UNDERLYING MEDICAL & SURGICAL ASEPSIS

Spread

of infection from source to others can be prevented by various methods to stop the spread as close to the source as possible Effectiveness of medical/surgical asepsis is dependent on the conscientiousness of those carrying out In observing medical asepsis, areas are considered contamintaed if they bear or are suspected of having pathogens

DISINFECTION AND STERILIZATION

DEFINITION OF TERMS

Disinfection

Destruction of pathogenic microorganisms except spores by physical or chemical means Process of completely ridding materials or tissue of the microorganisms, leaving no viable forms including spores the ability to produce a disease Substance, usually intended for use on inanimate objects that destroys pathogens but not genrally spores A substance usually intended for use on persons that inhibits the growth of pathogens but not necessarily destroy them

Sterlilization

Pathogenicity

Disinfectant

Antiseptic

MEANS OF DISINFECTION AND STERILIZATION

Physical Means
Dry heat oxidation process Moist heat coagulation of proteins within the cells Radiation altering metabolite process Steam Under pressure Boiling Free Flowing Steam Dry heat Radation

CHEMICAL MEANS

Ethylene Oxide Gas

The gas dstroys microorganisms even spore formers by interfering metabolic process in cells.
Phenolic compounds Chlorine Compounds Iodine and Iodofors Formaldehyde Glutardehyde Alcohols Quaternary Ammonium Compounds

Chemical Solutions

CARE OF PATIENT UNIT

PATIENT UNIT

Area Furnishing Equipment

OBJECTIVE

To provide clean, attractive and hygienic surrounding for the patient and hospital staff

ASSESSMENT

Condition of the environment Materials / Equipment Patients status who previously occupied the unit

PLANNING

Equipment and Supplies:

Basin/ pail with water Cleansing and dusting cloths Cleanser Soap in a soap dish Newspaper Brush Dust pan Broom Floor mop Sharp scissors disinfectant

Need for modification Recall related principles

PLANNING

Recall related principles

Body mechanics Infection control Work organization

Need for modification

IMPLEMENTATION

DAILY CARE OF ROOM OF BED UNIT

Assemble necessary equipment Maintain proper lighting and ventilation Remove all furniture from area to be cleaned Clean ceilings, wall, floor and window ledges Dust furniture Make bed, by using clean linens when necessary Clean equipment and articles Keep the drawers clean. See that articles are in proper order Keep mirrors clean and free from stain Take all flower to utility room. Empty and clean garbage can.

CLEANSING A ROOM OR BED UNIT AFTER THE PATIENT IS BEING DISCHARGE

Strip bed, pillows, screens and etc. Bath basin, emesis basin, soap dish rubber sheet should be taken into the utility washed with cleaner then with soap and water Both sides of pillows and mattress should be brushed. Place under the sun if possible 2-3 hrs Bed frame, bars, springs, bedside table, cabinet, dressers, drawers and chairs should be dusted. Drawers should be left for airing Wash toilet bowl and lavatory thoroughly Clean mirrors with cleanser and newspaper Air room for few hours, and then put the room back in order

CLEANING A ROOM USED BY PATIENT WITH INFECTIOUS CASES

Bed, pillows, screens should be disinfected Bath basin , emesis basin, soap dish, rubber sheet wash with cleanser soap and water. Disinfected and dried. Soap and water, clean the entire room or bed unit, furniture and fixtures. Beds should be clean with wash cloth treated with disinfectant. Bed is aired for 24 hrs Floor is mopped with 2% lysol

CARE OF TOILETS AND BATHROOM

Assemble necessary equipment Flush toilet Raise toilet seat Sprinkle scourging agent (cleanser) into the bowl Brush the inner , outer and under the brim part of the toilet bowl Flush toilet seat with soap and water. Dry If toilet bowl is clogged, use a rubber pump if unsuccsessful, poor declogger solution into the bowl and let it stay for 2-4 hrs after brushing, then flush the toilet bowl

CARE OF TOILETS AND BATHROOM

Wash toilet seat with soap and water. Dry. Scrub the walls of the bedroom/toilet and rub stain with fine abrasive. Rinse with water. Scrub, rinse and dry the floor. Check articles in the unit. Clean and return equipment in their proper places

CLEAN AND ARRANGEMENT OF FLOWERS

Take vase of flower to utility room. Line work with newspaper. Wash vase with soap and water, rinse thoroughly and dry. Fill vase with fresh water Wash stems of flowers remove wilted leaves.

CLEAN AND ARRANGEMENT OF FLOWERS

Cut the end stem of the flower diagonally to prolong the life of the flower. Rearrange the flower of vase avoiding crowding of stems. Match height of the stems with vase. Return vase of the flower at the beside. Flowers from the florist receive from the information desk is brought directly to the patient un open so that the patient may see the contents of the box then arrange attractively.

CARE OF NURSES STATION

Dust, tables counter and chairs including drawers and cabinets. Clean and arrange flowers and vase. Change hand solution and towels as often as necessary. Clean medicine cabinet (inside and outside). Place an oil empty bottles in appropriate place. Charts forms and report book must be kept in order.

CARE OF HOSPITAL SUPPLIES AND EQUIPMENT

Glasswares

Wash with warm soapy water, then rinse well with hot water.

Silverwares

Wash with hot water. Rinse well in hot water If stained, use fine abrasive or good metal polish

Rubber goods

Rubber Glove

Wash with soap and water. Rinse, invert and repeat washing. Hang to dry. Check for any punctures, powder surfaces and pack. Empty contents, wipe outside and hang dry with opening facing down. If contaminated, soak in 2% Lysol solution for hr After drying, place in cool dry place.

Hot Water Bag, Ice cap and Ice collars

Rubber goods

Rubber sheets and Rubber Aprons

Wash with soap and water. Rinse well. Wipe dry. Put powder, roll and keep in proper place. If contaminated treat with 2^ Lysol solution. Wash with cold water. Clean with soap and rinse well. Wrap with gauze and drop in boiling water for 3-5 mins. Let it dry.

Rubber Nipples

BEDPANS AND URINALS

Empty contents except gauze, cotton balls and tissue papers Wash with cold water. Use brush or bed pan swab when necessary Wash again with hot water Put bedpan in the can with disinfectant, 2% Lysol solution for 2-6 hours Wash the inside and outside of bedpans with warm water Remove any stains using cleanser applied to brush Rinse with hot water. Dry and place on bedpan rack.

TO STERILIZE .

Dull instruments

After washing, sterilize by boiling for 15-20 mins on a perforated tray that can be lifted out of water allowing instruments to drain. Surgical instruments are best sterilized by autoclaves. They should be placed im trays and packed. Can be soaked in Zephiran 1:1000 for 3 hours.

TO STERILIZE.

Sharp instruments

After washing, soak in Zephiran 1:1000 or 7% alcohol for 3 hrs Sharp instruments like scalpel, sharp eye instruments inserted into a small pieces of tubing to protect edges from destruction They are never boiled as boiling dulls the edges

REMOVAL OF STAINS

GENERAL RULES FOR REMOVAL OF STAINS

Note the kind of material, nature of stain and select the appropriate method Remove stains as soon as possible Try the simplest method When in doubt use cold water first Soap oil first When boiling water, stretch the stain and put over a bowl and our boiling water until the stain disappear

When using acid, stretch the stain over a bowl of boiling water and supply the acid with a medicine dropper or cold toothbrush applying water occasionally. When stain disappears rinse with cold water thoroughly then treat it with ammonia to neutralize the acid. Rinse it again. When bleaching in sunlight bleach in the presence of moisture In bleaching, strong chemicals are not used due to their injurious effect volatile liquids such as gasoline, benzene and alcohol should not be used within a closed doors not near a lamp or fire for they are inflammable.

REMOVAL OF STAINS

Blood stain

When still wet it can be removed with soap and cold water. If it fails, cover the stained surface with set starch and repeat the application. If it is an old blood (1 week or 1 month), soak it with hydrogen peroxide or ammonia solution for several hours

REMOVAL OF STAINS

Mucus Stain

Soak it in salt solution then wash, ammonia and water

Soak in cold water, scrub in soapy water then rinse well Soak in hot water then in Lysol solution. Wash with soap and water Wash thoroughly with soap and water and dry under the sun

Feces

Urine

Perspiration