2. INFECTION CONTROL
Infection control practices are
directed at controlling or
eliminating sources of infection
in the health care agency,
home, or community.
3. PATHOGENS AND INFECTION
TERMINOLOGY
Pathogenicity is the ability of a microorganism to
produce disease.
Microorganisms that cause diseases in humans are called
pathogens.
Virulence is the degree of pathogenicity of an
infection’s microorganism.
Infection is an invasion and multiplication of
microorganisms in body tissue that results in cellular
injury.
These microorganisms are called infectious agents.
4. CONTINUED
Communicable Disease
The result of a communicable agent being transmitted to a client by
direct or indirect contact, through a vehicle (or vector) or airborne route
Colonization is the multiplication of
microorganisms on or within a host that does
not result in cellular injury.
Flora are the vegetation of microorganisms on
the human body.
Resident flora
Transient flora
5. AGENT, HOST, AND ENVIRONMENT
Agents capable of causing disease:
Biological agents
Chemical agents
Physical agents
6. AGENT, HOST AND ENVIRONMENT
The environment consists of everything other than
the agent and host.
Water, food, plants, animals
Housing conditions
Noise
Meteorological conditions
Environmental chemicals
7. CHAIN OF INFECTION
Microorganism (infectious agent)
Source or reservoir
Portal of exit from reservoir
Mode of transmission
Portal of entry into host
Susceptible host
9. INFECTIOUS AGENTS
The ability of a microorganism to infect a client is
related to:
Virulence of the agent
Number of microorganisms present
Ability of the agent to enter and live in the client
Susceptibility of the client
10. INFECTIOUS AGENTS
Resident Infectious Agents
Microorganisms which are always present on skin.
Can be reduced through handwashing, but not
totally removed.
11. INFECTIOUS AGENTS
Transient Infectious Agents
Agents that are picked up by the skin from another
person or object.
Attach themselves to the skin and then may be
transmitted to a susceptible host.
12. SOURCE OR RESERVOIR
Required for the microorganism to survive while
awaiting a host.
May allow the organism to multiply, making it more
dangerous.
The human body is the most common reservoir.
Food, plants, animals, and feces are other common
reservoirs.
13. PORTAL OF EXIT
Pathway by which pathogens leave the body of a
host. Accessed by:
Direct Contact
Indirect Contact
Airborne Transmission
14. PORTAL OF EXIT
Direct Contact
Transmission of disease from the host
Touching, kissing, and sexual intercourse
Sources of Direct Contact
Skin, mucus membranes, urine, feces, reproductive
tract, blood
15. PORTAL OF EXIT
Indirect Contact
Occurs with the use of vehicles and vectors
Vehicles (fomites)
Toys, hospital supplies, instruments, dishes, cups,
or surgical dressings, food, fluids, blood
16. PORTAL OF EXIT
Airborne Transmission
Transmission of infectious agents through
coughing, sneezing, dust particles
Usually entry via the person’s respiratory tract
18. SUSCEPTIBLE HOST
A person with a reduced immune response has
increased susceptibility.
The immune response is the body’s natural defense
against infection.
20. FACTORS INFLUENCING
PRODUCTION OF AN INFECTIOUS
DISEASE
Age
The elderly and children under two years of age are
at greatest risk.
Heredity
Conditions or diseases resulting in the absence of or
inability to form immune defenses.
21. FACTORS INFLUENCING
PRODUCTION OF AN INFECTIOUS
DISEASE
Stress
Increase in metabolic rate which results in using up
stored energy
Elevation of blood cortisol, decreasing anti-
inflammatory responses
Continued stress produces exhaustion, further
depleting ability to ward off infection.
22. FACTORS INFLUENCING
PRODUCTION OF AN INFECTIOUS
DISEASE
Surgery
Eliminates primary barrier of infection.
Predisposes clients to surgical site infections.
Localized infection at wound site can progress to a
systemic infection.
Additional risks include catheters and tubes
23. FACTORS INFLUENCING
PRODUCTION OF AN INFECTIOUS
DISEASE
Nutrition
Insufficient protein consumption reduces antibody
production and inhibits the body’s ability to ward off
infection.
Health Status
Clients with disease of their immune system are at
greater risk.
Chronic diseases can predispose the client to
infection.
26. NONSPECIFIC IMMUNE DEFENSES
Skin and Normal Flora
Mucous Membranes
Sneeze, Cough Reflexes
Tearing Reflexes
Elimination
Acidic Environment
Inflammatory Response
27. NONSPECIFIC IMMUNE DEFENSES
Skin
Intact skin is the body’s first line of defense against
infection.
Sebum is produced by the skin and contains fatty
acids that kill some bacteria.
28. NONSPECIFIC IMMUNE DEFENSES
Normal Flora
Normal flora residing on the skin compete with
pathogenic flora for food and inhibit their
multiplication.
Inappropriate antibiotic use may disrupt the balance
of normal flora.
29. NONSPECIFIC IMMUNE DEFENSES
Mucous Membranes
Mucus entraps infectious agents and contains
substances that inhibit bacterial growth.
Cilia trap and propel mucus and microorganisms
away from the lungs.
30. NONSPECIFIC IMMUNE DEFENSES
Sneeze and Cough Reflexes
Physically expel mucus and microorganisms from
the respiratory tract and oral cavity with force
Tearing Reflex
Protects the eyes by continually flushing away
microorganisms
31. NONSPECIFIC IMMUNE DEFENSES
Elimination Patterns and Acidic Environment
Resident flora of the large intestines
Mechanical process of defecation
Flushing action of urination
Acidic environment of urine and vagina
32. NONSPECIFIC IMMUNE DEFENSES
Inflammatory Response
Tissue injury caused by bacteria, trauma, chemicals, heat, or
any other phenomenon
Release of substances that produce secondary changes in the
tissue
33. SPECIFIC IMMUNE DEFENSE (THE
IMMUNE RESPONSES)
Immunity is a specific defense mechanism that
creates an immune response to a specific
invading antigen.
34. SPECIFIC IMMUNE DEFENSE (THE
IMMUNE RESPONSES)
Immune Responses
Active immunity
Passive immunity
Acquired immunity
Natural immunity
Artificial immunity
35. IMMUNE RESPONSES
Active immunity results from the development within
the body of antibodies that neutralize the infective
agent.
Passive immunity is acquired by the introduction of
preformed antibodies.
36. IMMUNE RESPONSES
Acquired immunity results either from exposure to
an antigen or from the passive injection of
immunoglobulins.
Natural immunity refers to the genetically determined
response of protection within a specific species.
Artificial immunity is produced following a vaccine.
37. THE HUMORAL IMMUNE RESPONSE
B lymphocytes recognize the antigen as an enemy.
Immunoglobulins are plasma protein cells that
produce five different classes of antibodies (IgM, IgG,
IgA, IgD, and IgE).
Immunoglobulins circulate throughout the
bloodstream for the purpose of destroying antigens.
38. CELL-MEDIATED IMMUNITY
Fights pathogens that survive inside cells.
Antigen stimulates the release of activated T cells.
T-helper cells
T-suppressor cells
T-cytotoxic cells
39. LOCALIZED VERSUS SYSTEMIC
INFECTIONS
Infection results from tissue invasion and damage by
an infectious agent.
Localized infections are limited to a defined area or
single organ.
Systemic infections affect the entire body and
involve multiple organs.
40. FOUR STAGES OF INFECTION
Incubation
Prodromal
Illness
Convalescence
42. COMMON SITES OF NOSOCOMIAL
INFECTIONS
Urinary tract
Surgical sites
Respiratory tract
43. NOSOCOMIAL INFECTIONS
Procedures identified as possible sources of infection
are:
Inadequate handwashing
Catheterization technique
Improper suctioning technique
Improper dressing-change technique
Contamination of closed drain system
44. INFECTION CHAIN
Breaking the chain
of infection;
preventive measures
follow each critical
link in the chain of
infection.
45. ASEPSIS
Asepsis is the absence of microorganisms.
Aseptic technique is the infection control practice
used to prevent the transmission of pathogens.
46. MEDICAL ASEPSIS (CLEAN
TECHNIQUE)
Practices to reduce the number, growth, and spread
of microorganisms
The most common cause of nosocomial infections is
contaminated hands of health care providers.
Wash hands before and after every client contact.
47. SURGICAL ASEPSIS (STERILE
TECHNIQUE)
Practices that eliminate all microorganisms and
spores from an object or area
Surgical scrub
Surgical attire
Sterile fields
Sterile instruments and equipment
48. REDUCE OR ELIMINATE
INFECTIOUS AGENTS
Infection control practices to break the chain of
infection
Cleansing
Disinfection
Sterilization
49. REDUCE OR ELIMINATE
INFECTIOUS AGENTS
Cleansing
Removal of soil or organic material from instruments
and equipment used in providing care
Water, mechanical action, detergent
50. REDUCE OR ELIMINATE
INFECTIOUS AGENTS
Disinfection
Elimination of pathogens, except spores, from
inanimate objects
Use of germicides and antiseptics.
51. REDUCE OR ELIMINATE
INFECTIOUS AGENTS
Sterilization methods used for total elimination of all
microorganisms including spores are:
Moist heat or steam (autoclave, boiling water)
Radiation
Chemicals
Ethylene oxide gas
Plasma
Sterrad
52. REDUCE OR ELIMINATE
INFECTIOUS AGENTS
Home Health Care Considerations
Adapting acute care infection control practice to the
home care setting involves:
Cleaning and disinfecting equipment
Using clean versus sterile technique
Handling of the nursing supply bag
53. REDUCE OR ELIMINATE
INFECTIOUS AGENTS
Disposal of Infectious Waste in the Home
Biological Hazard Symbol
OSHA Regulations
55. GUIDELINES FOR STANDARDS
PRECAUTIONS
Body Substances
Blood
All body fluids
Secretions
Contaminated items regardless of whether or not
they contain visible blood
Nonintact skin
Mucous membranes
56. ROLE OF HEALTH CARE
PERSONNEL AND HEALTH
AGENCIES IN INFECTION CONTROL
Mask and eye protection or face shield
Non-sterile gown
Tuberculosis masks
Isolation precautions initiated when positive cultures
from a draining wound are reported
57. ROLE OF HEALTH CARE
PERSONNEL AND HEALTH
AGENCIES IN INFECTION CONTROL
58. ROLE OF HEALTH CARE
PERSONNEL AND HEALTH
AGENCIES IN INFECTION CONTROL
Reinforce adherence to isolation.
Post signs indicating type of isolation.
Provide necessary supplies.
Place clients in a private room with adequate
ventilation.
Use disposable supplies and equipment.
59. ROLE OF HEALTH CARE
PERSONNEL AND HEALTH
AGENCIES IN INFECTION CONTROL
Labeling of all articles leaving the room
Use of impermeable bags or double bagging
Client and family instruction
Alert to psychological discomfort
60. ROLE OF HEALTH CARE
PERSONNEL AND HEALTH
AGENCIES IN INFECTION CONTROL
Blood Borne Pathogen Exposure
OSHA requires that all health agencies make available the
hepatitis B vaccine and vaccination series to all employees.
61. ROLE OF HEALTH CARE
PERSONNEL AND HEALTH
AGENCIES IN INFECTION CONTROL
Exposure Control Plan
Begins with standard precautions and moves to
postexposure prophylaxis
Specific follow-up for blood-borne pathogens
Postexposure prophylaxis only in cases of highest
risk
62. ALTERNATIVE THERAPIES USED TO
TREAT INFECTIONS
Herbal Products
Antimicrobial action
Augment and vitalize the body’s own defenses
Client’s alternative practices should be documented.
Possible adverse reactions are possible when used
with prescribed drugs.
