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Infection Control

Chain of infection Pathogen-Reservoir Host -Portal of Exit- Mode of transmission-Portal of entry- Susceptible Host
Pathogenic Agents Bacteria , Rickettsia ,Fungi , Parasites, Viruses
Reservoir Host Harbors the pathogenic agent. Provides environment for growth. Moist mucous membranes Mouth Saliva Skin Feces Wounds
Portal Of Exit Means by which the pathogen escapes the reservoir host. Respiratory tract: Mouth, nose, throat—saliva, sneezing, coughing, talking. Eyes and ears GI tract: Feces, vomitus Urinary tract: Reproductive tract: Non-intact skin: Wounds
Mode of transmission The means by which the pathogen is passed on to another host.
Direct Contact Physical, droplets—aerosols/
Indirect Contact Intermediate objects
Airborne Droplet nuclei, e.g. TB, influenza, varicella, and rubeola.
Common vehicle Contaminated food and water.
Vector Intermediate hosts, e.g. insects.
Portal of entry The means by which a pathogen enters a host. Same as the portals of exit. Body orifices Mucous membranes Non-intact skin Indwelling devices Invasive procedures
Susceptible Host Persons at risk of acquiring the infection.
Incubation Time between exposure to appearance of SS.
Prodromal Time between SS and definitive illness.
Invasive: Illness fully apparent—acme: peak SS.
Decline Decreasing SS
Convalescence: Repair and recuperation.
Sequelae Persisting disease aftereffects.
Resident flora (normal flora) Normally reside in epidermis and dermis Generally harmless and nonpathogenic Difficult to remove (attached to deeper skin layers)
Transient flora Grow in epidermis (superficial skin layers) Picked up in the course of daily activities Often pathogenic Easily removed.
Compromised host: Dehydration Cilia damage Cancer AIDS Diabetes
Communicable infections Infections transmitted from person to person.
Nosocomial infection infections acquired in hospitals and health facilities.
Medical Asepsis Objects or areas that are free of pathogenic (infectious) material. Nonpathogenic agents may be present.
Hand Washing When the hands are visibly soiled with dirt or body fluids. Should be performed before assisting with surgery, before eating, and after bathroom use. Use of antimicrobial soap: Triclosan, chlorhexidine, hexachlorophene.
Hand Rub Alcohol based: 60 – 90% methanol. Gels, lotions, foams Used if hands are not visibly soiled. Repeated hand washing leads to dryness, irritation, chapping, and dermatitis. Effective at removing transient flora and reducing bacterial count.
Han washing Vs. Hand Rub Hands should be sanitized between patients. After handling specimens and contaminated materials After bathroom use Before leaving the lab or clinic Before eating.
Handwashing Procedure Remove jewelry except wedding rings. Turn on water faucet, wet hands, and apply antibacterial soap. Lather while keeping the fingers pointed downward. Scrub between fingers and over hands ten times or approximately 30 seconds.
Handwashing Procedure Cont. Scrub the palms using the tips of the fingers (or use a manicure stick). Rinse so that the water flows downward from the wrist to the finger tips. Turn water off with paper towel; discard. Dry hands with a clean paper towel and discard.
Hand Rub Procedure Make sure hands are unsoiled, remove jewlery, apply agent to palm of hand, gel or lotion dime size, foam walnut size, spread on handand 1/2 inch above wrist, rub hands until dry
Sanitization Process of cleaning or freeing materials such as instruments from dirt. Requires the use of a scrub brush and detergent.
Detergent Wetting agent that mechanically removes bacteria, emulsifies fats and oils, and dissolves high protein substances, e.g. blood.
Ultrasound A device containing a detergent solution that passes sound waves and vibration through the liquid to loosen contaminants from instruments.
Antiseptic: A sanitizing agent used on the skin
Disinfection Process of removing infectious material from objects Boiling. Chemical: Soap, alcohol (isopropyl), acids (phenol), alkalies (sodium hypochlorite), and formaldehyde.
Ultraviolet radiation: Surface microbes.
Dessication: Preservative.
Sterilization Process of completely destroying all microorganisms or infectious agents. Process of completely destroying all microorganisms or infectious agents. Chemical: Gluaraldehyde. Autoclave: Steam under pressure. Gas. Oven: Dry heat.
Engineering Controls Structural or mechanical devices designed to minimize exposure. Hand washing facilities Eye wash stations Sharps containers Biohazard labels
Work Practice control Policies and procedures that promote the behaviors necessary to properly use engineering controls and personal protective equipment.
Personal protective equipment PPE: Safety equipment that minimizes exposure beyond engineering controls. Lab coats Mask Goggles Face shields Gloves
Universal Precautions treat all blood, body fluids, secretions, excretions, and moist body substances as potentially infectious regardless of actual pathogenicity semen, vaginal fluid, breast milk,CSF, synovial, pleural fluid Saliva, feces, sputum, tears
Contaminated Sharps contaminated object that can cut , puncture wound shall be placed in clearly labeled, puncture-resistant, leak-proof containers immediatel Bending, shearing, or recapping needles is prohibited. Must maintain a log of injuries from contaminated sharps.
Biohazard Labels Will be placed on all devices and containers used to contain blood or OPIM. Must be fluorescent orange or red. Includes the biohazard symbol and the word, BIOHAZARD.
Regulated Waste Waste that poses a threat to health and safety. Contains liquid or dried blood or OPIM. Saturation v. spot. Biological waste. Body fluids or tissues. Shall be placed in biohazard waste containers located in each clinical area.
Post-exposure Evaluation When an employee incurs an exposure incident, it must be reported to that person’s supervisor and properly followed up.
Hepatitis A Virus (HAV) AKA infectious hepatitis Incubation: 2-6 weeks. Transmission: Fecal-oral route. S&S: Flu-like. Prognosis: Rarely fatal, recovery within 6-10 weeks. Not chronic. Vaccine preventable.
Hepatitis B Virus (HBV) AKA serum hepatitis. Most frequently reported occupational disease of health workers; usually though contaminated sharps injuries. Transmission: Exposure to blood and body fluid. 0.0001 ml (100 l or 1/500 gt) of blood can cause transmission.
Hepatitis B Virus (HBV) Risk: 0.06 to 0.3. Incubation: 1-6 months (2-3 on average). S&S: Flu-like. Prognosis: most recover. 10% suffer from chronic infection. 25% of chronic sufferers die of liver failure.
Hepatitis B Virus (HBV) Postexposure Prophylaxis: HBIG within 24 hrs to 7 days. Vaccine preventable: HepB Vaccine: Three IM doses at 0, 1, and 6 months.
Hepatitis C Virus (HCV) RNA virus of the Flaviviridae family Incubation: 0.5 to 6 months. Transmission: Blood, body fluids. S&S: Flu-like. Risk: 0.02. Not vaccine preventable.
Hepatitis C Virus (HCV) Prognosis: Its genetic diversity causes 55-85% of infected persons to become chronic carriers. More than 20% of those having chronic HCV develop cirrhosis making it the leading reason for liver transplantations.
Hepatitis C Virus (HCV) 1-5% of chronic disease sufferers will die of liver failure. Not vaccine preventable.
Hepatitis D Virus (HDV) Incubation: 0.5 to 5 months. Transmission: Blood, body fluids. Affects only those infected with HBV. S&S: Intensified flu-like. Prognosis: Frequently leads to chronic hepatitis. 30% fatality rate among chronic sufferers.
Hepatitis E Virus (HEV) Incubation: 3-6 weeks. Transmission: Fecal-oral route. Rare in U.S.—seen in developing countries in epidemic proportions. S&S: Flu-like. Prognosis: Not chronic—10-20% fatality among pregnant contractors.
Human Immunovirus (HIV) RNA virus of the retrovirus family. Etiologic agent of AIDS. Slowly attacks T-helper lymphocytes and macrophages.
Human Immunovirus (HIV) Allows severe opportunistic infections and cancer. Incubation period: 6 months to 7 years. Transmission: Sexual contact, contaminated needles. Risk: 0.003, 0.0009
Created by: lin_linxo
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