Infection Control

 Infection Control

Introduction

Infection prevention and control (IPC) is a cornerstone of patient safety and healthcare quality. Effective IPC reduces healthcare-associated infections (HAIs), protects healthcare workers, and limits antimicrobial resistance. This overview summarizes the essential concepts and best practices relevant to everyday clinical care.

1.Infectious Agent

fungi, bacteria, viruses, parasites, etc         

2. Reservoir

(where agents are found)

Animals, Humans, Food & water sources, Environment(lakes, soil, woods)

3. portal of exit

(where germs escape from)

 Openings in skin, Saliva & mucus, Stool,urine & blood Moisture & droplets

4.   Mode of transmission

(how agents travel)

 Superfi cial contact, Sexual contact, Aerosolized or droplet particulates, Underprepared food

5.   Portal of Entry

how agents enter the body

 Openings in skin, Body cavity, Mucous membrane(eyes, mouth, nose),

 eating & drinking

Stages of Infection

1-Incubation:                                                                                                           Time it takes for the infection to GROW and PRODUCE SYMPTOMS

2     
 Prodromal:                                                   

Infection is growing, but body is showing only EARLY signs of illness (contagious)

3     
Illness:                                                             

Obvious symptoms(person is clearly sick)

4      Decline:

Amount of infection DECLINES (due to time or medication), Symptoms are improving

person is at HIGH risk for another infection (their immunity is “down")

5      Convalescence:                                                                 

Improvement (person feels better)

 If chronic issues are present & related, these may  last longer or be continuous

PPE: Personal Protective Equipment

Donning: Putting on PPE

• Put on PPE before entering the patient’s room
•  Do not touch your face while wearing PPE
• Minimize contact with items in the patient’s room

1.     Perform hand hygiene

2.     Put on gown

3.     Put on mask/respirator

4.     Put on goggles/face shield

5.     Put on gloves

Doffing: Removing PPE

• Remove PPE at the patient’s doorway or outside the room

• If hands become soiled while removing PPE, stop & perform hand hygiene

• After hand hygiene, continue with PPE removal

• Remove gloves
• Remove protective eyewear
• Remove gown
• Remove & discard respirator
• Perform hand hygiene

COMMON HOSPITAL-ASSOCIATED INFECTIONS (HAIS)

• Also called nosocomial infection or hospital acquired infection.

• An infection that is contracted by the patient during their hospital stay, and that they did not have prior to admission

 CAUTI .............Catheter-associated urinary tract infection

SSI ..................Surgical site infection

CLABSI ...........Central line-associated bloodstream infection

VAP .................Ventilator-associated pneumonia

C. Diff .............Clostridium diffi cile

MRSA .............Methicillin-resistant Staphylococcus aureus

Transmission-Based Precautions

Precaution	Description	Equipment	Used for	Nursing
Standard or Universal	General infection control to protect yourself and others from spread of germs	Non-sterile gloves Goggles Surgical mask Face shield Gown	ALL PATIENTS!	Perform proper hand hygiene Use hand sanitizers on way in and out of patient rooms Never use same gloves/ PPE for different patients
Contact	Precautions taken to protect from infection spread mostly by touch/contact	Non-sterile gloves Surgical gown	Methicillin-resistant Staphylococcus aureus (MRSA) C. Difficile Drug-resistant organisms	Private room Keep patient in room as much as possible Visitors should avoid direct contact and wear gloves/gown
Droplet	Precautions taken to prevent infection spread by sneezing, coughing, or talking (anything that can spread via droplet)	Surgical mask	Adenovirus (pediatrics) Pertussis (whooping cough) Rubella Diphtheria Mumps Bacterial meningitis	Private room Door can stay open Patient must wear surgical mask outside of room (when going for imaging, procedures, etc.) Visitors should be 3 feet away (droplets can travel!)
Airborne	Precautions taken to protect against infection spread through particles that can stay in the air and travel	Gown Non-sterile gloves N95 respirator or respiratory hood	Measles (rubeola) tuberculosis varicella (chicken pox) & herpes zoster (shingles)	Private room with monitored negative air pressure (must keep the door closed) N95 respirator or respirator hood (supplies air through a hose) Patient must wear surgical mask outside of room (when going for imaging procedures, etc.)
Neutropenic	Type of isolation used to protect patients with weak immune systems from germs	Healthcare workers, all visitors, and the patient will wear: Gown Non-sterile gloves Surgical mask	↓ WBC count (neutropenia) Immunocompromised patients Oncology (cancer) patients Patients receiving chemotherapy	Avoid: Fresh flowers Fresh or raw fruits/vegetables Undercooked meats Standing water

Medical Disclaimer

The information in this article is for general health education purposes only and is not intended as a substitute for professional medical advice, clinical diagnosis, or treatment prescribed by a licensed physician. The authors of this content assume no responsibility for any medical decisions made based on the information provided herein.

Key References

·         World Health Organization (WHO). Guidelines on Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level (2016).

·         World Health Organization (WHO). WHO Guidelines on Hand Hygiene in Health Care (2009).

·         Centers for Disease Control and Prevention (CDC). Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (updated guidance).

·         CDC. National Healthcare Safety Network (NHSN) Patient Safety Component Manual.

·         Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Practice recommendations for prevention of healthcare-associated infections.