Infection Control, Safety, First Aid, & Personal Wellness

The goal of infection control is to develop and maintain an environment that minimizes the risk of acquiring or transmitting infectious agents to hospital personnel, patients, and visitors. It is not always possible for you to know if a patient is infectious or is incubating an infection. Therefore, it is important that you understand how infections occur and follow infection control practices and policies to protect yourself and your patients from infectious agents. Techniques for preventing transmission include hand hygiene, use of personal protective equipment, and use of both standard and expanded precautions. 




Infection:

        When a microorganism invades the body, Multiplies, & Causes injury or disease.    



Microbes include:

        Bacteria

                    Fungi

        Protozoa

         Viruses



Pathogen: 

        A microbe capable of causing disease




CHAIN OF INFECTION

1. Infectious (causative) agent

    - Pathogenic microbe responsible for causing an infection


2. Reservoir

    - Source of infectious agent

    -Place where microbe can survive & grow or multiply

    - Includes: humans, animals, food, water, soil, equipment


3. Exit pathway

    -A way an Infectious agent Is able to leave a reservoir host

    -Secretions & exudates, tissue specimens, blood, feces, urine


4. Means of transmission

    - Airborne

    - Contact

            -Direct (touching, kissing)

            - Indirect (contaminated objects)

    - Droplet (coughing, sneezing)

    - Vector (insect, arthropod, animal)

    - Vehicle (food, water, drugs)


5. Entry pathway

    - Way an infectious agent enters a susceptible host

    -Includes: body orifices, mucous membranes, & breaks in skin


6. Susceptible host

    - Someone with a decreased ability to resist Infection

    - Factors: age, health, immune status


• Types of Infection

        - Communicable

            • Able to be spread from person to person

            • CDC investigates & controls communicable diseases & epidemics


        -Nosocomial or healthcare-associated Infections (HAIs)

            • Infections acquired in hospitals & other healthcare settings

            • 1. 7 million HAIs & 99,000 associated deaths occur each year

            • caused by infected personnel, patients, visitors, food, drugs, or equipment


• Breaking the Chain of Infection

    - Hand hygiene

    -Nutrition, rest, stress reduction

    - Immunization

    - Insect & rodent control

    - Isolation procedures

    - Decontamination of surfaces & instruments

    - Disposal of sharps & infectious waste

    - Use of gloves, gowns, masks, &. respirators

    - Needle safety devices


• Infection-Control Program

    - To protect patients, employees, visitors, & others

    - To break chain of infection

    - Monitors & collects data on all infections occurring in institution

    - Institutes special precautions in event of outbreaks


            Components

                • Employee screening & immunization

                • Evaluation & treatment

                • Surveillance


OSHA Standard for Blood-Borne Pathogens (BBPs)

    - Enforced by federal law

    -Intended to reduce/eliminate occupational exposure to BBPs

    - Requires:

            • Use of engineering & work practice controls to prevent exposure incidents

            • Availability & use of PPE

            • Special training

            • Medical surveillance

            • Availability of vaccination against HBV for all at-risk personnel 




Blood-Borne Pathogen

    - Hepatitis B virus (HBV) • hepatitis D virus

            • Best defense: HBV vaccination

            • HBV exposure hazards

                    • Present in blood & other body fluids

                    • can survive up to a week on objects

                    • Transmitted via needle sticks, sexual contact

            • Symptoms: flu-like, fatigue, loss of appetite, mild fever, muscle/joint/abdominal pain, nausea, vomiting



    -Hepatitis C virus (HCV)

            • HCV exposure hazards

                    • Present in blood & serum; sometimes saliva

                    • Infection primarily occurs after large or multiple exposures

                    • Transmitted via needle sticks, sexual contact

            • Symptoms: flu-like, fatigue, loss of appetite, mild fever, muscle/joint/abdominal pain, nausea, vomiting




Exposure Control Plan

    - Must be written

    - Must be reviewed & updated at least annually

    - Non-managerial employees with risk of exposure must be involved in:

            • Identification

            • Review

            • Selection



BBP Exposure Routes

    - Skin is pierced by a contaminated needle or sharp object

    - Blood or other body fluid splashes In eyes, nose, or mouth

    - Blood or other body fluid contacts cut, scratch, or abrasion

    - A human bite breaks the skin



 Infection-Control Methods


    - Hand hygiene

        • Use of alcohol-based antiseptic hand cleaners

        • Hand washing


    - Personal protective equipment

        • Gloves

        • Gowns

        • Lab coats

        • Masks, face shields, & goggles

        • Respirators



Isolation Procedures: Overview

    - Keep patients with communicable infections separate from others

    - Prevent spread of Infection

    - Protect patients with compromised immune system

    - Isolation requires doctor's order

    - Infected patient Is confined to private room



Isolation Procedures

    - Protective/ reverse Isolation

        • For patients highly susceptible to Infections


    - Traditional Isolation systems

        • Category-specific system

        • Disease-specific system


    - Universal precautions 

        • Blood & body fluids of all people are potentially Infectious


    - Body substance Isolation

        • Goes beyond universal precautions: gloves for contacting moist body substances



Guideline for Isolation Procedures

    - Standard precautions

        • Used for all patients

        • # 1 strategy for control of nosocomial infection

        • Covers blood, all body fluids, skin breaks, mucous membranes


    - Transmission-based precautions

        • Used for patients known/suspected to have certain infections

        • Three types: 1. airborne, 2. droplet, 3. contact



Biohazard

    - Any material or substance harmful to health

    - Should be identified by a biohazard symbol



Biohazard Exposure Routes

    - Airborne

    - Ingestion

    - Non-intact skin

    - Percutaneous (through the skin)

    - Permucosal (through mucous membranes)




Exposure Incident Procedure


    - Needle stick or other sharps injury:

            • Carefully remove shards of glass or other objects

            • Wash site with soap & water at least 30 seconds


    - Mucous membrane exposure:

            • Flush site w. water or sterile saline at least 10 min

            • Use eyewash station if available to flush a splash to eyes

            • Remove contact lenses as soon as possible & disinfect them


    -Report incident to immediate supervisor

    - Report directly to provider for evaluation, treatment, counseling


Surface Decontamination (required by OSHA)

    - All surfaces In specimen collection & processing areas

    - 1:10 bleach solution or other disinfectant approved by EPA


Cleanup of Body Fluid Spills

    - EPA-approved chemical solutions & kits

    - Gloves must be worn

    - Absorb material without spreading it over wider area


Biohazard Waste Disposal

    - All non-reusable items contaminated with blood or body fluids go in biohazard waste containers



Safety Showers & Eyewash Stations

        - Phlebotomist should know location of these

        - Used for chemical spill or splash to eyes/body

        - Flush affected part with water at least 15 min.

        - Visit ER for evaluation



External Hemorrhage

    • Definition

            - Abnormal or profuse bleeding


    • Treatment

            - Firm, direct pressure to wound using cloth or gauze

            - Elastic bandage can be used to hold compress in place

            - Only use tourniquet as last resort



Shock

    • Definition

            -Condition involving insufficient return of blood to heart

            - Results in inadequate supply of oxygen to body organs/tissues

            - Caused by hemorrhage, heart attack, trauma, & drug reactions


    • Symptoms

            - Pale, cold, clammy skin

            - Rapid, weak pulse

            - Increased, shallow breathing rate

            - Expressionless face & staring eyes