INFECTION CONTROL

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INFECTION CONTROL

• First year
• Respiratory Therapy
• MJC

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Nosocomial Infections

• 5-10 of patients admitted to hospitals acquire
  an infection during their stay
• 10- 40 affect the respiratory system
• Respiratory therapy equipment has been identified
  as a major source
• Those affecting lungs are more likely to die

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Chain of Infection

• Six elements to spread disease

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Spread of Infection

• Source
• People or contaminated objects
• Route
• Contact, droplet, airborne
• Host
• Often patient is weakened to opportunistic
  bacteria

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Spread of Infection

• Infectious agent
• Causative microorganism
• Portal of entry and exit
• Is the pathway which an agent moves
• Respiratory, GI, surgical site
• Method of transmission
• Airborne, droplet, contact

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Infection Control Strategies

• 1. Eliminating the source of the pathogen
• Cleaning, disinfecting and sterilizing
• 2. Interrupting the route of transmission
• Creating barriers for equipment handling,
  maintenance
• 3. Monitor and evaluate effectiveness

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Methods of Transmission

• Airborne transmission
• Suspended in air
• Droplet Transmission
• Large drops from coughing, speaking, sneezing
• Contact Transmission
• Direct or Indirect methods

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Less Common Transmission

• Vector-borne transmission
• Mosquitoes and ticks
• Common Vehicle transmission
• Food and water
• Fomite
• bed linen or equipment that may be used to
  transmit pathogens

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Here, dont touch the stick.
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Isolation Precautions

• Barrier measures prevent the spread of infection
• Universal precautions
• Handwashing, gloves etc
• Wear mask, face visors, safety glasses during
  procedure that can generate splashes or sprays of
  body fluids or secretions

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Universal Precautions

• Standard precautions developed to protect heath
  care workers
• Wash hands between patient contacts
• Wear gloves when touching blood and body fluids
• Wear mask and eye protection when splashes are
  likely

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Universal Precautions

• Wear gown to prevent soiling of clothes
• Use resuscitation devices rather than mouth to
  mouth
• Never recap needles
• Use sharps containers
• Use private room to maintain appropriate hygiene

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Special Isolation Precautions

• Applied in addition to standard precautions
• Airborne precautions
• Droplet precautions
• Contact precautions
• Reverse isolation for immuno-compromised patient

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Airborne Precautions

• Visitors report to nurse before entering
  patients room
• Private, negative pressure room
• Wear respirator (95-99) Hepa mask
• Limit transport out of room
• Wear surgical mask during transport

15
Droplet Precautions

• Place in private room or group patients with same
  infection
• Wear mask when working within 3 feet of patient
• Limit transport
• Wear surgical mask during transport

16
Contact Precautions

• Wear and remove gloves after use
• Wash hands after leaving the room
• Wear gown when entering room
• Dedicated equipment to stay in room

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Reverse Isolation

• Barriers to protect PATIENT
• Usually on oncology ward with immuno-compromised
  patient with low (WBC) ability to protect
  themselves from outside germs

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Disinfecting

• Alcohol, phenols and iodophors are best for
  surface asepsis
• Gluteraldehyde (20 minutes) is the best choice
  for high-level disinfection
• Sterilization is needed to destroy all microbial
  life

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Handwashing

• The BEST single most important action respiratory
  therapist can take to stop the spread of
  infection.

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Barriers to Handwashing

• Sinks are not handy and have to go out of their
  way to use
• Too busy, no time, short staffed
• Irritation, redness and cracking of skin

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Anti-Microbial Lotions

• Test has shown that this innovation may improve
  compliance
• Dry, cracked hands can be prevented
• Hands can be cleansed while walking between
  patients

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Op-site

• Every IV site is covered with a small 2 by 2
  clear covering
• If you have an open sore, cut, hangnail, cover
  the open skin with op-site
• Will last for hours of repeated washings
• Bandaid will soil immediately op-site will only
  need to be replaced 2-3 times per shift

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Needlestick Injuries

• Can be prevented
• Never re-cap (or use one-hand scoop)
• Use safety equipment supplied
• Never bend or break needles
• Dispose in sharps container ASAP
• Never carry needle down hall
• Pre-plan what to do with needle

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Contacting HIV from Needlestick

• Over 20 pathogens can be transmitted through the
  blood
• Most common are Hepatitis B and C
• Risk is 10 to 30 with HBV and HCV
• Needlestick risk is 0.3 with HIV

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Latex Allergy

• Usually related to gloves we use
• Powdered gloves are used less
• Becomes abrasive rather than lubricant
• Clear vinyl non-allergic
• Blue or Purple (non-stretching)

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Drug-Resistant Pathogens

• Streptococcus pneumoniae
• Tuberculosis (MDR-TB)
• MRSA Methacylin resistant Staphlococcus Aureus
• VRE Vancomycin Resistant Endococcus

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Thats all folks!

• Stay clean
• Remember
• Life on under
• a microscope