infection control

• Infection


  When a microorganism invades the body, multiplies and causes injury or disease
• Types of infection


  • Communicable infection
  • Nosocomial and Healthcare-associated infections (HAIs)
• Communicable infection


  Infections that can be transmitted (e.g. Covid, cold, cough)
• Nosocomial and Healthcare-associated infections (HAIs)


  Infections acquired in a healthcare setting (e.g. using the same syringe to extract blood from two patients without knowing the first patient had HIV)
• Chain of infection


  • Infectious agent
  • Reservoir
  • Exit pathway / Portal of Exit
  • Means / Mode of Transmission
  • Entry Pathway / Portal Entry
  • Susceptible host

  
• Infectious agent


  Pathogenic microbe such as virus, bacteria, fungus, protozoa, and rickettsia (that cause disease e.g. COVID = Corona Virus)
• Reservoir


  Source of the agent of infection or place where the microbe could grow, survive, and multiply, which could be in humans, animals, food, water, soil or equipment
• Exit pathway / Portal of Exit


  A way or manner wherein an infectious agent can leave the reservoir host, which could be through secretions and exudates, tissue specimens, blood, feces, or urine
• Means / Mode of Transmission

  Airborne, direct (touching or kissing) or indirect contact (contaminated objects)
• Entry Pathway / Portal Entry

  The way an infectious agents enters a host, which includes body orifices, mucous membranes, and breaks in the skin
• Susceptible host

  Someone who is prone to infection, especially the elderly, newborn babies, patients who are immune-suppressed or unvaccinated, and those suffering from acute or chronic illness
• Infection control measures

  • Effective hand hygiene procedure
  • Good Nutrition
  • Immunization against common pathogens
  • Insect and pest control
  • Isolation and decontamination procedures
  • Use of proper safety devices
  • Use of PPE when needed
  • Proper disposal of sharps
• Infection Control Program


  • Protect patients, employees and visitors from infection
  • Screen employees for infectious diseases and require immunization when needed
  • Provide evaluation and treatment to health workers who were exposed to infections while performing their duty
  • Monitor employees and patients who are at risk of infection and collect data from patients and health worker who were exposed to such

  
• Proper Procedure for Hand Hygiene

  1. Stand a few inches from the sink to avoid contamination

  2. Turn on the faucet and place hands under the running water

  3. Use soap and work up a lather to ensure that surfaces are reached

  4. Scrubbing for at least 15 seconds is necessary, making sure to scrub all surfaces especially between fingers and the knuckles

  5. Apply a little friction and rub hands together for at least 15 seconds

  6. Rinse the hands from the wrist to fingertips using a downward motion

  7. Dry hands using a clean paper towel

  8. Use the paper towel to close the faucet except when it is foot or motion activated
• Steps in donning PPE


  • Perform hand hygiene prior to donning of PPE
  • Gown should be put on first, make sure that it is fastened, and the belt is tied
  • Mask should cover both the nose and mouth
  • Goggles or face shield is required, put this on after mask
  • Gloves should be pulled over the gown cuff
• Steps in doffing PPE


  • Gloves are removed first. Do not touch contaminated areas with ungloved hands
  • Gown should be pulled from the shoulders towards the hand so it is turned inside out
  • Mask should be removed by only touching the string
• Mask


  Hydrophilic (the blue color on the mask is to prevent blood from being absorbed)
• Gloves


  Worn to prevent contamination and reduce chances of transmission from personnel to patients. Should be worn over the cuffs of the lab gown to ensure protection
• Steps in doffing gloves

  1. The wrist of one hand is grasped by the opposite hand

  2. The glove is pulled inside out and off the hand

  3. Place the recently removed glove in the gloved hand. The fingers of the non-gloved hand are slipped under the wrist of the remaining glove but make sure not to touch the exterior surfaces

  4. The second glove is pulled inside out

  5. Drop the gloves in the proper receptacle
• Nursery & Neonatal ICU Infection Control Technique


  • Do the proper hand washing procedure before putting on the PPE
  • The phlebotomist should only bring items necessary for the specimen collection
  • Blood collection tray should be left outside the nursery, preferably the anteroom
  • Remove gloves, wash hands, and use a new pair of gloves between patients
• Blood-Borne Pathogens (BBP)


  Microorganisms in the human blood which are infectious and can cause diseases, including hepatitis B (HBV), hepatitis C (HCV) and Human Immunodeficiency Virus (HIV)
• Hepatitis types


  • Hepatitis A - transmitted through contaminated food
  • Hepatitis B - transmitted through blood or bodily fluids, has a vaccine but no cure
  • Hepatitis C - transmitted through blood or bodily fluids, no vaccine but can be treated
  • HIV - no vaccine or cure

  
• Exposure Control Plan


  • When a contaminated needle or sharp object pierces the skin of the health worker
  • Body fluid or blood splashes in the eyes, nose or mouth
  • Cut, scratch or abrasion has made contact with blood or body fluids
  • Human bite cuts the skin
• Procedure after needle stick or sharp injury

  1. Carefully remove the shards or foreign object

  2. Wash the site thoroughly with soap and water for at least 30 seconds
• Procedure after mucous membrane exposure


  1. Flush with water or saline for at least 10 minutes

  2. For the eyes, use eyewash station for flushing if available

  3. Remove contact lenses and disinfect them

  4. Report the incident to the immediate supervisor and the provider so that evaluation, treatment and counseling can be provided
• Biohazard


  Any material that could be harmful to one's health
• Biohazard exposure routes

  • Airborne
  • Ingestion
  • Non-intact skin
  • Electric shock
  • Fire
  • Radiation
• Airborne biohazard prevention


  1. Proper handling practices

  2. Wearing PPE properly

  3. Use safety shield and guards
• Ingestion biohazard prevention


  1. Frequent handwashing

  2. Avoid hand-to-mouth activities

  3. Stop placing items in the mouth
• Non-intact skin biohazard prevention


  Cover with non-permeable bandages
• Electric shock first aid

  1. Remove the source of electricity using non conductive object or turn off the source of electricity

  2. Ask for medical assistance, start cardiopulmonary resuscitation (CPR) if necessary and keep the victim warm
• Fire classes


  • Class A - common combustible such as wood, paper
  • Class B - Flammable liquids such as paints, oil, grease, gasoline
  • Class C - Electrical equipment
  • Class D - Metals like sodium, magnesium
  • Class K - Cooking oil, high temperature

  
• Fire response


  1. Rescue

  2. Alarm

  3. Contain

  4. Extinguish (PASS - pull, aim, squeeze, sweep)

  
• Radiation safety


  Depends on distance, shielding and time. The length of time of the exposure and the distance of the individual from the source of radiation matters because the effect is cumulative. The protection worn at the time would also have a bearing on the intensity of exposure.
• Shock


  Condition when there is not enough blood that circulates back to the heart which results in inadequate supply of oxygen in the body. Common causes are hemorrhage, heart attack, trauma and drug reactions.
• First aid for shock

  1. Keep the airway open

  2. Call for medical assistance

  3. Keep the patient lying down

  4. Control any bleeding or other cause of shock

  5. Keep the patient warm
• Cardiopulmonary Resuscitation (CPR)


  1. Place hands in the middle of the patient's chest and press down for about two inches, release to allow the chest to come back up. Repeat at a rate of 100 compressions per minute.

  2. Tilt the patient's head and lift their chin to open the airway. Pinch the nostrils and support the chin with the other hand. Take a normal breath, place your mouth over the patient's, and blow until you see the chest rise. Remove your mouth and watch the chest fall. Repeat once.

  3. Replicate the cycle of 30 chest compressions, to be followed by two rescue breaths. Continue this cycle.
• Proper chemical handling


  • Never store chemicals above eye level
  • Never add water to acid, do not mix chemicals indiscriminately
  • Never store chemicals in unlabeled containers
  • Never pour chemicals into used or dirty containers
  • Never use chemicals in ways other than their intended use
• First aid for chemical exposure

  1. Immediately flush the contaminated area with water. Use the eye station (if the eyes were contaminated) or the shower station.

  2. If the chemical penetrates the clothing, immediately remove the clothing and flush the skin with water.

  3. Seek medical attention promptly.
• Personal wellness


  • Proper hygiene (bathing, using deodorant, brushing teeth, keeping hair neat, trimming and cleaning nails, avoiding heavy lotions and colognes)
  • Proper nutrition and balanced diet (vegetables, fruits, legumes)
  • Enough sleep and regular exercise
  • Proper posture and safe lifting techniques
  • Work-life balance and stress relief