1. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. UNIT 6 INFECTION CONTROL AND BLOOD BORNE DISEASES

2. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Definitions Infection control Infectious disease Pathogens

3. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Signs and Symptoms of Infections Generalized or systemic –Affecting whole body Localized –Affecting one area of body

4. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Microbiology Microscope Microbiology Communicable or contagious disease Contaminated Normal flora (continued)

5. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Microbiology Immune response Antibiotic Opportunistic infection Aerobic Anaerobic Hosts (continued)

6. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Microbes Bacteria – one-celled plants, many produce toxins, require 02, grow best in moderate temperatures Viruses – smallest of microbes, cannot be seen under traditional microscopes. Very difficult to treat, cannot be destroyed by antibiotics Fungi – large group of simple plants, 2 forms – yeast and mold

7. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Video Pathogens http://youtu.be/_KGUHcwUMUM Right click on hyperlink, then click “Open Hyperlink”

8. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Chain of Infection Infectious agent Reservoir host Portal of exit Route of transmission Portal of entry Susceptible host (continued)

9. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Chain of Infection

10. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Infection Control Video http://youtu.be/DwpV1VWQANM (right click on hyperlink, then click on “Open Hyperlink”)

11. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Defense Mechanisms Cilia Cough and sneeze Tears Hydrochloric acid Mucous membranes Rise in temperature- Higher body temperature kills microorganisms Increase in leukocytes(WBC’s)

12. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Scope of the Problem Nosocomial infection Needle stick injuries Hand washing –Most important procedure for preventing health care-acquired infections –http://youtu.be/-1Hub6Ps_cchttp://youtu.be/-1Hub6Ps_cc Hand washing Video (right click on hyperlink, then click on “Open Hyperlink”)

13. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Infection Control Regulatory agencies –CDC – government agency. Is able to formulate safety guidelines to help prevent and control the spread of infections diseases. –OSHA – government agency. Two main functions: establish minimum health and safety standards for the workplace and to enforce those standards.

14. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Asepsis –Also known as aseptic technique Medical asepsis –Clean technique. Decreases the number and spread of pathogens. Examples – hand washing, cleaning rooms between patient use, disposal of gloves Surgical asepsis –Sterile technique – Eliminates the presence of pathogens from objects and areas. Examples - wearing sterile caps,gowns,masks,and gloves during surgery, etc

15. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Breaking the Chain of Infection Breaking just one link stops infection Six elements summarized –Source of infecting microorganism –Means of transmission –Susceptible host

16. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. How to Break Chain Decrease source of microorganisms –Wash hands –Decontaminate surfaces and equipment –Avoid contact when contagious Prevent transmission of microorganisms –Wear personal protective equipment (PPE) –Follow isolation precautions (continued)

17. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. How to Break Chain Maximize resistance –Provide good hygiene –Ensure proper nutrition and fluid intake –Decrease stressors that weaken immune response

18. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Normal Flora Transient flora Resident flora Standard precautions Handwashing –Removes transient flora –Diminishes resident flora

19. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Standard Precautions Follow at all times Potential fluid sources of microbes: –Blood –Body fluids, secretions, and excretions Except sweat –Nonintact skin (continued)

20. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Standard Precautions Potential fluid sources of microbes: –Mucous membranes –Any identified body fluids Handwashing PPE Patient-care equipment (continued)

21. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Standard Precautions Environmental control Linen Needle handling and disposal

22. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Reporting Exposure Must immediately report any exposure to blood or body fluids Write incident or injury report Refer to Exposure Control Plan

23. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Isolation Transmission-based precautions –Airborne –Droplet –Contact Consequences to patient, staff, and visitors Impact on facility

24. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Methods to Inhibit or Destroy Microbes Antiseptics-used on animate objects – “living” (people) Disinfectants-used on inanimate objects “non-living”(Countertops, tables, beds) Sterilization-kills all microorganisms

25. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Health Care Worker Risks –Hepatitis B – the Major infectious blood-borne occupational hazard for health care professionals –HIV – the virus that causes AIDS Human Immunodeficiency Virus –Tuberculosis (TB) – caused by Mycobacterium tuberculosis, an airborne pathogen –Drug-resistant infections – fairly recent. Result of the way that antibiotics are used in the US; overuse or not completing entire course. Methicillin Resistant Staphylococcus Aureus (MRSA)

26. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Hepatitis Virus Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E Hepatitis B - highest number of contracted cases by Healthcare workers each year Vaccines are available for Hepatitis A & B

27. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Human Immunodeficiency Virus HIV and AIDS –Carriers – carriers of HIV may not have symptoms or even detectable amounts of the virus in the blood during the first 6 months of infection. So, it is essential that health care professionals understand how the virus is transmitted and follow standard precautions with all patients.

28. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. –Transmission - only blood, semen, vaginal secretions and breast milk have been proven to transmit the virus. – Common modes of transmission are sexual intercourse; using contaminated needles; blood exposure via parenteral, mucous membrane, or non-intact skin contact; transfusions; transplants; semen used for artificial insemination; and contact with perinatal fluids. Human Immunodeficiency Virus

29. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Human Immunodeficiency Virus –Symptoms – This disease mimics symptoms of many other infections, such as: Flu-like illness Swollen lymph nodes Persistent fevers Night sweats Prolonged diarrhea Unexplained weight loss Purple bumps on skin or inside mouth and nose Chronic fatigue Recurrent respiratory infections

30. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Human Immunodeficiency Virus NOTE: These symptoms are not specific for HIV and may have other causes. Most persons with HIV have no symptoms at all for several years.

31. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Human Immunodeficiency Virus –Treatment – no preventative vaccine or cure available. Early diagnosis and treatment can extend life for years. –Prevention - is similar to other bloodborne diseases: Always use latex condoms/latex barriers during sex (if allergic to lates, use a condom made of polyurethane or other synthetic material).

32. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Do not share needles for drugs, tattooing or body piercings. Limit number of sex partners. Be tested and have potential partners tested for HIV; this can be done by providers, STD clinics and HIV counseling and testing sites. Notify sex and needle-sharing partners immediately if HIV infected. Human Immunodeficiency Virus

33. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. A healthcare worker can prevent workplace exposure by following Standard Precautions and avoiding needle stick injuries. Human Immunodeficiency Virus

34. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Legal Aspects of HIV/AIDS http://www.aids.gov/hiv-aids-basics/staying- healthy-with-hiv-aids/discrimination/legal- issues/#.U6hh91VVs1c.emailhttp://www.aids.gov/hiv-aids-basics/staying- healthy-with-hiv-aids/discrimination/legal- issues/#.U6hh91VVs1c.email

35. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Community Resources Counties: CollierCollier Collier County Health Department provides HIV/AIDS services (including ADAP - AIDS Drug Assistance Program) and AICP (AIDS Insurance Continuation Program), college and pre-employment physicals, family planning, STD counseling and testing, and vaccinations.

36. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Community Resources AIDS/HIV Hotline Counties served: Charlotte, Collier, DeSoto, Glades, Hendry, Lee, SarasotaCharlotteCollierDeSoto GladesHendryLeeSarasota Services: Counseling, HIV/AIDS, Hotline, Information ResourcesCounselingHIV/AIDSHotline Information Resources Tags: HIV/AIDSHIV/AIDS Description: Information, referral and counseling Contact: 800-352-2437, Spanish 800-545-7432, Creole 800-243-7101

37. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. TB Airborne pathogen Caused by Mycobacterium tuberculosis No prevention Skin test give for detection Latent TB infection and TB disease Still problematic in U.S. Drug-resistant strains developing

38. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Other Infectious Organisms Bird flu –Avian influenza Mad cow disease –Bovine spongiform encephalopathy (BSE) West Nile virus Swine flu –H1N1 influenza

39. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Drug-Resistant Organisms Developed from overuse of antibiotics Developed from patients who do not complete antibiotic treatment Long term antibiotic therapy destroys the body’s Normal Flora (continued)

40. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Drug-Resistant Organisms Methicillin-resistant staphylococcus aureus (MRSA) –Healthcare-associated MRSA (HA-MRSA) –Community-acquired MRSA (CA-MRSA) Vancomycin-resistant enterococcus (VRE)