1. Review Of Asepsis IV Therapy Summer 2011 The Chain of Infection
Retrieved July 4, 2007
from ed.sc.gov/agency/offices/cate/health_sciences/hsteteacherresourceguide/
ChainofInfection2.ppt.

2. The Chain of Infection

3. As healthcare professionals, it is important to understand two facts about infection:

4. The various ways infection can be transmitted.
2. The ways the infection chain can be broken.

5. There are six links in the chain of infection:

6. 1st - The Infectious Agent
- Any disease-causing microorganism (pathogen)

7. -The organism in which the infectious microbes reside
2nd - The Reservoir Host
-The organism in which the infectious microbes reside
Other possible reservoirs that support organisms are animals, soil, food, water, milk and inanimate objects. Some humans develop signs and symptoms of infection. foods such as apples and ground beef can be reservoirs and should be handled according to CDC recommendations. Pasteurization, and cooking well done

8. What are “Carrier Hosts?”
Hosts that do not show any outward signs or symptoms of a disease, but are still capable of transmitting the disease are known as carriers.
Example a person tests + for HIV but is asymptomatic- can still transmit the virus through sexual contact or sharing needles.

9. -Route of escape of the pathogen from the reservoir
3rd - The Portal of Exit
-Route of escape of the pathogen from the reservoir
Examples: respiratory secretions, blood exposure, breaks in skin
Other portals of exit are GI tract and GU tracts

10. 4th - The Route of Transmission
-Method by which the pathogen gets from the reservoir to the new host

11. Direct Contact Transmission may occur through:
Touching , kissing, sexual intercourse. Indirect contact includes personal contact with an inanimate object (touching contaminated equipment)

12. Air
The airborne route is another example of indirect contact (coughing, sneezing).

13. Insects
Such as mosquitoes, & ticks are carriers that transmit organisms from one host to another

14. 5th - The Portal of Entry
-Route through which the pathogen enters its new host

15. Respiratory System
inhalation

16. Gastrointestinal System
ingestion

17. Urinary & Reproductive Tracts
Sexual contact

18. Breaks in Protective Skin Barrier

19. 6th - The Susceptible Host
-The organism that accepts the pathogen
The support of pathogen life and its reproduction depend on the degree of the host’s resistance.

20. Organisms with strong immune systems are better able to fend off pathogens.
The less resistance of the patient the better chance of the organism entering. Hospital patients often have less resistance and weakened immune systems which makes them more susceptible to infection. review factors p ( nutritional status, skin integrity, stress level, etc.,)

21. Organisms with weakened immune systems are more vulnerable to the support and reproduction of pathogens.

22. How to interrupt the chain of infection:
-The essential part of patient care and self-protection.
Nurse assumes major responsibility for breaking the cycle of infection by providing safe patient care and protecting the patient as well as the nurse, from disease causing microorganisms..

23. 1. Pathogen Identification
-Identification of infectious agent and appropriate treatment
Cultures and antiinfectives

24. 2. Asepsis and Hygiene
-Potential hosts and carriers must practice asepsis and maintain proper personal hygiene
Care givers and patients should be taught hand washing. KNOW box 27-2 for basic principles of medical asepsis in pt. care.

25. 3. Control Portals of Exit
-Healthcare personnel must practice standard precautions:

26. Control body secretions and wash hands according to protocol.
Standard Precautions are precautions used in the care of all hospitalized individuals regardless of their diagnosis or possible infection status. These precautions apply to blood, all body fluids, secretions, and excretions except sweat, non intact skin and mucous membranes --this applies whether or not blood is visible.
Transmission-based precautions used in addition to standard precautions for patients in hospitals with suspected infection with pathogens that can be transmitted by airborne, droplet, or contact routes. These categories recognize that a disease may have more than route of transmission.

27. 4. Prevent a Route of Transmission
-Prevent direct or indirect contact by:
Proper handwashing
Disinfection & sterilization techniques
Isolation of infected patients
Not working when contagious
Imortant not to work while contagious and must report any contagious diseases to instuctor. Students may not attend clinical if sick. If you have open wounds take care to cover with a bandage to prevent infection of yourself and patients. –proper disposal of contaminated linen (leakproof bag) and equipment containing body fluids (biohazard bag)

28. 5. Protect Portal of Entry
-Healthcare professionals must make sure that ports of entry are not subjected to pathogens.
Use PPE, and cover wounds, and hand washing. Female patients should be wiped front to back
(nose, mouth, eyes, urinary tract, open wounds, etc.)

29. 6. Recognition of Susceptible Host
-Healthcare professionals must recognize and protect high-risk patients.

30. Cancer Patients AIDS Patients Transplant Patients Infants
Elderly Patients
Caner& AIDS patients are immunocompromised. Cancer patients who receive chemo may be placed on neutropenic precautions due to decreased # of WBCs. Neutrtopenic precautions include no standing water in pt room (no flowers), limit # of visitors and no sick visitors and caregiver should be healthy and free from infection. Neutropenic isolation also referred to reverse isolation (protecting patient from us)

31. “Remember--breaking the chain of infection is the responsibility
of each healthcare professional.”

32. Medical Asepsis Clean Technique Most important aspect
Proper hand hygeine
Standard Precations
GLOVES
PPE
Follow OSHA’s blood bourne pathogens standards
Cleaning and disinfecting equipment
*IV insertion is done using medical asepsis
Maintaining clean env, and preventing spread of infection
OSHA standards pg 41- disposal of blood and equipment in contact with blood (biohazard bags). Hep B immunizations. Post exposure procedures and follow up guidelines
Central lines are done using surgical asepsis with sterile kit including sterile gloves.

33. Surgical Asepsis Surgical technique, aseptic technique
Removes all microorganism, including spores.
Eliminates risk of infection
Required when performing all invasive procedures
Essential in the administration of IV fluids

34. Difference between Medical & Surgical Asepsis
Kills microbes on leaving body
Clean technique
Prevent transmission
Non-invasive procedures
Hand-washing & Gloves
Clean field
Protects health of patient and health worker
Kills microbes before entering body
Sterile technique
Necessary for invasive procedures
Sterile scrub hand-washing and sterile gloves
Sterile field
Protects patient

35. Surgical Asepsis in IV Therapy
Cleans IV site with antiseptic agent
Do not contaminate IV tubing
Keep infusion site clean with sterile dressing
Inspect IV fluid containers and equipment for any breach of integrity of packaging
Outer covering of IV bag not sterile but inner bag is sterile. Fluid inside bag remains sterile as long as sterile technique was used in prep. Same for iv tubing.

36. Standard Precautions Used in : The initiation Maintenance
Discontinuation and
Disposal of equipment related to IV therapy

37. Needlestick Safety and Prevention Act
Must be documented (including description of injury)
Cleansing / first aid first and then report to supervisor
Employer obtains consent from source
Post exposure prophylaxis and f/u testing

38. Questions