1. Infection Control Techniques

2. Learning Outcomes At the conclusion of today’s class I CAN:
10) Demonstrate mastery of concepts and skills related to asepsis, Universal Precautions, sanitation, disinfection, and sterilization for patient/client care settings in adherence to standards and guidelines from the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) in a lab/clinical setting. (TN Reading 3)
At the conclusion of today’s class I CAN:
Define key terms related to infection control
Compare and contrast sanitation disinfection and sterilization
Describe the significance of the CDC and OSHA related to workplace safety in healthcare

3. Introduction
Patients coming to the office for treatment may be more susceptible to infections
Immunizations and patient education are important methods of infection control
You will be introduced to Occupational Safety and Health Administration (OSHA) guidelines, the Blood-Borne Pathogen Standard, reporting guidelines, and isolation procedures.

4. Employee’s Role in Infection Control
To control infectious diseases, the cycle of infection must be broken
Apply principles of infection control in workplace setting

5. Employee’s Role in Infection Control (cont.)
Follow correct sanitization, disinfection, and sterilization procedures
Help patients understand basic disease prevention
Educate patients about immunizations
Administer immunizations

6. Correct! Apply Your Knowledge
What is the role of the healthcare professional in controlling infection in the medical office?
ANSWER: To apply principles of infection control by following correct sanitization, disinfection, and sterilization procedures.
Correct!

7. Infection Control Methods
Eliminate elements needed for disease to occur
Knowledge of
Medical asepsis
Based on cleanliness
As few microorganisms as possible
Surgical asepsis
Sterile environment
No microorganisms

8. Medical Asepsis Keep work area clean:
Reception area: sick vs. well patients
Reception room clean, well lit, and ventilated
No sick visitors in hospital
Limit visitors during cold and flu season
Keep furniture in good repair
Strict “no food or drink” policy
Empty trash as necessary

9. Medical Asepsis (cont.)
Hand washing
Beginning of day
After breaks
Before and after each patient
Before and after handling equipment or specimens
After blowing your nose or coughing
Before and after eating

10. Medical Asepsis (cont.)
Other precautions
Avoid leaning against sinks, supplies, equipment
Avoid touching your face and mouth
Use tissues when you cough or sneeze, and always wash your hands afterward
Avoid working directly with patients when you have a cold; wear gloves and mask if you must
Stay home if you have a fever

11. Apply Your Knowledge Good Answer!
Describe the difference between medical and surgical asepsis.
ANSWER: Medical asepsis is based on cleanliness and reducing the number of microorganisms as much as possible. Surgical asepsis is maintaining a sterile environment by eliminating all microorganisms.
Good Answer!

12. Sanitation Used to promote health and prevent disease.
the process of keeping places free from dirt, infection, disease, etc., by removing waste, trash and garbage, by cleaning streets, etc.

13. Sanitization
Scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow
For cleaning items that touch only healthy, intact skin OR
First step in disinfection and sterilization for other equipment

14. Sanitization (cont.) Rubber and plastic items
Collect items for sanitization
Place in water and special detergent solution
Use utility gloves
Separate sharps from other equipment
Scrub items
Follow manufacturers’ guidelines
Dry thoroughly
Examine carefully
Rubber and plastic items
Syringes and needles – use disposable whenever possible

15. Nice Job! Apply Your Knowledge
What is sanitation, and what types of items is it adequate for cleaning?
ANSWER: Sanitation is scrubbing with a brush and detergent to remove blood, mucus, and other contaminants or media where pathogens can grow. It is adequate for cleaning items that touch only healthy, intact skin. Can also include removing trash.
Nice Job!

16. Disinfection
Adequate for instruments that do not penetrate skin or mucous membranes and surfaces not considered sterile OR
Second step in infection control prior to sterilization
Will not kill spores, certain viruses

17. Disinfection (cont.) Using disinfectants
Cleaning products applied to inanimate materials to reduce or eliminate infectious organisms
Antiseptics are anti- infective cleaning agents used on human tissue
Follow manufacturers’ guidelines

18. Disinfection (cont.) Factors impacting effectiveness of disinfectants
Number of times solution is used
Wet items – surface moisture may dilute solution
Traces of soap left from sanitization – alters chemical composition
Evaporation

19. Disinfection (cont.) Choose the correct disinfectant
Germicidal soap products
Alcohol
Acid products
Formaldehyde
Glutaraldehyde – “cold disinfection”
Bleach
Iodine and iodine compounds

20. Disinfection (cont.) Handling disinfected supplies
Prevent contamination with other surfaces
Use sterile transfer forceps
Wear gloves
Store in clean, moisture-free environment

21. Apply Your Knowledge Excellent!
What is the difference between a disinfectant and an antiseptic?
ANSWER: Disinfectants are cleaning products applied to inanimate materials to reduce or eliminate infectious organisms. Antiseptics are anti-infective cleaning agents used on human tissue.
Excellent!

22. Surgical Asepsis
Goal is to keep the surgical environment completely free of all microorganisms
Used for even minor operations and injections
Surgical includes ANYTHING that penetrates the skin
The more extensive the procedure, the greater the risk of infection

23. Sterilization Required for all instruments or supplies that
Penetrate the skin
Contact normally sterile areas of the body
Object is either sterile or not sterile
If unsure of sterility, consider it not sterile
Prior to sterilization
Sanitize
Disinfect

24. The Autoclave Primary method of sterilization Pressurized steam
Operates at lower temperatures than dry heat sterilization
Moisture causes coagulation of proteins in microorganisms at lower temperatures
Cell walls burst when cell cools, killing the microorganism

25. The Autoclave (cont.) Prevent incomplete sterilization Timing
Correct timing
Adequate temperature
Properly wrapped packs
Adequate steam levels
Timing
Preset for load types
Use sterilization indicators

26. The Autoclave (cont.) Temperature Do not overcrowd autoclave
Too high – steam too little moisture
Too low – steam too much moisture
Do not overcrowd autoclave
Steam level
If incorrect, items will not be sterile at end of cycle

27. Sterile Technique Strict adherence to set order of procedures
Sterile against sterile
Clean against clean
Unclean against unclean
Surgical scrub
Never skimp on a surgical
scrub!

28. Surgical Asepsis During surgical procedures
Do not touch sterile items without sterile gloves or transfer forceps
Aseptic technique
Throughout surgical procedures
Caring for surgical wounds

29. Surgical Asepsis (cont.)
After procedures
Sanitize, disinfect, and sterilize reusable items
Disinfect surfaces
Waste disposal
Biohazard waste containers
Leak-proof containers either color-coded red or labeled with biohazard symbol
Biohazardous materials
Biological agents that can spread disease to living things

30. Apply Your Knowledge 1. What items need to be sterilized?
ANSWER: Sterilization is required for all instruments or supplies that penetrate the skin or come in contact with normally sterile areas of the body.

31. Right! Apply Your Knowledge
2. The physician is going to remove a small growth from your patient’s back. In order to prepare for this procedure, what steps would you take to prevent the spread of infection?
ANSWER: Use medical asepsis while preparing the patient, and then use surgical asepsis during the procedure.
Right!

32. OSHA Guidelines Blood-Borne Pathogen Standards
Protect health-care workers from health hazards on the job
Also protect patients and others who come to medical facilities
Dictate how to handle infectious or potentially infectious wastes
Discarded
Held for processing
Blood-borne pathogens can enter the skin through any opening, break in skin, or mucous membranes

33. OSHA Guidelines (cont.)
Blood-Borne Pathogen Standards
Measures to prevent the spread of infection
Provide a margin of safety by ensuring that medical facilities meet minimal standards for asepsis
Requirements for training, keeping records, housekeeping, and personal protective gear

34. OSHA Guidelines (cont.)
Universal Precautions
Prevent health-care workers from exposure to infections
Assume that all blood and body fluids are infected with blood-borne pathogens

35. OSHA Guidelines (cont.)
Standard Precautions
Combination of Universal Precautions and Body Substance Isolation guidelines
Used in health-care facilities to prevent transmission of disease

36. OSHA Guidelines (cont.)
Categories of tasks
Tasks that expose a worker to blood, body fluids, or tissues and require specific protective measures
Tasks that usually do not involve risk of exposure but require precautions in certain situations
Tasks that have no risk of exposure, so no special protection is required

37. Respiratory Hygiene/Cough Etiquette
Guidelines established by CDC
Education
Posting signs
Controlling source or transmission
Proper hand hygiene
Separating patients with respiratory infections from other patients

38. BBP Safety
Flush your eyes for 10 minute if blood or potentially infectious materials are splashed into your eye
Always dispose of sharps in approved container
NEVER EVER RECAP
Use ¼ cup bleach:1 gal water to effectively decontaminate most surfaces. Leave for 10 minutes

39. Personal Protective Equipment
Protective gear worn to protect against physical hazards
Employers must provide PPE at no charge to the employee
Disposable, sterile exam and utility gloves
Masks and protective eyewear or face shields
Protective clothing

40. Postprocedure Cleanup
Decontaminate all exposed surfaces
Replace protective coverings on surfaces or equipment
Decontaminate receptacles
Pick up any broken glass with tongs
Discard all potentially infectious waste materials

41. OSHA Guidelines (cont.)
Apply guidelines daily on the job
Exposure incidents
Contact with infectious substance
Rules apply to all serious infections – HIV, HBV
HBV vaccine
Transmission to patients
Nosocomial infection – an infection acquired by a patient in a health-care facility

42. Apply Your Knowledge
OSHA divides medical tasks by level of risk. What are these risk categories?
ANSWER: There are three categories of risk:
Category 1: Expose a worker to blood, body fluids, or tissues and require specific protective measures
Category 2: Usually do not involve risk of exposure, but precautions are required in certain situations
Category 3: No risk of exposure, so no special protection is required

43. Apply your knowledge
Mary was a patient in the hospital after suffering from a broken hip. Two days after admission she began running a fever. She was diagnosed with a Urinary Tract Infection. What type of infection is this?
Nosocomial Infection

44. Reporting Guidelines
Certain diseases must be reported to state or county health department
Information is forwarded to the CDC – control of the spread of infection

45. Reporting Guidelines (cont.)
National Notifiable Disease Surveillance System (Table 33-2)
Examples
HIV/AIDS  Cholera
Rubella  Hepatitis
Legionellosis  Lyme disease
Mumps  Smallpox
Tetanus  Tuberculosis

46. Good Answer! Apply Your Knowledge
How is the information on reportable diseases used by the CDC?
ANSWER: The CDC uses the information reported to them to help control the spread of infection.
Good Answer!

47. Isolation Guidelines CDC guidelines
Types of precautions needed
Patients requiring precautions
Create an environment that protects against pathogens
Standard Precautions

48. Isolation Guidelines (cont.)
Select appropriate PPE
Gloves
Masks, face shields, respirators
Gowns

50. Nice! Apply Your Knowledge
Mrs. Findley brings her child with chickenpox into the medical office. What type of personal protective equipment should you use when caring for this child?
ANSWER: Chickenpox requires airborne and contact precautions, so you should use gloves and a mask and goggles or a respirator.
Nice!

51. Immunizations Immunization Reduces risk of infection spread
Administration of a vaccine or toxoid to protect susceptible individuals from infectious diseases
Reduces risk of infection spread
Decreases the susceptibility of the host

52. Immunizations (cont.) When administering, you must explain
The need for immunization
Side effects
Soreness at site
Low-grade fever
General malaise

53. Immunizations (cont.) Concerns Pediatric patients
Do not give if child has a high grade fever
Informed consent – explain benefits and risks
Contraindications – symptoms that render the use of a remedy or procedure inadvisable because of the risk
What would be contraindications for vaccines?
Immunization records
National Childhood Vaccine Injury Act of 1988
Instruct parents keep record as proof of immunization

54. Immunizations (cont.) Pregnant patients Elderly
Avoid live virus vaccines
FDA categories A, B, C, D, and X
Elderly
Dispel common misconception and cost concerns
More likely to develop side effects

55. Immunizations (cont.) Immunocompromised patients Health-care workers
May experience minimal to dangerous effects
Adjust dosage or delay administration
Must also consider immunization status of family and caregivers
Health-care workers
Hepatitis B vaccination offered by employer at no cost to employee

56. Apply Your Knowledge Great! What is an immunization?
ANSWER: An immunization is the administration of a vaccine or toxoid to protect susceptible individuals from infectious diseases.
Great!

57. Preventing Disease Transmission
Educate patient on
Nutrition and diet
Exercise and weight control
Prevention of STDs
Smoking cessation
Alcohol and drug abuse prevention and treatment
Proper use of medications and prescribed treatments
Stress-reduction techniques

58. Preventing Disease Transmission (cont.)
Goal of patient education
Help patients take care of themselves
Encourage patients to participate actively in their own health care

59. Bravo! Apply Your Knowledge What is the goal of patient education?
ANSWER: Help patients take care of themselves. Empowering the patient!
Bravo!

60. Apply your knowledge How is the spread of infectious diseases stopped?
Answer: Break any chain in the chain of infection

61. Think.Pair.Share.
Compare and contrast medical and surgical asepsis.

62. Apply your knowledge
Annie works as a nursing tech in the hospital. She is cleaning the over-the-bed tray with cleaning wipes before placing the patient’s food tray on it. Is Annie using sterilization, disinfection or sanitation?
Answer: disinfection
Before Annie leaves the room she notices the trash can is full and removes the bag. What practice is in place?
Answer: Sanitation

63. Apply your knowledge
Which of the following would not require surgical asepsis?
Caring for a wound two days post op
Starting a new IV
Removing head lice from a patient
Removing a mole from a patient
Answer: Removing head lice from a patient

64. Apply your knowledge
What type of PPE would be required to care for a patient with TB, an airborne disease?
Mask (respirator), gloves

65. Apply your knowledge
What vaccine must be offered to you free of charge in any healthcare facility?
Answer: Hepatitis B

66. Apply your knowledge
Which disease is NOT required to be reported to the CDC?
HIV
Small Pox
Influenza
Tetanus
Answer: Influenza

67. Soap and education are not as sudden as a massacre, but they are more deadly in the long run.
~ Mark Twain