1. Disease Control and Prevention
Chapter 3

2. INTRODUCTION
Epidemiology-study of disease patterns and spread of diseases
Microbes are responsible for epidemics but there have been some improvements.
However there are some diseases that are re-emerging such as tuberculosis, measles, and then new ones such as Zika virus among others.
It is vital that health care workers know about infection control and understand how microorganisms can be spread.
In this chapter we will learn healthcare associated
infections and how microbes are spread
Present day
Numerous classifications of microbes
Numerous classifications of antibiotics
Numerous vaccines against disease

3. Interaction Between Microbes and their Hosts
Relationship between humans and microbes is complex
Not all pathogens are harmful-nonpathogens
Chain of infection
Pathogen
Reservoir (carrier)
Portal of Exit
Mode of Transmission
Portal of Entry
Susceptible Host
Goal is to break a link in the chain of infection

4. Interaction Between Microbes and their Hosts

5. Interaction Between Microbes and their Hosts
Normal Flora
Body surface
Gastrointestinal track
Female Reproductive track
Helps to keep harmful bacteria at bay
Pathogens
Parasitic relationship with host
Use host as habitat, but also does harm
Some are specific to one type of disease;
others can cause several different diseases

6. Interaction Between Microbes and their Hosts
Bacteria
Recall different ways that survive
Fungi
Viruses
Dependent on the host to survive
Can lay dormant in the body such as varicella
zoster and then re-emerge as shingles

7. Reservoirs of Infection
Carriers (asymptomatic, but spread disease to others)
Animals
Environment
Fomites (nonliving objects harboring and transmitting diseases)
Hospital procedures
5-5

8. Interaction Between Microbes and their Hosts
Portal of Exit and Portal of Entry
Way that the pathogens can be expelled from the reservoir/carrier to a possible new place for the pathogen to affect
Contact
Airborne
Droplet
Vector

9. Interaction Between Microbes and their Hosts
Standard precautions
Minimum standards; considers all patients capable of transmitting disease
Transmission-based precautions
Three types (contact, droplet, and airborne precautions); used with standard precautions if patient is known or suspected to have transmittable disease, or infection with multidrug-resistant bacteria

10. Interaction Between Microbes and their Hosts
Standard precautions are used when possible exposure to blood and/or body fluids from any patient or from contaminated equipment
Include
Hand hygiene and proper use of personal protective equipment (PPE)
Cough etiquette/respiratory hygiene
Safe injection practice
Safe handling of potentially contaminated surface/equipment

11. Interaction Between Microbes and their Hosts
Mode of Transmission
Be aware that some pathogens can be transmitted in more than one way such as chickenpox-airborne and contact due to lesions
Contact
Direct
Indirect
Airborne
Droplet
Vector
Biological
Pathogen located inside vector’s body (e.g., mosquito as carrier of malaria)
Mechanical
Pathogen located outside vector’s body (e.g., fly walks on food)

12. Transmission-Based Precautions
Three types: contact, airborne, droplet (all used in conjunction with standard precautions)
Contact precautions
Private room; dedicated equipment for patient; disinfect equipment when removed
Hand hygiene and proper use of PPE
5-23

13. Cough Etiquette and Respiratory Practices
Droplet precaution
Used with standard precautions
Avoid direct patient contact if you have respiratory illness (or wear mask HEPA or N95 if direct contact cannot be avoided)
Hand hygiene
Illness spread by large particle droplets (e.g., flu, whooping cough)
Private room; door may remain open

14. Transmission-Based Precautions
Airborne precautions
Transmission by droplet or dust (e.g., TB, measles)
Negative-pressure room with door closed
Proper PPE (mask must be fit-tested for health care worker)

15. Safe Needle Practices
Discard used syringes/needles at point of use (in puncture-resistant, closable, leakproof sharps container)
Dispose of single-use lancets properly and immediately after use
Perform phlebotomy in dedicated areas containing proper supplies and hand washing stations
Label blood tubes prior to phlebotomy procedure
Place blood-containing tubes only on surfaces that can be properly cleaned if contamination occurs

16. Cough Etiquette and Respiratory Practices
Tissues and no-touch waste cans available in reception areas
Cover mouth when coughing or sneezing
Cough/sneeze into crook of elbow if tissue is not available
Perform hand hygiene after contact with respiratory secretion (yours or patient’s)

17. Interaction Between Microbes and their Hosts
Host Susceptibility
Ability of a pathogen to cause disease
Weakend immune system
Virulence of microbes

18. Signs and Symptoms of Infection
Will vary according to site and type of infection
Local
Fever of Over
Feeling of Overall Malaise. ...
Green, Cloudy (Purulent) or Malodorous Drainage. ...
Increasing or Continual Pain from Wound. ...
Redness Around Wound. ...
Swelling of Wounded Area. ...
Hot Skin Near Wound. ...
Loss of Function and Movement.

19. Signs and Symptoms of Infection
Will vary according to site and type of infection
Systemic-Sepsis
Fever and chills
Very low body temperature
Urinating less than normal
Rapid pulse
Rapid breathing
Nausea and vomiting
Diarrhea

20. Health Care Associated Infections
Infections obtained in a health care related facility
Handwashing is the number one reason
Difficult to distinguish if infection contracted in health care facility or at home

21. Health Care Associated Infections
Number of reasons that make patients more vulnerable to infection than before
Immune system-such as cancer patients
Other diseases affecting healing such as with diabetics and wound healing
Age-young and elderly
Natural defense mechanisms such as intact skin
Exposure to infections

22. Infection Prevention and Control
Key Components of Infection Control Program
Infection Control Nurse-will be training and assisting personnel in following policies and procedures; will monitor any possible occurrences that might indicate possible problems
Outbreaks can happen anywhere, but more difficult when in close counters

23. Infection Prevention and Control
Precautions and Asepsis
Standard precautions
Application of principles of medical asepsis
Conscientious handwashing
Transmission-based precautions
Prevent and control HCAI (nosocomial) and community-acquired infections
Intentional, consistent nursing measures

24. Infection Prevention and Control
Needlestick Inuries
Threats: Infectious diseases, e.g., Hepatitis B, AIDS
Standard precautions; Gloves, new needleless access devices
Postexposure recommendations
Report injury; document in writing; identify person or source
Obtain HIV and HBV status of source
Counseling about infection potential
Postexposure prophylaxis; disease antibody testing; medical follow-up

25. Interaction Between Microbes and their Hosts
Opportunistic infections
Also known as superinfections
Nonpathogens or pathogens
Take advantage of favorable situation
Overwhelm host
Common among immunocompromised clients