1. Nursing Tech-Prep Mrs. Pike

2. Disease Transmission Why is it important to understand the infectious process? As a health care provider, the contact you make with individuals can result in spread of infection You have the ability to educate others about preventing the spread of illness/disease. Understanding the infectious process will help you understand break the chain.

3. The Infectious Process Infection requires 3 elements A source of microorganisms A susceptible host A means of transmission to the host Sources May be the patient Other people Inanimate objects Host Must be lacking sufficient resistance or Must be susceptible to the infecting agent (portal of entry).

4. Methods of Transmission 5 Main Methods of Transmission Contact Direct or indirect; through an inanimate object Droplet Airborne Common Vehicles Water, food, or contaminated equipment Vectors Mosquitoes, flies, rats, and other such vermin

5. Infections Infection is always caused by a microorganism Present in the air and on the surfaces of all objects When an animal harbors or hosts a microorganism without self-injury, they are called a carrier. May be symptomatic or asymptomatic Local Infection An infection limited to a small area of the body Systemic An infection located throughout the body May occur in a general or local manner

6. Signs and Symptoms (s/s) of an Infection General s/s include Fever Chills Pain An ache or tenderness General feeling of tiredness Night sweats Local Infections in a wound or incision my include Redness, heat, swelling, pain, or fluid that is white, yellowish, or greenish

7. 6 Major Groups of Organisms Bacteria Most common cause of infection and human disease They are single-celled organisms that are neither animals nor plants; they may grow single or clump together Placed into smaller groups according to their shape Rods, cocci (round), spirilla (spiral) Botulism, cholera, conjunctivitis Fungi Yeasts and molds They grow in groups or colonies on other organisms, so they are parasitic athletes foot, vaginitis, ringworm Protozoans (amebic dysentery, malaria) Animal-like, unicellular organisms that cause a variety of disorders.

8. Groups of Organisms Metazoans (trichinosis, intestinal diarrhea, pinworm) Microscopic animals that may be parasites in humans Viruses Not really cells but contain bits of genetic information that can reproduce and cause illness inside of a cell of the body (mononucleosis, common cold, herpes, chicken pox) Rickettsiae Small bacteria-like organisms that cannot live outside of living tissue (Typhus, Rocky Mountain Spotted Fever).

9. Infections Many bacteria live on the surface of or inside the body without causing harm (nonpathogenic); these are also called normal flora. Microorganisms that damage the host organism on or in which they live are called parasites. Microorganisms may be nonpathogenic in certain circumstances but cause disease in others. Escherichia coli (E. coli) is normal in the intestines but pathogenic in the rest of the body.

10. Treatment Not all infections are treated the same Dependant on the causative agent and if a treatment is available Bacterial infections Require an antibiotic; determine microorganism susceptability; PCN, Cipro, Levaquin, etc. Viral infections Requir Fungal infections Require an antifungal; lotrimin, lamisol, etc.

11. Blood Borne Pathogens Pathogen present in the blood that can be transmitted to an individual who is exposed t the blod or body lfids of an nfected indivduals. Common blood borne pathogens Hepatitis C, Hepatitis B HIV

12. Immunity The leukocytes form antibodies in response to antigens or foreign materials that enter the body. Non-specific (innate)- provides general protection; skin, mucous membranes, tears, etc. Inflammatory response- type of non-specific defense can be localized or systemic. When bacteria or infection enter the body and damage cells, the injured cells release chemicals This causes vascular dilation and increased blood flow This allows other molecules to enter the area and wall off the injured site. Then phagocytosis of the WBC’s occurs.

13. Immunity Systemic inflammatory response- another form of nonspecific defense that affects the whole body. Additionally increases neutrophil production, fever, and fluid loss in tissues. Can lead to shock and death if not treated. 2 types of immunity Acquired Natural Caused by exposure to the agent unintentionally; formation of antibodies to prevent reoccurrence of measles; breast milk is passive/natural Artificial Obtained intentionally Vaccination against polio Inherited Develops before birth and is a genetic trait

14. Allergies Hypersensative response by the immune system to an outside substance; an otherwise harmless substance becomes an allergen in the body. Antibodies are then formed in the blood to combat the allergen.

15. Nosocomial Infections Infections acquired by the patient as a result of the care or as a result of pathogens in the facility Approximatley 2 million people acquire nosocomial infections while in the hospital each year. Epidemiology is a science devoted to studying health- related events in the human population. Principles of epidemiology are used to trace the source and minimize the risk of nosocomial infections.

16. Antibiotic Resistance Created when some but not all of the microorganisms being treated are killed. The few that survive may develop a resistance to the antibiotic. In 2005, the CDC listed 8 diseases that have been connected to antibiotic resistance. Gonorhea, head lice, malaria, MRSA, strep, typhoid fever, VRSA, VRE Of the infections acquired in the hospital, the CDC reports 70% resistant to at least one of the drugs commonly used to treat them. MRSA most relevant in the U.S. Main mode of transmission to patients is hands Contact with contaminated needles or sharp instruments is most common method of transfer of pathogenic organisms causing serious illness in the health care worker. Main mode of transmission to patients is hands

17. Infection Control In the past, procedures and precautions based on patient diagnosis; separated from others. In 1996, CDC established 2 level set of guidelines for isolation in hospitals. Isolation Precautions Standard precautions Apply to all patients Transmission-based precautions Apply to patients with known or suspected infections

18. Standard Precautions Combined features of previously used Universal Precautions and Body Substance Guidelines. Applied at all times to all patients Apply to all body fluids except perspiration Designed to reduce transmission of microorganisms from both diagnosed and undiagnosed infection sources. Handwashing, PPE, sharps control, education, proper housekeeping/waste disposal/laundry, hep B vaccine, exposure protocols, employee medical records

19. Transmission-Based Precautions Used for patients with known or suspected infections Used in addition to standard precautions 3 categories of guidelines Airborne Droplet Contact precautions *special precautions may be used for antibiotic-resistant microorganisms and patients with immunosuppressed conditions *Isolation guidelines also include procedures in the event of the use of bioterrorism agents (anthrax)

20. Primary Method of Protection Proper Handwashing technique Wash when you begin work Between patients Before and after eating Before and after using restroom Before leaving work

21. Gloving Sterile Worn to protect the patient during care or procedures Non-sterile Worn when contact is made with body fluids, mucous membranes, wet secretions (urine, blood, saliva, feces, sputum, wound drainage) When removed, always place in designated receptacle Always wash hands after removing

22. Personal Protective Equipment (PPE) Gloves Gowns Eye protection Head cover Footwear *disposable aprons, goggles, and masks are worn with a chance of the secretions splattering

23. Ways to Limit Exposure Wash hands properly and following guidelines Never recap needles and place all sharps in designated containers Obtain Hepatitis B vaccine Use devices for CPR that eliminate mouth-to-mouth contact

24. Methods Not Considered Effective Disposable eating utensils “protective” isolation Disinfectant fogging Double bagging waste and linens for removal *always dispose of waste and linens according to agency policy

25. Asepsis “Asepsis” is the absence of disease causing microorganisms (pathogens) Also includes the methods used to prevent their spread. “Medical asepsis” is a state of cleanliness or the use of clean technique An area or object that becomes unclean is considered contaminated

26. Medical Asepsis Can be evaluated on 3 levels Antiseptic Antiseptics inhibit the growth of bacteria Can be used on the skin Disinfectant Agents that destroy most bacteria and viruses Can be caustic or harmful to the skin Can be accomplished by boiling and/or chemical agents Sterile Surgical asepsis is a state of sterility or the use of sterile technique Removal of all microorganisms including viruses and endospores Accomplished by autoclave