1. Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing Assistants Chapter 7 - Communicable Disease and Infection Control

2. Slide 2 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. What are Communicable Diseases?

3. Slide 3 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Communicable diseases are diseases that can be given from one person to another You must learn to protect yourself, your family members, and your patients or residents from catching a communicable disease You must also learn about the causes of communicable disease, and the ways communicable diseases are spread from one person to another. After all, it is hard to protect yourself and others from communicable disease if you do not know what causes it or how it is spread! Communicable Diseases

4. Slide 4 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. What is a Microbe?

5. Slide 5 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A microbe, also called a microorganism, is a living thing that cannot be seen with the naked eye Most microbes cause no harm and are actually essential for healthy living: called normal (resident) flora Some microbes, however, can cause illness and are known as pathogens What is a Microbe?

6. Slide 6 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Sometimes microbes can be considered normal flora in one part of the body and pathogens in another These types of microbes are called opportunistic microbes For example: Escherichia coli. When E. coli finds its way out of the intestine and into another part of the body where it is not normal flora, such as the bladder, it can cause an infection. Opportunistic Microbes

7. Slide 7 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Classification of Microbes BacteriaVirusesFungi MICROBES Parasites

8. Slide 8 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Bacteria cause many of the infections you will encounter in the health care setting The ability of bacteria to adapt to all sorts of environments is proof of this life form’s ability to survive Scientists classify and name bacteria in many different ways By their shape By the way they arrange themselves in a colony By the way they stain (i.e., how they react to the dye scientists use to make microbes more visible under a microscope) Microbes - Bacteria

9. Slide 9 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Microbes - Bacteria - Classification Round bacteria are called cocci Rod-shaped bacteria are called bacilli Spiral-shaped or curved bacteria are called spirilla Classification on the basis of shape

10. Slide 10 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Microbes - Bacteria - Classification Pairs of bacteria (indicated by the prefix diplo-) Chains of bacteria (indicated by the prefix strepto-) Grape-like clusters of bacteria (indicated by the prefix staphylo-) By the way they arrange themselves in a colony

11. Slide 11 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Microbes - Bacteria - Classification Aerobic - need oxygen to live Anaerobic - die if oxygen is present By their basic requirements for survival

12. Slide 12 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Some types of bacteria can surround themselves with a hard shell, called an endospore, and enter a state of inactivity Once the inactive bacterium’s best growing conditions become available, the bacterium will become active again Because of their protective endospores, these types of bacteria are very difficult to kill using the standard techniques Microbes - Bacteria - Endospores

13. Slide 13 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Illnesses caused by bacteria: Tetanus (lockjaw) Botulism (food poisoning) Strep throat Some bladder infections Some skin infections Rocky Mountain spotted fever Typhus Some types of pneumonia Some infections of the reproductive and urinary systems Microbes - Bacteria - Illnesses

14. Slide 14 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Viruses are the smallest of all microbes They can only be seen using a special kind of microscope, called an electron microscope Many illnesses are caused by viruses, such as: The common cold Fever blisters Chicken pox Hepatitis AIDS Microbes - Viruses

15. Slide 15 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Fungi are a group of plant-like organisms that scientists have classified together because of certain characteristics, including the make-up of their cell walls Examples of illnesses caused by fungi are: Ringworm Athlete’s foot Thrush Candidiasis Microbes - Fungi

16. Slide 16 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Parasites live in or on a host, such as a plant or animal, and use that host for food and protection Examples of parasites are: Helminths Protozoa Examples of illnesses caused by parasites are: Scabies Pediculosis (lice) Microbes - Parasites

17. Slide 17 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Defenses Against Communicable Disease

18. Slide 18 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Many, many microbes share the Earth with us If microbes are everywhere, and some of them can make us sick, then why aren’t we all always sick? The answer to this question lies in the body’s immune system, the wonderful defense system that protects us from infection The Immune System

19. Slide 19 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Our main nonspecific defense mechanism is healthy, intact skin and mucous membranes Skin that is without cuts, scrapes, or wounds physically prevents pathogens from entering the body Mucous membranes line all of the organ systems that come in contact with the outside world (namely, the respiratory, digestive, urinary, and reproductive systems) Nonspecific Defense Mechanisms

20. Slide 20 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. If a pathogen gets past the first lines of defense and an infection results, the body activates a general immune response Fever, inflammation, warmth, and redness at the site of infection: a normal response to infection Nonspecific Defense Mechanisms

21. Slide 21 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The immune system also has the ability to develop specialized proteins called antibodies, which help our bodies to fight off specific microbes A person develops antibodies following exposure to the microbe Vaccines expose the body to the microbe, stimulating antibody production without causing actual illness Specific Defense Mechanisms

22. Slide 22 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. An antibiotic is a drug that is able to kill bacteria or make it difficult for them to reproduce and grow Two types of bacteria, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin- resistant enterococci (VRE), have become resistant to two of the most powerful antibiotics we have invented to date (methicillin and vancomycin) Although antibiotics have given us more options for treating infectious disease than we had in the past, they do not work against all pathogens all of the time The best policy is clearly to avoid infection in the first place Antibiotics

23. Slide 23 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Communicable Disease and the Chain of Infection

24. Slide 24 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. For a person to get a communicable infection, six key conditions must be met These six key elements are known as the chain of infection Eliminating any one of the six key elements breaks the chain and prevents the spread of infection Chain of Infection

25. Slide 25 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Chain of Infection

26. Slide 26 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Breaking the Chain of Infection

27. Slide 27 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Infection Control in the Health Care Setting

28. Slide 28 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Maintaining cleanliness in health care facilities is essential, because exposure to pathogens is increased in these settings Most of the people in health care facilities are there because they are not in good overall health and their potential to become infected is increased A nosocomial infection is an infection gotten while in a hospital or other health care setting All health care facilities follow basic practices that are designed to decrease the chance that an infection will be spread from one person to another. These practices are called infection control Infection Control in the Health Care Setting

29. Slide 29 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. There are four major methods of infection control Medical asepsis Surgical asepsis Barrier methods Isolation (transmission-based) precautions Methods of Infection Control

30. Slide 30 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Medical asepsis involves physically removing or killing pathogens, and is primarily achieved through processes involving soap, water, antiseptics, disinfectants, or heat There are four techniques that make up the practice of medical asepsis: Sanitization Antisepsis Disinfection Sterilization Medical Asepsis

31. Slide 31 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Sanitization is the word we use to describe practices associated with basic cleanliness, such as: Handwashing Cleansing of eating utensils and other surfaces with soap and water Providing clean linens and clothing Sanitization practices physically remove pathogens, thereby preventing their spread Medical Asepsis: Sanitization

32. Slide 32 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Antisepsis takes sanitation one step further, by actually killing microbes or stopping them from growing An antiseptic is a chemical that is capable of killing a pathogen, or preventing it from growing Antiseptics can be used on the skin or other surfaces to kill pathogens Examples of antiseptics: Rubbing alcohol Iodine Medical Asepsis: Antisepsis

33. Slide 33 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Disinfection involves the use of stronger chemicals to kill pathogens The chemicals used for disinfection are too strong to be used on the skin Disinfectants are used to clean non-living objects that come in contact with body fluids or substances, such as bedpans, urinals, and tray tables Medical Asepsis: Disinfection

34. Slide 34 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Sterilization is the most thorough method of killing microbes Sterilization is used on objects that must be completely free of any microbe, such as surgical instruments, hypodermic needles, or intravenous (IV) catheters Equipment is sterilized either by placing items in an autoclave or by soaking the items in chemicals that destroy all microbes Boiling is not an effective method of sterilization Medical Asepsis: Sterilization

35. Slide 35 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. In the health care setting, handwashing takes on a special importance because the chance of picking up a pathogen and passing it on to someone else is greater than in normal, everyday life Although the specifics of how handwashing is performed vary from setting to setting, one aspect of handwashing always remains the same - it must be performed thoroughly, properly, and consistently Medical Asepsis: Sanitization – Handwashing

36. Slide 36 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. At the minimum, wash your hands: When you first arrive at your facility Before entering a resident’s room or a “clean” supply room Before obtaining clean linen from a linen cart Before handling a patient’s or resident’s meal tray Before you go on break and before you leave your shift Before and after drinking, eating, or smoking Before and after inserting contact lenses After using the bathroom After coughing, sneezing, or blowing your nose After touching anything that may be considered dirty After picking an object up from the floor After removing disposable gloves, including those times when you are replacing a torn glove After handling your hair or applying make-up or lip gloss Medical Asepsis: Sanitization – Handwashing

37. Slide 37 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Alcohol-based hand rubs have several advantages: Using an alcohol-based hand rub is quicker than washing your hands at the sink Alcohol-based hand rubs are gentler on the skin than soap and water Alcohol-based hand rubs are used without water, so they can be used anywhere Handwashing: Using an Alcohol-Based Rub

38. Slide 38 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. It is very simple to use an alcohol-based hand rub The label on the product will tell you how much product to use Apply this amount to one of your palms and rub your hands together, covering your hands and fingers (front and back) with the product Continue rubbing your hands together until your skin is dry. That's all there is to it! Handwashing: Using an Alcohol-Based Hand Rub

39. Slide 39 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Surgical asepsis is used for procedures that involve entering a person’s body Examples of procedures that require surgical asepsis include: Surgical procedures Injections The insertion of intravenous (IV) catheters The insertion of urinary catheters In most states, performing procedures that require surgical asepsis is not within a nursing assistant’s scope of practice Surgical Asepsis

40. Slide 40 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A barrier is an object that physically prevents microbes from reaching a health care provider’s skin or mucous membranes Examples of barriers used in infection control, called personal protective equipment (PPE), include: Disposable gloves Gowns Masks Protective eyewear Barrier Methods

41. Slide 41 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Gloves are the most commonly used barrier method Gloves are worn in the following situations: When there is a possibility that you will come in contact with body fluids or substances When you are performing or assisting with perineal care When you have a cut or abrasion on your hands When you are shaving a patient or resident When you are performing care on a patient or resident who has an open wound or other break in the skin Barrier Methods: Gloves

42. Slide 42 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. To effectively prevent contamination of your hands gloves must be intact they must fit properly The most common error made by people who wear gloves for barrier protection is becoming too comfortable with the fact that they are protecting themselves, and forgetting to protect others! If you are wearing gloves and you touch a surface that is contaminated, then your gloves become contaminated. If you then touch something else, that surface becomes contaminated too. Barrier Methods: Gloves

43. Slide 43 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A gown (fabric or paper) should be used when it is likely that your uniform will be soiled with body fluids or substances The use of the gown prevents contamination of your uniform Each gown is worn only once Any gown, fabric or paper, is considered contaminated if it becomes wet Barrier Methods: Gowns

44. Slide 44 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Masks prevent you from breathing in microbes through your nose or mouth, and are worn when there is a chance that you will be exposed to pathogens that are transmitted through the air or in droplets of saliva Surgical masks are most commonly used, but if you are caring for a person with TB, you may be required to wear a special high-filtration mask All masks are used only once Barrier Methods: Masks

45. Slide 45 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Goggles, face shields, and other types of protective eyewear are used to protect your eyes from substances that may splash Barrier Methods: Protective Eyewear

46. Slide 46 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Isolation (transmission-based) precautions are guidelines, based on a pathogen’s method of transmission, that we follow to contain the pathogen and limit others’ exposure to it as much as possible There are two “levels” of isolation precautions The first level, called standard precautions, is a set of precautions used to protect against pathogens that are transmitted in blood The second “level” of isolation precautions includes precautions that are used when a person is known to have a disease that is transmitted a certain way, for example, via the air, in droplets, or by direct contact Isolation (transmission-based) Precautions

47. Slide 47 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Airborne precautions are used when caring for people infected with pathogens that can be transmitted through the air Droplet precautions are used when caring for people with diseases caused by pathogens that are transmitted by direct exposure to droplets released from the mouth or nose (for example, when the person coughs, sneezes, or talks) Contact precautions are used when caring for people with diseases caused by pathogens that are transmitted directly (by touching the person), or indirectly (by touching fomites) Isolation (transmission-based) Precautions

48. Slide 48 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. End of Presentation