1. Best Practices for Environmental Cleaning Module 1 – Chain of Transmission

2. 2 Learning Objectives At the end of this session you will be able to: 1.Explain the importance of environmental cleaning 2.Describe the general principles of transmission of infectious agents 3.Suggest some strategies to break the chain of transmission

3. 3 Background Healthcare Associated Infections (HAIs) occur as a result of health care interventions in any health care setting HAIs are a client/resident/patient safety issue and represent a significant adverse outcome of the healthcare system The environment around the client/patient/resident influences the incidence of infection  Cleaning and disinfection reduces the numbers of microorganisms in the healthcare environment The goal of cleaning is to keep the environment safe for clients/residents/patients, staff and visitors

4. Chain of Transmission Infection prevention strategies are aimed at “breaking the chain” at one of its links 4

5. 5 Infectious Agent The Germ Reservoir Hiding Places Portal of Exit Way Out Means of Transmission Getting Around Portal of Entry Way In Susceptible Host Next Sick Person Chain of Transmission

6. 6 Reservoir Hiding Places Portal of Entry Way In Infectious Agent The Germ Susceptible Host Next Sick Person Means of Transmission Getting Around Portal of Exit Way Out

7. 7 Infectious Agent – The Germ Germs are everywhere! Bacteria  MRSA, VRE, C. difficile, Salmonella, Group A Streptococcus Viruses  Influenza, Hepatitis B, HIV Parasites  Giardia, Malaria Fungi  Candida, Aspergillus * The State of Queensland

8. 8 Chain of Transmission Reservoir Hiding Places Portal of Entry Way In Infectious Agent The Germ Susceptible Host Next Sick Person Means of Transmission Getting Around Portal of Exit Way Out

9. 9 Reservoir – Hiding Places Place where infectious agent can survive, but may or may not multiply:  People  Cases and carriers  Food  Environment (water, solutions)  Animals

10. 10 You cannot tell by looking...

11. 11

12. You cannot tell by looking... 12

13. 13 Chain of Transmission Reservoir Hiding Places Portal of Entry Way In Infectious Agent The Germ Susceptible Host Next Sick Person Means of Transmission Getting Around Portal of Exit Way Out

14. 14 Portal of Exit – Way OUT How an infectious agent gets out of reservoir Human portals of exit: Respiratory system Genital and urinary tracts Intestinal tract Skin/mucous membrane Trans-placental Blood

15. 15 Learning Checkpoint

16. Which of the following are reservoirs for germs? a)An individual with a cold b)Outdated cleaning solution c)Visiting pets d)All of the above 16

17. Learning Checkpoint Answer The correct answer is d – All of the above are reservoirs for transmission of germs.

18. 18 Chain of Transmission Reservoir Hiding Places Portal of Entry Way In Infectious Agent The Germ Susceptible Host Next Sick Person Means of Transmission Getting Around Portal of Exit Way Out

19. 19

20. 20 Transmission – Getting Around Direct Indirect CONTACT

21. Transmission – Getting Around 21 <2 metres Droplet

22. Transmission – Getting Around 22 Airborne transmission <2 metres Droplet

23. Transmission – Getting Around 23 VEHICLE

24. Transmission – Getting Around 24 Vectorborne

25. 25 Chain of Transmission Reservoir Hiding Places Portal of Entry Way In Infectious Agent The Germ Susceptible Host Next Sick Person Means of Transmission Getting Around Portal of Exit Way Out

26. 26 Portal of Entry – Way IN Non-intact skin Mucous membranes Respiratory system Gastrointestinal system Genitourinary system Aerosol image: http://staff.vbi.vt.edu/pathport/pathinfo_images/Mycobacterium_tuberculosis/AerosolTransmission.jpg

27. 27 Learning Checkpoint

28. Learning Checkpoint What is the most common mode of transmission for infection? a.Droplet b.Airborne c.Contact d.Respiratory 28

29. Learning Checkpoint Answer The correct answer is c – The majority of infections are spread through direct and indirect Contact

30. 30 Chain of Transmission Reservoir Hiding Places Portal of Entry Way In Infectious Agent The Germ Susceptible Host Next Sick Person Means of Transmission Getting Around Portal of Exit Way Out

31. 31 Susceptible Host The Next Sick Person Anyone who lacks immunity or has reduced resistance to a particular infectious agent

32. Host Characteristics Age Disease history Underlying illness Lifestyle 32

33. When you return to your job, what will you do differently as a result of this session? 33

34. 34 Thank You!

35. Image Sources – Module 1 Getty Images used in:  Slides 9, 10, 11, 12, 20 & 22  Quiz question 7 iStock photos used –  Slides 19 & Quiz question 7 – PersonSneezing- iStock_000003466751  Slide 24 – Mosquito_iStock_000018469709 Microsoft Clipart used in:  Slides 12, 15 & 27  All quiz answers All other images are © PHO 2013