Wilk: Sorrentino's Canadian Textbook for the Support Worker, 5th Edition

Chapter 19: Preventing Infection

Chapter 19

Preventing Infection

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Introduction (1 of 2)
 Infection is a serious safety and health
hazard.
 The health care team follows certain
practices and procedures to prevent the
spread of infection.
 This is called infection control—policies and
procedures to prevent the spread of infection
within health care settings.
• Infection control protects clients, residents, visitors, and
staff from infection.
• Proper hand hygiene should always accompany any
other infection-control efforts.
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Slide 2

Introduction (2 of 2)
 Who is at risk?
 Older persons
 People with health challenges
 People with disabilities
 Infections can easily spread from person to
person.
 Support workers must follow an employer’s
infection-control policies.

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Slide 3

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 Microorganisms (1 of 6)
 A microorganism (microbe), sometimes called
a germ or bug, is a small living plant or
animal seen only with a microscope.
 Microbes are everywhere.
 Some microbes are harmful and can cause
infections.
• They are called pathogens
 Nonpathogens are microbes that do not usually
cause an infection.

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Microorganisms (2 of 6)
 There are four major types of microbes:
 Bacteria are one-celled microbes.
 Viruses invade living cells in order to grow and
multiply.
 Fungi are microbes that live on organic matter,
such as plants or animals.
 Parasites are organisms that derive nourishment
and protection from other living organisms, known
as hosts.

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Microorganisms (3 of 6)
 Requirements of microbes
 Microbes need a reservoir (host) to live and grow
• Microbes need water and nourishment from the
reservoir.
• Most microbes need oxygen to live.
• A warm and dark environment is needed.
• Most grow best at body temperature.
• They are destroyed by heat and light.

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 Microorganisms (4 of 6)
 Normal flora
 Microbes that live and grow naturally in a certain
area of the body.
 They are nonpathogens when in or on a natural
reservoir.
 When a nonpathogen is transmitted from its
natural site to another site or host, it becomes a
pathogen.
 When a person is ill or taking medication,
some normal flora can be killed, which
increases the risk of developing an infection.
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Slide 7

Microorganisms (5 of 6)
 Multidrug-resistant organisms (MROs)
 Sometimes called “superbugs”
 Microbes that can resist the effects of antibiotics
• Antibiotics are drugs that kill microbes that cause
infections
 MROs are caused by:
• Doctors prescribing antibiotics when they are not needed
(over-prescribing)
• Patients not taking antibiotics for the full length of time
prescribed

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Microorganisms (6 of 6)
• MROs pose a serious threat to clients in
health care facilities.
 Three common types of MROs are resistant to
many antibiotics:
• Methicillin-resistant Staphylococcus aureus (MRSA)
• Vancomycin-resistant Enterococcus (VRE)
• Clostridium difficile (C. difficile)
 Extended-spectrum beta-lactamase (ESBL) is
also becoming more commonly associated with
with urinary tract infections, wound infections
• See textbook box: Think About Safety: Caring for
Clients Who Are Infected With an MRO in Their Home
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Slide 9

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 Infection (1 of 3)
 Infection is a disease state resulting from the
invasion and growth of pathogens in the body.
 A local infection is in a specific body part.
 A systemic infection involves the whole body.
 Three possible outcomes of exposure to
pathogens:
 Immune system destroys pathogen
 Immune system does not destroy pathogen, but no
infection develops
 An infection develops sometime later, after
exposure to the pathogen

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Infections (2 of 3)
 Health care–associated infections (HAI)
 An infection that develops in a client who is cared
for in any setting where health care is given
• HAIs were traditionally called nosocomial infections.
• HAIs are caused by:
 Normal flora
 Microbes transmitted to the client from another
source
 See textbook box: Focus on Older Persons:
Signs and Symptoms of Infection

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Infections (3 of 3)
 Common HAI infections include:
 Urinary tract infections
 Respiratory system infections (colds, pneumonia,
bronchitis, flu)
 Gastro-intestinal system infections (nausea,
diarrhea)
 Skin (wound or IV site) infections

 HAIs are prevented by:

 Medical asepsis, especially hand hygiene
 Isolation precautions
 Surgical asepsis
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 Pandemics (1 of 2)
 A pandemic occurs when a communicable
illness/infection spreads quickly country-wide
and even world-wide.
 Normally, people who become ill from a virus
develop memory cells that will recognize at least
some of the proteins of that virus, and allow quick
recovery if that virus (or a mutated version) is
contracted again.
 In a pandemic, there are NO memory cells for new
strain of virus.

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Slide 13

Pandemics (2 of 2)
 When we have no memory cells for an antigen,
this can cause immune systems to overreact,
causing death
• For example: SARS (2002-2003)
• Current COVID-19 pandemic (2020-?)

 See textbook box Think About Safety: COVID-19

and Its Effect on the World

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Slide 14

H1N1 Virus and New Strains

 H1N1 flu virus is contagious and is spread
the same way as regular seasonal flu
(influenza).
 It is not possible to catch the disease by eating
pork or through blood transfusions.
 Main symptoms are fever and cough.

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 The Chain of Infection (1 of 2)
 Pathogen
 Reservoir
 Portal of exit
 Mode of transmission
 Portal of entry
 Susceptible host

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The Chain of Infection (2 of 2)

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Vaccinations
 Vaccination has been proven to prevent serious
communicable illnesses.
 Health care agencies require workers to have their
routine vaccinations up to date before they start work.
 Hepatitis B vaccination is recommended for all those
working in health care settings.
 A yearly influenza vaccination is also highly
recommended (and sometimes required).
 New staff and residents of long-term care facilities
are required to have a two-step tuberculosis (TB) skin
test.

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 Medical Asepsis (1 of 2)
• Asepsis is the practice of eliminating or
reducing potential pathogens.
• Medical asepsis (clean technique) includes
the practices used to:
 Remove or destroy pathogens
 Prevent pathogens from spreading from one client
or place to another client or place
• Surgical asepsis (sterile technique) is the
practice that keeps items free of all microbes
and their spores.
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Medical Asepsis (2 of 2)
 Sterile means being free from all microbes.
 Pathogens and nonpathogens and spores
 Sterilization is the process of destroying all
microbes.
 Contamination is the process of exposure to
pathogens.
 In medical asepsis, an item or area is clean when
it is free of pathogens.
 A sterile item or area is contaminated when
pathogens or nonpathogens are present.
 Aseptic practices break the chain of infection.

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Hand Hygiene (1 of 2)
• Hand hygiene is the easiest and most
important way to prevent the spread of
infection.
 Practise hand hygiene before and after giving care.
 Use waterless, alcohol-based sanitizers, or
handwash using soap and water.

• See textbook box: Think About Safety: Four Moments for

Hand Hygiene

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 Hand Hygiene (2 of 2)
• Wearing gloves
 Gloves provide a protective barrier between your
hands and the client’s blood, body fluids,
secretions, excretions, nonintact skin, and
mucous membranes.
 Gloves are additional protection and not a
substitute for hand hygiene.
 Do not wear gloves when not needed—
continuous unnecessary wear can lead to dry,
cracked skin.
 Replace gloves if you touch an unclean surface.
• See textbook box: Focus on Home Care: Hand Hygiene

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Slide 22

Care of Supplies and Equipment

(1 of 2)
 Cleaning
 Reduces the number of microbes present and
removes visible organic matter.
 Disinfection
 Process of destroying all pathogens; spores are
not destroyed.
• Chemical disinfectants are used to clean reusable items.
 Sterilization
 Destroys all nonpathogens and pathogens,
including spores.
 Very high temperatures are used.
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Slide 23

Care of Supplies and Equipment

(2 of 2)
 Personal protective equipment (PPE)
 Always wear PPE when cleaning items that may
be contaminated with blood, body fluids,
secretions or excretions.

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Slide 24

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 Isolation Precautions (1 of 13)
 Blood, body fluids, secretions, and excretions
can transmit pathogens.
 Sometimes barriers are needed to prevent their
escape.
 Isolation precautions are guidelines to
prevent the spread of pathogens
(communicable diseases, contagious
diseases).
 Two types:
• Standard Practices (Routine Practices, Standard
Precautions)
• Transmission-Based Practices

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Isolation Precautions (2 of 13)

 Standard Practices:
 Practised all of the time, in all settings.
 Reduce the risk of spreading known and unknown
infections.
 Are used for all persons, whenever care is given.
 Prevent the spread of infection from:
• Blood
• All body fluids, secretions, and excretions (except sweat),
even if blood is not visible
• Nonintact skin (skin with open breaks)
• Mucous membranes (including in the nose, eyes, mouth,
vagina, and rectum)
 See textbook Box 19.7: Standard Practices
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Isolation Precautions (3 of 13)

 Transmission-Based Practices
 Three types:
• Airborne precautions
• Droplet precautions
• Contact precautions
 Follow guidelines to contain pathogens in one
area (usually the client’s room).
 You will be told when Transmission-Based
Practices are ordered for a client.

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 Isolation Precautions (4 of 13)
 Transmission-Based Practices
 The client is usually placed in a private or semi-
private room to isolate his or her germs from
others, in order to prevent infection.
• See textbook Box 19.8: Types of Transmission-Based
Practices
• See textbook Box 19.9: General Rules for Transmission-
Based Practices

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Isolation Precautions (5 of 13)

 Protective measures
 Isolation precautions involve wearing personal
protective equipment (PPE).
 PPE includes gloves, mask, gown, and eye
protection.
 Removing linens, garbage, and equipment from
the room may require double bagging.
 Follow agency procedures when collecting
specimens and transporting persons.

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Isolation Precautions (6 of 13)

 Wearing Masks and Respiratory Protection
 Masks are worn for the following reasons:
• For protection from contact with infectious agents from
the client or resident
• During sterile procedures to protect the client from
infectious agents carried in your nose or mouth
 Tuberculosis respirators are worn when caring for
clients with tuberculosis (TB), e.g., N-95 respirator
(airborne isolation precautions)
 It is your responsibility to be fitted for the correct
type of mask and to wear it properly, following
employer policy.

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 Isolation Precautions (7 of 13)
• Wearing Personal Protective Equipment
 Gloves
• Wear gloves whenever contact with blood, body fluids,
secretions, excretions, mucous membranes, and
nonintact skin is likely.
 Gowns and other attire protect your clothes and
body form contact with blood, body fluids,
secretions, and excretions.
• They protect against splashes and sprays.
• Gowns must completely cover you from your neck to
your knees.
• Gowns are used once.
• A wet gown is contaminated.
• Disposable gowns are discarded after use.

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Isolation Precautions (8 of 13)

 Wearing Eye Protection and Face Shields
 Goggles and face shields protect your eyes,
mouth, and nose from splashing or spraying of
blood, body fluids, secretions, and excretions.
• The front of goggles or a face shield is contaminated.
• Discard disposable goggles or face shields after use.
• Reusable eyewear is cleaned before reuse, following
your employer’s procedures.

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Isolation Precautions (9 of 13)

 Disposing of Sharps
 You may come across needles that are improperly
disposed of.
• This is especially common in home care settings.
 Used needles must not be bent or broken.
 Never ignore a sharps injury—treat and report!
 Place sharps into a container that is:
• Tightly capped
• Puncture-resistant
• Leak-proof

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 Isolation Precautions (10 of 13)
 Bagging Items
 Contaminated items are bagged to remove them
from the person’s room.
 Leak-proof plastic bags are used.
 Bags have the BIOHAZARD symbol.
 Biohazardous waste is items contaminated with
blood, body fluids, secretions, or excretions.
 Trash is placed in a container labelled with the
BIOHAZARD symbol.

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Isolation Precautions (11 of 13)

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Isolation Precautions (12 of 13)

 Transporting Biohazardous Waste
 Double-bagging is not needed unless the outside
of the bag is soiled or the bag contains linens that
are wet or soiled.

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 Isolation Precautions (13 of 13)
 Transporting Clients on Transmission-Based
Practices
Clients do not typically leave their rooms.
• This excludes leaving the room for treatments or tests.
 Procedures vary among employers.
 A safe transport means that other persons are
protected from the infection.
 Follow employer’s guidelines to safely transport
clients.

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Slide 37

Basic Needs and Transmission-

Based Practices
• Meeting basic needs:
 Often love, belonging, and self-esteem needs are
unmet when Transmission-Based Practices are
used.
• Visitors and staff often avoid the person.
 The person may feel lonely, unwanted, and
rejected.
 You can help meet love, belonging, and self-
esteem needs.
 Always treat the person with respect, kindness,
and dignity.

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Surgical Asepsis (1 of 2)
 Surgical asepsis (sterile technique) is the
practices that keep equipment and supplies
free of all microbes.
 Sterile means the absence of all microbes,
including spores.
 Surgical asepsis (sterile technique) is required any
time the skin or sterile tissues are entered:
• If a break occurs in sterile technique, microbes can enter
the body.
• Infection is a risk.

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 Surgical Asepsis (2 of 2)
 Principles of surgical asepsis:
 All items in contact with the client are kept sterile.
A sterile field is needed.
• A sterile field is a work area free of all pathogens and
nonpathogens (including spores).
 You might need sterile gloves when assisting with
a sterile procedure
• The sterile field is set up first. Then sterile gloves are put
on.
• After sterile gloves are on, you can handle sterile items
within the sterile field.
 Do not touch anything outside the sterile field.

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