Major Components of Infection Prevention Control Roy

Major Components of Infection Prevention & Control Roy Thompson

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Objectives At the end of this two hour lecture students will be able to: 1. review modes and mechanisms of transmission of pathogenic organisms in the health care according to Pan American health Organization 2011

Objectives 2. define major concepts of infection prevention and control according to WHO (2013). 3. list the main components of infection prevention and control according to WHO (2013). 4. discuss the components of infection prevention and control according to WHO (2013).

Source People with active infections or disease carriers • Patients • Staff members • Visitors Endogenous flora Inanimate objects Medications (Pan American Health Organization, 2011)

Host • Susceptible hosts lack effective resistance against certain microbes and develop clinical disease • Some hosts resist colonization by infectious agents • Other hosts develop commensal relationships with microbes and become asymptomatic carriers (PAHO, 2011)

Factors affecting Susceptibility • • • Co-morbidities Antimicrobials Immunosuppressive agents Irradiation Breaks in skins Invasive lines (PAHO, 2011)

Modes of Transmission • • • Contact Droplets Airbourne Common vehicle Vectorbourne (PAHO, 2011)

Contact Direct Indirect • Involves body surface to • Involves contact of body surface contact susceptible hosts and • Physical transfer of contaminated objects microbes between host • These include needles, and carrier/infected person dressings, contaminated • May occur when giving gloves and unwashed clients baths, turning hands between and other health care procedures related activities

Droplets • Droplets from infected persons during coughing sneezing, coughing, suctioning and bronchoscopy • Droplets containing microbes are deposited on hosts conjunctivae, nasal mucosa or mouth • Transmission requires a distance of less than 1 meter (PAHO, 2011)

Airbourne • Microbes are dispersed widely by air currents • Spread by airbourne droplets nuclei containing microbes or dust particles • Microbes remain suspended for a longer time • Control is challenging and requires controlling air flow through ventilation systems (PAHO, 2011)

Common Vehicle • Food eg. Salmonellosis • Water eg. Shigellosis • Medication/Intravenous solutions • Blood eg. HIV, Hepatitis B and C • Equiptment and devices Transmissions may result in explosive outbreaks (World Health Organization, 2013)

Vectorbourne • Occurs when vectors such as mosquitoes, flies, rats and other vermins transmit microbes • Prevented by good house keeping, closed or screened windows and proper health care facility maintenance. (World Health Organization, 2013)

Chain of Infection http: //www. bing. com/images/search? q=mode+of+transmission+of+pathogens&qs=n&form=QBIR&pq=mode+of+transmission+of+pa thogens&sc=1 -33&sp=-1&sk=#view=detail&id=4024 DD 5709 FEEF 11 AFA 39 D 2 F 0555 F 7 DD 6 F 59 FE 21&selected. Index=7

Infectious Agent • Microbes with the ability to cause disease. • The greater the organism's virulence (ability to grow and multiply), invasiveness (ability to enter tissue) and pathogenicity (ability to cause disease), the greater the possibility that the organism will cause an infection. • Infectious agents are bacteria, virus, fungi, and parasites. (PAHO, 2011)

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Reservoir • A place within which microorganisms can thrive and reproduce. For example, microorganisms thrive in human beings, animals, and inanimate objects such as water, table tops, and doorknobs. (PAHO, 2011)

Human Reservoir • Acute Clinical Cases -become ill -contacts and activities may be limited -more likely to receive treatment (WHO, 2013) • Carriers -do no become ill from infectious agents -activities not restricted -more risky as contacts are unaware of their infection

Human Carriers • • Incubatory carriers Inapparent infection (subclinical cases) Convalescent carriers Chronic carriers (WHO, 2013)

Incubatory carriers • Going to become ill and begin transmitting their infection before their symptoms start. • Example 1: Measles virus spread in nasal and throat secretions a day or two before any cold symptoms or rash are noticeable. • Example 2: HIV infection may be present for years before the person develops any symptoms. (International Labour Organization, 2005)

Inapparent infection • Persons never develop an illness, but are able to transmit their infection to others. • Example 1: Only 1/100 individuals infected with poliomyelitis virus becomes paralyzed. • 4/100 will have mild illness (fever, malaise, headache, nausea and vomiting) • 95/100 will have no symptoms at all, although they pass the virus in their faeces. (WHO, 2013)

Convalescent carriers • Person who are infectious during and even after their recovery from illness. • Example 1: Salmonella patients may excrete the bacteria in faeces for several weeks and rarely even for a year or more. • Treatment with inappropriate antibiotics may prolong the convalescent carrier phase (WHO, 2013)

Chronic carriers • People who continue to harbor infections for a year or longer after their recovery • Example: Chronic carrier state is common following hepatitis B infection, whether or not the person became ill, and may be lifelong. • The risk of developing chronic hepatitis B depends on the person’s age at infection. (WHO, 2013)

Portal of Exit • A place of exit providing a way for a microorganism to leave the reservoir. • Microbes may leave the reservoir through the nose or mouth when someone sneezes or coughs. • Microbes carried away from the body by faeces may also leave the reservoir of an infected bowel. (WHO, 2013)

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Mode of Transmission • Method of transfer by which the organism moves or is carried from one place to another. The hands of the health care worker may carry bacteria from one person to another.

Portal of Entry • An opening allowing microbes to enter the host • Portals include body orifices, mucus membranes, or breaks in the skin • Portals also result from tubes placed in body cavities, such as urinary catheters, or from punctures produced by invasive procedures. (PAHO, 2011)

Susceptible Host • A person who cannot resist a microorganism invading the body, multiplying, and resulting in infection. • The host is susceptible to the disease, lacking immunity or physical resistance to overcome the invasion by the pathogenic microorganism. (PAHO, 2011)

Susceptible Host The last essential component in the chain of infection is the susceptible host. Susceptibility is affected by: • Genetic factors • General resistance factors • Specific acquired immunity (PAHO, 2011)

Specific acquired immunity • Has most potent influence on host’s susceptibility • This immunity is specific to a particular disease agent, and it may be acquired Naturally or Artificially (PAHO, 2011)

Natural Immunity • May be acquired by experiencing an infection (active natural immunity). • A single bout of measles or chickenpox confers lifelong immunity to that disease • Influenza and salmonella are examples of infections that do not confer immunity and therefore may recur (WHO, 2013)

Artificial Immunity May be acquired through the use of vaccines, toxoids and immune globulins • Active immunity: A vaccine or toxoid stimulates “active” immunity, since the recipient responds by producing antibodies. (WHO, 2013)

Artificial Immunity • Passive immunity: Receiving an antitoxin or immune globulin confers passive immunity, essentially by borrowing the antibodies of other people. (WHO, 2013)

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Look up terms • • Asepsis Medical Asepsis Aseptic technique Isolation Reverse isolation Barrier nursing Nosocomial infection

Look up terms • • Bloodborne pathogens/disease Universal precautions Standard precautions Basic precautions Transmission based precautions Air-borne precautions Droplet precautions Contact precautions

Look up terms • Personal protective equipment

Recall • • List 5 infectious agents List 3 modes of disease transmission Review steps in chain of infection Discuss 5 nursing interventions in breaking chain of infection

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References International Labour Organization (2005). Joint ILO/WHO guidelines on health services and HIV/AIDS. Retreived from: http: //www. ilo. org/wcmsp 5/groups/public/@ ed_protect/@protrav/@ilo_aids/documents/ publication/wcms_116240. pdf

References Pan American Health Organization (2011). Infection Prevention and Control. Polices and guidelines for health care services (2 nd ed. ). Retrieved from: http: //www. google. com. jm/? gws_rd=cr&ei=9 r 0 m. Uo. C 6 NY_a 9 ASkr. YHYCw#psj=1&q=manual +for+infection+control+trinidad

References • World Health Organization (2013). Health worker occupational health. Retrieved from: http: //www. who. int/occupational_health/top ics/hcworkers/en/