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Unit 3-Infection Control

This document provides an overview of infection control for nurse aides, including how diseases are transmitted through the chain of infection, defining medical asepsis and practices to promote it, describing methods to kill microorganisms like disinfection and sterilization, and examining bloodborne diseases such as HIV and HBV. Nurse aides are responsible for understanding and following infection control policies and procedures to prevent the spread of infection to residents and themselves.

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100% found this document useful (1 vote)

493 views108 pages

Unit 3-Infection Control

Uploaded by

tau88

We take content rights seriously. If you suspect this is your content, claim it here.

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Download as PPT, PDF, TXT or read online on Scribd

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Unit 3

Nurse Aide I Course

DHSR Approved Curriculum-Unit 3 1

Introduction to
Infection Control
Infection control is one of the most
important aspects of environmental
safety. Nurse aides have the
responsibility to understand and follow
the facility’s infection control policies
and procedures.
This unit introduces medical
asepsis, Standard Precautions and
care of the resident on Transmission-
Based Precautions.
DHSR Approved Curriculum-Unit 3 2
DHSR Approved Curriculum-Unit 3 3
3.0 Apply the basic principles of
infection control.

DHSR Approved Curriculum-Unit 3 4

Microorganisms (Germs)
• Can only be seen by using a
microscope
• Surround us
– in air
– on our skin and in our bodies
– in the food that we eat
– on every surface we touch

DHSR Approved Curriculum-Unit 3 5

Microorganisms (Germs)
(continued)

• May cause
– illness
– infection
– disease
• Benefit us by maintaining a balance
in our environment and in our body

DHSR Approved Curriculum-Unit 3 6

Microorganisms (Germs)
(continued)

• Require certain elements to survive:

– oxygen – aerobic
– no oxygen – anaerobic
– warm temperatures
– moisture
– dark area to grow

DHSR Approved Curriculum-Unit 3 7

Microorganisms (Germs)
(continued)

• Require certain elements to survive

(continued):
– food
• dead tissue – saprophytes
• living tissue – parasites

DHSR Approved Curriculum-Unit 3 8

Body Defenses Against
Microorganisms/Germs
• External natural defenses
– skin as mechanical barrier
– mucous membrane
– cilia – fine microscopic hairs
in nose
– coughing and sneezing
– hydrochloric acid in stomach
– tears
DHSR Approved Curriculum-Unit 3 9
Body Defenses Against
Microorganisms/Germs
(continued)

• Internal natural defenses

– phagocytes
– inflammation
– fever
– immune response

DHSR Approved Curriculum-Unit 3 10

3.1 Identify how diseases are
transmitted.
3.1.1 List the six components in the
chain of infection.

DHSR Approved Curriculum-Unit 3 11

Chain of Infection
Causative Agent – Pathogen

• Bacteria
• Viruses
• Fungi
• Protozoa

DHSR Approved Curriculum-Unit 3 12

Chain of Infection
Reservoir of the Causative Agent
• Human with active
cases of disease or
those that carry disease
without having
symptoms
• Animals/insects
• Fomites
• Environment
DHSR Approved Curriculum-Unit 3 13
Chain of Infection
Portals of Entry of Causative Agent
• Cuts/break in skin
• Openings in the mucous
membranes
• Respiratory system
• Gastrointestinal system
• Urinary system
• Reproductive system
• Mother to fetus
DHSR Approved Curriculum-Unit 3 14
Chain of Infection
Portals of Exit of Causative Agent
• Tears (slight risk)
• Saliva/respiratory tract
secretions
• Urine
• Feces
• Wound drainage
• Reproductive tract secretions
DHSR Approved Curriculum-Unit 3 15
Chain of Infection
Mode of Transmission
• Contact
– direct – person to person
– indirect – fomite to person
– droplet – common cold
• Common vehicle
– salmonella in food

DHSR Approved Curriculum-Unit 3 16

Chain of Infection
Mode of Transmission
(continued)

• Airborne
– tuberculosis
• Vectorborne
– mosquito harbors
malaria parasite

DHSR Approved Curriculum-Unit 3 17

Chain of Infection
Host

• The host is the

individual who
harbors the
infectious
organisms

DHSR Approved Curriculum-Unit 3 18

DHSR Approved Curriculum-Unit 3 19
3.2 Define medical asepsis.
3.2.1 Identify practices the nurse aide
can use to promote medical
asepsis in personal life and in
work setting.

DHSR Approved Curriculum-Unit 3 20

Medical Asepsis

Definition: The practice

used to remove or
destroy pathogens and
to prevent their spread
from one person or
place to another
person or place; clean
technique

DHSR Approved Curriculum-Unit 3 21

Practices To Promote
Medical Asepsis
In Personal Life And Work Setting

• Washing hands after use of

bathroom
• Washing hands prior to
handling food
• Washing fruits and vegetables
before serving or consuming
DHSR Approved Curriculum-Unit 3 22
Practices To Promote
Medical Asepsis
In Personal Life And Work Setting
(continued)

• Covering nose and

mouth prior to
coughing, sneezing or
blowing nose and then
washing hands

DHSR Approved Curriculum-Unit 3 23

Practices To Promote
Medical Asepsis
In Personal Life And Work Setting
(continued)
• Bathing, washing hair and
brushing teeth on a regular
basis
• Washing cooking and
eating utensils with soap
and water after each use
DHSR Approved Curriculum-Unit 3 24
Practices To Promote
Medical Asepsis
In Personal Life And Work Setting
(continued)
• Following sanitation practices
– Proper disposal of garbage
– Proper disposal of waste
materials

DHSR Approved Curriculum-Unit 3 25

Practices To Promote
Medical Asepsis
In Personal Life And Work Setting
(continued)
• Washing hands before and
after caring for each resident
• Using approved waterless
hand cleaner
• Washing resident’s hands
before meals
DHSR Approved Curriculum-Unit 3 26
Practices To Promote
Medical Asepsis
In Personal Life And Work Setting
(continued)

• Cleaning resident’s
unit
• Cleaning all
reusable equipment
after use

DHSR Approved Curriculum-Unit 3 27

3.2.2 Discuss the methods used to kill
or control microorganisms.
3.2.3 Observe basic cleaning,
disinfecting and sterilizing tasks.

DHSR Approved Curriculum-Unit 3 28

Methods To Kill Or Control
Microorganisms
• Disinfection (kills most microorganisms
but not spores)
– boil small items in water
for 15 minutes
– use chemical
disinfectants for cleaning
supplies and equipment

DHSR Approved Curriculum-Unit 3 29

Methods To Kill Or Control
Microorganisms
(continued)
• Sterilization
– kills all microorganisms,
including spores
– autoclave – steam
under pressure
– other methods

DHSR Approved Curriculum-Unit 3 30

Methods To Kill Or Control
Microorganisms
(continued)

• Care of supplies and

equipment
– Central supply
– Disposable
equipment used
once and discarded
in proper manner
DHSR Approved Curriculum-Unit 3 31
Methods To Kill Or Control
Microorganisms
(continued)
Care of supplies and equipment
• Cleaning non-disposable equipment
– Rinse in cold water to remove
organic material
– Wash with soap and hot water
– Scrub with a brush if necessary
– Rinse and dry equipment
– Sterilize or disinfect equipment
DHSR Approved Curriculum-Unit 3 32
3.2.4 Discuss other aseptic measures
to prevent the spread of
infection.

DHSR Approved Curriculum-Unit 3 33

Methods To Kill Or Control
Microorganisms
(continued)
• Other aseptic measures
– Hold equipment and supplies away
from uniform
– Avoid shaking linen
– Damp dust furniture
– Clean from cleanest area to the
most soiled area
DHSR Approved Curriculum-Unit 3 34
Methods To Kill Or Control
Microorganisms
(continued)

• Other aseptic measures (continued)

– Direct cleaning away
from your body and
uniform
– Pour contaminated
liquids into sinks or
toilets; do not splash
DHSR Approved Curriculum-Unit 3 35
Methods To Kill Or Control
Microorganisms
(continued)

• Other aseptic measures (continued)

– Do not sit on resident’s bed
– Do not transport equipment
from one resident’s room to
another without cleaning

DHSR Approved Curriculum-Unit 3 36

DHSR Approved Curriculum-Unit 3 37
3.3 Describe HIV and HBV as two
examples of blood borne
diseases.

DHSR Approved Curriculum-Unit 3 38

Human Immunodeficiency Virus
(HIV)

• Persons infected with HIV may

carry virus without developing
symptoms for several years
• HIV infected persons will
eventually develop AIDS
(Acquired Immune Deficiency
Syndrome)

DHSR Approved Curriculum-Unit 3 39

Human Immunodeficiency Virus
(HIV)
(continued)
• Persons infected with HIV may
develop AIDS-related illnesses
including neurological problems,
cancer, and other opportunistic
infections
• Persons infected with HIV may
suffer flu-like symptoms, fever,
diarrhea, weight loss and fatigue
DHSR Approved Curriculum-Unit 3 40
Human Immunodeficiency Virus
(HIV)
(continued)
• Brain of persons infected
with HIV may be affected,
causing confusion,
memory loss, depression
or motor dysfunction
• Although drugs may delay
symptoms, there is no known cure for
AIDS
DHSR Approved Curriculum-Unit 3 41
Hepatitis B Virus (HBV)
• About one third of persons infected
do not show symptoms
• Another one third have mild flu-like
symptoms which go away
• The last one third experience
abdominal pain, nausea and
fatigue; skin and eyes jaundiced
and urine dark
DHSR Approved Curriculum-Unit 3 42
Hepatitis B Virus (HBV)
(continued)
• Six to ten percent of HBV infected
persons become chronic carriers
(may or may not have active
infection, few or no symptoms, but
can transmit disease)
• HBV preventable with
use of HBV vaccine

DHSR Approved Curriculum-Unit 3 43

3.3.1 Describe the modes of
transmission of HIV and HBV.

DHSR Approved Curriculum-Unit 3 44

Bloodborne Pathogens
Modes of Transmission
• Sexual contact
• Sharing contaminated needles
• Receiving blood transfusions
• Pregnant mother to unborn
baby
• Nursing mother to baby
through breast milk (for HIV,
not HBV)
DHSR Approved Curriculum-Unit 3 45
Bloodborne Pathogens
Modes of Transmission
(continued)

• Puncture wounds from sharps

• Mucous membrane contact
• Contact of infectious substances
(urine, feces, saliva) with non-intact
skin
• Contaminated surfaces (for HBV,
not HIV)
DHSR Approved Curriculum-Unit 3 46
3.3.2 Identify the critical elements in
the Exposure Control Plan.

DHSR Approved Curriculum-Unit 3 47

Bloodborne Pathogens
Exposure Control Plan

• Copy must be
available at workplace
• Mandated by OSHA
• Identifies employees
at risk of exposure by
tasks performed

DHSR Approved Curriculum-Unit 3 48

Bloodborne Pathogens
Exposure Control Plan
(continued)
• Specific measures to decrease risk to
exposure
– Administrative controls
– Work practice controls
– Engineering controls
– Housekeeping
– HBV vaccine
DHSR Approved Curriculum-Unit 3 49
Bloodborne Pathogens
Exposure Control Plan
(continued)
• Post-exposure evaluation
and follow-up
– Wash the area
immediately
– Complete a facility
incident report
– Follow procedures for
testing and treatment
DHSR Approved Curriculum-Unit 3 50
DHSR Approved Curriculum-Unit 3 51
3.4 Demonstrate an understanding of
the principles of Standard
Precautions.

DHSR Approved Curriculum-Unit 3 52

Standard Precautions
• Standard Precautions – CDC
procedures to control and
prevent infections.
• Contains two tiers of
precautions:
– Standard
– Transmission-Based
• Standard precautions are used for
the care of all residents
DHSR Approved Curriculum-Unit 3 53
Standard Precautions
HANDWASHING

• Handwashing
– After touching blood,
body fluids, secretions,
excretions, and
contaminated items,
whether or not gloves
are worn

DHSR Approved Curriculum-Unit 3 54

Standard Precautions
HANDWASHING
(continued)
• Handwashing (continued)
– Immediately after gloves
are removed, between
resident contacts, and
when otherwise indicated
to prevent transfer of
microorganisms to other
residents or environments
DHSR Approved Curriculum-Unit 3 55
Standard Precautions
HANDWASHING
(continued)
• Handwashing (continued)
– Between tasks and
procedures on the
same resident to
prevent cross-
contamination of
different body sites

DHSR Approved Curriculum-Unit 3 56

Standard Precautions
GLOVES
• Wear gloves (clean, nonsterile gloves)
when:
– touching blood, body fluids,
secretions, excretions, and
contaminated items
– before touching mucous
membranes and non-intact skin

DHSR Approved Curriculum-Unit 3 57

Standard Precautions
GLOVES
(continued)
• Wear gloves (clean, nonsterile gloves)
when (continued):
– change gloves between tasks and
procedures on the same resident
after contact with material that may
contain a high concentration of
microorganisms

DHSR Approved Curriculum-Unit 3 58

Standard Precautions
MASK, EYE PROTECTION,
FACE SHIELD
• Wear a mask and eye protection or a
face shield:
– to protect mucous membranes of the
eyes, nose, and mouth

DHSR Approved Curriculum-Unit 3 59

Standard Precautions
MASK, EYE PROTECTION,
FACE SHIELD
(continued)
• Wear a mask and eye protection
or a face shield (continued):
– during procedures and
resident care activities that
are likely to generate
splashes or sprays of blood,
body fluids, secretions, and
excretions.
DHSR Approved Curriculum-Unit 3 60
Standard Precautions
GOWN
• Wear a gown:
– during procedures and
resident care activities that
are likely to generate
splashes of blood, body fluids,
secretions or excretions
– remove soiled gown as soon
as possible and wash hands
DHSR Approved Curriculum-Unit 3 61
Standard Precautions
MULTIPLE-USE RESIDENT CARE
EQUIPMENT
• Commonly used equipment
or supplies (stethoscope,
etc.) must be cleaned and
disinfected after use or
when soiled
• Single-use equipment is
preferred and must be
discarded properly
DHSR Approved Curriculum-Unit 3 62
Standard Precautions
LINEN

• Handle, transport, and

process used linen soiled with
blood, body fluids, secretions,
and excretion
– in a manner that prevents
skin and mucous
membrane exposures and
contamination of clothing
DHSR Approved Curriculum-Unit 3 63
Standard Precautions
LINEN
(continued)

• Handle, transport, and process used

linen soiled with blood, body fluids,
secretions, and excretion (continued):
– in a manner that prevents transfer
of microorganisms to other
residents and environments

DHSR Approved Curriculum-Unit 3 64

Standard Precautions
RESIDENT PLACEMENT

• Place resident who

contaminates environment
or who does not, or cannot
be expected to assist in
maintaining appropriate
hygiene or environmental
control, in private room

DHSR Approved Curriculum-Unit 3 65

Standard Precautions
RESIDENT PLACEMENT
(continued)

• If a private room is not

available, consult with
infection control
professionals regarding
resident placement or
other alternatives

DHSR Approved Curriculum-Unit 3 66

Standard Precautions
TRANSPORT OF INFECTED
RESIDENTS
• Appropriate barriers
(masks, impervious
dressings) are worn
• Personnel in area to
which resident is taken
are notified of arrival
and precautions to take
DHSR Approved Curriculum-Unit 3 67
Standard Precautions
TRANSPORT OF INFECTED
RESIDENTS
(continued)

• Inform residents
in ways they can
assist in
prevention of
transmission

DHSR Approved Curriculum-Unit 3 68

DHSR Approved Curriculum-Unit 3 69
Transmission Based Precautions
AIRBORNE PRECAUTIONS

In addition to Standard Precautions,

use Airborne Precautions, or the
equivalent, for resident known or
suspected to be infected with
microorganisms transmitted by
airborne droplets that remain
suspended in the air and can be
widely dispersed by air currents.
DHSR Approved Curriculum-Unit 3 70
Transmission Based Precautions
AIRBORNE PRECAUTIONS
(continued)

• RESIDENT PLACEMENT:
Private room. Negative
air pressure in relation to
the surrounding areas.
Keep doors closed at all
times and resident in
room.

DHSR Approved Curriculum-Unit 3 71

Transmission Based Precautions
AIRBORNE PRECAUTIONS
(continued)

• GLOVES: Same as Standard

Precautions
• GOWN OR APRON: Same as
Standard Precautions

DHSR Approved Curriculum-Unit 3 72

Transmission Based Precautions
AIRBORNE PRECAUTIONS
Mask and Eyewear

• For known or suspected

pulmonary tuberculosis:
– Mask N-95 (respirator)
must be worn by all
individuals prior to
entering room

DHSR Approved Curriculum-Unit 3 73

Transmission Based Precautions
AIRBORNE PRECAUTIONS
Mask and Eyewear
(continued)
• For known or suspected airborne viral
disease (e.g., chickenpox, or measles)
– Standard mask should be worn by
any person entering the room unless
the person is not susceptible to the
disease
– When possible, persons who are
susceptible should not enter room
DHSR Approved Curriculum-Unit 3 74
Transmission Based Precautions
AIRBORNE PRECAUTIONS
Handwashing
• Hands must be washed before
gloving and after gloves are
removed
• Skin surfaces must be washed
immediately and thoroughly
when contaminated with body
fluids or blood
DHSR Approved Curriculum-Unit 3 75
Transmission Based Precautions
AIRBORNE PRECAUTIONS
Resident Transport

• Limit transport of the

resident for essential
purposes only
• Place a mask on the
resident, if possible

DHSR Approved Curriculum-Unit 3 76

Transmission Based Precautions
AIRBORNE PRECAUTIONS
Resident Care Equipment
• When using equipment or
items (stethoscope,
thermometer), the equipment
and items must be
adequately cleaned and
disinfected before use with
another resident
DHSR Approved Curriculum-Unit 3 77
Transmission Based Precautions
DROPLET PRECAUTIONS
In addition to Standard Precautions,
use Droplet Precautions, or the
equivalent, for a resident known or
suspected to be infected with
microorganisms transmitted by
droplets that can be generated by the
resident during coughing, sneezing,
talking, or the performance of
procedures that induce coughing.
DHSR Approved Curriculum-Unit 3 78
Transmission Based Precautions
DROPLET PRECAUTIONS
(continued)

• RESIDENT PLACEMENT: Private

room or with resident with same
disease.
• GLOVES: Must be worn when in
contact with blood and body fluids.