INFECTION CONTROL / PREVENTION / SPREAD OF INFECTION
Infection control is preventing the spread of germs that cause illness and infection. The control starts with understanding germs and the discipline exercised in preventing nosocomial infections (nosocomial infections can be defined as those occurring within 48 hours of hospital admission, or 3 days of discharge, or 30 days of an operation) or healthcare-associated infection. It is an essential, though often under-recognized and under-supported part of the infrastructure of health care.
Everyone comes in contact with millions of germs (microorganisms) each day. All germs need warmth, moisture, darkness and oxygen to live and grow. Many germs are harmless and are needed for our bodies to function in a healthy way. For example, certain kinds of germs or bacteria are needed for the digestion of food and for the elimination of waste products (feces and urine) from our bodies. Some germs are very harmful and cause infections, diseases, and illnesses by rapidly multiplying and overwhelming the body’s natural defenses. An infection can be local in one spot, like an infected cut, or it can be systemic, throughout the whole body, like food poisoning or pneumonia.
DIFFERENT WAYS OF GERMS SPREAD
Germs are spread in the environment three ways: direct contact, indirect contact, and droplet spread.
1. Direct Contact: Germs are spread from one infected person to another person. An example of direct contact is the person infected with a cold putting his hands to his mouth while coughing or sneezing and then touching or contacting another person before he has washed his hands. A similar situation happens when the person has an infected or open sore or wound or body fluids that are full of germs(feces, urine) or blood (HIV, AIDS, Hepatitis A, B, or C) or saliva that is contaminated, and the other person is contacted directly by the germs.
2. Indirect Contact: Germs are spread from one infected person to another person through an object. The germ from the person infected contaminates the object, and the person who touches the object is then contaminated. Indirect contact is a common way for germs to spread between people who live, work, and play together. The spread of germs through indirect contact can happen when eating contaminated food (E. coli, salmonella-typhoid causing organism), handling soiled linens, soiled equipment, using soiled utensils and cups, and drinking or using contaminated water. Dysentery, a serious gastrointestinal infection, can be spread indirectly. The hepatitis B virus can live up to 10 days in dried blood and can also be spread indirectly.
3. Droplet Spread: Germs are spread through the air from one infected person to another person. The germs are airborne and are carried over short distances. When people talk, cough, or sneeze, they are spreading germs into the air. The germs of the common cold, flu, and even tuberculosis travel from one person to another by droplet spread.
INFECTION CONTROL IN HEALTHCARE FACILITIES:
Aseptic technique is a key component of all invasive medical procedures. Similarly, infection control measures are most effective when Standard Precautions are applied. Standard precautions are a set of infection control safeguards. They are especially important to prevent the spread of blood-borne and other infectious diseases (AIDS (HIV virus), hepatitis A, B, and C).
You should use these precautions when coming in contact with blood and all body fluids, secretions, and excretions (urine and feces), whether or not they contain visible blood; when touching mucous membranes such as the eyes or nose; and when dealing with skin breakdown such as a cut, abrasion, or wound.
Body fluids include:
- Blood products.
- Vaginal secretions.
- Nasal secretions.
- Saliva from dental procedures.
Anti-infective agents include: antibiotics, antibacterials, antifungals, antivirals and antiprotozoals.
TYPES OF INFECTION CONTROL:
Infection control addresses factors related to the spread of infections within the healthcare setting (whether patient-to-patient, patients-to-staff, staff-to-patients, or among-staff). Prevention includes: hand washing, gloving, sterilization, disinfection, use of disposable PPE, vaccination, surveillance, etc.). It is on this basis that the common title being adopted within health care is "infection prevention and control."
It is well documented that the most important measure for preventing the spread of disease-causing agents is effective hand washing.” Frequent, thorough, and vigorous hand washing will help in decreasing germs and spread of infection.
Hands should be washed before touching or using:
- An individual’s medicine.
- Kitchen utensils and equipment.
- Someone’s skin that has cuts, sores, or wounds.
- Disposable gloves.
- The bathroom.
Hands should be washed after:
- Using the bathroom.
- Sneezing, coughing, or blowing one’s nose.
- Touching one’s eyes, nose, mouth, or other body parts.
- Touching bodily fluids or excretions.
- Touching someone’s soiled clothing or bed linens.
Drying is an essential part of the hand hygiene process. Use of paper towels is the best since it showed no significant spread of micro-organisms. Alcohol based hand rubs or hand sanitizers may also be used. They provide a great alternative to hand washing.
Practicing standard precautions also includes the wearing of disposable (single use) latex gloves whenever you come in contact with body fluid. (Non-latex gloves should be purchased for people who are allergic to latex.)
Putting on disposable gloves and taking them off correctly is especially important in preventing the spread of germs and infection. Gloves should be used only one time and disposed after each use. New gloves should be put on each time you work with a different individual. If bodily fluid or blood touches the skin, wash the area vigorously and thoroughly with soap and warm water. If the gloves tear, take them off and thoroughly wash your hands. Put on a new pair of gloves and continue assisting the individual. Never wash gloves and use again.
Sterilization is a process intended to kill all microorganisms and has the highest level of microbial kill. It is employed for cleaning of the medical instruments or gloves, and basically any type of medical item that comes into contact with the blood stream. Sterilization is done by:
- Autoclave (by using high-pressure steam)
- Dry heat (in an oven)
- Using chemicals
Steam sterilization is done at a temperature of 121 C (250 F) with a pressure of 209 kPa (15 lbs/in2).
Chemical sterilization, also referred to as cold sterilization is used to sterilize instruments that are not normally
disinfected by other processes.
Disinfection uses liquid chemicals on surfaces and at room temperature to kill disease causing microorganisms. Ultraviolet light has also been used to disinfect the rooms of patients infected with Clostridium difficile after discharge from the hospital. Disinfection is less effective than sterilization because it does not kill bacterial endospores.
Personal protective equipment: Disposable PPE
Personal protective equipment (PPE) is specialized clothing or equipment worn by a worker for protection against a hazard. The hazard in a health care setting is exposure to blood, saliva, or other bodily fluids or aerosols that may carry infectious materials such as Hepatitis B, C, HIV, or other blood borne or bodily fluid pathogen. PPE prevents contact with a potentially infectious material by creating a physical barrier between the potential infectious material and the healthcare worker.
Components of PPE include gloves, gowns, bonnets, shoe covers, face shields, CPR (cardiopulmonary resuscitation) masks, goggles, surgical masks, and respirators.
Antimicrobial copper use:
Microorganisms are known to survive on non-antimicrobial inanimate ‘touch’ surfaces (e.g., bedrails, over-the-bed trays, call buttons, bathroom hardware, etc.) for extended periods of time. Use of antimicrobial copper alloy (brasses, bronzes, cupronickel, copper-nickel-zinc, and others) destroys a wide range of microorganisms.
Health care workers may be exposed to certain infections in the course of their work. Vaccines are available to provide some protection to workers in a healthcare setting. Vaccinations are available for hepatitis B; influenza; measles, mumps and rubella (MMR); tetanus, diphtheria, pertussis (DPT); meningitis; and chickenpox.
Surveillance traditionally involved significant manual data assessment and entry in order to assess preventative actions such as isolation of patients with an infectious disease. Surveillance and preventative activities are increasingly a priority for hospital staff.
Tags: Infection Control , Hand washing , Prevention of Infection , Vaccination administration , Gloving , sterilization , microorganisms , Precautions to control Germs