1. Infection Control and Medical Asepsis
Chapter 22
Infection Control and Medical Asepsis

2. Impact of Infectious Diseases
Discovery of germ theory: Louis Pasteur and Robert Koch
Pharmacologic agents: antibiotics and vaccines
Edward Jenner: smallpox vaccine
Epidemiology: history, cause, patterns of infectious diseases

3. Impact of Infectious Diseases
Infection control and prevention
Resistant microorganisms
Bloodborne pathogen transmission
Increased immunosuppressed populations
Global access
Effect infectious diseases have on lifestyles

4. The Process of Infection
Caused by pathogenic microorganisms capable of causing disease
Normal flora
Similar steps occur in all infectious diseases
MAs must apply theory of disease growth and transmission

5. The Process of Infection
Growth requirements for microorganisms
Oxygen
Lack of or no oxygen
Moisture
Nutrition
Temperature
Darkness
Time
Neutral or slightly alkaline pH

6. Infection Cycle Infectious agent Reservoir Portal of exit
Means of transmission
Portal of entry
Susceptible host

7. Infection Cycle Infectious agents Viruses Bacteria Fungi Parasites
Rickettsia
Prions
(See Table 22-1: Common Viral Diseases)
(See Table 22-2: Examples of Infectious Bacterial Diseases)

8. Infection Cycle Reservoir Portal of exit Source of a pathogen
Method by which infectious agent leaves reservoir

9. Infection Cycle Modes of transmission Portal of entry Direct contact
Droplet
Airborne
Vector
Portal of entry
Enter susceptible host

10. Infection Cycle Susceptible host Number and specific type of pathogen
Duration of exposure to pathogen
General physical condition
Psychological health status
Occupation or lifestyle environment
Presence of underlying diseases or conditions
Youth or advanced age

11. Infection Cycle Susceptible host
Nosocomial infection or healthcare-associated infections (HAI)
Rise of antibiotic resistant bacteria

12. The Body’s Defense Mechanisms for Fighting Infection and Disease
The body’s natural barriers
Physical
First line of defense
Skin and associated accessories
Chemical
Tears, sweat, mucus, saliva, gastrointestinal secretions, vaginal secretions
Cellular
White blood cells

13. The Body’s Defense Mechanisms for Fighting Infection and Disease
Inflammatory response
Response when body invaded by pathogen or physical trauma
Nonspecific response
Redness, heat, swelling, pain
Antibiotic therapy

14. The Body’s Defense Mechanisms for Fighting Infection and Disease
The immune system and immunity
Protect against pathogens and abnormal cell growth
Cell-mediated immunity: attacks against viruses, fungi, organ transplants, cancer cells
Humoral immunity: antibody mediated system

15. The Body’s Defense Mechanisms for Fighting Infection and Disease
The immune system and immunity
Recognition of invader
Growth of defenses; multiplication of helper T cells and B cells
Attack against infection
Slowdown of immune response after death of infectious agent

16. The Body’s Defense Mechanisms for Fighting Infection and Disease
The immune system and immunity
Resistance: after exposure to pathogen; antigen–antibody reaction
Naturally acquired active immunity
Artificially acquired active immunity
Congenitally acquired passive immunity
Artificially acquired passive immunity

17. The Body’s Defense Mechanisms for Fighting Infection and Disease
The immune system and immunity
Specific defenses: things that protect us against specific pathogen
Nonspecific defenses: not so particular
Immunization: provides immunity with active or passive vaccines
Live attenuated (changed) pathogens
Pathogenic toxins
Killed pathogens

18. Stages of Infectious Diseases
Incubation
Prodromal
Acute
Acme
Declining
Convalescent
Sequelae

19. Disease Transmission
Consider each patient potentially infectious for AIDS, hepatitis B and C, other bloodborne pathogens
Apply techniques of Standard Precautions
(See Table 22-3: Examples of Infectious Diseases)

20. HIV and Hepatitis B and C
HIV and AIDS
AIDS caused by bloodborne virus HIV
HIV responsible for T-cell destruction
Carried in semen, blood, other body fluids
No curative treatment of HIV infections
Antiviral drugs used to slow process
(See Table 22-4: Facts About HIV and Aids)

21. HIV and Hepatitis B and C
Acute viral hepatitis diseases
Liver inflamed; hepatic cells destroyed
Several types of viral hepatitis
Risk for contracting HBV and HCV greater than for contracting HIV
No vaccine to prevent HCV
No treatment after exposure to prevent infection
Medication: immunomodulators
(See Table 22-5: Hepatitis Viruses A to C)

22. Reporting Infectious Disease
Certain infectious diseases must be reported to state and county health departments
CDC requires information reported to them
Notifiable Disease Surveillance System
Helps CDC control spread of infection
(See Table 22-6: Partial listing of Diseases that Must Be Reported to the CDC)

23. Standard Precautions Blood and body fluids
Blood, secretions, excretions
Personal protective equipment
Gloves, mask, gown, goggles/face shield
Needlestick
Contaminated needles never recapped, broken off, removed from syringes, manipulated
Disposed of in approved puncture-proof container designated for sharps

24. Standard Precautions Blood
All body fluids, secretions, excretions regardless of whether they contain visible blood
Nonintact skin
Mucous membranes
Personal protective equipment (PPE) >>
[FIGURE 22-12A]

25. Standard Precautions Transmission-based precautions
Airborne, contact, droplet precautions
Use of barriers (gown, mask, goggles, gloves, cap)
Biohazard puncture-proof sharps container>>
[FIGURE 22-13]
(See Procedure 22-4: Transmission-Based Precautions: Donning a Gown, Mask, Gloves, and Cap (Isolation Technique))

26. Standard Precautions Disposal of infectious waste
Items in contact with patient blood or body fluids
Place in appropriate biohazard containers
Incinerated (burned) or sterilization by autoclave

27. Removing Contaminated Gloves
[FIGURE 22-28A, FIGURE 22-28B, FIGURE 22-28G, FIGURE 22-28H]
(See Procedure 22-3: Removing Contaminated Gloves)

28. Standard Precautions Federal organizations and infection control
CDC: studies pathogens and diseases
Standard Precautions
Transmission-Based Precautions
Guideline for Isolation Precautions
Personal protective equipment (PPE)
Respiratory hygiene/cough etiquette

29. OSHA Regulations The Bloodborne Pathogen Standard
Methods of compliance to prevent exposure
Universal Precautions
Engineering and work practice controls
Personal protective equipment (PPE)
Cleanliness of work areas
Hepatitis B vaccine
Follow-up after exposure
Medical records

30. OSHA Regulations and Students
Students with potential exposure to chemicals and bloodborne pathogens should follow OSHA safety procedures
Students do not fall under OSHA guidelines
Potential increases when invasive procedures performed

31. Medical Asepsis Hand washing
Cleaning and disinfecting contaminated surfaces
Standard and Transmission-Based Precautions
[FIGURE 22-27C and FIGURE 22-27E]
(See Table 22-7: Recommendations for Hand Hygiene)

32. Medical Asepsis Disinfection Sterilization
Medical assistant sanitizing instrument>>
[FIGURE 22-25]
(See Procedure 22-4: Sanitization of Instruments)

33. Bioterrorism
Use of biologic weapons (pathogenic microorganisms) to create fear
Agents can spread through air, food, water
Can be very difficult to detect and difficult to protect against
Most dangerous: anthrax, botulism, pneumonic/bubonic plague, smallpox, tularemia
(See Table 22-8: Example of Six Agents that Could Be Used in a Bioterrorism Attack)