* The spread of infection requires a

Safety in
Phlebotomy source of infecting organisms, a
susceptible host and means of
Infection Control transmission of the organism

* Standards and procedures need to be * Source

formalized to protect the health care associate of
the patient- these procedures are often - Can be health associates, other
established to protect the health care associate patients or visitors
from being infected by the patient (vice versa)
- Can be a person who has an active
acute infection or who is carrying
* Nosocomial Infection the infect and does not realize he/she
- Also known as a health care associated has it
of hospital- acquired infection.
- The infection can be come from the
* if the infection occurs before 48 hours after source’s own flora (autogenous
admission, the infection is considered a infection)
community- acquired infection.

* A patient’s infection can be local infection, * Person who has never had
which is an infection restricted to one area of chickenpox usually becomes infected
the body when placed in contact with a source
(varicella), unless vaccinated, the
* Systematic infection affects the entire body person gains immunity.

* if the organism that causes infection and * Key concepts to infection: person
disease spreads from one person to person, it is must be susceptible (age, disease
classified as a communicable disease [HIV], medication, and
immunosuppressive agents [ex:
chemotherapeutic agents])
Chain
Of Infection * Means of transmission: contact
(direct and indirect), droplet, vehicle,
Susceptible Host airborne, or a vector borne
(immunosuppressed
patient, diabetic
patient, burn patient) Source (people, * Direct Contact
equipment, water)
- consists of a direct physical
transfer of infective material from
Portal of Entry the source to the susceptible host
(mucous membrane,
GI tract, Respiratory
tract, broken skin) * Indirect Contact
Portal of Exit
(excretion, secretion, droplets - Involves personal contact of the
susceptible host to some type of object
Mode of that has been contaminated, such as
Transmission
(direct contact, instruments, bed linens, furniture
ingestion, fomites, air) or shared bathrooms.
* Droplets transmission
- Transfer of the microorganisms causing
infection to the nose, mouth, or eye by contact
with the mucous membrane of the susceptible
host; spread infectious droplets through air by
the source person coughing, sneezing or
talking
* Vehicle route
- transfer of disease causing organism
through contaminated items
- contaminated water often causes parasitic
and cholera infections
- blood and body fluids vehicle transferring
HIV or hepatitis to the host
* Airborne transmission
- concern in patients disseminating airborne
droplets of infectious material as a result of
coughing, sneezing, or talking
- surgical masks- sufficient for most
infectious agents because it all filtered out
- mycobacterium tuberculosis and ebola
necessitate special respirators and downing
precautions
* Vector transmission
- transmission of a disease by insects
- most widely known vector-transmitted
disease is mosquito-transmitted malaria
- hospitals need to be concerned with flies,
cockroaches, and other insects carrying
microorganisms on their feet or other body
parts
* Universal precautions
- developed in 1985 by CDC as a
increase in blood-borne diseases such as
AIDS and Hepatitis B
- assumed that all blood and most body
fluids were potentially infectious
- included a variety of body substances-
body substances linked to the
transmission of hepatitis and HIV were
blood, semen, vaginal secretions,
cerebrospinal fluid, pericardial fluid,
amniotic fluid, human breast milk and
wounded drainage
- also applied to all tissue samples before
they are chemically fixed
- other body fluids such as stool, urine,
vomitus, and oral secretions, are not
included in universal precautions,
unless they contain visible blood
- involved into a system called body
substance isolation (BSI) - (same with
UP) assumed that each patient had the
potential to spread disease through body
substances; key change was the
requirement that gloves be worn when a
healthcare provider is in contact with
any body substance
* Standard precautions
- a revised version of UP made by CDC
in 1996
- combine many of the many basics
principles of UP with techniques from
BSI
- maintain that PPE and barrier
controls must be worn for contact with
body fluids, whether or not blood visible
- Goal: reduce the risk of transmission of
microorganisms from both recognize and
unrecognized sources of infection

- 5 main points must be followed in SP

* wash hands when changing gloves and

between patients

* wear gloves when likely to touch body

substances, mucous membranes, or non-
intact skin and during all blood drawing

* wear protective cover when clothing is

likely to be soiled

* wear a mask and eye protection in

addition to a protective body cover when
likely to be splashed with body substances

* placed intact needle/syringe and sharps

containers. Do not bend, break, or cut needles

ENGINEERING CONTROLS

* Physical and mechanical devices that are

available to the health care associate to reduce
or eliminate the potential to transfer
infectious diseases

* Examples: self- sheathing needles,

autoclaves and puncture-proof sharps
containers

WORK PRACTICE CONTROLS

* Practices that are incorporated into all

health care associates work habit to prevent
the spread of infection

* Hands must be washed after each patients

contact or blood and body fluid exposure
even when gloves are used