Lesson 2.

Infection Control
Infection Control
Infection Control
- Performed in hospitals
- Prevention of nosocomial (hospital-acquired disease) or health-care-associated infections
- Ex: providing isolation rooms for infected patients
Factors of Infection Control
1. Prevention
o Proper hygiene and handwashing to avoid being infected
2. Monitoring/Investigation
o Identifying the suspected cause of the spread
3. Surveillance, Investigation, and Management
o Investigating and surveying how big the spread of the outbreak is
o Importance of minimizing the spread of the infection

Prevention of Infection Control

1. Hand hygiene compliance
2. Contact tracing
3. Asset management
4. Medical scope management
5. Environmental monitoring
6. Surgical sterile processing
Nosocomial Infection
- Also known as “hospital-acquired or healthcare-associated infection”
- The patient contracts the disease during the hospital stay
- Those not becoming clinically apparent until the discharge of the patient or infections contracted by the health
care professionals as a result of their direct or indirect contact with patients
Community-Acquired Infection
- Infections contracted outside the hospital
- Those who become clinically apparent within 48 hours of the hospital admission
Types of Infections
1. Local Infection
o Only occurs in one area of the body
2. Systemic Infection
o Occurs in a specific system or all of the body
o Ex: lupus erythematosus
3. Autogenous infection
o Came from the host flora or the bacteria inside the body

Chain of Infection
1. Portal of Exit
o How germs get out
i. Mouth (vomit, saliva)
ii. Cuts in the skin (blood)
iii. During diapering and toileting (stool)
o Prevention:
i. Hand hygiene
ii. PPE
iii. Control of aerosols and splatter
iv. Respiratory etiquette
v. Waste disposal
2. Mode of Transmission
o How germs get around
i. Direct Transmission
 Contact
 Droplets
ii. Indirect Transmission
 Airborne
a) Ex: Measles, Bacillus anthracis
 Vehicle-borne
a) Ex: Hepa A, Clostridium botulinum infection from unsanitary canned goods
 Vector-borne
a) Usually parasites from hosts and Infectious agents from mosquitoes, fleas,
ticks
b) Ex: malarial infection from mosquito bites, Shigella, Yersinia
o Prevention:
i. Hand hygiene
ii. PPE
iii. Food safety
iv. Cleaning, disinfection, sterilization, isolation
3. Portal of Entry
o How germs get in
i. Mouth
ii. Cuts in the skin
 Mostly opportunistic bacteria like Staphylococcus aureus
iii. Eyes
o Prevention:
i. Hand hygiene
ii. PPE
iii. Personal hygiene
iv. First aid
v. Removal of catheters and tubes
4. Susceptible Host
o The next sick person
i. Babies
ii. Children
iii. Elderly
iv. People with a weakened immune system
v. Unimmunized people
vi. Anyone
o Prevention:
i. Immunizations
ii. Treatment of underlying disease
iii. Health insurance
iv. Patient education
5. Causative Agents
o The germs itself
i. Bacteria
 Single-cell microorganism
 Ex: Escherichia coli
ii. Viruses
 Infectious microbe consisting of a segment of nucleic acid (either RNA or DNA)
 Ex: Varicella zoster virus for chickenpox, SARS-COV for COVID-19, Lyssavirus for
rabies, Clostridium tetani for tetanus infection, Bacillus anthracis for
iii. Parasites
iv. Fungi
o Prevention:
i. Diagnosis and treatment
ii. Antimicrobial stewardship
6. Reservoir
 o Where germs live
i. People
ii. Animals/pets
iii. Wild animals
iv. Food
v. Soil
vi. Water
o Prevention:
i. Cleaning, disinfection, sterilization
ii. Infection prevention policies
iii. Pest control
Personal Protective Equipment (PPE)
- Equipment that is worn to minimize exposure to hazards that cause serious workplace injury or illness that
may result from contact with chemical, radiological, physical, electrical, mechanical, or other workplace
hazards
Types of PPE
1. Lab Gown
o Adds an additional layer of protection for skin
2. Gloves
o Avoid direct contact with highly infectious agents
3. Mask
o Required when drawing blood from patients with transmissible diseases
o Proper way of wearing:
i. Wash your hands before touching the mask
ii. Inspect the mask for tears or holes
iii. Find the top side, where the metal piece or stiff edge is
iv. Ensure the colored-side faces outwards
v. Place the metal piece or stiff edge over your nose
vi. Cover your mouth, nose, and chin
vii. Adjust the mask to your face without leaving gaps on the sides
viii. Avoid touching the mask
ix. Remove the mask from behind the ears or heads
x. Keep the mask away from you and surfaces while removing it
xi. Discard the mask immediately after use preferably into a closed bin
xii. Wash your hands after discarding the mask
o Types of masks:
i. N95
 Has the strongest protection
o 95% virus filter
o 100% bacterial filter
o 100% dust filter
o 100% pollen filter
ii. Surgical Mask
 For medical use
o 95% virus filter
o 80% bacterial filter
o 80% dust filter
o 80% pollen filter
iii. FFP1 Mask
 Isolates suspended particles
o 95% virus filter
o 80% bacterial filter
o 80% dust filter
o 80% pollen filter
iv. Activate Carbon
 Stops odor
 o 10% virus filter
o 50% bacterial filter
o 50% dust filter
o 50% pollen filter
v. Cloth Mask
 DIY mask
o 0% virus filter
o 50% bacterial filter
o 50% dust filter
o 50% pollen filter
vi. Sponge Mask
 For fashion use
o 0% virus filter
o 5% bacterial filter
o 5% dust filter
o 5% pollen filter
4. Goggles
o Protects eyes from spills and splashes

Hand Hygiene
1. Before touching a patient
o Clean your hands before touching a patient when approaching them
o To protect the patient against harmful germs carried on your hands
2. Before clean/aseptic procedure
o Clean your hands immediately before performing a clean/aseptic procedure
o To protect the patient against harmful germs, including the patient’s own, from entering their body
3. After body fluid exposure risk
o Clean your hands immediately after an exposure risk to body fluids and after glove removal
o To protect yourself and the healthcare environment from harmful patient germs
4. After touching a patient
o Clean your hands after touching a patient and their immediate surroundings, when leaving the
patient’s side
o To protect yourself and the healthcare environment from harmful patient germs
5. After touching patient surroundings
o Clean your hands after touching any object or furniture in the patient’s immediate surroundings, when
leaving even if the patient has not been touched
o To protect yourself and the healthcare environment from harmful patient germs

Proper Handrub
1. Apply a palmful of the product in a cupped hand, covering all surfaces
2. Rub hands palm to palm
3. Right palm over left dorsum with interlaced fingers and vice versa
4. Palm to palm with fingers interlaced
5. Backs of fingers to opposing palms with fingers interlocked
6. Rotational rubbing of left thumb clasped in right palm and vice versa
7. Rotational rubbing backwards and forwards with clasped fingers of right hand in left palm and vice verse
8. Once dry, your hands are safe
Isolation
1. Source Isolation
o When patients with contagious diseases are placed into a room to protect other people from becoming
infected
o Isolates the source of the disease
2. Protective Isolation
o Protect an immunocompromised patient who is at high risk of acquiring microorganisms from either
the environment or from other patients, staff, or visitors
o Isolates the people who might acquire the disease
o Ex: chemotherapy patients, ICU patients

Standard Precautions
- Everyone must:
a. Clean hands when entering and leaving room
b. Cover mouth and nose with arm or tissue when coughing or sneezing
- Doctors and staff must:
a. Gown and glove if soiling likely
b. Wear mask and eye cover if splashing body fluids likely
Transmission-Based Precautions
1. Airborne Precautions
o PPE
i. Wear a fit-tested, NIOSH-approved N95 or higher-level respirator for respiratory protection
when entering the room of a patient when listed diseases are suspected or confirmed
o Hand Hygiene
i. Hand hygiene according to standard precautions
o Patient Placement
i. Place in an AIIR (Airborne Infection Isolation Room)
ii. Monitor air pressure daily with visual indicators
iii. Keep door closed when not required for entry and exit
iv. In ambulatory settings instruct patients with a known or suspected airborne infection to wear
a surgical mask and observe Respiratory Hygiene/Cough Etiquette, the mask may be removed
once in an AIIR
o Patient Transport
i. Limit transport to medically necessary purposes
ii. If transport outside an AIIR is necessary, instruct patients to wear a surgical mask and
observe Respiratory Hygiene/Cough Etiquette
2. Droplet Precautions
o PPE
i. Don mask upon entry into the patient room or cubicle
o Hand Hygiene
i. Hand hygiene according to standard precautions
o Patient Placement
i. Private room, if possible
ii. If private room is not available, cohort or maintain spatial separation of 3 feet from other
patients or visitors
o Patient Transport
i. Limit transport to medically necessary purposes
ii. If transport or movement in any healthcare setting is necessary, instruct patient to wear a
mask and follow Respiratory Hygiene/Cough Etiquette
iii. No mask is required for persons transporting patients on Droplet Precautions
3. Contact Precautions
o Hand Hygiene
i. Hand hygiene according to standard precautions
o Gloves
i. Don gloves upon entry into the room or cubicle
ii. Wear gloves whenever touching the patient’s intact skin or surfaces and articles in close
proximity to the patient
 iii. Remove gloves before leaving patient room
o Gowns
i. Don gown upon entry into the room or cubicle
ii. Remove gown and observe hand hygiene before leaving the patient-care environment
o Patient-Care Equipment
i. Use disposable noncritical patient-care equipment or implement patient-dedicated use of such
equipment
o Patient Transport
i. Limit transport of patients to medically necessary purposes
ii. Ensure that infected or colonized areas of the patient’s body are contained and covered
iii. Remove and dispose of contaminated PPE and perform hand hygiene prior to transporting
patients on Contact Precautions
iv. Don clean PPE to handle the patient at the transport destination