Instructor : Ms Robinson

Human are surrounded by a word of tiny organism (living being). These cannot be seen with
the naked eye. They make their presence known only by their effect, in the same way we
become aware of the wind. We cannot see the wind but we can see its effects on the trees,
which bend and sway.
There organism can be seen only with a microscope. They are everywhere in us , on us and
around us.. they are:
• On our skin
• In our mouth
• Within our bodies
• In and on the food we eat
• On what we touch and handle
Micro mean small. Because these organisms are so tiny, they are called microorganisms or
microbes. The organism live in relationship to us and to each other.
Many of these microbes are microbes are useful to us. They are called non pathogens
because they do not produce diseases. They help in the:
• Cure of lather
• Processing of cheese, beer, and yogurt
• Baking of bread

Other microbe are not useful. Microbes that cause disease in human are called pathogens or
pathogenic organisms. Pathogen grows best:
• At body temperature
• Where light is limited
• Where there is moisture where there is a supply of food
• Where oxygen need can be meet
Infections occurs when the pathogens invade the body and cause disease.
Microbes/ pathogens
There are many different types of microbes, many of which are pathogenic to human beings.
Microbes are classified as:
• Bacteria
• Viruses
• Fungi
• protozoa
Bacteria(singular: bacterium)
These are simple one- celled microbes. They are named according to their shapes and
arrangement. They cause infections in the skin, respiratory tract, urinary tract, and
bloodstream.
Shapes in the following list the first term is the singular form of the word. The word in the
parentheses is the plural form.
• Coccus( cocci) -round or spherical
• Bacillus (bacilli)-straight rod
• Spirillum (spirilla)- spiral, corkscrew, or slightly curved

Arrangements- bacteria grow in groups called colonies. if should look at a small part of
colony under a microscope, we see that the bacteria typically are arranged in pairs, clusters or
chains.
• Single
• Pairs(diplo)
• Chains (Strepto)
• Cluster(staphylo)
The shapes and groups arrangement of bacteria are important factors in identification. For
example, round microorganism grouped in chains are called streptococci. Avery important
member of the family is streptococcus hemolyticus. It causes sore throat and rheumatic fever.
Round organism grouped in a cluster are called staphylococci. Cause many infection, such
as
• Boils
• Abscesses
• Toxic shock syndrome

Round organisms in pairs are called diplo cocci. A diplococcus, the Neisseria gonorrhoea,
causes gonorrhoea.
Fungi – (singular: fungus) – two groups of fungi are most commonly associated with
infection in humans:
• Yeast – single-celled budding forms of fungus. Yeast can infect area such as:
➢ Mouth/vagina: candida albicans
➢ Skin: tinea capitis (ringworm)
➢ Feet: tinea pedis (athlete’s foot)
Moulds – a common mold that can cause infection in the lungs of humans is asperillus.
Yeasts and molds are knows as opportunistic parasite. A parasite is an organism that lives in
or on another organism without benefiting the host organism.
Viruses- A virus is the smallest microbe. Viruses come in variety of shapes. Way viruses
are classified includes:
• Types of nucleic acid core ( DNA or RNA)
• Clinical properties
Common viral infection includes:
 • Hepatitis
• Herpes
• human immune deficiency syndrome(HIV)
• acquire immune deficiency syndrome (AIDS)
• Chickenpox
• Influenza
• Common cold
• Measles
• Mumps
Protozoa - ( singular: protozoan) are simple one-celled organism that live on living matter.
These organisms have a true nucleus. They are a classified by the way in which they move.
For example, some move by whip-like tails and other by hair-like projection. They cause
diseases such as:
• Malaria
• Toxoplasmosis
• African sleeping sickness
• Amebiasis
Some signs and symptoms are of diseases cause by protozoa include:
• diarrhoea
• dysentery (infection in the lower bowel)
• inflammation of the brain(encephalitis)
The chain of infection
Infection occurs when certain condition exist. These conditions are called the chain of
infection and includes:
• Causative agent (pathogen) that causes the disease
• Reservoir or source ( where the pathogen can live and reproduce)
• Portal of exit (manner in which the pathogen leaves the body)
• Method are modes of transmission (manner in which the pathogen is carried to
another person)
• Portal of entry ( manner in which the pathogen enters another person)
• Susceptible host9 a person who will become ill from the entry of pathogen into the
body through a portal of entry. They spread the disease to others by leaving the body
through the portal of exits and being transmitted to another person. They enter in the
person’s body and can cause the disease again.
The objective of infection control is to disrupt the chain of infection. Breaking the one
link in the chain the chain of infection is all you need to prevent the spread of disease.
Pathogen enter the body through body opening such as the:
• Eye, ears, nose or mouth
• Breaks in the skin, hand contact with mouth and other mucous membranes
• Penis , vagina, urinary meatus (bladder opening) or rectum
Causative agent – the microorganism that that can produce the disease in humans. The
mouse common biological agent of infectious disease are:
• Bacteria
• Virus
• Fungi
• Protozoa
Reservoir – The reservoir or source is where the pathogen can suervive. They may or may
not multiply in the reservoir. The four most common reservoirs are:
1. Humans- active cases and carriers
2. Insects and animals
3. Environment
4. Fomite –objects that that become contaminated with infectious materials that contain
microbe.
Reservoir In the health care setting includes:
• Patient
• Health care workers
• Environment
• Equipment
Portal of entry
Organism enter the body through the following portals of entry:
• Breaks in the skin or mucous membranes – many organism that are part of the
normal flora, such as staphylococci, enter through breaks in the skin.
• Respiratory tract-organization that cause the common cold and many childhood
diseases.
• Genitourinary tract- organisms that cause syphilis, AIDs, gonorrhoea, and other
sexually transmitted diseases enter this way
• Gastrointestinal tract- salmonellosis, typhoid fever, and hepatitis A are examples of
diseases caused by organisms in the digestive tracts.
• Circulatory system- malaria, yellow fever and meningitis are diseases that can enter
the body directly into the blood through the bite of an insect.
• Trans-placental (mother to fetus ) (AIDs hepatitis B)

Portal of exits
Infection organism leave the reservoir of the host through the body secretions (portals of exit)
Including:
• Excretion of the respiratory tract ( spectrum) or genitival tract (semen or vaginal
excretion)
• Draining wounds
• Urine
 • Faeces
• Blood and other body fluid
• Saliva
• Tear
these products must be considered infectious or capable of transmitting the disease agent.

Modes of Transmission
Transmission- of infectious organism might happen in one of three ways:
• Airborne transmission- small particles remain suspended in the air and move with
air currents, or become trapped in dust, which are also carried in the air currents.
The patient breathes in pathogens carried in this manner.
• Droplet transmission- droplets are moist particles produced by people coughing,
sneezing, talking laughing, . Pathogens are transmitted into the air with the
droplet, droplets usually satay within three feet of the source.
• Contact transmission- direct contact occurs with a person who is the reservoir of
the pathogens. Indirect contact occurs when a person touches an item
contaminated with pathogens, such as soiled linen.

Not all organism are transmitted in the same way, and some organism may be
transmitted in more than one way .
Host – the person who harbours the infectious organism is call the host. The person
does not have enough resistance to the infectious agent. An infection develops in the
host when infectious organisms:
• Penetrate the body
• Begin to multiply
• Cause damage to the host

Types of infections
➢ Local (confined to one area) - such as a boil or skin abscess
➢ Generalized- pneumonia(in the lungs)
➢ Systemic- widespread through the blood stream (bacteremia)
Body Flora-Different microbe lives in and on our on our body surfaces. These microbes are
called the normal body flora. The flora are not same in all body areas.
The balance of the body flora can be disturbed:
• Pathogenic organism
• Normal flora organism become pathogenic
 • Flora from one area being transferred in to different areas of the where they do not
usually resides
• Drugs such as antibiotic that upset the normal balance of organism within the body
flora, allowing one group flourish.

Body defence- The body has some natural defences to protect it from infections. There are
natural external defences. The most important of these is the skin, Intact skin acts as
mechanical barrier against the entry of pathogens.
Other defences includes:
• Mucus membranes lining the respiratory, reproductive, gastrointestinal and urinary
tract. The mucus is sticky and trap foreign materials before they can cause damage.
• Cilia ( fine microscopic hairs) lining the respiratory tract propel the mucus and trap
mucus out of the body.
• Coughing and sneezing remove foreign materials from the respiratory tract.

Immunity – is the ability to fight of diseases cause by microbes. A pathogenic microbe that
enters the body is antigen. In response to this, the blood develops substances called
antibodies. These antibodies provides immunity(resistance) to this disease caused by that
particular antigen. For example, if an individual has had antigens in the blood stream from
measles, he or she will form antibodies in blood that prevent the occurrence of measles a
second time.
Immunization- Artificial defences called immunizations protect against specific pathogens.
Vaccines provide immunization. Various vaccines are available, and are recommend for
health care worker to have. These vaccines will protect you from contacting certain diseases.
It protects both staff and patients.
The immunizations that re recommended includes:
• Hepatitis B
• Influenza
• Measles, mumps and rubella
• Tetanus diphtheria
• polio
Immunosuppression –occurs when the body’s immune system is in adequate and fails to
respond to challenges of infectious disease organism that it normally would fight
successfully. The individual is likely to develop variety of infections. A number of factors
leading to this condition includes:
➢ Advance age
➢ Frailty
➢ Chemotherapy
➢ Infection with human immunodeficiency virus
➢ Injury or removal of spleen
 ➢ Radiation therapy
Disease Prevention
Asepsis – the absences of disease producing organisms
This can be achieved, through medical and surgical asepsis
Medical asepsis- this refers to medical practices that reduce the numbers of microorganisms
or interrupt transmission from one person to another person or from person to object.
However, microbes can be reduced by the essential practice of medical aseptic technique:
➢ Handwashing
➢ Using nonsterile glove when contact with blood, moist body fluids (except sweat),
mucous membranes or non-intact skin is likely
➢ Cleaning and or disinfecting equipment.
Handwashing
Handing washing is single most important health procedure any individual can perform to
prevent the spread of microbes. It is the vigorous, short rubbing of the surfaces of soap-lather
hands.
The most important aspect of handwashing is the friction created by rubbing the hands
together. This friction mechanically removes microbes from the hand.
Hand washing should be done:
➢ At the beginning of the shift
➢ After the picking up of any item from the floor
➢ Before handling food
➢ After personal use of the bathroom
➢ After personal use
➢ After using tissue
➢ After you cough or sneeze before handling a patients, food and drink.
➢ After handling a patient’s belongings
➢ Before and after contact with your mouth
Procedure for washing your hand:
1. Check to see if there is enough water and soap and paper towel. A waste container
lien with plastic bag should be in area near you.
2. Remove rings, if possible, or be sure to lather soap underneath.
3. Remove watch, or push over wrist
4. Turn on facet
5. Adjust water to warm temperature. Once used drop the paper towel in the waste
container. Stand back from the sink so that you don’t contaminated your uniform. Wet
your hands, keep finger- tip downwards.
6. Apply soap and lather over your hands and wrist, between fingers. And under the
rings. Use friction an interlace your fingers work lather over every part of your hand
 and wrist. Clean your finger nails by rubbing them against the palm of the other hand
to force to force soap under the nails for 15 t0 20 seconds
7. Rinse hand with your fingernail point down. Do not shake water from hands
8. Dry hand thoroughly with paper towel, drop towel in the waste container.

Infection control measure:

1. Universal precaution- all human blood and body fluid are to be treated as if they are
known to have HIV or hepatitis B. these precaution are design to prevent HIV,
Hepatitis B and their blood borne disease.
This standard requires:
• Proper hand washing after touching potentially infectious materials and after
removing glove.
• Wear gloves when touching blood and body fluids
• Wear mask and goggles or face shield when you are likely to be exposed to
splashes of infectious materials.
• Never reuse needles
• Dispose shards in to appropriate containers
2. Standard Precautions- Standard Precautions apply to blood; all body fluids,
secretions, and excretions, except sweat, regardless of whether or not they contain
visible blood; non-intact skin; and mucous membranes. Standard precautions are
designed to reduce the risk of transmission of microorganisms from both recognized
and unrecognized sources of infection in hospitals. Standard precautions includes the
use of:
• hand washing,
• appropriate personal protective equipment such as gloves, gowns, masks,
whenever touching or exposure to patients' body fluids is anticipated.
• Handle patient care equipment soiled with care potentially infectious material
so that you don’t infect yourself and others
• Change gloves between task on the same patient
• Routinely clean and disinfect the surfaces throughout the ward or office of
your facility
• Handle contaminated linen so that potentially infectious material does not
transfer to other patients or staff
• Ensure that single used items are properly discarded.

3. Transmission-Based Precautions (i.e., Airborne Precautions, Droplet Precautions,

and Contact Precautions), are recommended to provide additional precautions beyond
Standard Precautions to interrupt transmission of pathogens in hospitals.

• Airborne Precautions used for infections spread in small particles in the air such as
chicken pox.
 • Droplet Precautions used for infections spread in large droplets by coughing, talking,
or sneezing such as influenza.

• Contact Precautions used for infections spread by skin-to-skin contact or contact with
other surfaces such as herpes simplex virus.

• Isolation of patients

• Wearing mask within 3 feet of the patient

Isolation Technique
There are four key points to be remembered at all times for isolation technique
1. Isolation technique is the name given to the method of caring for patient with
highly contagious diseases.
2. It is essential that every person know how to select the correct PPE and takes
responsibility for using the proper isolation technique to prevent the spread of
disease to other.
3. All items that come into contact with the patient’s excretions, secretion, blood.
Body fluid, mucous membrane, or no-intact skin are considered to be
contaminated. This potentially infective material must be treated in a special way.
4. Standard precaution are always used in addition to transmission.
Isolation unit
The isolation unit may be an area or a private room. Patient with the same disease may share
a room. A room with handwashing facilities is best. A private room is indicated for patient
who:
➢ Are highly infectious
➢ Have poor personal hygiene
➢ Require special air control procedure within the room
Preparing for isolation
To prepare patient room for isolation, do the following:
1. Place a card introducing the type of isolation precaution on the door to the
patient’s room. Hospitals has become more creative in the alternating their
personnel to the need for special precautions while observing the privacy and
confidentiality rules. Follow your facility procedures for positing signs and other
information.
2. Place an isolation cart outside the room, next to the door. Place in it quantities of
personal protective equipment as needed:
• Gown
• Mask
• Gloves
 • Goggles or face shields
• Plastic bag marked for biohazardous waste
• Plastic bag for soiled linen
3. Line the wastepaper basket inside the room with a plastic bag labelled or colour-
coded for infection waste.
4. Place a laundry hamper in the room and line it with a colour-coded biohazard
laundry bag.
5. At the sink, check the supply of paper towel and soap. Soap should be in a wall
dispenser or foot operated dispenser.
Personal Protective Equipment
Personal protective equipment includes gloves, gown, mask and goggles or face shield.
Following sections, or face shield. The following describe the correct use of this equipment.
✓ Gown – a gown made of moisture-resistant material is used when soiling or splashing
with blood, body fluids secretions or excretions is likely. The gown prevent
contamination of the health care provider’s uniform.
✓ Gloves- the glove prevent the spread of disease. Usually the nursing assistant will
wear nonsterile latex or disposable glove, but there also times when others types of
gloves are worn. Glove must be worn for most health care procedures. gloves are
used for three main purpose:
1. To prevent the health care provider from picking up a pathogen from
the patient.
2. To avoid giving the patient a pathogen that the health care provider has
picked up on hands
3. To avoid picking up pathogen on a patient or the environment and carry
it to another patient on hands.
✓ Mask- surgical masks should be worn when exposed to droplet secretion. The masks
should cover the nursing assistant’s nose and mouth. The mask protect you when you
are working within three feet of the patient. It is also used whenever protective
eyewear is worn. When a surgical mask is need, it is:
• Use only once and discarded
• Changed if it becomes moist, handled only ties
• Never left secured around the neck because it contaminate the uniform
and the environment

✓ Protective eye wear – a full face shield or goggles are worn at any time splashing of
blood, body fluids, secretion, or excretion my occur. The eyewear does not protect the
mucous membrane of the nose and mouth, so surgical mask is always worn with the
eyewear.

Sequence for Applying Personal Protective Equipment

1. Wash hands
2. Gown
3. Mask
 4. Goggles or face shield
5. Gloves
Sequence for Removing Personal Protective Equipment
1. Gloves
2. wash hands
3. googles/face shield
4. gown
5. mask
6. wash hands
Putting on a Mask
1. Assemble equipment
-Mask
2. Tie top strings of mask first, and then bottom strings.
3. Adjust mask over nose and mouth by fitting the flexible bridge to the nose
4. Adjust the mask so it fits snugly around the face and chin.
5. Replace your mask if become moist during procedures.
6. Do not reuse a mask and do not mask hang around your neck
Putting on a Gown
To be effective, gown should have long sleeves, be long enough to cover the uniform. And
big enough to overlap in the back. Gown should be waterproof.
1. Assemble equipment:
• Clean gown
• Paper towel
2. Remove wristwatch; place it on a paper towel.
3. Wash hands
4. Put on the gown outside the patient’s room. Put on gown by slipping your arm into
sleeves.
5. Slip the finger of both hands under the inside neckband and grasp the ties in back.
Secure the neckband.
6. Reach behind and overlap the edges of the gown. Secure the waist ties
7. Take your watch into the isolation unit, leaving it on the paper towel.
Remember when using gowns:
• A disposable gown is worn only once then it is discarded as infectious waste.
• Reusable cloth gown is worn only once and then is handled as contaminated linen.
• Cary out all procedure in the unit at one time, to avoid unnecessary waste of
gowns.
Putting on Gloves
1. Assemble equipment
• Disposable gloves in correct size
2. Wash your hands
 3. If gown is required put on gloves after gown is put on
4. Pick up gloves by cuff place it on hand.
5. Repeat with a glove for the other hand
6. Interlace fingers to adjust the gloves on your hands
7. If wearing a gown, pull cuff of gloves up over the gown sleeves
8. Remember when using gloves:
• Wash hands before and after using gloves.
• Remove gloves if they tear or become heavily soiled. Wash hands and put on a
new pair
• Gloves are used whenever there is the possibility of contacting body fluids,
blood, secretion, excretion, mucous membranes, or non-intact skin
• Change gloves between patients and wash hands
• Discard gloves immediately after removing them. Put them in a biohazardous
waste receptacle.
• Avoid touching your face. Exposed skin or environmental surfaces used glove
•
Remove contaminated gloves
1. Grasp the cuff of one gloves on the outside with the fingers of the other hand
2. Pull the cuff of the gloves down, drawing it over the glove. Pull that glove off your
hand.
3. Holds the glove with the still-gloved hand.
4. Insert the finger of the ungloves hand under the cuff of the glove on the other hand
5. Pull the glove off inside drawing it over the first glove
6. Drop both glove together into the biohazardous waste receptacle
7. Wash your hands. Dry with paper towel and discard the towel in the proper container.
Use a dry towel to turn off the water facet. Discard the towel.

Removing contaminated gloves , Eye protection, Gown and Mask

1. Assemble equipment
• Biohazards waste receptacle for disposable items
• Waste receptacle for gown if is not disposable
• Paper towel
2. Undo waist ties of gown, if they are in the front. Follow procedure 5 for removing
contaminated gloves.
3. Grasp the earpieces or head strap or face shield and lift the eye protection outward,
away from the face and up discard or reprocess according to facility policy.
4. Undo waist ties of gown, if they are in the back.
5. Undo neckties and loosen shoulders.
6. Slip the fingers of your dominant hand inside the cuff of the other hand without
touching the outside of the gown.
7. Using the gown covered hand, pull the gown down over the other hand and then off
both arms.
 8. As the gown is, remove, fold it away from the body with the contaminated side
inward and then roll it up. Dispose of contaminated gown in the correct receptacle
9. Turn faucets on with a clean paper towel.
10. Wash your hands and dry paper towel to turn off the faucet.
11. Use a clean paper towel to turn off the faucet.
12. If you brought a watch into the area, remove paper towel. Hold the clean side of the
paper towel and dispose of towel paper in the waste paper receptacle.
13. Use a paper towel to grasp the door handle as you leave the patient’s room.
Discarding the paper towel in the correct repeatable before you leave before you leave
the unit.
14. Remove mask:
• Undo the bottom tie first, then the top ties
• Hold the top ties, dispose of mask in appropriate waste receptacle
15. Wash your hands.

Disinfection – the process of eliminating harmful pathogen from equipment and instrument.
A chemical called a disinfectant is used for this procedure.
Sterilization – removes all microorganism from an item. This process can be completed in an
autoclave, which use steam and pressure to kill germs.
Sterile procedures
Surgical asepsis is the means by which the environment is kept free of all microbe both
pathogen and non-pathogens. In procedures where surgical asepsis is, used equipment and
supplies must be sterile.