CORE 7: MAINTAIN HEALTHY

AND SAFE ENVIRONMENT

Learning Outcome 7.3: Supervise
The Safety Of Clients

Ms cristine may lita

INFECTION CONTROL PROCEDURES
INTRODUCTION
The caregiver must learn what infection control is and how it is
achieved. All healthcare providersmust have a thorough understanding
of the spread of microorganisms and how they are controlled
anddestroyed. Infection control is necessary to prevent the spread of
illness and infectious and contagiousdiseases. The caregiver will come
into contact with many different kinds of diseases, illnesses, andinjuries.
Many of these conditions are caused and transmitted by
microorganisms. Parts of the patient'shome can become a breeding
ground for germs and proper precautions must be observed by
everyoneat all times. Therefore, the caregiver must learn how to
control and destroy these pathogenic organisms with good and
conscientious practice and techniques.
MICRO ORGANISMS
.
Definition - also called as "microbe", is a small (micro) living plant or animal
(organism)
seen only with a microscope

Characteristics of microorganisms
a. Naturally present in the environment and in the body
Some microbes do not usually cause an infection
Some are harmful and can cause infection

Key terms
a. Normal flora - microbes that live and grow in certain area in our body
that helps prevent the growth of pathogens; they should grow in its
natural site (e.g.Escherichia coli is in the colon)
MICRO ORGANISMS
Drug resistant organisms - microbes that are able to resist the
effects of
antibiotics
Antibiotics - drugs that kill microbes that causes infection or disease
Opportunistic pathogen - microbes that causes disease only in a
susceptible host
Spores - bacterium protected by a hard shell
True pathogen - causes disease or infection in a healthy individual
Pathogen - microbes that can cause infection
Non-pathogen - microbes that do not usually cause an infection
MICRO ORGANISMS
Types of microbes
a. Bacteria - a one cell plant life that multiplies rapidly; often called "germs";
they can cause infection in any body system
b. Fungi - plants that live on other plants or animals; mushroom, yeast, and
molds are common fungi; it can infect the mouth, vagina, skin, feet and other
parts of the body
c. Protozoa - one-celled animal; can infect the blood, brain, intestines and
other partsof body
d. Rickettsiae - found in fleas, lice, ticks, and other insects; spread to human
by
insect bites
e. Viruses - grow in living cells; they cause harmful and fatal diseases
MICRO ORGANISMS
. Requirements of microbes
Reservoir - called host; the environment in which they can live and grow (e.g.
people, plant, animals, water, soil and food)
Water and food - nourishments for them to live, multiply and grow
Oxygen - oxygenation to survive
Warmth and darkness - grows best at body temperature; they are destroyed by
heat and light
6. Variations of microorganisms
a.Virulence (pathogenicity) - their ability to produce disease
b. Severity - the degree of disease they produce
c. Communicability - the degree of how they are transferred
INFECTION AND ASEPTIC TECHNIQUE
.INFECTION
Definition - a disease resulting from the invasion and growth of microbes in the
body; it .occurs as a result of a cyclical process
Signs and symptoms of systemic infection
a. febrile (with fever)
b. tachycardia (increased pulse) and tachypnea(increased respiration)
c. malaise (feeling sick) and fatigue (loss of energy)
d anorexia (loss of appetite) or diarrhea
e. nausea (fainting) and vomiting
f enlargement and tenderness of lymph nodes that drain the area of infection
g.pain and tenderness
h.rashes or sores on mucous membrane
INFECTION AND ASEPTIC TECHNIQUE

Types of infection
Local - limited to the specific part of the body where the microorganism remain
Systemic (septicemia) - if the microorganisms spread and damage different par
of the body
Acute infection - generally appear suddenly or last a short time
Chronic infection - may occur slowly over a long period of time (months or
years)
Nosocomial - associated with the delivery of health care service in a health care
facility
INFECTION AND ASEPTIC TECHNIQUE
1) Transmission
(a) develop either during the stay in hospital or after discharge
(b) common settings are medical-surgical units, OR and ICU
(c) common infection sites are urinary tract, respiratory tract, bloodstream
and wounds
(d) infection may originate from clients themselves (endogenous) or
hospital environment and personnel (exogenous)
(2) Contributing factors to nosocomial infection
(a) latrogenic infection - direct result of diagnostic or therapeutic
procedure
(b) Compromised host - client's normal defense have been lowered by
surgery or illness
(c) Insufficient hand washing - vehicle of transmission of infection
Subclinical infection (asymptomatic infection) - if the microorganism produces no
clinical evidence of disease but can cause significant damage
FACTORS INCREASING
SUSCEPTIBILITY TO INFECTION
Age
a. Newborns
(1) protected by immature immune system only for the first 2 or 3 months by the
immunoglobulins passively passed by the mother
(2) between 1 and 3 months, infants begin to synthesize their own antibodies
(3) immunization must start as early as 2 month old (DTP)
b. Older adults
(1) advancing age makes the immune responses weaker
(2) pneumococcal vaccine and immunization against influenza to elderly is
recommended especially those with chronic cardiac, respiratory, metabolic
and renal disease
FACTORS INCREASING
SUSCEPTIBILITY TO INFECTION
2. Heredity
a. some people have a genetic susceptibility to certain infections
b. deficiency in serum antibody
3. Stress
a. nature, number, and duration of physical and emotional stressor can influence
susceptibility
b. stressors can elevate blood cortisone which decreases anti-inflammatory
responses, depletes energy store leading to exhaustion and decreases resistanc
to infection
4. Nutrition
antibodies are protein and it can be depleted due to inadequate nutrition
FACTORS INCREASING
SUSCEPTIBILITY TO INFECTION
2. Heredity
a. some people have a genetic susceptibility to certain infections
b. deficiency in serum antibody
3. Stress
a. nature, number, and duration of physical and emotional stressor can influence
susceptibility
b. stressors can elevate blood cortisone which decreases anti-inflammatory
responses, depletes energy store leading to exhaustion and decreases resistanc
to infection
4. Nutrition
antibodies are protein and it can be depleted due to inadequate nutrition
FACTORS INCREASING
SUSCEPTIBILITY TO INFECTION
5. Medical therapies
a. radiation treatment destroy cancerous and some normal cells making the person more vulnerable to
infection
b. invasive medical procedure may predispose patient to infection (e.g. intubation andsurgery)
Medications
a. antineoplastic (anticancer) medication mat depress bone marrow function resulting to inadequate
production of WBC which fights infection
b. anti-inflammatory drugs (corticosteroid) inhibits inflammatory response essential fordefense against
infection
c. antibiotics kills resident flora in the Gl system allowing invasion of microorganism
7. Disease and Illness
a. chronic pulmonary disease impairs ciliary action and weakens mucous barrier
b. peripheral vascular disease (PVD) restricts blood flow
c burns and wounds impairs skin integrity
d. leukemia and anemia alters the production of WBC
e diabetes mellitus (DM) predispose patient to infection due to compromised
peripheral vascular status and increased blood glucose levels
SUPPORTING DEFENSES OF A
SUSCEPTIBLE HOST
1. Hygiene
keep skin and mucous membranes clean and intact
b. provide good and proper oral care including flossing the teeth
regular bathing and shampooing can remove dirt and microorganisms
2.Nutrition
a balance diet enhances the health of all body tissues and enables tissues to
maintain and rebuild themselves and helps good functioning of immune system
b. give vitamin C for wound healing and increase defense against common cold
3. Fluids
a. give adequate amount of fluid to prevent dehydration and flushes out
microorganisms out of the bladder and urethra
b. minimize intake of orange juice and sodas that could increase blood glucose
c. glass of cranberry juice every week can prevent UTI
SUPPORTING DEFENSES OF A
SUSCEPTIBLE HOST
4. Rest and Sleep
a. plan hours of activity (ADL), procedures, leisure and rest to renew energy
b. plan hours for visitors to promote sleep
5. Stress
a. assist client to learn stress-reducing technique
b. give time to talk to clients in order for them to ventilate emotions
c. let the client know of his/her health status and let the patient and family get
involvein the nursing plan of care
d. always be ready to assist them with their needs and answer their inquiries
6. Immunization
a. advise parent to have their children receive immunization at the right schedule
b. it is advisable to update immunization schedules yearly especially infants,
children,elderly and health care providers
 ASEPSIS
Key terms
Asepsis- the absence of disease-producing microorganisms
Contamination- process by which something is rendered unclean or unsterile
Resident flora or bacteria microorganisms that normally live on the skin of an individual
Transient flora or bacteria - microorganisms picked up on skin as result of normal
activities and that can be removed readily
Sterile - the absence of all microbes including spores of both pathogens and
non-pathogens
Types of asepsis
Medical asepsis - also called "clean technique"; practices to reduce the number and
transfer of pathogens from one person or place to another
Surgical asepsis - also called "sterile technique"; practices that render and keep objects
and areas free from all types of microorganisms.
 ASEPSIS practices
Personal hygiene
(1) Handwashing - the most easiest way to stop chain of infection
(2) Bathing, shampooing and oral hygiene
(3) Nails and foot care
(4) Personal care items and clothing
(5) Covering mouth and nose when coughing and sneezing
Home and environment
(1) Vacuuming, dusting, cleaning and scrubbing
(2) Proper disposal of garbage; follow recycling procedure
(3) Proper buying, cooking, handling and storing of foods
(4) Sanitation of kitchen and bathroom
(5) Proper laundering and storing of clothes and linens
(6) Proper storage of chemicals and disinfectants
 Supplies and equipment
(1) Cleaning - reduces the number of microbes and removes organic matter
such as blood, body fluids, secretions and excretions
(a) Wear personal protective equipment or PPE (gloves, mask, gown, eye
shield) when cleaning items with blood, body fluids, secretions and excretions
(b) Rinse the items in cold water first (hot water causes organic matter to
become thick, sticky and hard to remove)
(c) Wash the item with soap and hot water
(d) Scrub thoroughly and use brush if necessary
(e) Rinse the item in warm water and let dry
(f) Disinfect or sterilize the item
(g) Disinfect equipment and the sink used in cleaning procedure
(h) Discard personal protective equipment (PPE)
(i) Wash hands properly
Supplies and equipment
2) Disinfection - the process of destroying the pathogens but not the spores
(a) Germicides are disinfectants applied to skin, tissues and non-living objects
(b) Alcohol is the most common germicide
(c) Detergents and hot water are used for eating and drinking utensils,
linens and clothes
(d) Commercial products disinfect household surfaces such as sink,
kitchen counters, floors, toilets, tubs and showers
(e) Vinegar can be used to disinfect bedpans, urinals, commode and toilet
(1 cup white vinegar to 3 cups of water)
(f) Chemical disinfectants can burn and irritate skin; wear waterproof
utility gloves or rubber household gloves; do not wear disposable latex) gloves;
follow instructions on proper use and storage
Supplies and equipment
Sterilization - destroys all non-pathogens and pathogens including spores;
very high temperatures are used and microbes are destroyed by heat
(a) Radiation, liquid or gas chemicals, dry heat and steam under pressure
(b) Autoclave is a pressure steam sterilizer used for glass, surgical items
and metal objects (sterilization time is 30 to 45 minutes)
(c) Boiling is the common sterilization process used at home; items must
be completely under water; pot should have the proper lid; bring the
water into full boil and boil the item for 15 minutes; remove items from pot
with tongs and let items air dry on top of a clean towel
 Sterile Field General
Principles
Sterile items becomes contaminated when touched by anything that is
not sterile
Sterile field that becomes wet is considered contaminated
Sterile items out of eyesight or below waist level are considered non-
sterile
Sterile gauze/cotton soaked on sterile liquids should be held down
One inch from edges inside a sterile package is considered contaminated
You cannot reach over a sterile field
5. Isolation and Barrier Technique - protective aseptic practices that limit
the transfer of microorganisms either from the infected person or to a
highly susceptible person
 type of isolatiom Indication example of disease

pread of pathogens through

Enteric isolation Hepatitis A
the feces

pread of pathogens through

Respiratory isolation Tuberculosis
the air

spread of pathogens through

Strict isolation chicken poxs
the air contact

spread of pathogensby
drainage contact with infected person draining wounds
or contaminated articles

protect from transmission by

universal floodnamd and
direct or indirect contact with aids
bloody fluid
infective blood
 protect a highly
susceptable person form lukemia, aids, burn
reverse/ protective
becoming infected ( low patients
resistance)

each disease receives ikts

disease specific conjunctivitis, influenza
specific protective measures
iNFLAMMATORY RESPONSE
Inflammation- local and non-specific defensive response of an
injurious and infectious agent
A. MECHANISMS OF INFLAMMATION
destroys and dilutes the injurious agent
prevents further spread of the injury
promotes the repair of damaged tissue
SIGNS OF INFLAMMATION
Pain
Swelling
Heat or warm to touch
Impaired function of the injurious part
Red
iNFLAMMATORY RESPONSE

iNJURIOUS AGENTS
Physical agents- include mechanical objects causing trauma
to tissue, excessive heat or cold, and radiation
Chemical agents- include external irritants (e.g. strong acids,
alkalis, poison) and internal irritants (e.g. excessive hydrochloric
acid in the stomach) Microorganisms- include the broad
groups of bacteria, viruses, fungi and parasites
HANDWASHING
RULES ON HANDWASHING
Wash your hands with soap and water when they are visibly dirty or soiled with blood,
body fluids, secretions and excretions
Wash hands with soap and water after using the bathroom (urinating, BM, changing
tampons and sanitary pads)
Wash hands after covering mouth when sneezing, coughing or blowing your nose Wash
hands before and after handling, preparing and eating foods
Wash hands before and after providing care for the patient
Bed bath, shampooing, giving back rub and oral care
Changing bed linens and clothing
Ambulating and repositioning the patient
Wound care and skin care
VS assessment, assisting with medications and feeding
Assisting patient to bathroom and assisting with perineal care
Handling contaminated equipment and organic materials and collecting specimens
Use an alcohol-based hand rub to decontaminate your hands if they are not visibly
soiled
GUIDELINES IN HANDWASHING
Do not perform handwashing haphazardly
Gloves are not use to replace handwashing
Be decisive when to do handwashing Pay attention to areas
often missed during hand washing
Use a lot of lather and friction during handwashing
Use clean orange stick or nail file to clean under the nails Keep
a short trimmed nails at all times
Avoid touching the sink during handwashing; if that happens,
the procedure must be repeated
Apply hand lotion or cream to prevent skin chapping and
drying
PURPOSES OF HANDWASHING

Reduce the numbers of transient and resident

bacteria residing on the hands
Prevent transmission of infection to a patient and
family members
Prevent transmission of infection to other health
care workers or personal contacts
Prevent transmission of infection to oneself
thank you for
listening....