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INFECTION CONTROL

VIEWS: 8 PAGES: 30

									     INFECTION
CONTROL/PREVENTION
    IMMUNITY & DISEASES
               IMMUNITY
Immunizations are:
• Artificial defenses that protect against specific
  pathogens

• Artificial or weakened antigens that help the body
  develop protective antibodies

• Vaccines that can prevent most childhood
  diseases such as measles, rubella (German
  measles), meningitis, mumps, polio, diphtheria,
  chickenpox, whooping cough, and tetanus
       IMMUNITY (CONT’D)
Active immunity:
• exposure to a disease organism triggers the
  immune system to produce antibodies to that
  disease. There are 2 types:

• Natural active: antibodies develop during
  infection with the actual disease. (measles,
  chickenpox)

• Artificial active: introduction of a killed or
  weakened form of disease organism thru vaccines
  (MMR, Hep B, polio)
    IMMUNITY (CONT’D)
Passive immunity:
person is given antibodies to a disease. There are 2
  types:
• Natural passive: mother to child thru placenta or
  milk
• Artificial passive: used during potentially fatal
  diseases. Provides an instant response of
  temporary antibodies (tetanus, gamma globulin)

Protection for active immunity is permanent and
  takes several weeks to become active

Passive immunity is temporary and acts
  immediately
      BACTERIAL/VIRAL
        INFECTIONS
Immunosuppression:
Occurs when the body’s immune system is
  inadequate. A number of factors can lead to this
  condition, including:

• Advanced age and Frailty

• Chemotherapy

• Infection with Human immunodeficiency virus
  (HIV)

• Radiation therapy
 BACTERIAL INFECTIONS
       (CONT’D)
Methicillin-resistant Staphylococcus aureus (MRSA):
  Is a virulent staph infection, normally found on
  skin and mucous membranes.
  Resistant to antibiotic treatment, and can prove
  fatal very quickly
Vancomycin-resistant enterococci (VRE):
Entero-cocci are found in the gastrointestinal tract.
  Major cause of infections acquired in health care
  facilities. Most strains are highly resistant to
  many antibiotics.
  Newer strains are resistant to vancomycin
 BACTERIAL INFECTIONS
        CONT’D
Streptococcus A:
• Is a bacterium that produces very powerful
  enzymes that destroy tissue and blood cells.
• Infection is pass on to others by coughing or
  sneezing, touching environmental surfaces
  without washing your hands.
• Strep A infection occurs when bacteria enters the
  body through minor trauma or a break in the skin
• Good hand washing helps reduce the risk of
  infection.
• Treatment with antibiotics and surgery, the
  results are not always good
 BACTERIAL INFECTIONS
       (CONT’D)
• Clostridium difficile (C.diff) is a bacterium which
  causes diarrhea
  > develops after a series of antibiotic therapy.
  > affects the lining of the intestine, causing
  inflammation.
  > results in sudden, severe, foul-smelling, watery
  diarrhea. More commonly acquired in hospitals

• Escherichia coli: commonly found in the intestinal
  tract (feces). A small amt of this bacteria can
  contaminate meat, especially ground beef

• Salmonella: a group of bacteria that cause mild
  to life threatening intestinal infection (food
  poisoning)
 BACTERIAL INFECTIONS
       (CONT’D)
Precautions:
• Wash your hands regularly with soap and water
  before and after patients care, and removal of
  gloves
• Wear gloves and gown when coming in contact
  with infectious material
• Encourage visitors to wash their hands before
  and after patients visit to ensure that they don’t
  carry germs
• Carry alcohol wipes and extra gloves to use
  between patients
• Remove gown and gloves and dispose of them
  appropriately as per policy, outside of patients
  room
• Have visitors report to the nurses’ station before
  entering room
          TUBERCULOSIS
            INFECTION
Tuberculosis (TB): is an infectious disease caused
  by the organism Mycobacterium tuberculosis
  (tubercle bacilli)

• Tubercle bacilli: are spread by airborne droplets
  expelled when a person with active TB coughs,
  sneezes, or talks

• Individuals exposed to contaminated air may
  breathe in the organism. This is more likely to
  occur in poorly ventilated or closely confined
  spaces (vehicles, trains, crowded areas)
     TUBERCULOSIS
   INFECTION (CONT’D)
TB: an increase in the number of people
  who are at risk, including those who are:
• HIV positive
• Infected but fail to take their meds
• Live in poverty and are malnourished
• Immigrants to the United States from
  countries where TB is still common
• Have had inactive TB but have grown
  older and experience increased disability
      TUBERCULOSIS
    INFECTION (CONT’D)
Latent TB:
• An estimate of 10 to 15 million people in the U.S.
  have latent TB infection
• A person infected and has a strong immune
  system, is able to contain the infection and will
  not become ill with the disease.
• Persons are not contagious (cannot transmit TB
  infection to others
• Only 1 in 10 persons with latent TB infection will
  ever develop active TB, as long as they are HIV
  negative
      TUBERCULOSIS
    INFECTION (CONT’D)
Active TB: occurs when an individual’s immune
  system fails to keep the TB organism contained

• Can involve almost any organ in the body, but is
  most commonly spread from person to person
  when lungs or airways are involved

• Airborne precautions are required (mask,
  negative pressure room) until three consecutive
  Acid Fast Bacilus (AFB) sputum smears are
  negative
     TUBERCULOSIS
   INFECTION (CONT’D)
• Signs/symptoms of TB: as disease
  progresses, the person will show one or
  more symptoms:
• Fatigue
• Loss of appetite and weight
• Weakness
• Elevated temp in the afternoon and
  evening
• Night sweats
• Spitting up blood (hemoptysis)
• Coughing
      TUBERCULOSIS
    INFECTION (CONT’D)
TB diagnosis: the presence of TB bacterium in the
  body can be shown by:
• A sputum culture: grows the organisms from a
  specimen of secretions from the person’s lungs
• Chest X-rays: show the extent of the disease
  process in the lungs
• A positive skin test (Mantoux test) shows the
  presence of antibodies to the TB organisms in the
  body, and is not an indication of the active
  disease
• Most health care workers must undergo a skin
  test for TB before employment
      TUBERCULOSIS
    INFECTION (CONT’D)
TB treatment/prevention
• A person with TB is treated with a selected
  antibiotic or combination of antibiotics
• Once drug therapy starts, the patient usually
  becomes noncontagious (cannot spread the
  disease organism) within two to three weeks
• Cure for TB requires 6-12 months, or longer, of
  continuous treatment
• The course of treatment must be completed to
  avoid recurrence
• All new TB and suspected cases should be
  reported promptly to the Health Department by
  the health care provider, as required by the state
           AIDS AND HIV
• Acquired Immune Deficiency syndrome (AIDS),
  which is a serious condition that affects the
  body’s ability to fight infections
• AIDS is caused by the Human Immunodeficiency
  Virus (HIV)
• HIV in the body, can destroy the immune cells
  (T-cells and white blood cells) that defend the
  body against infections
• Without these cells, the body cannot defend itself
  from illness
• Disease and infections can now move into the
  body without a fight
AIDS AND HIV (CONT’D)
HIV can be transmitted by:
• Blood and plasma
• Semen
• Vaginal secretions
• Cerebrospinal fluid
• Bone marrow
• Sharing injection needles or syringes
• Placenta
• Breast milk
• Body fluids containing blood
• Body tattooing/piercing
AIDS AND HIV (CONT’D)
HIV cannot be transmitted by:
• Shaking hands
• Coughing
• A dry kiss
• Swimming pools
• Sharing food
• Donating blood
• Hugging
• Sneezing
• Toilet seats or rest rooms
• Sharing eating or drinking utensils
• Insects, including mosquitos
• Door knobs
• Sweat, saliva, or tears
 AIDS AND HIV (CONT’D)
HIV tests and treatment:
• Most widely used test is the enzyme-linked
  immunosorbent assay (ELISA) test

• Positive results, the test is repeated. After two
  positives, a Western Blot Test is done to confirm
  the results

• No cure for AIDS and no vaccine available for
  HIV.

• Antiretroviral therapy, which is known as cocktail
  drugs, combination therapy, or highly active
  antiretroviral therapy (HAART). Each type of drug
  fights HIV differently to slow down the spread of
  the HIV virus (combivir, invirase, atripla, norvir)
AIDS AND HIV (CONT’D)
Stages of the Disease: Person who is exposed to
  HIV develops antibodies to the virus within 2 –
  24 weeks (window period)
• Stage 1: Newly exposed persons may exhibit flu
  like symptoms that may last one to two weeks
• Stage 11: symptoms such as weight loss, night
  sweats, fevers, swollen lymph nodes, dry
  persistent cough, oral candidasis (thrush), and
  fatigue
• Stage 111: T cell count is below 200/m3
(normal T Cell count in a healthy adult is 800-1000)
Stage 11 symptoms with one or more opportunistic
  infections are present
(Kaposi’s Sarcoma, pneumocystis carinni) develops
AIDS AND HIV (CONT’D)
Standard precautions:
• Assume that all blood and bodily fluids are
  contagious

• Use appropriate Personal protective Equipment
  (PPE) (mask, gown, gloves, or goggles) when
  appropriate

• Dispose of blood, body fluids, and contaminated
  materials in the appropriate containers such as
  (red bags, needle/sharps boxes)

• Do not touch broken glass with your hand. Use
  forceps or tongs to dispose of glass
AIDS AND HIV (CONT’D)
Standard precautions:
• Keep all cuts and breaks on skin covered with a
  band-aid, and wear disposable gloves
• Disinfect surfaces contaminated with blood or
  body fluids using 1:10 bleach solution
• Do not eat, drink, smoke, or apply cosmetics or
  lip balms in areas where there may be blood or
  body fluids
• Do not store food or drink in refrigerators where
  blood or body fluids may be present
• Practice hand hygiene frequently and thoroughly,
  even after using gloves
             HEPATITIS A
Hepatitis A virus (HAV) is most common and
  transmitted by:
• Feces, saliva, and contaminated food
Symptoms: Yellowish color of skin (jaundice) and
  sclera, fever, nausea, vomiting, diarrhea, fatigue,
  abdominal pain, dark urine, and appetite loss.
  respiratory symptoms, rashes, and joint pain
Treatment:
• Vaccine available
• Rarely fatal
• Bedrest and avoidance of alcoholic beverages

Precautions: wash hands before and after handling
  food, wash fruits and vegetables thoroughly
  HEPATITIS B (CONT’D)
• Hepatitis B virus (HBV)
• Causes inflammation of the liver
• Tissue response to virus may be mild, flu-like, or
  so severe as to cause hospitalization
HBV may be present in blood and body fluids such
  as:
• Bloody saliva contacted during dental procedures
• Blood
• Semen
• Vaginal secretions
• Cerebrospinal fluid
• Synovial fluid (fluid lubricating the joints)
  HEPATITIS B (CONT’D)
Full immunizations:
• Requires three doses of vaccines over a 4–6
  month period
• Personnel screened for the hepatitis B surface
  antibody, after the immunization is completed
  (blood test to determine titer levels)
• Incidence of side effects to the vaccine is very
  low
• Effective at providing protection against the Hep
  B virus
• Vaccine is available at no cost through the
  Employee Health Department
  HEPATITIS B (CONT’D)
Accident exposure to blood and body fluids:
• You must be evaluated and treated by the
  employee health department within four hours of
  exposure

• If the employee health department is closed, you
  should go to the emergency room within the
  same time frame of less than four hours of
  exposure

• Facility will provide upon consent, a confidential
  medical evaluation including blood tests, post-
  exposure prevention treatment and follow-up
  counseling
  HEPATITIS C (CONT’D)
Hep C virus (HCV
• Transmitted through blood and blood products
• May be mistaken for the flu

Common signs and symptoms include:
• Fatigue
• Depression
• Fever
• Mood changes
• Weakness
• Pain and Loss of appetite
• May cause liver cancer and liver failure
  HEPATITIS C (CONT’D)
Protect yourself by:
• Using standard precautions

• Taking the vaccine, if available

• Practicing safe sex (using condoms)

• Not using illegal drugs

• Giving your full attention to the handling of
  sharps such as needles or razors
PREVENTING INFECTION
• Assist patients to maintain adequate fluid intake
• Wipe from front to back when cleaning perineal
  area

• Observe patient carefully and report to the nurse:
  > changes in frequency of urination
  > complaints of pain/burning on urination
  > coughing or respiratory problems
  > confusion or disorientation that is unusual
  > drainage or discharge from any body opening
  or wound
  > changes in skin color
  > complaints of pain, discomfort or nausea
  > elevated temp, red, swollen areas on body

								
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