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Health Skills I Student Lecture Packet - Kirkwood Community College

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					    Health Skills I
Student Lecture Packet
Health Skills I

    Unit 101
Infection Control
                Objectives
• Identify the nature of microorganisms, how
  organisms grow, their transmission, body
  defenses of the human host, and related
  terminology
                   Unit 101.1
                 Microorganisms

• Anton Van
  Leeuwenhoek
  – first observed
    microorganism under
    a microscope in 1693
 Microorganisms are Everywhere!
• inside and outside our bodies
• in food, air, and water
• some are useful
  – fermentation of food
• small percentage cause disease
• organisms can be spread
• healthcare workers need to understand how
  to break cycle
Exciting Moments in Microbiology
• Ignatz
  Semmelweiss
  1860
• reduced the
  transmission of
  puerperal fever by
  handwashing
         More Exciting Moments in
              Microbiology

• LOUIS PASTEUR
  1861
• proposed the
  “Germ Theory”
                 Definitions
• Microorganism
  – microscopic living things that individually are
    too small to be seen with the naked eye, only
    seen under microscope
     • example: germs & microbes
• Pathogen
  – microorganisms capable of causing disease
                 Definitions
• Communicable disease
  – a pathogenic organism passed from one host
    to another
• Host
  – one infected with a pathogenic
    microorganism
• Susceptible host
  – one unable to fight off infection due to low
    resistance
                 Definitions
• Colonized
  – presence of microorganisms in or on a
    patient, without clinical signs and symptoms
• Infection
  – colonization invasion of body tissues by
    disease producing pathogenic microorganisms
• Re-infection
  – infected a second time by same pathogen
                 Definitions

• Cross infection
  – spread to another person by air currents or
    health worker
• Co-infection
  – infected with more than one organism
• Secondary infection
  – an infection acquired following a primary
    illness
• Nosocomial
  – infection acquired within a healthcare facility.
         Pathogenic Organisms
                Virus
• acellular
  – cannot survive independently
• parasite
  – can only survive on living tissue
  – cannot be treated by antibiotics, may use
    antiviral drugs
  – vaccinations can prevent a number of viral
    infections
           Pathogenic Organisms
                  Virus
• Examples:
  – polio, influenza,
    common cold, HIV,
    Hepatitis B, mumps,
    herpes




                          Bacteriophage (virus that infects bacteria)
                  Pathogenic Organisms
                        Bacteria
• simple unicellular
  organism
   – three shapes
      • coccus, bacillus,
        spirillium
• Clostridium tetani
   – bacterium that causes
     tetanus
  Pathogenic Organisms Bacteria

• can be treated by antibiotics
  – examples:
     • strep throat, abscesses, gonorrhea, syphilis,
       chlamydia, Rocky Mountain Spotted Fever, Lyme
       disease
• vaccinations can prevent some bacterial
  infections
  – example:
     • pneumonia
    Pathogenic Organisms Fungi
• molds and yeast
  – multicellular or unicellular organisms, more
    complex than bacteria
     Pathogenic Organisms Fungi

• Examples:
  – athletes foot,
    ringworm, vaginal
    yeast infection, thrush




                              Pilobolus, a fungus
    Pathogenic Organisms Protozoa
•   largest single celled organism
•   relatively few cause disease in humans
•   many parasites passed by insects
•   transmitted by food
   Pathogenic Organisms Protozoa


• Examples:
  – malaria, dysentery,
    sleeping sickness




                          Amoeba, a protozoan
         Pathogenic Organisms
          Clostridium difficile
              (C. difficile)
• C. difficile is:
   – a pathogenic species of anaerobic bacteria
     causing pseudomembranous colitis and
     diarrhea, after receiving antibiotic therapy.
     This is frequent cause of nosocomial diarrhea
                Definitions

• Anaerobic
  – a microorganism that grows and lives in the
    complete or almost complete absence of
    oxygen
• Pseudomembranous colitis
  – diarrhea caused by overuse of antibiotics
    transmitted by healthcare workers not
    washing hands properly
      Pathogenic Organisms
           C. difficile
– common hazard of antibiotic use
– most common cause of nosocomial infectious
  diarrhea
– may cause bleeding & bowel perforation
– can exist months on environmental surfaces &
  flourishes on hands of healthcare workers
– At risk patients:
  • chemotherapy, antibiotic therapy &
    gastrointestinal procedures
                  C. difficile

• Standards of care for patient w/ diagnosis of
  C. difficile
  – good handwashing before & after patient care
    procedures
  – use of Standard Precaution barriers for Contact
    Isolation guidelines (gown, gloves, private room)
  – the antibiotic related to the cause of C. difficile
    will be discontinued by physician and further care
    will begin
     Pathogenic Organisms
Vancomycin Resistant Enterococcus
             (VRE)
• VRE is:
  – a bacteria that normally lives in the digestive
    tract that has developed a resistance to the
    antibiotic vancomycin and most other
    antibiotics
                Definitions

• Vancomycin
  – antibiotic used to treat strep and staph
    infections
• Enterococcus
  – any Streptococcus that inhabits the intestinal
    tract
 Pathogenic Organisms VRE
– caused by overuse of antibiotics
– VRE infections frequently found in:
   • urinary tract, at surgical sites, and in the bloodstream
– spreads through:
   • direct contact with a VRE infected patient
   • direct contact with surfaces & equipment
     contaminated with VRE
   • hands of a healthcare worker contaminated with VRE
– lives weeks on surfaces
                      VRE

• At risk patients for VRE:
  – immunosuppressed conditions
  – history of vancomycin therapy
  – indwelling urinary or central venous catheters
  – elderly
  – abdominal surgery patients
  – wounds/burn victims
                     VRE

• Standards of Care for VRE diagnosed
  patients:
  – good handwashing before & after care
  – use Standard Precaution barriers and contact
    Isolation Precautions
  – the antibiotic will be discontinued by a
    physician with plan for further care
      Pathogenic Organisms
             (MRSA)
• Methicillin Resistant Staphylococcus
  Aureus (MRSA) is:
  – bacteria that populates the skin, mucous
    membranes and upper respiratory tract, the
    intestines and genitourinary tracts that has
    become resistant to the antibiotics methicillin
    and penicillin
Pathogenic Organisms MRSA

– endemic (expected “normal” incidence)
  within community & tertiary hospitals,
  skilled-nursing facilities & long-term care
– most frequent sites of this bacteria is the
  nares, groin, axilla and gut
– transmitted primarily on the hands of the
  healthcare workers
                   MRSA

• At risk patients for MRSA:
  – those on broad-spectrum antibiotics therapy
  – immunosuppressed patients
  – burn patients
  – central venous catheters
  – surgical wounds
  – prolonged hospital stays
                     MRSA

• Standard of care for patient w/MRSA
  diagnosis:
  – topical ointment to nostrils
  – if infected, vancomycin
              Key Factors
        C. difficile, VRE, MRSA

– handwashing & standard precautions
– single room for infected/colonized patients
– use antiseptic cleansers in high risk areas
– daily cleansing of environmental surfaces that
  have had direct hand contact
             Key Factors
       C. difficile, VRE, MRSA

– dedicate equipment for exclusive use for
  infected patient(stethoscopes, BP cuffs, etc.)
– keep equipment off bed & bed tables
– provide protective gear to patient when
  leaving their room (mask, gown, etc.)
                 Infection Cycle

• Three Elements
  Required:
                                         source
  – source of infecting
    microorganisms
                           susceptible
  – susceptible host       host
  – mode of transmission

                                     mode of
                                     transmission
            Infection Cycle

• Source
  – may include persons with acute disease
  – persons in the incubation period of disease
  – persons who are colonized by infectious agent
  – persons who are chronic carriers
  – can be inanimate objects
              Infection Cycle
• Host
  – one infected with a pathologic microorganism
  – resistance varies
  – may develop immunity
  – may be an asymptomatic carrier
  – may develop clinical disease
               Infection Cycle
                Transmission
• May be transmitted by more than one
  route
• Five main routes:
  – contact-direct or indirect
  – droplet
  – airborne
  – common vehicle
  – vectorborne
       1. Contact Transmission
• *most frequent mode of noscomial infection
• Direct Contact
  – skin to skin
• Indirect Contact
  – contact with an inanimate object contaminated
    by the infected patient
         2. Droplet Transmission

– a form of contact
  transmission
– droplets are propelled
  a short distance (3
  feet)
– droplets are deposited
  on hosts such as the
  mucous membranes
  of eye, nose or mouth



                           droplets are generated by
                           coughing, sneezing or talking
      2. Droplet Transmission

– droplets transmitted during medical
  procedures of bronchoscopy or suctioning
  that put healthcare workers at risk
– private room ideal
   • Can be placed w/other similar conditions 3’ apart
     if room availability is an issue
– healthcare worker must wear mask when
  caring for a person with droplet isolation
  precautions
– Example:
   • Influenza
     3. Airborne Transmission
– spreads by way of airborne droplets or dust
  particles containing infectious agents
  (microorganisms) and inhaled by the new host
– spread by air currents
– special handling and ventilation required to
  prevent transmission
– requires private room
– Examples
   • tuberculosis, rubeola, and varicella (chicken pox),
     herpes zosters viruses spread via airborne transmission
     3. Airborne Transmission
– spreads by way of airborne droplets or dust
  particles containing infectious agents
– spread by air currents
– special handling and ventilation required to
  prevent transmission
– requires private room
– Examples
   • tuberculosis, rubeola, and varicella (chicken pox),
     herpes zosters viruses spread via airborne transmission
             4. Common
         Vehicle Transmission
– microorganisms transported by contaminated
  food, water, medication or equipment
– Examples:
  • Hepatitis A, salmonella, Typhoid Fever
   5. Vectorborne Transmission

– vectors transport
  disease
   • mosquitoes, flies, ticks,
     rats and other vermin
     transmit disease
– Examples:
   • rabies, malaria, Rocky      Tick
     Mountain Fever
           How Microorganisms
             Grow in Humans
• Need:
  – food
  – oxygen
     • aerobes-need oxygen
     • anaerobes-do not need oxygen
  – temperature
     • 98.6 F or 36 C or warmer
  – moisture
  – pH
     • acidity or alkalinity
     Natural Defenses of the Host
• Hairs                      • Natural Immunity
   – cilia                      – childbirth & disease
                                  process
• Fluid
   – tears, ear wax, blood
                             • Phagocytosis
                                – cells that can destroy
• Skin Tissue                     bacteria
   – intact and healthy
                             • Normal flora
• Proper Rest                   – bacteria present that do
• Proper Nutrition                not normally cause
                                  disease
                                – streptococci
                Predisposing Factors
                    for Disease
•   Poor nutrition         • Age
•   Fatigue                  – very young
                             – very old
•   Poor health habits
                           • Medical treatment
•   Pre-existing illness
                             – chemotherapy, radiation
•   Gender                     therapy, bone morrow
•   Genetics                   transplants, immuno-
                               suppressed conditions,
•   Climate/Weather            indwelling catheters
•   Occupational
         Knowledge Assessment
• 1. Give the definition for microorganism.
• 2. List two examples of virus, bacteria, and fungi.
• 3. List the 3 required elements of the infection cycle.
• 4. Compare and contrast contact, droplet, and
  airborne transmission of microorganisms.
• 5. List five natural defenses of the body.

				
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posted:12/10/2012
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