Section 8: Infection Control

What is infection?

The CDC is charged with the investigation and control of various diseases, especially those that are communicable and have epidemic potential. The CDC also develops guidelines and recommends safety precautions to protect healthcare workers and others from infection. The National Institute for Occupational Safety and Health (NIOSH), which is part of the CDC, is responsible for conducting research and making recommendations for the prevention of work-related illness and injury. 

Healthcare associated infections (HAI) is a term that applies to infections acquired during healthcare delivery in all healthcare settings, including home care. HAIs can result from contact with various sources, including infected personnel, other patients, and visitors, as well as contaminated food, drugs, or equipment. The most common HAI is a urinary tract infection (UTI). UTIs account for over 30% of all HAIs. A Nosocomial Infection is where a bloodborne pathogen is contracted in a healthcare setting. According to the National Conference of State Legislatures, between 5-10 percent of patients will contract a nosocomial infection. We will learn more about specific bloodborne pathogens in the next section.

1. Agents are infectious microorganisms such as viruses, bacteria, fungi, and parasites.

   • BREAK THE CHAIN HERE: Prevent infectious agents' existence through sanitization, disinfection and sterilization.

2. The Reservoir is the location in which the microorganism is living. This can be a person, animal, food, water, insect, countertop or any other surface where the germ can survive. 

   • BREAK THE CHAIN HERE: Handwashing, healthy living, and housekeeping can prevent disease from surviving in reservoirs. Healthy living includes immune boosting activities such as eating good food, taking vitamins, drinking water, exercise, and up to date immunizations. Housekeeping refers to keeping your living and work areas clean and sanitized. 

3. Portal of Exit refers to the method by which the microorganism leaves the reservoir. Coughing, sneezing, blood, feces, bodily secretions and excretions, and open skin/wounds, are examples of this. 

   • BREAK THE CHAIN HERE: If a person is sick with an illness, to prevent spread they should isolate themselves until well (stay home when they are sick), sterilize things they touch, use masks if necessary, cover coughs, wash hands, avoid touching  or breathing on other people. specific measures taken will, of course, depend on what kind of illness the person has and how it is spread. 

4. Mode of Transmission is how the microorganism travels from the reservoir to the susceptible host. Transmission occurs by direct or indirect physical contact with fomites (objects or materials which are likely to carry infection, such as clothes, utensils, and furniture). Airborne transmission, droplets by coughing or sneezing, and common vehicle transmission are other ways disease travels. Vehicle transmission can be as simple as touching a common "community" object like a doorknob, telephone, faucet, or pen, and then touching the nose, eyes, mouth and face. Vector borne illness is a transmission of disease passed through an invertebrate, like insects and worms. Parenteral  Transmission is disease that is spread through other portals of exit other than the mouth, such as needlesticks, open wound contact, etc. 

   • BREAK THE CHAIN HERE: Again, HANDWASHING. We touch a lot of germs, so don't touch your face. Wash your hands often. Using PPE such as gloves, masks, goggles, and gowns to protect yourself from disease is also a way to prevent the spread. Using insect repellants to avoid bites is another helpful measure. Sanitization of common vehicles and disinfection and sterilization of exposed locations such as medical offices, operating rooms, and any tools is crucial.

5. Portal of Entry refers to how the microorganisms enter the host. Infection can enter the body through mucous membranes (mouth, nose, eyes, ears, urethra, reproductive parts, anus). They can enter via broken skin. Any small cut is an opening. The integumentary system does an effective job of preventing disease from entering unless there is a breakage in the barrier. Even dry skin that cracks can be a risk for entry of microorganisms.

   • BREAK THE CHAIN HERE: Same as before, handwashing, PPE, avoiding touching of the mouth and face.

6. Susceptible hosts are individuals who have traits that affect their vulnerability to disease. Examples of people who might be at a higher risk of contracting disease are people with immune deficiencies, autoimmune diseases, burn patients, recovering surgery recipients, and the old or very young.

   • BREAK THE CHAIN HERE:  Healthy living can ensure a person is able to avoid belonging to many susceptible groups. Eat wholesome foods, take daily vitamins, drink water, exercise, use stress reduction techniques, get plenty of rest, participate in appropriate immunizations, and cover open wounds till they heal. All of these are techniques that will help a person avoid being a susceptible host. Of course, there are some ailments which are unavoidable. For people who suffer with one of those, additional precautions may be necessary.  

BREAKING THE CHAIN

Breaking the chain of infection involves stopping infections at the source, preventing contact with substances from exit pathways, eliminating means of transmission, blocking exposure to entry pathways, and reducing or eliminating the susceptibility of potential hosts. 

Here are some examples of how to break the chain of infection (some have already been mentioned above):

• Effective hand hygiene procedures

• Good nutrition, adequate rest, and reduction of stress

• Immunization against common pathogens

• Proper decontamination of surfaces and instruments

• Proper disposal of sharps and infectious waste

• Use of gloves and other personal protective equipment (PPE) when indicated

• Use of needle safety devices during blood collection

• Infection control programs

• Insect and rodent control

• Isolation procedures 

For more information and references on the reading material found in Section 8: Infectious Control, click the link below. Test questions will be based on the reading in the sections and not from more information found in external references and website links.