Infection Control
Asepsis – a practice that retards the growth of pathogenic bacteria

–	Medical –disinfection
•	Examples are; hydrogen peroxide
•	Chlorine
–	Surgical –sterilization
•	Mostly in OR
•	Must be used during invasive procedures
•	Moist heat most effective method
•	Sterile corridor- the area between the draped patient and the instrument table.

Sterile Technique
•	Opening a sterile package
–	Place in the center of the table
–	Open away from you
–	Do not reach across field 
–	Small packages can be opened in your hand without touching contents and dropped onto a tray
–	When using solutions, check name and date when possible, show to another person
•	Prepping patient skin – start in center working outward in circular motion. Do not go back over area

Pathogens
Nosocomial Infections 
 are those that originate or occur in a hospital or hospital-like setting.
Nosocomial infections are the result of three factors occurring in tandem: 
•	high occurrence of pathogens 
•	high occurrence of compromised hosts 
•	efficient mechanisms of transmission from patient to patient

The sites of nosocomial infections, in order from most to least common, are as follows:

•	urinary tract 
•	surgical wounds 
•	respiratory tract 
•	skin (especially burns) 
•	blood
•	gastrointestinal tract 
•	central nervous system 

•	Methods of prevention (breaking the chain)
–	observance of aseptic technique 
–	frequent hand washing especially between patients 
–	careful handling, cleaning, and disinfection of fomites 
–	where possible use of single-use disposable items 
–	patient isolation 
–	avoidance where possible of medical procedures that can lead with high probability to nosocomial infection 
–	various institutional methods such as air filtration within the hospital 
–	general awareness that prevention of nosocomial infection requires constant personal surveillance 
–	active oversight within the hospital

Cycle of Infection
•	1. pathogen
•	2. source or reservoir of infection
•	3. susceptible host
•	4. method of transmission 
–	a. contact (direct, indirect) 
–	b. droplet 
–	c. airborne/suspended 
–	d. common vehicle 
–	e. vector borne

Standard Precautions
•	1 hand washing- use after each patient 
•	2. gloves- use with blood /body fluid contact 
gowns- Use when clothing contamination can occur
•	3. masks- prevent transmitting airborne pathogen

•	4. medical asepsis –elimination of microorganisms
Transmission-Based Precautions
–	1. airborne 
•	respiratory protection, patient in private negative ventilation room, wear mask
•	Examples: TB, Varicella, Rubeola
–	2. droplet 
•	Patient wear mask, private room
•	Examples: Rubella, Mumps, Influenza
–	3. contact 
•	gloves, gown, mask, patient in private room
•	Examples: MRSA, C-diff, some wounds, Hepatitis A

Disposal of Contaminated Materials
–	1. linens
–	2. needles
–	3. patient supplies (e.g., tubes, emesis basin)

Standard Precautions (they must be practiced on all patients without exception)
•	1. hand washing
•	2. gloves, gowns
•	3. masks
•	4. medical asepsis (e.g., equipment disinfection)
 Protective or Reverse Isolation
•	Strict isolation 
•	Use to protect the patient who is highly susceptible to becoming infected
•	Examples: Chemo, AIDS

Physical Assistance and Transfer
•	Patient Transfer and Movement
•	1. body mechanics 
–	Hold object close to body
–	Keep back straight 
–	Don’t twist
–	Bend at the knees; use legs
–	Push rather than pull

Patient Transfer
•	Stand by assist
•	Assisted pivot
•	3 person lift
•	Cart transfers
Assisting Patients with Medical Equipment

•	1. infusion catheters and pumps
–	IV’s should remain 18-24 inches above the vein
•	2. oxygen delivery systems
–	Never remove patient from oxygen 
•	3. other (e.g., nasogastric tubes, urinary catheters, tracheostomy tubes)
–	Watch tubes when transporting patient. Catheter bags should remain below the level of the bladder

•	Physical signs and symptoms 
–	Diaphoretic –pale, cool skin
–	Fever- hot dry skin
–	Anxiety- sweaty palms
–	Cyanotic- bluish lips
•	Documentation- Chart all information