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Module 3.

0 Infection Control

RET 1024 Introduction to Respiratory Therapy

Infection Control
Nosocomial Infection;
An infection acquired after hospitalization - AKA: hospital-acquired infection

Infection Control
Nosocomial Infection;

Account for an estimated 2 million infections and 90,000 excess deaths annually

Infection Control
Nosocomial Infection
Infections acquired by those in the intensive care unit (ICU) account for >20% of all HAIs (CDC 2007)
Immunocompromised by disease and/or treatment Major trauma Respiratory failure Myocardial infarction CHF Overdose

Infection Control
Nosocomial Infection
Approximately 25% of patients undergoing mechanical ventilation develop pneumonia as a complication

Infection Control

Nosocomial Infection
Approximately 30% of patients who develop ventilatoracquired pneumonia (VAP) will die

Infection Control

Nosocomial Infection
Historically, non-disposable respiratory equipment was identified as a major cause of respiratory infection

Infection Control

Nosocomial Infection
Today, procedures have evolved, and with the advent of single-patient use equipment, infections associated with respiratory equipment have decreased significantly

Infection Control

Nosocomial Infection
Healthcare workers must remain vigilant to protect their patients and themselves against infection; to do so, requires strict adherence to infection control procedures

Infection Control
Infection control procedures aim to:
Eliminate the sources of infectious agents Create barriers to their transmission Monitor and evaluate the effectiveness of control

Infection Control
Spread of Infection
Infection occurs when a pathogen overcomes the barrier of the host
Pathogen; a microorganism capable of producing a disease Host; an organism in which another, usually parasitic, is nourished and harbored

Infection Control

Spread of Infection
Three elements needed to spread an Infection
Source of pathogens Route of transmission Susceptible host

Infection Control
Source of Pathogens
People
Patients, personnel, visitors Acute disease with symptoms Incubation period (exposed, but no symptoms yet) Colonized by pathogens without symptoms Autogenous infection (originating from within the body)

Infection Control
Source of Pathogens
Contaminated objects
Equipment Linen Medication

Infection Control
Transmission Route
Contact Droplet Airborne Common vehicle Vectorborne
NOTE: Some organisms may be spread by multiple routes

Infection Control
Contact Transmission
Direct Contact
Body-surface-to-body-surface contact (person-to-person)

Indirect Contact
Contaminated object (fomite) to host contact
Clothing (uniforms, lab coats, isolation gowns) Equipment Dressings Instruments Shared toys

Infection Control
Droplet Transmission
Contaminated respiratory droplets
Discharged into the air (up to 10 feet) during: Coughing, sneezing, talking Suctioning, bronchoscopy, intubation, cough induction Deposited on the hosts mucosal surfaces Nasal mucosa Mouth

Infection Control
Droplet Transmission
Contaminated respiratory droplets
Currently Health Care Infection Control practices Advisory Committee (HICPAC) guidelines state it may be prudent to don a mask when within 6 feet of the patient or upon entry into the room of a patient who is on droplet isolation

Infection Control
Droplet Transmission
Haemophilus Influenzae
Pneumonia / Epiglotitis

Influenza virus Rubella (German measles)

Infection Control
Airborne Transmission
Contaminated droplet nuclei
Residue of evaporated water droplets containing infectious microorganisms Can remain suspended in air for long periods Respirable particles of less than 5 m

Dust particles
Act as fomites

Infection Control
Airborne Transmission
Mycobacterium tuberculosis (TB) Mycobacterium Tuberculosis Rubeola (Measles) Varicella-zoster (Chicken Pox)
Note: Special air handling and ventilation, as well as respiratory protection are required

Infection Control
Common Vehicle Transmission
Pathogens in water and food
Food
Salmonellosis Hepatitis A

Water
Shigellosis Cholera

Medications (e.g., heparin solution)

Infection Control
Vector borne Transmission
Animals or insects transfer pathogens
Malaria West Nile Virus Rabies

Note: Vectorborne transmission are of little significance in hospital-acquired infections

Infection Control
Spread of Infection to the Lungs
Pathogens enter the lungs via:
Aspiration of contaminated Oropharyngeal secretions Gastric secretions

Inhaled droplets, droplet nuclei, or dust particles containing pathogens (fomites) Hematogenous
Via the blood

Infection Control

Host
Host infection dependent upon:
Virulence of the organism

Resistance of the host