Chapter 10: Principles of Infection Control and OSHA Standards

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College (Clinical Medical Assisting) Clinical Medical Assisting Fichas sobre Chapter 10: Principles of Infection Control and OSHA Standards, creado por La'Shae el 11/07/2015.
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Epidemiolody study of infectious diseases
Normal Flora Microorganisms are helpful, providing protection and promoting the survival of plants, animals, and humans
Pathogens Microorganisms that cause disease
Chain of Infection -causative agents -reservoir -portal of entry -means of transmission -portal of entry -susceptible host
Viruses submicroscopic parasites and the smallest organisms. Nonliving because they lack DNA or RNA can live outside the body will vary from minutes to days classified as intracellular parasites
Bacteria single celled microbes that lack a nucleus yet are capable of carrying out everyday life functions most prevalent lives everywhere Can be nonpathogenic or pathogenic -nonpathogenic: normal flora, Pathogenic: strep throat
Fungi develop as single celled or multiple pathogenic or nonpathogenic includes yeast and molds
Parasites must live in another organism to receive their nutrients multicellular or unicellular
Parasite Types -protozoa: single celled, causes malaria, amoebic dysentery, and vaginal trichomonas infections -metazoa: multicelled pathpgens that cause hookworms, pinworms, tapeworms, and trichinosis -ectoparasites: multicelled pathogens that live on the surface of a host, like lice
Rickettsiae a type of bacteria known as obligate parasites, because they require a living cell to grow -transmitted by arthropods: lice, fleas -typhus, lime disease
Reservoir -anything can be a reservoir - humans, animals, water, food
Breaking the Chain in the Reservoir -disinfect work areas, equipment, and supplies -wear gloves and other personal protective equipment -regularly perform medical aseptic handwashes
Portal of Exit -pathogens spread from person to the next by portal of exit -can leave through fluids or drainage of respiratory tract, gastrointestinal tract, urinary tract, skin, reproductive tract, and mucous membranes -pregnant women can pass pathogens through the placenta into the baby's bloodstream
Mode of Transmission pathogens must have a method of transmission from one individual to another
Modes of Transmissions -direct transmission/contract: transmitted through physical contact: kissing, sexual contact -indirect transmission/contact: ingestion of contaminated food or drinks, vectors, and fomites, contaminated nonliving objects such as water glasses -droplet transmission: through coughs or sneezes; can pass through portal of entry
Portal of Entry -portal of entry and exit may be the same -can be inhaled, ingested, absorbed, or transmitted
Susceptible Host -people who are immunosuppressed (immune has been suppressed of weakened) are more at risk -people who have undergone a trauma, or surgical procedure
Environmental Requirements -Proper nutrition -Oxygen; some grow without-anaerobes; grow with-aerobes; can grow with or without; facultative aerobes -temperature: optimal is normal body temps (98.6F), can be between 77F and 104F -Proper pH: grow best in neutral pH approx 7.0 -darkness: most grow best in the dark -moisture: provides a good environment for microorganisms to grow and multiply
Wound Care always keep the outer layer of dressings dry to prevent microorganisms from getting in the wound
Invasion and Multiplication Stage -the first stage of the infection process -the pathogenic enters the body and begins to multiply -no identifiable signs or symptoms during this stage
Incubation Stage the period of time between exposure to the pathogen and the appearance of the first signs and symptoms -some diseases have short incubation period while others can last years
Prodromal Stage the interval of time between the appearance of the first signs and symptoms and the appearance of definitive symptoms -patient may complain of malaise
Acute Stage reaches its peak; symptoms are well developed
Declining Stage the symptoms begin to subside; infection still present; patient begins to return to the previous state of health
Convalescent Stage the point where the patient recovers from the infectious disease, and returns to normal state of health
External Natural Barriers -intact skin: keeps them from getting into deeper tissue -eyelids and eyebrows:help keep debris and microorganisms away from the eye -tears: wash debris out of the eye
Internal Natural Barriers -mucous membranes: within the respiratory tract, genital region, and GI tract help trap them white blood cells assist in destroying them -cilia: small hairs found in the respiratory tract that trap them, and sweep debris out the body -coughing and sneezing -acids: within the stomach and vagina provide hostile environment that hinders growth
Inflammation -the body's attempt to protect itself; heals and replaces injured issue -inflammation and infection are not synonymous; you can have inflammation without infection, but cannot have infection without inflammation -may be classified as local or systemic
Inflammation- continued -sometimes is not enough to stop the infection -indicated by pus, swelling of lymph nodes, or septocemia(when the pathogen enters the blood stream) -antibiotic therapy
The Immune System -recognizes, suppresses, fights, and removes pathogens -promotes immunity -provides resistance -Macrophages: engulfs and swallows pathogens -T Cells(lymphocytes), B Cells, and protein particles
Immune Response -cell mediated (T-Cells): involved in attacks against cancer cells and infections caused by fungi and viruses; responsible for delayed hypersensitivity reaction with organ transplants -humoral immunity (B-Cells): turn into plasma lymphocytes and produce antibodies, they neutralize antigens rather than destroying them, the interlock like a puzzle piece with the antigen
Natural Immunity occurs naturally as a result of being exposed to the pathogen
Natural Passive Immunity antibodies can be passed from mother to fetus or by genetic inheritance -certain races are immune to specific diseases
Natural Active Immunity immunity is developed as a result of direct exposure to the antigen (when infection occurs)
Artificial Passive Immunity result of being injected with either the antigen or antibodies
Artificial Passive Immunity occurs when the patient is given direct antibodies (immunoglobulins) to fight off infection
Artificial Active Immunity occurs when the patient is given small amounts of the antigen (through immunization) to stimulate an antibody reaction so that by the time the body is exposed to the antigen it already has antibodies ready to attack
Immunizations -provide immunity against specific infectious diseases -the U.S Department of Health and Human Services (HHS) strongly recommends that preschoolers under age two be fully vaccinated
Live Attenuated Vaccines -are weakened form of a pathogen, altered by the manufacturer using a specific chemical or mechanical process -stimulates the immune system to produce antibodies against the pathogen without causing the patient to contract the disease itself Example: tuberculosis (BCG), measles, mumps, rubella (MMR), and smallpox
Toxin Vaccines or Antitoxins -are toxins produced by pathogens, which have been extracted from the gamma globulin portion of the blood from humans and animals who have been vaccinated against a specific disease -the immune system is stimulated to produce antibodies against the specific pathogen -examples: tetanus antitoxin and diphtheria antitoxin
Killed Vaccine -inactivated pathogens (killed by physical or chemical means to make them harmless) -will stimulate antibody production by the immune system -a series of vaccine may be needed to produce long time immunity -examples: whooping cough, rabies
Medical Asepsis -destruction of microorganisms after leaving the body -handwashing, practicing Standard, Universal, and Transmission based Precautions, cleaning countertops, flooring, and exam tables, using PPE as barriers
Good to Know - all blood and bodily fluids should be considered potentially infectious. -during early stages of disease many people are unaware they are infected, signs and symptoms may not be present
Resident Flora -normally found in the epidermis and dermis layers of the skin and is harmless
Transient Flora normally found in the superficial layers of the epidermis and is picked up through direct contact. Ex: doorknobs, people, surfaces -may be harmful
When to Wear Gloves Risk of Contact with -blood -other potentially infectious material (OPIM) -nonintact skin -mucous membranes -sterile gloves should be worn when performing a sterile procedure
Sanitization the proces
Disinfection is the use of chemical agents to destroy pathogenic organisms -performed on inanimate (nonliving) objects like counter surfaces -not used on skin, can be irritating to the skin and mucous membranes
Sterilization is the complete destruction of all microorganisms and is the process that should be used on any instrument that will penetrate the skin.
Autoclaving the process in which heat, steam, and pressure are used to destroy all forms of microorganisms, including large numbers of spores
Universal Blood and Body Fluid Precautions (universal precautions) -standards and guidelines that help control the transmission of HIV and the hepatitis B virus -1987
Standard Precautions -established in 1996; its a new set of guidelines which includes the previous Universal Precautions, as well as body substance isolation (BSI)
Body Substance Isolation (BSI) takes universal precautions to the next level by requiring barriers for all body substances, including secretions that are not considered OPIM (except sweat); tears, saliva, urine
Transmission Based Precautions established in 1996, was designed to decrease the risk of transferring pathogens by direct or indirect contact, or through droplet transmission
Indirect contact/ airborne precautions -use of respirators and surgical masks, placing a patient in a private room with filtered air
Direct Contact Precautions include the use of all PPE, and cleaning all equipment if used by or for more than one paitent
Droplet Precautions include wearing a mask and eye protection or a complete face shield
Acquired Immune Deficiency Syndrome (AIDS) -caused by a bloodborne virus known as the human immunodeficiency virus (HIV) -attacks the white blood cells known as CD4 cells or T-cells
Primary HIV Infection -begins when an individual becomes infected with the virus -large amounts of HIV antigens present -seroconversion (detectable antibodies are present in the serum, causing positive antibody test)
Clinically Asymptomatic Stage -the second stage, may last several years; usually no detectable symptoms -HIV would be present in the peripheral blood stream
Clinically Symptomatic Stage -third stage; starts to show signs of AIDs -starts mild but becomes severe -diarrhea, fatigue, mouth ulcers, nail fungus, thrush, weight loss
Progression of HIV to AIDS -the 4th and final stage; the individual becomes very sick -AIDS is usually fatal
Good to Know the CDC estimates that over one million Americans are now living with HIV, 24% to 27% of those people are unaware
Occupational Safety and Health Administration (OSHA) created in 1971 by the federal government; establishes standards and regulations for all employers to ensure employees work in a safe a healthy environment
Bloodborne Pathogen a pathogen that can be transmitted by means of blood or OPIM
Exposure Control Plan should include -compliance rules for exposure prevention -hepatitis B vaccination, postexposure evaluation, and follow up procedures -a listing of all hazards -guideline for the employee to follow through the reporting process -record keeping procedures
Engineering Controls devices used to separate employees from hazards
Work practice controls methods by which a task is performed
Regulated Waste (infectious Waste) is any medical
Exposure Incidents -must be kept separate from employees personnel record -must be kept on file for the length of the employment plus 30 years
Chemical Exposure Plan -inventory of all hazardous chemicals; chemical name, quantity, physical state, hazard class, and manufacturer -a material safety data sheet MSDS -all chemicals labeled according to the national fire protection Associations color and number method
HMIS Hazardous Chemical Labeling Method Blue- health hazard Red- fire hazard Yellow- reactivity hazard White- PPE
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