in Rehabilitation Centers GDIPC MOH 26102020 1 1 Epidemiological triangle Consist of The host is the human The environment consists of all external factors associated with the ID: 907840
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Slide1
Basic Infection Control
in Rehabilitation Centers
GDIPC - MOH
26-10-2020
1
1
Slide2Epidemiological triangle
Consist of :
The host is the
humanThe environment consists of all external factors associated with the host. The agent which may be a bacteria, virus, fungus, protozoan,
helminth, or prion.2
Slide3Chain of infection
Infectious agent
Reservoir
Portal of exit
Portal of entry
Mode of transmission
Susceptible host
3
Slide41- The infectious agent
The infectious agent of infection is the first link in the chain
.
the
infectious
agent is a
biological
,
physical
,
or
chemical
entity capable of causing disease
.
Biological agents
may be bacteria,
viruses, fungi,
protozoa, helminths, or prions.
4
Slide5The infectious agent
Some biological agents
have characteristics that make them more successful in causing infection.
To cause disease, these agents must be invasive enough to enter tissues, multiply, and cause some amount of damage.They must be sufficiently virulent to be pathogenic. The infectious dose (the number of organisms required to cause disease) how viable an organism is in the free state also determines whether infection will develop.Host specificity affects organism
success as well.
5
Slide6The infectious agent
Organisms
may also have high
rates of antigenic variation that help to overcome host-immune responses.This is the case with influenza, in which the outer protein antigens change from year to year, necessitating the yearly development of a new influenza vaccine.The ability to develop antimicrobial resistance also provides the organism with an advantage to continue causing infection, despite what was previously appropriate treatment.
6
Slide7Infectivity
Infectivity is an organism's (a bacteria, virus, fungus, parasite, etc.) ability to infect you. You can be infected but not sick, and there are plenty of times when you're infected but the organism doesn't cause disease.
7
Slide8Pathogenicity
Biological term that refers to the ability of microbes to cause a disease in living organism through entering to the host and start multiplying and cause illness .
The degree of pathogenicity of an organism depends upon the following factors such as number of infecting bacteria. route of entry into body.
specific host defense mechanism. non-specific host defense mechanism, virulence factors of the bacteria.
8
Slide92- Reservoir
The
next link in the chain is the reservoir
which is the place in which an infectious agent can survive but may or may not multiply. The reservoir may or may not be the source from which an agent is transferred to a host.There are three common reservoirs of interest: humans animalsenvironment
Common reservoirs associated with HAIs include patients, healthcare personnel, and healthcare equipment and environment.
9
Slide10Path
by
which a pathogen leaves its host. The portal of exit usually corresponds to the site where the pathogen is localized.
3- Portal of exit
Respiratory tract
Genitourinary
tract
Gastrointestinal
tract
Skin/mucous
membrane
Transplacental
(fetus to
mother)
Parenteral
(
percutaneous
via
blood
)
10
Slide11The mode of transmission, the next link in the chain of infection, Transmission occurs when the agent leaves its reservoir or host through a portal of exit, is conveyed by some mode of transmission, and enters through an appropriate portal of entry to infect a susceptible host.
There
are
three main modes of transmissionContactDropletAir borne
4- Modes of transmission11
Slide12Standard Precautions are the minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where healthcare is delivered.
The goal of using standard precautions is to reduce the risk of transmission of microbes from both recognized and unrecognized sources of infection.
Standard Precautions
Hand hygiene • Personal protective equipment (PPE) • Environmental controls • Safe handling and disposal of potentially infectious material (Waste, Sharps, Laboratory Specimens, Proper handling of linen) • Appropriate reprocessing of instruments and equipment following use • Aseptic practices. COMPONENT OF STANDARD PRECAUTIONS?
12
Slide13Direct-contact
transmission
Direct-contact transmission also can occur between two patients (e.g. by hand contact), with one serving as the source of infectious microorganisms and the other as a susceptible host.Contact transmissionIndirect-contact transmission involves contact of a susceptible
host with a contaminated intermediate object, usually inanimate, in the patient's environment.Some organisms, such
as MRSA or vancomycin-resistant enterococci (VRE), may survive for days or weeks in the environment and be available for direct or indirect contact transmission.
13
Slide14Contact precautions
S
W
OSTRENGTHSWEAKNESSTHREATS
patient placement
Use a single-patient room as possible. Consult with Infection Control staff if not possible.
place the patient in isolation room with clinic hand washing sink.
Cohort patients who are infected /colonized with the same organism.
Patient Care Equipment
Use single-patient equipment, left in the room, as possible.
dedicated patient-care equipment (e.g., blood pressure cuffs), multiple devices is unavoidable, clean and disinfect such equipment before use on another patient.
Hand hygiene
Hand hygiene is critical in the care of these patients.
personal protective equipment (PPE)Wear gloves to enter the room. Change gloves as specified by Standard Precautions. Wear a gown to enter the room.
transport
Limit transport, ,cover or contain the infected or colonized areas of the patient’s body.Environment Decontamination
cleaning and disinfection rooms of patients and focusing on frequently-touched surfaces at least daily.
14
Slide15Droplets are generated from the source person primarily during coughing, sneezing, or talking, and during the performance of certain procedures such as suctioning and bronchoscopy.
Transmission via large-particle droplets requires close contact between source and recipient persons because droplets do not remain suspended in the air and generally travel only short distance, usually 3 feet or less, through the air.
Because droplets do not remain suspended in the air, special air handling and ventilation are not required to prevent droplet transmission.
Droplet transmission
15
Slide16Droplet precautions
S
W
OSTRENGTHSWEAKNESSOPPORTUNITIESTHREATS
patient placement
Use a single-patient room as possible. Consult with Infection Control staff if not possible.
Chorting
may be considered for those with similar symptoms.
Maintain at least 3 feet separation between the patient and others. and draw the curtains between bed.
Patient Care Equipment
Use single-patient equipment, left in the room, as possible.
Hand hygiene
Hand hygiene must be done as specified for Standard Precautions.
personal protective equipment (PPE)
Staff should wear surgical mask to enter the room.
transport
Limit transport patient .If transport is necessary, instruct patient to wear a mask and follow Respiratory Hygiene/Cough Etiquette
.
Droplet Precautions are used to provide care to patients with influenza, pertussis, some types of meningitis, undiagnosed respiratory infections, and several other diseases.
16
Slide17Airborne spread is an efficient mode of transmission and may involve varying distances between the source and host. The most efficient means of airborne transmission is by droplet nuclei.
Droplet nuclei are very small,
about 1 to 5 μm, and can be suspended in air for extended periods of time. The size of the particle makes it ideal for inhalation because it is small enough to reach the respiratory tree without being swept up by cilia. The small size of the particle and its ability to remain suspended in air also means that droplet nuclei may spread through ventilation systems.Tuberculosis is the classic example of a disease spread by droplet nuclei.
Air borne transmission
17
Slide18Airborne
precautions
S
WOSTRENGTHSWEAKNESSOPPORTUNITIESTHREATS
patient placement
Airborne Infection Isolation room—AIIR—a negative pressure isolation room
Patient Care Equipment
Use single-patient equipment, left in the room, as possible.
Hand hygiene
Hand hygiene must be done as specified for Standard Precautions.
personal protective equipment (PPE)
Use N-95 respirator or PAPR.
transport
If patients must come out of the AIIR, put a simple mask on them, as a tight-fitting respirator may not be tolerated and is not indicated.
infectious skin lesions must be covered.
18
Slide19The portal of entry refers to the manner in which a pathogen enters a susceptible host. The portal of entry must provide access to tissues in which the pathogen can multiply or a toxin can act. Often, infectious agents use the same portal to enter a new host that they used to exit the source host.
For example, influenza virus exits the respiratory tract of the source host and enters the respiratory tract of the new host. In contrast, many pathogens that cause gastroenteritis follow a so-called “fecal-oral” route because they exit the source host in feces, are carried on inadequately washed hands to a vehicle such as food, water, or utensil, and enter a new host through the mouth.
5- Portal of entry
19
Slide20Respiratory tract
Genitourinary
tract
Skin/mucous
membraneTransplacental (fetus to mother)
Parenteral
(
percutaneous
via
blood
)
6- Portal of entry
20
Gastrointestinal
tract
Slide21Nonspecific factors that defend against infection include the skin, mucous membranes, gastric acidity, cilia in the respiratory tract, the cough reflex, and nonspecific immune response.
Factors that increase the risk of susceptibility are:
Age (Either Very Young Or Very Old)Underlying Medical Conditions E.G. DiabetesTreatments Or Invasive DevicesPoor Nutrition/General HealthBurnsSurgeryImmunosuppression
Host
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Slide24Thank You