Infection Control
Script
Note: This script may vary slightly to the recording
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Segment 1
In this segment I will introduce to infection control, explain the desired outcomes, what the objectives are, what history taught us and how disease spreads
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Infection Control Standards are in place with the expectation that Consumers, staff and visitors will be have improved safety, that staff will have an increased awareness of the importance of sound infection control practices and facilities will identify consistent and applicable infection control baseline for services
So what does that all mean?
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Essentially it means that the overall objectives of Infection Control practices will
- Minimize risk – so that everyone in the environment will be protected and free from harm or risk of infection. This includes consumers, staff and visitors
- It places the onus on organizations to be accountable for their practice by continually improving the quality of care and safeguarding high standards of care
- That staff will be provided with the resources in which to carry out their work
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- The organization will have documented Policies and procedures in place to help staff understand what to do and to prove they are following sound infection control practices
- That staff will be Educated in these safe practices
- All infections will be recorded and evaluated
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However in order to understand why Infection Control practices are important it is good to revisit history because like today, people did not understand the importance hands played in passing on infections.
In 1847 an Austrian Professor Dr Ignez Semmielweis, was the first person to note the connection between hands being a source of infection. He noted that in wards where midwives worked delivering babies, the death rate was very low but on the wards he worked in the rate was very high. It got to a point where women wouldn’t come into hospital to have their babies as they new they would die.
When one of his students, Jakob Kolleska, died of similar symptoms to the women in the maternity annex, he reasoned the difference between the student doctors and the midwives was his students spent time in the mortuary examining bodies as part of their training but midwives didn’t go near the mortuary. He then implemented a strict hand washing policy and got all his student doctors to wash their hands in buckets of carbolic (soap) that he placed in the wards and instructed them wash their hands on entering the ward and when they examined any women. He enforced the importance of clean hands before they touched the mothers. Consequently, the infection rate dropped and women stopped dying. Today, hand washing still remains the best defense against cross infection.
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Then shortly after that, 1854 Florence Nightingale reasoned the environment was the source of infection and the proximity of beds played a part in people being infected with organisms and she spent her time on building design.
Today buildings are designed to reduce cross infection and all health professionals are trained in sound infection control practices to help reduce risk of infections. When an outbreak occurs it generally indicates there has been breakdown in hand washing and cleaning standards.
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In 1929, Alexander Fleming discovered penicillin. He found that a fungal colony he was working on had grown a bacteria, staphylococcus aureus, around it and these cells were dying. This fungal colony was known as Penicillin Notatum.
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However it wasn’t till 1945 that two people name Florey and Chain were able to develop it in any quantities because Penicillin Notatum was very unstable. While antibiotics were hailed the wonder drug, unfortunately with it’s over use we have developed far greater problems than was ever envisaged. We will talk more about the effects of antibiotic misuse in later slides.
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So if one of the objectives of sound infection control practices is to minimize risk. Who exactly is as risk? They are the people which include you, and your families, your clients and their families
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The environment in which you work and live and includes your home, where you work and of course your clients or residents homes as well.
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and of course the community in which you are all part of. Micro-organisms are all around us. People think they need to have known they are exposed to an infection to get sick but this is not so. We come into contact with micro-organisms every day of our life. Some are harmful and some are not. A lot depends on your immune system and your body’s ability to combat the micro-organisms and will determine whether you become unwell or not.
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How does disease spread? Here we will discuss the 3 elements that are necessary for infection to spread. This should help explain the reason behind infection control practices and why it is important for them to be implemented
Firstly you need to have a susceptible host this is the body. The organism has to have something to live on. Remember objects and surfaces can also be hosts to harbor organism which is why cleaning is so very important
Secondly the organism has to be provided with the right environment for it to multiply and the body doesn’t have the ability to resist it.
Thirdly if a person has a sickness or disease where their immune system doesn’t have the ability to fight off infections, then they are going to be more at risk.
So who are these people? For examples a person with diabetes or leukemia will not be to resist infections that well. Older people, or people with chronic debilitating diseases are also at risk as are people who are in a coma or have suffered a traumatic injury or surgical procedure. In fact anyone who is undergoing any aggressive treatment doesn’t have the ability to fight off infections. .
Now some people have had a previous exposure to the organism which may give them the ability to resist the damaging effects of the organism or if the person is really healthy they too will be able to resist it. Some people are what are known as carriers which means they do not show any signs of being affected by the organism but they can infect others.
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How does the organism get into the body? This is called transmission on infection
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and they fall into the following categories
Contact, direct or indirect,
Airborne/Droplet,
Airborne,
Ingestion and
Vectors. I will talk about each of these separately.
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Contact transmission: This can divided into direct contact which is directly from person to person.
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and indirect contact where it is transmitted from an object like a piece of clothing, instruments like forceps or scissors, equipment like a wheel chair or a utensils like a knife or fork
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Airborne/Droplet transmission. This is where large droplets are expelled into the air by coughing, sneezing, talking and during any procedures which may generate droplets like suctioning i.e. a person with a tracheostomy that requires suctioning frequently.
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Airborne Transmission: Is where there are smaller micro-organisms that are dispersed into the air like virus, or airborne dust particles. These are then inhaled or deposited on a susceptible host or settle on surfaces where a person can become infected
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Ingested: This mean that a person can become infected by drinking contaminated water or eating contaminated food. Once the organism enters the body it becomes active and causes people to become unwell
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Then we have Vectors. These are such things as Flies, mosquitoes, rats, mice and birds. This is why it is important to keep food covered away from vectors, as they can infect food and make people unwell.
Segment 2 Slide 1
In this segment I will discuss the virus of infections, how they enter the body and what the organisms look like. We are now going to take a more in-depth look at virus’, bacteria’s’ parasites and fungi.
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Firstly let’s look at virus. These are very common and mostly affect the nose, throat, upper respiratory tract but can infect any part of the body.
A virus is a very small organism that enters the body as a single cell where it injects a substance into another cell. The original organism then dies but the substance then reproduces and infects other cells.
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Virus Transmission- Virus’ can be transmitted through droplet or airborne infection where a person inhales it through their nose or ingested which means they swallow it through their mouth. If you look at the picture you can see how it is transmitted from the man sneezing/coughing. Those little droplets are floating around in the air and if you are a susceptible host, with a poor immune system you are at risk of receiving the virus.
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You can also contract a virus through the skin by a needle like HIV and Hepatitis B or C or through direct contact by having unprotected sex contact and contract herpes (warts, cold sores) HIV. They can also enter the body through a vector like mosquitos who carry Dengue Fever. Virus’ can also enter the body by eating contaminated food, drink or utensils. Common virus’ contracted by ingestion are rotavirus, gastroenteritis (noro-virus) or polio
Virus can also float around in the air and you will have no idea that you have become infected. For example, often a child will get chicken pox yet you are not aware of them being in contact with someone with it or glandular fever or rotavirus (diarrhea and vomiting) or viral meningitis. So you see they often float in the air and if your body provides the right environment, you may get the virus.
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Now let’s take a look at what virus look like and how they relate to different conditions. Firstly let’s look at Influenza. Remember a virus starts off as a single cell. You can see this in the first picture then it infects other cells and in the case of influenza the virus’ forms a chain which is why it stays around in your body for a while.
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When you look at the Herpes Virus can see how one cell is invaded by the virus. The herpes family can affect different parts of the body. Firstly there is the cold sore which many of you may be familiar with. Then there is shingles. Some of your clients or residents may have had this. Then there is chicken pox, really common in children but rare in adults and then there is Genital herpes commonly referred to as genital warts. They are the same thing all caused by the viral family.
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Now if you look at Hepatitis A virus. You will see it is different but still starts as a single organism. Hepatitis A used to be known and Infectious hepatitis as it is contracted through ingestion of the virus in contaminated food or eating from contaminated utensils. This is not so common now in developed countries but is still a problem in developing countries. You can see on this map of the world the countries that are at risk. Hygiene is really important in preventing the spread of this disease and making sure food does not get contaminated by people or vectors.
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Now let’s look at something that is really common – yes the wart. You may even have one of these or have had one in the past. It looks just like this picture. Generally warts are not painful but if occur on the feet and are called Verruca’s or sometimes Planter Warts and these can be very painful.
Segment 3 Bacteria
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In this segment we will look at bacteria. While there are many different bacteria, we will only look at Staphylococcus Aureus, Streptococcus, Escherichia Coli which is known commonly as E-Coli and Pseudomonas
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Bacteria
Bacteria’s are a large group of small single cell organisms that don’t have a nucleus. They normally exist in millions and not all bacteria are harmful to us, in fact they are very helpful and necessary for our body function. This is what is classed as normal flora for our body. They are neither plant nor animal but belong to a group all by themselves.
However when these bacteria’s get out of its normal happy environment, they can make us very unwell and sometimes people can die from the infection.
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Bacteria come in a variety of shapes from spheres, rods and spirals as you can see in the picture below. There are many different bacteria’s but to illustrate them and what they look like I will discuss later 4 common bacteria in some later slides so you can understand them. They are Staphylococcus, Streptococcus, EColi and Pseudomonas.
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However lets first look at where bacteria are found. It may surprise you just where they live.
Soil In this picture you can see bacilli bacteria in soil
They can also be found in radioactive waste
You can see in this picture bacteria on uranium waste.
When water was put under the microscope you can see bacteria floating around in it. Now don’t get paranoid about this. In most developed country our water is really safe to drink however if you are travelling in developing countries you are best to stick to bottled water.
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Plants can also harbor bacteria and you can see on this tomato how the bacteria has affected it. You obviously wouldn’t eat this. It doesn’t look that attractive does it. This is why you must wash all your fruit and vegetables before you eat them.
Animals too carry bacteria on them as well but as I said earlier Bacteria’s are very small and you often don’t see them but if you have a healthy and robust immune system you should be okay. Being exposed to the average household pet can in fact boost your immune system
Deep in the earth's crust you will find bacteria as well but it is confined there and often does good rather than harm
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Organic material has bacteria’s in it as well and is what is necessary to break down waste for compost. Now you wouldn’t eat the compost but you wouldn’t have the manure if the bacteria wasn’t there to do its job
Even in the Arctic ice there is bacteria that can withstand the cold and of course are necessary for the survival of the arctic which proves that bacteria are extremely adaptable.
Glaciers The same goes for glaciers – bacteria can survive there as well.
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It is obvious that bacteria can survive in hot springs as usually the heat makes bacteria multiply. If you have ever been to a hot spring you will be told not to put your head under the water. This is to keep you save so you won’t inhale or ingest bacteria into your body and become unwell.
Bacteria has even been discovered inthe stratosphere (between 6 to 30 miles up in the atmosphere) and in the oceans deep under the water.
Bacteria is everywhere. You are coming in contact with them every day of our life and most of the time they are not harmful to you. You remain healthy. It is nothing to panic about, just be aware that they are around and know when they are in their natural environment, they are happy and generally harmless.
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So now let’s look at some of the common bacteria’s you may know and I will show you what bacteria look like. Firstly there is Staphylococcus. Staphylococcus naturally lives on the skin
This bacteria lives very happily on our skin and mucous membrane especially the nose
Staphylococcus aureus only becomes a problem when it gets away from its normal environment and enters the body though broken skin. Therefore this bug is most common in cellulites, boils, abscesses, and impetigo which are all generally very localized infections and is common in urinary tract infections too. You can see in the picture this picture how it the staphylococcus infection has travelled under the skin to cause a cellulitis. However when it gets into the blood stream it can cause osteomyelitis,, bacteremia endocarditis and a number of other conditions.
It is transmitted through being in contact with it directly.
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It gets its name from the word Staphyle which is Greek for bunch of grapes and kokkus meaning berry. You can see on this picture that this is what they look like. There are many different strains of Staphylococcus but the most common is Staphylococcus Aureus.
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These are ball shaped bacteria. Coccus means round or shaped like a ball. That is a clue when you hear the name of a bacteria and as they multiply they form a group.
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As I said earlier, staphylococcus is not a problem for healthy people but when it enters the body through an open wound or through the mucous membrane as in via the urethra into the bladder, it will become a problem. It is common in Urinary Tract Infections.