Infection Control

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Course Objectives
  1. Describe the steps of the chain of infection
  2. Identify strategies used to prevent disease transmission in healthcare settings
  3. Explain the major components and functions of the immune system
  4. Identify key agencies involved in infection prevention and control
Course Content
Course Creator: Kristen Moylen
Total CE Hours: 1 Credit Hour 
Pace Course #: 586-2109-24 until 9/30/2026 then  
586-2707-26 until 9/30/2028

Key terms: 
Medical asepsis
Standard precautions
Healthcare-associated infection (HAI)
Personal protective equipment (PPE)
Vector 
 
Outline:
I. Introduction
  • Purpose and importance of infection control
  • Learning objectives:
II. Key Infection-Control Terms
  • Medical asepsis
  • Standard precautions
  • Healthcare-associated infections (HAIs)
  • Pathogens
  • Transmission
  • Personal protective equipment (PPE)
III. The Chain of Infection
A. Infectious Agent
  • Definition of an infectious agent
  • Major types of pathogens: 
    • Bacteria
    •  Viruses
    •  Fungi
    •  Protozoa
    •  Helminths
B. Bacteria
  • Normal microbiota
  • Pathogenic bacteria
  • Bacterial classification:
    • Morphology and arrangement
    •  Oxygen requirements
    •  Staining characteristics
  • Culture media:
    • General-purpose
    •  Enriched
    •  Selective
    •  Differential
  • Bacterial shapes:
    • Bacilli
    •  Cocci
    •  Spiral-shaped bacteria
    •  Vibrio
  • Gram-positive and Gram-negative bacteria
  • Antibiotic susceptibility and resistance
C. Viruses
  • Viral structure and replication
  • DNA and RNA viruses
  • Examples of viral diseases
D. Fungi
  • Superficial, cutaneous, and systemic infections
  • Mycoses
  • Common examples of fungal infections
E. Protozoa and Helminths
  • Definition of parasites
  • Single-celled protozoa
  • Parasitic worms
F. Reservoir
  • Definition of a reservoir
  • Common reservoirs: 
    • People
    •  Animals
    •  Food and water
    •  Soil
    •  Healthcare equipment and surfaces
G. Portal of Exit
  • Respiratory secretions
  • Blood
  • Feces
  • Urine
  • Drainage from wounds
  • Other bodily fluids
H. Mode of Transmission
  • Direct transmission
  • Indirect transmission
  • Contact transmission
  • Droplet transmission
  • Airborne transmission
  • Common examples of diseases transmitted by each route
I. Portal of Entry
  • Eyes
  • Nose
  • Mouth
  • Respiratory tract
  • Broken skin
  • Mucous membranes
  • Invasive devices and needlestick injuries
J. Susceptible Host
  • Weakened or compromised immune system
  • Immunosuppressive medications and treatments
  • Extremes of age
  • Chronic illness
  • Lack of vaccination
  • Other factors that increase infection risk
IV. Breaking the Chain of Infection
A. Infection-Prevention Responsibilities
  • Shared responsibilities of healthcare workers, patients, and the community
  • Interrupting one or more links in the chain of infection
  • Proper use of PPE
B. Standard Precautions
  • Used during all patient care
  • Hand hygiene
  • PPE based on anticipated exposure
  • Safe sharps use and disposal
  • Respiratory hygiene and cough etiquette
  • Cleaning and disinfecting equipment and surfaces
C. Transmission-Based Precautions
Contact Precautions
  • Appropriate patient placement
  • Use of gowns and gloves
  • Dedicated or properly disinfected equipment
  • Limiting unnecessary patient transport
Droplet Precautions
  • Appropriate patient placement
  • Use of a medical or surgical mask
  • Patient masking for source control
  • Limiting transport
Airborne Precautions
  • Airborne infection isolation room
  • Keeping the room door closed
  • Respirator use
  • Limiting patient transport
  • Patient masking during necessary transport
D. Precaution Signage
  • Identifying required precautions
  • Reviewing signage before entering a room
  • Following facility-specific directions
E. Knowledge-Application Scenarios
  • Responding to a patient with symptoms of a respiratory infection
  • Applying contact precautions when collecting from a patient with active C. difficile
  • Selecting the appropriate PPE
  • Preventing equipment contamination
V. Personal Protective Equipment
A. Common Types of PPE
  • Gloves
  • Gowns
  • Masks
  • Respirators
  • Goggles and face shields
B. Donning PPE
  1. Perform hand hygiene
  2. Put on the gown
  3. Put on the mask or respirator
  4. Put on eye protection
  5. Put on gloves
C. Doffing PPE
  1. Remove gloves
  2. Remove eye protection
  3. Remove the gown
  4. Remove the mask or respirator
  5. Perform hand hygiene
VI. Hand Hygiene
  • Importance of proper hand hygiene
  • Handwashing versus alcohol-based hand sanitizer
  • When to perform hand hygiene:
    • Before and after patient contact
    •  Before an aseptic task
    •  After exposure to blood or bodily fluids
    •  After touching contaminated objects or surfaces
    •  After removing gloves
Common Hand-Hygiene Mistakes
  • Improper management of jewelry
  • Using too little product
  • Cleaning hands for an insufficient amount of time
  • Shaking or waving hands to dry them
  • Touching the faucet with clean hands
  • Touching contaminated surfaces immediately afterward
  • Reducing hand hygiene because of skin irritation
  • Using lotions that are incompatible with gloves or facility products
VII. Methods Used to Eliminate Microorganisms
A. Cleaning
  • Removal of dirt, blood, organic material, and other debris
  • Cleaning reusable equipment before disinfection or sterilization
B. Disinfection
  • Destruction or inactivation of many microorganisms
  • Levels of disinfection:
    • Low-level
    •  Intermediate-level
    •  High-level
C. Sterilization
  • Elimination of all viable microorganisms, including bacterial spores
  • Common methods:
    • Autoclaving
    •  Gas sterilization
    •  Liquid chemical sterilants
    •  Other approved methods
D. Antiseptics and Disinfectants
  • Antiseptics used on living tissue
  • Disinfectants used on equipment and environmental surfaces
E. Engineering Controls
  • Ventilation systems
  • Safety-engineered needles
  • Sharps containers
  • Splash guards
  • Patient-lifting equipment
  • Other built-in safety features
F. Knowledge-Application Scenario
VIII. The Immune System
A. Innate Immunity
  • Body’s first line of defense
  • Physical barriers
  • Chemical barriers
  • Mechanical defenses
  • Nonspecific immune cells
B. Natural Body Defenses
  • Skin and mucous membranes
  • Urination
  • Blinking and tear production
  • Coughing and sneezing
  • Body pH
  • Enzymes
  • Antimicrobial substances
C. Adaptive Immunity
  • Development through exposure to specific pathogens
  • Antigens and immune recognition
  • Production of targeted immune responses
  • Antibody formation
  • Immune memory
D. White Blood Cells
  • Lymphocytes:
    • B lymphocytes
    •  T lymphocytes
    •  Natural killer cells
  • Monocytes:
    • Macrophages
    •  Dendritic cells
  • Neutrophils
  • Basophils
  • Eosinophils
E. Immunological Testing
  • Use of antibodies and immune-based reactions
  • Common tests:
    • Urine pregnancy tests
    •  Fecal occult blood tests
    •  Allergy tests
    •  Infectious-disease antigen and antibody tests
IX. Special Infection-Control Concerns
A. Healthcare-Associated Infections
  • Definition of an HAI
  • Effects on patient outcomes
  • Common HAIs:
    • Clostridioides difficile
    •  Surgical-site infections
    •  MRSA infections
    •  Catheter-associated urinary tract infections
    •  Central-line-associated bloodstream infections
    •  Ventilator-associated events
B. Antibiotics
  • Treatment of bacterial infections
  • Bactericidal antibiotics
  • Bacteriostatic antibiotics
  • Broad-spectrum antibiotics
  • Narrow-spectrum antibiotics
C. Antimicrobial Resistance
  • How resistance develops
  • Genetic changes and selection of resistant organisms
  • Effects on patient care:
    • Fewer treatment options
    •  Longer illnesses
    •  Increased healthcare costs
    •  Greater risk of complications and death
  • Antibiotic resistance over time
D. Bloodborne Pathogens
  • Occupational exposure risks
  • Safe handling of needles and sharps
  • Use of safety-engineered devices
  • PPE and standard precautions
  • Hepatitis B vaccination
E. Response to an Occupational Exposure
  1. Perform immediate first aid
  2. Wash skin exposures with soap and water
  3. Flush exposed eyes, nose, or mouth
  4. Report the exposure promptly
  5. Seek immediate medical evaluation
  6. Complete required documentation
  7. Follow recommendations for testing and post-exposure treatment
IX. Public-Health Reporting and Surveillance
A. Notifiable Diseases
  • Diseases and conditions that must be reported
  • Differences in state and local requirements
  • Reasons a condition may be reportable:
    • Communicability
    •  Severity
    •  Outbreak potential
    •  Need for public-health intervention
B. Case Surveillance
  • Identification and tracking of suspected or confirmed cases
  • Recognizing trends and outbreaks
  • Monitoring disease spread
  • Guiding prevention and control measures
  • Evaluating public-health interventions
XI. Key Infection-Control Agencies
A. Centers for Disease Control and Prevention
  • Infection-control guidance
  • Standard precautions
  • Disease surveillance
  • Outbreak investigation
  • Public-health education
B. Occupational Safety and Health Administration
  • Protection of healthcare workers
  • Bloodborne Pathogens Standard
  • Exposure-control plans
  • PPE requirements
  • Hepatitis B vaccination access
  • Post-exposure evaluation and follow-up
XII. Conclusion

References:
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