Chapter 1: Infection Prevention and Control

1.2 Infection Prevention and Control Practices

Critical Thinking Exercises: Questions, Answers, and Sources / References

Critical thinking questions are in bold type, and the answers are italicized. Additional resources or references are provided below.

  1. Name six elements in the chain of infection.
  • Infectious agent: micro organism, pathogen, disease causing organism
  • Reservoir: the natural environment that a pathogen needs for survival
  • Portal of exit: the pathogen has to leave the reservoir
  • Means of transmission: a way for the micro organism to travel, such as: direct contact, indirect contact, ingestion, or inhalation
  • Portal of entry: the way the organism enters the new host
  • Susceptible new host: anyone who is immuno-compromised 

Sources:

Association for Professionals in Infection Control and Epidemiology. (2019). Break the chain of infection. https://professionals.site.apic.org/protect-your-patients/break-the-chain-of-infection/

Center for Disease Control and Prevention (CDC). (2012). Lesson 1: Introduction to Epidemiology. In, Principles of epidemiology in public health practice: An Introduction to applied epidemiology and biostatistics (3rd ed.). https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section10.html

 

2. Identify two things that can be done at each of the points in the chain of infection to break the chain.

Element in Chain of Infection

How to Break / Interrupt the Chain at This Point in the Infectious Process
Infectious agent
  • Pasteurize milk
  • Chlorinate drinking water
  • Use disinfectants
Reservoir
  • Medical treatment / testing
  • Insect / rodent eradication
  • Quarantine
Portal of exit
  • Cover your mouth and nose when sneezing or coughing
  • Contain stool or urine that carries infectious organisms
  • Avoid kissing or sharing of things where saliva might be exchanged
Means of transmission
  • Wear PPE, including gloves, gowns, masks
  • Use antiseptics on surfaces to reduce risk of indirect contact
Portal of entry
  • Use principles of asepsis when:
    • Changing dressings to avoid introducing organisms into wounds
    • Inserting catheters to avoid introducing organisms to urinary tract
    • Using masks to prevent airborne transmission
    • Using negative pressure rooms
    • Pericare
Susceptible host
  • Separate people with known or suspected infectious disease from others

Sources:

Association for Professionals in Infection Control and Epidemiology. (2019). Break the chain of infection. https://professionals.site.apic.org/protect-your-patients/break-the-chain-of-infection/

Centers for Disease Control and Prevention (CDC). (2012). Lesson 1: Introduction to Epidemiology. In, Principles of epidemiology in public health practice: An introduction to applied epidemiology and biostatistics (3rd ed.).  https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section10.html

 

3. What types of patients are at an increased risk for an hospital acquired infection (HAI)?

Answer: Patients at risk for hospital acquired infection include pretty much anyone in hospital. If they are sick, they are immuno-compromised. This includes those with tubes, on medications that suppress the immune system, anyone with non-intact integument, the elderly, and the very young.

 

4. How can healthcare providers reduce patient susceptibility to infection?

Answer: Consistent use of routine practices at all times and in all healthcare settings reduces patient susceptibility to infection. The principles of routine practices are based on the premise that all patients are potentially infectious, even when asymptomatic, and infection prevention and control practices should be used to prevent exposure to blood, body fluids, secretions, excretions, mucous membranes, non-intact skin, or soiled items (PIDAC, 2012a).

This includes:

  • Point of care risk assessment prior to each patient interaction
  • Good hand hygiene practices
  • Proper cleaning and disinfecting procedures
  • Respiratory etiquette: cover mouth and nose, preferably with one’s elbow, when coughing and sneezing; proper disposal of tissues; wear a mask if indicated; stay home if sick
  • Wear clean gloves if risk of coming into contact with blood or body fluids
  • Use additional precautions if necessary
  • Staff not eating or drinking in patient areas

Sources:

Centers for Disease Control and Prevention (CDC). (2007). Part III: Precautions to prevent the transmission of infectious agents. In, Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings. http://www.cdc.gov/hicpac/2007IP/2007ip_part3.html

Centers for Disease Control and Prevention (CDC). (2014). Types of healthcare-associated infections. http://www.cdc.gov/HAI/infectionTypes.html

Perry, A. G., Potter, P. A., & Ostendorf, W. R. (2017). Clinical nursing skills and techniques (9th ed.). Elsevier; Mosby.

Provincial Infectious Diseases Advisory Committee (PIDAC). (2012a). Routine practices and additional precautions in all health care settings (3rd ed.). http://www.publichealthontario.ca/en/eRepository/RPAP_All_HealthCare_Settings_Eng2012.pdf

Public Health Agency of Canada (PHAC). (2012b). Routine practices and additional precautions for preventing the transmission of infection in healthcare settings. http://www.phac-aspc.gc.ca/nois-sinp/guide/ summary-sommaire/tihs-tims-eng.php

Public Health Agency of Canada (PHAC). (2013). The Chief Public Health Officer’s report on the state of public health in Canada: Infectious disease, the never ending threat. http://www.phac-aspc.gc.ca/cphorsphc-respcacsp/2013/infections-eng.php#a8

World Health Organization (WHO). (2009). WHO guidelines for hand hygiene in health care: First global patient safety challenge. http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf?ua=1

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