HLTINF001 Comply With Infection Prevention and Control Policies and Procedures-Practice of Respiratory

Identifies four (4) infection risks/hazards that may be present in a hospital environment. These hazards always need to be to be reported to a senior staff member or manager, documented correctly and control measures initiated.
Build on this table by identifying the likelihood and severity of harm from each hazard/risk by using the risk ranking matrix below, immediate steps that will need to be taken to manage the situation and possible procedures that will need to be put in place (minimum one point in each section).

Contamination of materials, equipment and instruments by aerosols and splatter in an active TB client hospital room 

Determine which personal protective equipment would be required during these cleaning procedures.

However, some individuals are more susceptible to infections than others which require even more stringent care when looking after them. Building on your understanding of infection and its spread, develop a list of 4 susceptible hosts and propose why these hosts are at a higher risk of developing an infection

Understanding the basis of infection is essential when working in a healthcare environment. Demonstrate your understanding of the following terminology.

Terminology
a. Colonisation
b. Infection
c. Disease

The Department of Health, Australia, lists certain habits to maintain good personal hygiene as follows:

• Regular washing of body when water is insufficient.
• Washing the body with sponge or wet cloth or a swim, when there is a shortage of water.
• Cleaning and brushing of teeth every day and hair at least once every week.
• Washing of hands using soap after using the toilet and prior to making or after consumption of food (Pittet, Boyce and Allegranzi, 2017).
• Wearing clean cloths, washing dirty cloths, and drying wet cloths in the sun.
• Covering the nose and mouth while sneezing or coughing (Swan, 2017).

Risk ranking, Severity of harm and Likelihood of risks

Procedures for terminally cleaning of the hospital room:

The following procedures can be undertaken to terminally clean the hospital room:

• Cleaning of the items in the room using hospital grade, EPA approved disinfectant (Rutala, and Weber, 2014).
• For bathroom, the highest surfaces must be cleaned first and the toilet cleaned last.
• Privacy curtains needs to be double packed. The person collecting the laundry bag should wear protective gloves.
• Cleaning of ceiling or walls or window curtains.
• Cleaning and disinfection of clinical equipment.
• Once the room is cleaned, the gloves should be removed and its outer surface should not be touched.
• Hands should be cleaned before and after using new gloves using antimicrobial soap or rubbing with alcohol (Carling, 2017).

High Risk patients:

Patients suffering from HIV: These patients due to the immune compromised state like HIV.

Children, infants and Elderly since their immune systems might not be fully functional.

Healthcare Professionals/ Health Workers are at an increased risk of infection due to their regular exposure to pathogen.

Drug abusers who periodically use hypodermic needles.

Definitions:

1. Colonization: Is a situation in which the germs/ pathogen are living in or on the body of a person but have not caused any disease symptoms.
2. Infection: Is a situation when the pathogen/ germs have invaded the body, causing infection and the onset of symptoms like fever, high WBC count, pus or pneumonia.
3. Disease: It is a situation in which there is a disorder in the normal structure or function of the body and exhibits specific symptoms or affecting particular locations and is not the result of any injury.

Contact:

Here the infection needs a form of touch (direct/ indirect). In direct contact involves physical contact with the infected individual. Indirect contact involves touching an object (Fomite) that is already contaminated by an infected individual. Example: Ebola, Small Pox and Influenza (Gabbard et al., 2014).

Droplet:

The pathogen released from the upper respiratory system because of sneezing, coughing or talking, contained in droplets of moisture, causing disease. Example Tuberculosis and Influenza (Zhang et al., 2013).

Airborne:

Here the pathogens are spread in the air, via tiny droplets (expelled while coughing. Sneezing or talking) containing the pathogen. Example: Measles. (Liu et al., 2017).

Vehicle (borne transmission):

A vehicle, which is a non living object or material (also called “formite”), is contaminated with the pathogen, and infection occurs when a person gets in contact with the formite. Example: Giardia, Cholera.

Vector Borne:

In this form the pathogen is transmitted from one person to another by the means of a vector, which are living organisms. In this case, the pathogen generally remains non infective to the vector, and needs the vector to complete a part of its life cycle. Example: Diseases spread by mosquitoes (WHO, 2014).

Bacteria, Fungi and Virus:

Bacterium are a prokaryotic (without a nucleus), unicellular, microscopic organisms. They generally exist in the shape of spheres, rods and spirals, and are one of the most primitive forms of life on earth. Example: Eschericia coli.

Fungi are eukaryotic (with a true nucleus) organisms, and can be microscopic (like yeasts) or macroscopic (like mushroom). They are heterotrophic like animals, and do not perform photosynthesis. Example: Aspergillus sp.

Virus is a group of microscopic infectious agents that performs the activities of living organism only when inside a host. The virus hijacks the host’s metabolic mechanisms, and uses it to replicate its genetic material, and create more viruses. Example Human Immunodeficiency Virus.

Chain of Infection

This is the infectious agent that invades a healthy organism, multiplies within it, and produces symptoms of disease. Example Salmonella sp

Reservoir: 

This is an intermediate host for a pathogen. The pathogens do not produce disease symptoms inside the reservoir, but uses it to overcome adverse environmental conditions, or between infecting two hosts. Example: Bats/ foxes/ raccoons act as reservoirs for Rabies.

Portal of Exit: 

Is the place from which the pathogen leaves an infected host to enter a new host? Example nose or mouth for the exit of Mycobacterium tuberculosis.

Transmission: 

Is the process of the spread of the pathogen from one host to another, directly or indirectly. Example spread of Malaria or Other infectious diseases.

Portal of Entry: 

Is the place from which the pathogen enters a new host, after leaving the old host. Example- the mouth, for the entry for pathogen causing enteric diseases.

Susceptible Hosts: 

Are the individuals (member of the population) who have the risk of being infected by the pathogen. Example: People with Immunodeficiency.

Respiratory Hygiene and Cough Etiquette:

The National Health and Medical Research Council lists the following six steps to maintain respiratory hygiene and cough etiquettes:

• Covering the mouth/nose using single use, disposable tissue napkins when sneezing, coughing, blowing nose or wiping.
• Using the tissue to contain secretions from respiratory system.
• Disposing the tissue safely after use.
• If tissue is not available, use the inner elbow to sneeze or cough, instead of the hand.
• After contact with respiratory contaminants, secretions and materials, hands must be washed properly.
• Keeping contaminated hands away from mucosa of the eyes or nose.

Reference:

Carling, P.C., Kleancheck Systems, Llc, 2017. Monitoring Cleaning of Surfaces. U.S. Patent Application 15/449,386.

Gabbard, J.D., Dlugolenski, D., Van Riel, D., Marshall, N., Galloway, S.E., Howerth, E.W., Campbell, P.J., Jones, C., Johnson, S., Byrd-Leotis, L. and Steinhauer, D.A., 2014. Novel H7N9 influenza virus shows low infectious dose, high growth rate, and efficient contact transmission in the guinea pig model. Journal of virology, 88(3), pp.1502-1512.

Liu, L., Li, Y., Nielsen, P.V., Wei, J. and Jensen, R.L., 2017. Short?range airborne transmission of expiratory droplets between two people. Indoor air, 27(2), pp.452-462.

Pittet, D., Boyce, J.M. and Allegranzi, B. eds., 2017. Hand Hygiene: A Handbook for Medical Professionals (Vol. 9). John Wiley & Sons.

Rutala, W.A. and Weber, D.J., 2014. Selection of the ideal disinfectant. Infection Control & Hospital Epidemiology, 35(7), pp.855-865.

Song, M. and Yang, N., 2016. High School Students’ Knowledge and Practice of Respiratory Hygiene/Cough Etiquette following Education. Pp 20-22

Swan, J., 2017. Influenza: Seasonal Flu 2017–2018. Pp 15

World Health Organization, 2014. Vector-borne diseases.

Zhang, Q., Shi, J., Deng, G., Guo, J., Zeng, X., He, X., Kong, H., Gu, C., Li, X., Liu, J. and Wang, G., 2013. H7N9 influenza viruses are transmissible in ferrets by respiratory droplet. Science, 341(6144), pp.410-414.