Infectious disease

Every health care worker plays a vital part in helping to minimise the risk of cross infection – for example, by making certain that hands are properly washed, the clinical environment is as clean as possible, ensuring knowledge and skills are continually updated and by educating patients and visitors. Standard precautions (formerly known as universal precautions) underpin routine safe practice, protecting both staff and our residents from infection. By applying standard precautions at all times and to all residents, best practice becomes second nature and the risks of infection are minimised.

They include: 1 achieving optimum hand hygiene 2 using personal protective equipment 3 safe handling and disposal of sharps 4 safe handling and disposal of clinical waste 1. Hand hygiene Hand hygiene is widely acknowledged to be the single most important activity for reducing the spread of disease, yet evidence suggests that many health care workers do not decontaminate their hands as often as they need to or use the correct technique which means that areas of the hands can be missed components of a healing hospital.

We receive training and prompts from managers and colleagues alike to ensure correct hand washing is adopted at all times The diagram attached demonstrates the hand hygiene procedure that should be followed when washing with soap and water or using an alcohol hand gel or rub. Hands should be decontaminated before direct contact with patients and after any activity or contact that contaminates the hands, including following the removal of gloves. While alcohol hand gels and rubs are a practical alternative to soap and water, alcohol is not a cleaning agent.

Hands that are visibly dirty or potentially grossly contaminated must be washed with soap and water and dried thoroughly. Hand preparation increases the effectiveness of decontamination. You should: * keep nails short, clean and polish free * avoid wearing wrist watches and jewellery, especially rings with ridges or stones * artificial nails must not be worn * any cuts and abrasions should be covered with a waterproof dressing. Remove your wristwatch and any bracelets and roll up long sleeves before washing your hands (and wrists). In addition, bear in mind the following points: Facilities.

Adequate hand washing facilities must be available and easily accessible in all residents areas, treatment rooms, sluices and kitchens. Basins in clinical areas should have elbow or wrist lever operated mixer taps or automated controls and be provided with liquid soap dispensers, paper hand towels and foot-operated waste bins (NHS Estates, 2002). Alcohol hand gel must also be available at ‘point of care’ in all primary and secondary care settings (National Patient Safety Agency (2004). 2. Using personal protective equipment Personal protective equipment (PPE) is used to protect both myself and our residents from the risks of cross-infection.

It may also be required for contact with hazardous chemicals and some pharmaceuticals. PPE includes items like gloves, aprons, masks, goggles or visors. In certain situations such as theatre, it may also include hats and footwear. Disposable gloves Gloves should be worn whenever there might be contact with blood and body fluids, mucous membranes or non intact skin. They are not a substitute for hand washing. They should be put on immediately before the task to be performed, then removed and discarded as soon as the procedure is completed. Hands must always be washed following their removal.

Disposable plastics aprons These should be worn whenever there is a risk of contaminating clothing with blood and body fluids and when a residents has a known infection, for example, direct residents care, bed making or when decontaminating equipment. You should discard them as soon as the intended task is completed and then wash your hands. They must be stored safely so that they don’t accumulate dust which can act as a reservoir for infection 3. Safe handling and disposal of sharps Sharps include needles, scalpels, stitch cutters, glass ampoules and any sharp instrument.

The main hazards of a sharps injury are hepatitis B, hepatitis C and HIV. Second only to back injuries as a cause of occupational injuries amongst health care workers, between July 1997 and June 2002, there were 1,550 reports of blood-borne virus exposures in health care workers – of which 42 per cent were nurses or midwives. 4. Safe handling and disposal of chemical waste Our workplace has a written policy on waste disposal, which provides guidance for all staff on all aspects, including special waste, like pharmaceuticals and cytotoxic waste, segregation of waste and an audit trail.

This should include colour coding of bags used for waste, for example: * yellow bags for clinical waste * black bags for household waste * special bins for glass and aerosols * colour coded bins for pharmaceutical or cytotoxic waste. All staff are instructed in the safe handling of waste, including disposal and dealing with spillages. Understand the causes of infection Germs live everywhere. You can find germs in the air, on food, plants and animals, in the soil, in the water, and on just about every other surface — including your own body. Most germs won't harm you. Your immune system protects you against a multitude of infectious agents.

However, some germs are formidable adversaries because they're constantly mutating to breach your immune system's defences. Knowing more about how germs work can increase your chances of avoiding infection. Infectious agents come in a variety of shapes and sizes. Categories include: * Bacteria * Viruses * Fungi * Protozoa * Helminths Bacteria Bacteria are one-celled organisms visible only with a microscope. They're so small that if you lined up a thousand of them end to end, they could fit across the end of a pencil eraser. They're shaped like short rods, spheres or spirals. Not all bacteria are harmful.

In fact, less than 1 percent cause disease, and some bacteria that live in your body are actually good for you. For instance, Lactobacillus acidophilus — a harmless bacterium that resides in your intestines — helps you digest food, destroys some disease-causing organisms and provides nutrients to your body. Many disease-causing bacteria produce toxins — powerful chemicals that damage cells and make you ill. Bacteria cause diseases such as: * Strep throat * Tuberculosis * Urinary tract infections * Viruses Viruses are much smaller than cells. In fact, viruses are basically just capsules that contain genetic material.

They may be shaped like rods, spheres or tiny tadpoles. To reproduce, viruses invade cells in your body, hijacking the machinery that makes cells work. Host cells are eventually destroyed during this process. Viruses are responsible for causing a wide range of diseases, including: * AIDS * Common cold * Ebola hemorrhagic fever * Genital herpes * Influenza * Measles * Smallpox * Antibiotics have no effect on viruses. Fungi There are many different varieties of fungi, and we eat quite a few of them. Mushrooms are fungi, as is the mold that forms the blue or green veins in some types of cheese.

And yeast, another type of fungi, is a necessary ingredient to make most types of bread. Other fungi can cause illness. One example is candida — a yeast that can cause infection. Candida can cause thrush — an infection of the mouth and throat — in infants and in people taking antibiotics or who have an impaired immune system. Fungi are also responsible for such skin problems as athlete's foot and ringworm. Protozoa Protozoa are single-celled organisms that behave like tiny animals — hunting and gathering other microbes for food. Many protozoa call your intestinal tract home and are harmless. Others cause disease, such as: * Giardia.

* Malaria * Toxoplasmosis Protozoa often spend part of their life cycle outside of humans or other hosts, living in food, soil, water or insects. Some protozoa invade your body through the food you eat or the water you drink. Others, such as malaria, are transmitted by mosquitoes. Helminths Helminths are among the larger parasites. The word "helminth" comes from the Greek for "worm. " If this parasite — or its eggs — enters your body, it takes up residence in your intestinal tract, lungs, liver, skin or brain, where it lives off the nutrients in your body.

Some types of helminths include tapeworms and roundworms. Understanding infection vs.disease There's a distinct difference between infection and disease. Infection, often the first step, occurs when bacteria, viruses or other microbes enter your body and begin to multiply. Disease occurs when the cells in your body are damaged — as a result of the infection — and signs and symptoms of an illness appear. In response to infection, your immune system springs into action. An army of white blood cells, antibodies and other mechanisms goes to work to rid your body of whatever is causing the infection. For instance, in fighting off the common cold, your body might react with fever, coughing and sneezing.

Warding off germs and infection What's the best way to stay disease-free? Prevent infections from happening in the first place. You can prevent infection through simple tactics, such as regular hand-washing, vaccinations and appropriate medications. * Hand-washing. Often overlooked, hand-washing is one of the easiest and most effective ways to protect yourself from germs and most infections. Wash your hands thoroughly before preparing or eating food, after coughing or sneezing, after changing a diaper, and after using the toilet. When soap and water aren't readily available, alcohol-based hand-sanitizing gels can offer protection.

* Vaccines. Vaccination is your best line of defense for certain diseases. As researchers understand more about what causes disease, the list of vaccine-preventable diseases continues to grow. Many vaccines are given in childhood, but adults still need to be routinely vaccinated to prevent some illnesses, such as tetanus and influenza. * Medicines. Some medicines offer short-term protection from particular germs. For example, taking an anti-parasitic medication might keep you from contracting malaria if you travel to or live in an area where your risk is high. When to seek medical care.

You should seek medical care if you suspect that you have an infection and you have experienced any of the following: * An animal or human bite * Difficulty breathing * A cough lasting longer than a week * A fever of 100. 4 F (38 C) or more * Periods of rapid heartbeat * A rash, especially if it's accompanied by a fever * Swelling * Blurred vision or other difficulty seeing * Persistent vomiting * An unusual or severe headache Your doctor can perform diagnostic tests to find out if you're infected, the seriousness of the infection and how best to treat that infection.