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  2. PRETEST True or False • A microorganism is a tiny living plant or animal that cannot be seen with the naked eye. • A disease-producing microorganism is known as a nonpathogen. • Microorganisms grow best in an acidic environment. • Coughing and sneezing help force pathogens from the body. • An alcohol-based hand rub should be used to sanitize hands that are visibly soiled.

  3. PRETEST True or False • OSHA stands for Occupational Safety and Health Administration. • A biohazard warning label must be fluorescent orange or orange-red in color. • Prescription eyeglasses are acceptable eye protection when handling blood. • Hepatitis B is an infection of the liver caused by a virus. • Many people do not develop symptoms when they first become infected with HIV.

  4. Content Outline Introduction to the Medical Asepsis and the OSHA Standard • Medical asepsis and infection control • Important in preventing the spread of disease 2. OSHA Bloodborne Pathogens Standard • Required by federal government • Purpose: To reduce the exposure of health care employees to infectious diseases

  5. Microorganisms and Medical Asepsis Microorganism: tiny living plant or animal Cannot be seen with naked eye Must be viewed by microscope

  6. Microorganisms and Medical Asepsis, cont. • Common types of microorganisms: • Bacteria • Viruses • Protozoa • Fungi • Animal parasites • Nonpathogen: Microorganism that does not normally cause disease • Pathogen: Disease-producing microorganism

  7. Microorganisms and Medical Asepsis, cont. Medical asepsis: Practices that are employed to reduce the number and hinder the transmission of pathogens Object or area is clean and free from infection All pathogens are eliminated Nonpathogens are still present

  8. Growth Requirements for Microorganisms Proper nutrition Autotroph: uses inorganic or nonliving substances for food Heterotroph: uses organic or living substances for food Oxygen Aerobe: needs oxygen to grow Anaerobe: grows best in absence of oxygen

  9. Growth Requirements for Microorganisms, cont. Temperature Optimum growth temperature: temperature at which a microorganism grows best 98.6˚ F: most microorganisms grow best (human body temperature) Darkness:microorganisms grow best in darkness Moisture:microorganisms need moisture for cell metabolism and to carry away wastes

  10. Growth Requirements for Microorganisms, cont. pH Most microorganisms prefer a neutral pH Too acidic or too basic: microorganisms die If growth requirements taken away from microorganisms Unable to survive One way to reduce growth and transmission of microorganisms in medical office

  11. The Infection Control Proecess The chain of infection has fourlinks. Each link is a condition that must be present in order for disease to occur.

  12. Infection Process Cycle Pathogen must have continuous cycle to survive If cycle broken: pathogen dies Responsibility of MA to break cycle By practicing good techniques of medical asepsis

  13. Infection Process Cycle, cont. • Components of the infection process cycle:

  14. Infection Process Cycle, cont. Reservoir host: one that becomes infected by the pathogen (people, animals) Source of transfer of the pathogen Provides nourishment for growth and multiplication of pathogen Means of exit from the reservoir host: mouth, nose, throat, ears, eyes, intestinal tract, urinary tract, reproductive tract, and open wounds

  15. Infection Process Cycle, cont. Means of transmission from one person to another Direct contact with infected person or discharge Indirect transfer by: Water vapor from the lungs Breathing Coughing Sneezing

  16. Infection Process Cycle, cont. Contaminated hands and equipment Contaminated food and water Insects Means of entry into the host: mouth, nose, throat, ears, eyes, intestinal tract, reproductive tract, open wounds, breaks in the skin, and mucous membranes

  17. Infection Process Cycle, cont. Susceptible host: one who is capable of being infected by the pathogen Low resistance increases susceptibility Contributes to low resistance: Poor health Poor hygiene Poor nutrition Stress

  18. In Review Infection Process Cycle, cont. Airborne Medical or Dental Setting Vector AGE Vehicle Medical or Dental Treatment Service Users Method of Transmission Immunity ENVIRONMENT DISEASE Skin Injury CONTACT Nutrition workplace Life Style Direct Indirect Socioeconomics SOURCE HOST

  19. Protective Mechanisms of the Body Helps prevent entrance of pathogens Helps break infection process cycle Includes: Skin: most important defense mechanism of body Provides protective barrier against entrance of microorganisms

  20. Protective Mechanisms of the Body, cont. Mucous membranes: line nose and throat, respiratory, GI, and genital tracts Protects from invasion by microorganisms Mucus and cilia: in nose and respiratory tract Mucus: traps microorganisms that enter the body Cilia: beat toward outside to remove pathogens

  21. Protective Mechanisms of the Body, cont. Coughing and sneezing: force pathogens from body Tears and sweat: remove pathogens Urine and vaginal secretions Are acidic in nature Pathogens cannot grow in acid

  22. Protective Mechanisms of the Body, cont. Stomach secretes hydrochloric acid Used for digestion Discourages growth of pathogens that enter stomach

  23. Hand Hygiene • Hand hygiene: process of cleansing or sanitizing the hands • Most important medical aseptic practice to prevent spread of infection

  24. Hand Hygiene, cont. Includes: Handwashing with detergent soap and water Handwashing with antimicrobial soap and water Applying an alcohol-based hand rub CDC issued new recommendations for hand hygiene

  25. Resident and Transient Flora Resident and Transient Flora General categories of microorganisms found on the hands 3. Resident flora (normal flora) Normally reside in epidermis and dermis Generally harmless and nonpathogenic Difficult to remove (attached to deeper skin layers)

  26. Transient Flora Transient flora:picked up in day-to-day activities Grow in epidermis (superficial skin layers) Picked up in the course of daily activities In medical office, may include: Contact with an infected patient Touching contaminated equipment or surfaces

  27. Transient Flora Often pathogenic Attached loosely to skin Easily removed by: Handwashing Applying an alcohol-based hand rub

  28. Handwashing Handwashing Use detergent (plain) soap and water Detergent: breaks down and emulsifies dirt and oil Friction must be used: to ensure removal of all transient flora

  29. Use Friction During Handwashing

  30. Handwashing, cont. CDC recommends that handwashing be performed: When the hands are visibly soiled with dirt or body fluids Before eating After using the restroom

  31. CDC Recommendations CDC recommends if hands are not visibly soiled: Use of alcohol-based hand rub rather than handwashing Reason: Repeated handwashing tends to dry the hands (leads to irritation, chapping, dermatitis)

  32. Antiseptic Handwashing Antiseptic Handwashing Use of antimicrobial soap and water Contains an antiseptic Antiseptic: An agent that functions to kill or inhibit the growth of microorganisms Sanitizes the hands by Mechanical scrubbing Action of the antiseptic

  33. Antiseptic Handwashing, cont. Removes all soil and transient flora Advantage: Deposits antibacterial film on skin to inhibit bacterial growth Perform antiseptic handwash: Before assisting with minor office surgery g. Examples of antiseptics in antimicrobial soaps: Triclosan Chlorhexidine Hexachlorophene

  34. Alcohol-Based Hand Rubs Alcohol-Based Hand Rubs For sanitizing hands: when not visibly soiled Consists of 60% to 90% alcohol Types Gels Lotions Foams

  35. Alcohol-Based Hand Rubs, cont. • More effective than regular soap and water for: • Removal of transient flora • Reducing bacterial count

  36. Alcohol-Based Hand Rubs, cont. Advantages More accessible than sinks Do not require rinsing Less time required to sanitize hands Contain emollients to prevent drying of hands

  37. Alcohol-Based Hand Rubs, cont. Disadvantages More expensive than soap Brief stinging sensation if applied to broken skin

  38. What Would You Do?What Would You Not Do?

  39. What Would You Do?What Would You Not Do?

  40. Infection Control Infection Control Other good aseptic practices include: Follow OSHA Bloodborne Pathogens Standard Keep office free from dirt and dust Keep reception and examining rooms well ventilated and bright Light discourages growth of microorganisms

  41. Infection Control, cont Eliminate insects Means of transmission of microorganisms Dispose of wastes properly Handle wastes as if they contain pathogens Do not let soiled items touch clothing

  42. Infection Control, cont Avoid coughs and sneezes of patients Water vapor may contain pathogens Wear minimal jewelry or no jewelry at all Microorganisms can lodge in grooves and crevices Teach patients how to prevent spread of infection

  43. Gloves Gloves CDC recommendation Wear clean disposable gloves when you are likely to come in contact with any body substance (e.g., blood, urine, feces, mucous membranes, nonintact skin) Examples: Administering an injection Performing venipuncture

  44. Gloves, cont. Advantages of clean disposable gloves: Reduces hand contamination by 70% to 80% Prevents cross-contamination between patients Protects patients and health care workers from infection

  45. Gloves, cont. Important to change gloves before and after patient contact Sterile gloves: used to perform sterile procedures Examples: Dressing change Minor office surgery

  46. OSHA Bloodborne Pathogens Standard Purpose of the Standard • Occupational Safety and Health Administration (OSHA) • Established by the federal government • Purpose of OSHA: To assist employers in providing a safe and healthy working environment for their employees

  47. Purpose of the Standard, cont. OSHA Occupational Exposure to Bloodborne Pathogens Standard Set of regulations: went into effect in 1992 Purpose: Reduce the risk to employees of exposure to infectious diseases

  48. Purpose of the Standard, cont. • Must be followed by employees with occupational exposure to pathogens such as: • Medical assistants • Physicians • Nurses • Dentists and dental hygienists • Medical laboratory personnel • EMTs • Law enforcement officers • Custodians

  49. Purpose of the Standard, cont. Revision to Bloodborne Pathogens Standard Went into effect in 2001 Because of high frequency of needlestick injuries among health care workers • Failure to comply could result in OSHA citation • Payment of a penalty Needlestick Safety and Prevention Act (NSPA)

  50. Needlestick Safety and Prevention Act (NSPA), cont. • Includes stronger measures to reduce needlestick and other sharps injuries • Requires employers to identify and make use of safer medical devices