Preventing the spread of infectious disease is a critical component of the patient care cycle. Even amid the hectic pace of work in the healthcare setting, healthcare professionals have a responsibility to their patients as well as colleagues to follow universal precautions and prevent contact with blood and other potentially infectious materials in the workplace. Doing so begins with understanding the nature of infectious diseases and how they are transmitted from person to person.
The Basics: How Infection Spreads
There are three things that contribute to the spread of infection: a source (the infected person); a host (the person to whom the disease is transmitted by the host); and a mode of transmission. Diseases may be transmitted in one of the following ways:
- Contact. Contact may be direct (actual physical contact with the source) or indirect (contact with objects, surfaces, etc. contaminated by the source).
- Droplets. Droplets transmit infection when propelled at a short distance (as with coughing, sneezing) through the air from the source and reach the nasal mucosa, mouth or conjunctivae of a new host.
- Airborne. Airborne pathogens are small enough that they remain suspended in the air and can be transmitted simply through breathing.
- Common Vehicle. Infection is spread through contaminated items such as food or water (e.g. an outbreak of E. coli from contaminated meat).
- Vector. Vector transmission occurs when infections spread through vectors—or carriers—such as rats, mosquitoes or flies. Diseases such as plague and malaria are spread this way.
Common-sense Precautions
Stopping the transmission of germs is the key to controlling infection. In fact, it is the only part of the infection cycle we can consistently control, so it is imperative that healthcare workers understand how to successfully protect their patients and themselves.
The Centers for Disease Control and Prevention (CDC) recommends Standard Precautions be implemented to ensure the optimal care of all patients, regardless of their diagnosis or presumed infection status. Such precautions are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection and apply to blood; all body fluids, secretions, and excretions (except sweat), regardless of whether or not they contain visible blood; non-intact skin; and mucous membranes. They include:
- Hand washing
- Wearing appropriate personal protective equipment (PPE) whenever exposure to infectious materials is anticipated:
- Gloves
- Gowns/aprons
- Masks/face shields/goggles
- Clean and disinfect reusable patient care equipment such as IV pumps and beside commodes after each use and between patients
- Dispose of needles and sharp instruments in special puncture-resistant containers; do not re-cap used needles
- Keep clean linen away from soiled linen; handle and transport soiled linen in such a way that it cannot touch or contaminate anything else
The Occupational Safety and Health Administration (OSHA) requires healthcare employers to provide gloves—including hypoallergenic and non-latex—protective gowns and sharps boxes in all patient care areas, as well as annual education about bloodborne pathogens to help prevent patient-to-healthcare worker infection transmission.
Prevention Begins with You
As a healthcare worker, you hold the key to preventing or promoting infection in the workplace. By observing standard precautions when dealing with every patient and observing transmission-based precautions when indicated, you can stop infection transmission and help safeguard your health and the health of others.