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Breaking the chain of infection with universal/standard precautionsThe “chain of infection” is a common phrase used to describe the six main sources, or links, of infection:
1 | Infectious agent:Pathogens/germs
2| Reservoir:Where the germs live & multiply
3 | Portal of exit:How germs get out
4 | Mode of transmission:How germs get around
5 | Portal of entry: How germs get in
6 | Susceptible host:The vulnerable recipient of germ transmission
Covering a cough, disinfecting surfaces and social distancing are simple ways to help break the chain of infection, but hand hygiene is one of the most important steps in preventing infection.
Hand hygiene is key in reducing the transmission of infectious agents in the healthcare setting and is an essential element of standard precautions.
When to practice hand hygiene:6PPE refers to a variety of barriers and respirators used alone or in combination to protect mucous membranes, airways, skin and clothing from contact with infectious agents.
COVID-19 changed the way providers think about PPE estimation, usage and preparedness. Tools like theCDC’s PPE calculatorhave helped providers plan ahead for their inventory needs.
Gloves reduce hand contamination by 70-80%, preventing cross-contamination and protecting patients and healthcare personnel from infection.5
Surgical and isolation, or procedure, gowns are used to protect the healthcare workers’ arms and exposed body areas and prevent contamination of clothing with blood, body fluids and other potentially infectious material. If fluid penetration is likely, a fluid resistant gown should be used.
Gowns are rated according to their AAMI level, which indicates how a gown performs against a series of barrier performance criteria and ranges from 1 to 4, with level 4 providing the highest barrier to fluids and microorganisms. Most isolation gowns used in post-acute care fall into AAMI 1 or 2. AAMI levels are used in both surgical and procedure gowns.7
The highest barrier protection is in the primary “critical zones” of the gown, in the front and on the sleeves, where direct contact with blood, body fluids and other infectious material is likely to occur. Higher-level gowns have larger critical zones and the sleeves and seams are fully sealed, not sewn, to prevent fluid penetration.
Masks are used for three primary purposes in healthcare settings:
Industry-standard American Society for Testing and Materials (ASTM) test methods are used to measure mask performance. To carry an ASTM rating, NIOSH requires that masks be tested for:
A mask may be rated ASTM level 1, 2 or 3, with the highest performance rated level 3. But note that not all masks in the marketplace are ASTM-rated.
Procedure masks:Used for performing patient procedures, or when patients are in isolation, to protect them from potential contaminants. Procedure masks are used for “respiratory etiquette” to prevent people from spreading germs via talking, coughing or sneezing and have ear loops for quick donning and can be worn without a surgical cap.
Surgical masks:Used inside the operating room or during other sterile procedure areas, these types of masks help protect the patient environment from contamination. They also help protect the clinician from contaminated fluid or debris generated during the procedure. Surgical masks have ties so they can be adjusted for fit and are tied over top of a surgical or bouffant cap.
Respirators:戴在面部或头部和覆盖至少nose and mouth, a respirator is used to reduce the wearer’s risk of inhaling hazardous airborne particles (including infectious agents), gases or vapors. Respirators, including those intended for use in healthcare settings, are certified by the CDC or National Institute for Occupational Safety and Health (NIOSH).
There are seven classes of filters for NIOSH-approved filtering face-piece respirators (FFR). Ninety-five percent is the minimal level of filtration that will be approved by NIOSH. The most-used respirators in healthcare settings are the N95, N99 or N100 particulate respirators.
A surgical N95 (also referred to as a medical respirator) is recommended only for use by healthcare personnel (HCP) who need protection from both airborne and fluid hazards (e.g., splashes, sprays), such as in operative or procedural settings.
Respirator users should perform a user seal check to ensure proper fit each time a respirator is used. Workers must pass a fit test to confirm a proper seal before using a respirator in the workplace.
1:https://www.cdc.gov/handhygiene/providers/guideline.html
2:https://www.cdc.gov/healthywater/hygiene/fast_facts.html
3:https://www.cdc.gov/coronavirus/2019-ncov/hcp/hand-hygiene.html
4:https://www.cdc.gov/handwashing/when-how-handwashing.html
5:https://www.cdc.gov/media/pressrel/fs021025.htm
6: Centers for Disease Control and Prevention, Guide to Infection Prevention for Outpatient Settings
7:https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/medical-gowns
8:https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirator-use-faq.html
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Be advised that information contained herein is intended to serve as a useful reference for informational purposes only and is not complete clinical information. This information is intended for use only by competent healthcare professionals exercising judgment in providing care. McKesson cannot be held responsible for the continued currency of or for any errors or omissions in the information.
