Prevention and Control of Infection


Terms and Definitions

Carrier -

An individual who harbors (in the body) the specific organisms of a disease without manifesting its symptoms, thus acting as a transmitter of the infection

Contaminate -

Is to make unsterile or unclean

Cycle of infection

A chain of events necessary for an organism to survive and to continue to grow, multiply, and possibly do injury to human life


Infectious Agents -

Pathogenic microorganisms that invade tissues and organs of the body, producing infections and contagious diseases


Isolation -

To separate, set apart from others


Microorganism -

An organism that cannot be seen by the naked eye, but can be seen with a microscope (such as bacteria, viruses, fungi, and protozoa)


Mode of escape -

The means or avenues by which the organism leaves the reservoir

Nosocomial infection–an infection acquired during hospitalization which was not present or incubating at the time of hospital admission


Pathogenic -



Reservoir -

The place the organism needs to live in order to grow and multiply


Universal Precautions (Standard precautions) -

Precautions established by Centers for Disease Control and Prevention in an effort to control the spread of diseases


Modes of Escape/Means of Control

Respiratory tract (examples:  Tuberculosis, common cold)

(1)        Breathing out (coughing, sneezing, etc.)

(2)        Means of control--covering nose and mouth

Gastrointestinal tract (examples:  Hepatitis and Cholera)

(1)        Body secretions and excretions

(a)        Secretions - Release of chemical substances manufactured by cells of glandular organs

(b)        Excretions - Process of eliminating, shedding, or getting rid of substances by body organs or tissues, as part of a natural metabolic activity

(2)        Means of control--personal hygiene


(1)        Wound drainage

(2)        Means of control--personal hygiene, wound care

 Genitourinary tract (examples:  Syphilis, Gonorrhea, Urinary tract infections)

(1)        Body secretions and excretions

(2)        Means of control--personal hygiene gloves

Susceptible Hosts

Any person whose resistance to infection is insufficient to combat the invading infectious organism

 High-risk individuals--persons who are very young, very old, malnourished, chronically diseased, receiving chemotherapy, ill, in shock, and persons with open wounds


Means of control

(1)        Standard precautions

(a)        Handwashing

(b)        Gloves

(c)        Mask, eye protection, face shield

(d)        Gown

(2)        Miscellaneous guidelines

(a)        Ensure sharps are placed in a biohazard needle box

(b)        Spills of blood or body fluids are cleaned up with 1:10 solution of bleach and water

(c)        All soiled linen is placed in laundry bag

(d)        Soldier medics with exudative (draining) lesions should refrain from direct patient care and from handling patient care equipment

(e)        Separation of high-risk person from those with known or potential infections

(f)         Separation of high-risk person from those with known or potential infections


Category-Specific Isolation Precautions

NOTE:         In most cases when a private room is required, patients infected with the same organism may share a room

Strict isolation

(1)        Prevent transmission of highly communicable disease spread by contact and airborne routes.  Most restrictive of isolation measures

(2)        Disease example–chickenpox, diphtheria, herpes

(3)        Equipment--private room, mask, gown, and gloves will always be worn


Contact isolation

(1)        Prevents serious diseases, infectious and/or conditions caused by highly contagious organisms that do not require strict isolation.  Diseases are primarily spread by close or direct contact with patient or items used by the patient.

(2)        Disease example–pediculosis, scabies, acute respiratory infections in infants and young children

(3)        Equipment--private room, mask for close contact, gowns if there is potential for soiling, gloves if contact with infective material is likely


Respiratory isolation

(1)        Reduces transmission of infectious diseases over short distances through the air by sneezing, coughing, or exhaling pathogens

(2)        Disease example–measles, mumps, pneumonia, meningitis, or pertussis

(3)        Equipment--private room and mask for close contact


Acid-fast bacillus (Tuberculosis) isolation

(1)        Indicated for patients who have been diagnosed with tuberculosis

(2)        Disease example–pulmonary or pharyngeal tuberculosis

(3)        Equipment--private room (negative pressure room in level 3 hospital), mask with special filter, gown to prevent gross contamination

 Enteric precautions

(1)        Prevents infections that are transmitted by direct or indirect contact with feces

(2)        Disease example--Hepatitis A, Salmonellosis, infectious gastroenteritis

(3)        Equipment--private room if hygiene is poor, gowns if there is potential for soiling, gloves if contact with infective material is likely


Drainage and secretions precautions

(1)        Prevent infections that are transmitted by direct or indirect contact with material or drainage from infectious body sites

(2)        Disease examples–skin infection, wound, burn, abscess, conjunctivitis

(3)        Equipment--gowns if there is potential for soiling, gloves if contact with infective material is likely


Blood and body fluid precautions

(1)        Prevent infections that are transmitted by direct contact with infected blood or body fluids.

(2)        Disease example–AIDS, hepatitis B and C, malaria

(3)        Equipment--private room if hygiene is poor, mask if contact with blood or body fluids is likely, gowns if contact with splashes of blood or body fluids is likely, gloves if contact with blood or body fluids is likely


Protective (reverse) isolation

(1)        Used for patients who are susceptible to disease, due to their low immunity status, low white blood cell counts.  Measures are taken to prevent transmission of pathogens from the outside to the susceptible patient and his surroundings

(2)        Disease example--leukemia, cancer chemotherapy, AIDS


Equipment--private room, mask, gown, gloves, and hair coverings


NOTE:      Equipment needed will depend on type of isolation and specific order or hospital SOP.


NOTE:      Isolation equipment is needed to protect hospital staff, visitors, and patients.


NOTE:      Placards are placed on the door to the patient's room and contain specific instructions for hospital staff and visitors to follow prior to entering isolation area.

General Procedures of Isolation


(1)        The single most important precaution to take to eliminate the spread of disease

(2)        Before and after contact with each patient

(3)        Use antiseptic soap/detergent.  Keep non-disposable equipment (i.e., thermometers, B/P cuffs, etc) in isolation areas


Patient's charts are NOT taken into STRICT ISOLATION areas


Double bag all contaminated items when leaving isolation areas



(1)        Keep to minimum

(2)        Explain isolation precautions to take before, during, and after visit

(3)        Ensure precautions are followed at all times


Inform patients about potential of spreading their disease(s)

 Principles of Universal Precautions


To protect health care providers and to minimize cross-infection of pathogens between patients


General precautions

(1)        Wear gloves

(a)        When touching blood or body tissue, body fluids containing blood and body fluids (semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, and amniotic fluid)

(b)        Handling items or surfaces soiled with blood or body fluids

(c)        Performing venipuncture and other vascular access procedures


NOTE:         Blood is the single most important source of HIV, hepatitis B virus and blood-borne pathogens in the health care facility.


(2)        Use protective barriers (mask, protective eyewear, face shields, gowns or aprons) when performing procedures that may produce blood or body fluids splashes when conditions permit

(3)        Wash hands and skin surfaces immediately if contaminated with blood or body fluids.

(4)        Take precautions to prevent injuries from needles, scalpels, and other sharp objects during use, clean up, or disposal(5)        Used needles should NEVER be recapped!

(6)        Health care workers with lesions or dermatitis should refrain from all direct patient care and from handling patient-care equipment until the condition resolves


Protective equipment

(1)        Gloves

(2)        Mask

(3)        Protective eyewear, face shield

(4)        Gowns or aprons