Before COVID-19, infection prevention and control might not have been on the forefront of everyone's minds. With the pandemic, that has certainly changed.
During Infection Prevention Week, which takes place October 17- 23, 2021, the Association for Professionals in Infection Control and Epidemiology (APIC) aims to help everyone learn about how to prevent infections. Improving patient safety and quality care doesn't just involve medical professionals: It starts with the individual.
Understanding the chain of infection
In order to prevent infections, the first step is knowing how they actually start. There are six links in what is known as the "chain of infection," at which infections can either be spread or be stopped:1
1 | Infectious agent. This is the germ causing the infection, which can be a virus, bacteria or fungus.
2 | Reservoir. The reservoir is where the pathogen lives: people, hospital equipment, insects, food or water, etc.
3 | Portal of exit. This is how the germ gets out of its reservoir -- examples are an open wound, a sneeze or saliva.
4 | Mode of transmission. How is the pathogen being transported? Is it transmitted by ingestion, inhalation, direct contact or indirect contact?
5 | Portal of entry. This is how the infectious agent gets into a new host. Broken skin, catheters, needles and mucous membranes can all be portals of entry.
6 | Susceptible host. Anyone can be a host to an infectious agent, and some are at higher risk. This includes people who are immunocompromised or require invasive medical equipment.
Breaking the chain & preventing infections
Stopping the chain of infection at any of the six links prevents the spread of infection. Infection preventionist Benjamin Galvan, MLS(ASCP)CM, CIC®, shares several practical tips for interrupting the chain.2
"There are many ways to protect ourselves and others," Galvan says, suggesting a multi-pronged approach:
Practice hand hygiene. Infection prevention and control begins with frequent hand washing. "We don't realize how often we touch our faces," Galvan says, "or how often we contaminate our hands. Clean them as often as possible."
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Cover coughs and sneezes. "These are portals of exit introducing contaminants to someone else. Tissues and masks block these infectious aerosols from entering the environment," he says. Additionally, coughing and sneezing into the crook of your arm limits transmission.
Keep your environment clean. Improving patient safety and quality of care requires frequently cleaning surfaces to remove bacteria and viruses. "They are everywhere, so cleaning keeps the amount of infectious agents lower," Galvan says.
Get vaccinated. If vaccination is an option to protect against a specific pathogen, Galvan encourages this. He says, "Vaccines are not 100% effective, but they help, and we can protect ourselves by being less susceptible to an infectious agent."
Hydrate your skin. With frequent hand washing comes dry skin, so moisturizing your hands and the rest of your skin is essential to preventing pathogens from entering the body via cracks and abrasions. "If the skin is nice and intact," Galvan says, "We're going to keep the infectious agent out."
Galvan recommends leaving your contained work space often for fresh air breaks.
"People are always talking and coughing in stagnant offices," he says. "Health is not just the absence of disease. We want to make sure we are low stress and low anxiety, as all of that plays a part in disease prevention. The healthier everyone is, the better."
Addressing antibiotic resistance
Personal responsibility is essential and dramatically reduces the spread of infection in the community. It also plays a role in keeping antibiotic resistance at bay on a larger scale.
Ann Marie Pettis, RN, BSN, CIC, FAPIC, President of APIC, warns that antibiotic resistance is causing issues in infection prevention and control. "Germs have been around longer than human beings and will be around after human beings are no longer, and they are amazing at adapting," Pettis says. "These germs are becoming super germs, resistant to antibiotics."
Pettis warns that resistant organisms throw us back prior to the 1940s when Penicillin was developed. "People used to die from simple infections," she says.
In order to combat the increase of antibiotic-resistant germs, Pettis stresses proper use of antibiotics, including only using them to treat bacterial infections and completing the prescribed course of antibiotics. "Providers will sometimes bend to the pressure of patients who insist they need an antibiotic," Pettis says, "But it's important to know when an antibiotic will work and when it won't. It won't help viruses."
Additionally, Pettis reminds patients to take an antibiotic for as many days as it has been prescribed. "A lot of the time, people start feeling better and stop before the end, when they haven't totally treated the microorganisms." This is a mistake that can actually fuel antibiotic resistance.
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Empowering your community during Infection Prevention Week
While most people outside of the healthcare field have only started to really care about infection prevention during the pandemic, Pettis and other infection specialists have been training for this their entire careers. "We've been talking about a pandemic for so long – not if, but when – and we knew that it would be tough, but you never could have really imagined what it has been like," Pettis says.
During Infection Prevention Week, APIC celebrates the field of infection prevention while working to spread awareness of infection prevention and control. Pettis emphasizes that you need to be deliberate in your efforts and use this week as an opportunity to bring focus to important infection prevention habits.
"You have to be very intentional to create the habits so that your good infection prevention practices are habitual," she says.
Pettis also recommends an acronym: SAFE. While this acronym is primarily used for keeping schools infection-free, it is certainly relevant in other environments as well.3 Pettis suggests how healthcare facilities can apply the SAFE framework:
- Support: Wearing masks even if you are vaccinated is a way to support those around you who cannot be vaccinated.
- Action: Stay home if you are sick. Be up to date on all your vaccinations. Teach proper masking and hand washing to patients – and practice it yourself.
- Facts: Get your information from trusted sources like the CDC, FDA and APIC. Encourage your patients to refer to these, too, instead of relying on social media.
- Engagement: Staff and patients alike should engage in conversations about what they are doing to prevent infection so that everyone is invested in the process.
Empowering your community to prevent infection through individual actions such as frequent hand washing, as well as communal efforts towards improved health and cleanliness, help to promote a safer environment for everyone.
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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.
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