Breaking The Chain of Infection
Posted By Chris on March 6, 2010
The last post briefly explained the roles of both the Centers for Disease Prevention and Control (CDC) and the Occupational Safety and Health Administration (OSHA) and their influence on Universal, Standard, and Transmission Based Precautions, also known as Isolation Precautions.
Thinking in terms of interrupting transmission of infectious agents in everyday situations is known as Breaking the Chain of Infection. This term uses a metaphor to create a visual interpretation; each link depends on the last and the next, in order to continue. Break one link and there is no longer a connection. An example might be:
The 1st link is the pathogen, let’s use MRSA.
The 2nd link is the reservoir or house the pathogen lives in. In this case it’s living in the nares (nose) of a nurse but not causing any clinical signs of infection.
The 3rd link is the portal of exit (the nurse rubs her nose, now the pathogen is on her hands).
The 4th link is the mode of transmission, the nurses hands.
The 5th link is the new host, her patient.
The 6th link is the portal of entry. The nurse does not take time to wash her hands and transmits the MRSA to her patient’s skin while taking her blood pressure.
The patient is a susceptible host because her immune status is impaired by her chronic medical conditions and diabetes. Her arm itches, she scratches it and places the MRSA she picked up from the nurse, directly into her open skin (portal of entry) and develops an MRSA wound infection.
Looking back we see one of the links could have been broken at any time, to prevent this infection. The only barrier needed was simple, effective hand washing or the use of an alcohol sanitizer, which could have prevented transmission at every link.
Next: Infection Control Situations in LTC
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