CROSS INFECTION

The following are the methods of transmission of cross infection :

Direct contact : The organisms can be transmitted directly from person to person through kissing, sexual contact, droplet infection and infected hands.

Indirect contact : Contact with the secretions and excretions of the infected persons.

Through fomites : Eg., instruments, utensils etc.

Through contaminated food and water.

Through insects.

Through dust.

Through carriers.

PREVENTION OF CROSS INFECTION IN THE HOSPITALS

1. The hospital should be well ventilated.
2. Maintain the general cleanliness of the hospital. Sweeping and mopping of the floor should be done daily with antiseptic lotions and damp dusting should be done to keep the articles free from dust. All the articles are kept clean and dry. Once in a week, roof is swept to remove the cobwebs. Beds, lockers, stools etc should wash and cleaned. The mattress, pillows and other unwashable articles are exposed to sunlight and aired. Periodical white washing of the walls, painting of the doors and windows etc., should be done.
3. Safe food and water supply : Many diseases are transmitted through food and water. Kitchen and pantry are protected from flies. There must be provision for safe water supply.
4. Safe disposal of excreta : Urine, stool, sputum etc., should be disposed safely. The bedpans, urinals, sputum cups etc., are cleaned and disinfected before it is used for the next patient.
5. Safe disposal of refuse : Discarded dressings, garbage etc., are collected daily and burnt to prevent the spread of infections.
6. Destruction of rodents and insects : Rodents and insects play a great role in the spreading of diseases, so, they should be destroyed.

PREVENTION OF DIRECT CONTACT WITH INFECTED PERSON (BARRIER NURSING)

Barrier nursing or isolation technique is intended to confined the micro-organisms within a given and recognized area. There are a number of isolation techniques and precautions used to prevent the spread of infections.

Respiratory isolation : Respiratory isolation is indicated in the situations where the pathogens are spread on droplets from the respiratory tract. In this type of isolation, masks are generally worn by the nurses. Gowns are also worn when caring for the small infants because of the possibility of drooling by the infants. When possible the patients are taught to cover their noses and mouths with several layers tissue paper or handkerchief. If tissue paper is used they should be disposed properly. Handkerchiefs are cleaned and disinfected before it is used again. Restrict the number of visitors. Precautions must be taken when collecting sputum specimens from the patients. When attending to a patient with respiratory infection, the nurses should keep a reasonable distance to prevent the droplet infection and to prevent breathing contaminated air. If the nurse suffering from respiratory diseases should not attend to the patients.

Enteric isolation : Enteric isolation is indicated when the pathogens are transmitted in faeces. For this type of isolation it is not necessary to wear a mask, but it is recommended that gloves and gowns be worn when handling soiled articles.

Thorough hand-washing should be emphasized both by the patients and the nurses. The excreta may be disinfected by adding lime to it before the disposal. The soiled articles such as linen should be disinfected before it is sent for washing.

Wound and Skin isolation : This type of isolation is for pathogens which are found in wounds and can be transmitted by the contact with the wounds or by contact with the articles contaminated with the wound discharges. Usually gowns and gloves are worn in this type of isolation. Important point to remember is the safe disposal of dressings and discharges from the wounds and the disinfection of the articles. Strict isolation techniques should be followed when caring for the patients with abscesses, boils, infected burns, gas-gangrene, anthrax, rabies, tetanus, venereal diseases, scabies etc. All the articles used for these patients should be kept separate.

Great care should be taken by the nurses to prevent cuts or abrasions on their hands. Frequent and thorough hand washing reduces the chances of infection.

Blood isolation : This type of isolation is intended to prevent transmission of pathogens that are found in blood. Therefore any equipment that comes in contact with the patient's blood should be carefully disinfected before touching another object or person. Use of mosquito nets are also emphasized to prevent this type of infection.