The Chain of Infection
The Chain of Infection
Learning Objectives Covered
LO 01.01 – Describe each of the 6 links on the chain of infection
Career Relevancy
As a medical assistant, you will wear many hats. And one of your core responsibilities will be to help maintain a germ-free medical environment. But to understand the importance of implementing infection control methods, you’ll need to know how infections start and spread. This will help you interrupt the chain of infection, which will protect both you and your patients. As you learn about the chain of infection, which is a key element of medical asepsis, you’ll also learn about specific ways to manage patients, use personal protective equipment, and decontaminate appropriately. In fact, without an understanding of these links and preventive techniques, you could inadvertently support the chain of infection even when you’re trying to keep your patients safe and healthy.
Background
Luca
Meet Luca. He’s a newly certified medical assistant who has just started working at Stonehill Community Clinic. This is his first official, hands-on clinical job! And as excited as he is, he’s also realized that he still has a lot to learn. This is where he really begins to apply some of the procedures and processes he has practiced.
In school, Luca learned a lot about various diseases, infections, and pathogens. So, on his first day at Stonehill Community Clinic, he walks in feeling confident—he knows a lot about microorganisms and what they’re capable of. But in his initial orientation, Luca’s supervisor, Penny, mentions a term Luca feels like he only heard about briefly in school: asepsis.
Penny explains that asepsis is the state or condition of being free of disease-carrying microorganisms. Asepsis often refers to the practices and procedures used in clinical facilities to prevent the spread of infection, from surgical or operative contexts to doctor’s exam rooms. But what’s key, Penny says, is that medical asepsis isn’t only concerned with achieving sterility. In fact, it’s more focused on eliminating disease. This objective is a fundamental concept in clinical work—it is integral to the delivery of safe, high-quality healthcare.
One objective of medical asepsis is to stop the chain of infection. The chain of infection is the series of events that make it possible for pathogens to enter and infect someone’s body, leading to disease transmission and infection. Each of these events in the chain—often known as “links”—can be prevented or interrupted to keep someone from getting sick. And in medical facilities, this is critical.
In his orientation, Luca learns that there are 6 links in the chain of infection and a few ways to address them.
The infectious agent. An infectious agent is a microorganism—a pathogen of some kind, like bacteria, virus, parasites, or fungi—that causes diseases. If people are sick in the vicinity, diagnosing them and treating them can help eliminate infectious agents. Another tool here is antimicrobial stewardship, which encourages medical providers to be prudent and strategic when prescribing and using antimicrobials in order to reduce bacterial resistance and improve patient outcomes.
Reservoir. A reservoir is a place where the infectious disease lives and multiplies. This can be any number of environments, including a person, an animal or insect, medical equipment, or even water. In medical facilities, cleaning, disinfecting, or sterilizing equipment can help get rid of potential reservoirs, and pest control and infection prevention policies can help keep environments and people disease-free.
Portal of exit. A portal of exit is the way the infectious agent leaves the reservoir. If the reservoir is another person, for instance, infectious agents can leave through an open wound, coughing, sneezing, or saliva. If the reservoir is a different type of environment, a portal of exit could also be an aerosol. To intervene at this link in the chain, medical professionals can wash their hands, use surgical masks, and dispose of waste properly. They can also use protective personal equipment and control aerosols.
Mode of transmission. The mode of transmission is the way the infectious agent can be passed on. The mode of transmission usually falls into one of several categories: direct or indirect contact, ingestion, or inhalation. As a result, hand hygiene, food safety, and isolation can help prevent this link in the chain. Additionally, cleaning and disinfecting surfaces and using personal protective equipment can help.
Portal of entry. The portal of entry is the means through which an infectious agent can enter a new host. On the body itself, these portals could be broken skin, the respiratory tract, or mucous membranes. They could also be catheters, tubes, or other medical equipment. In addition to practicing hand and personal hygiene, medical professionals can remove catheters and tubes and use first aid procedures to prevent the entry of infectious disease.
Susceptible host. Finally, the chain of infection requires a person—someone who will become infected. This can be any person, from a doctor to a patient to a janitor, but the most vulnerable people are those who are receiving medical treatment, are sick, or are connected to invasive medical devices. Receiving immunizations, vaccines, and treatment for underlying diseases can help address this link, as can patient education.
As he hears more about the 6 links in the chain of infection, Luca wishes he had learned more about this flow of germs from one place or person to another. As he starts his new job and begins to face real-life situations that require medical asepsis, he also decides to educate himself on the ins and outs of disease prevention in clinical settings. In his initial search, he finds this video (3:01 min) on the chain of infection.
Resources and References
AHE: The Chain of Infection. (2018, December 7). AHEofAHA. Retrieved from https://youtu.be/IBX3jj2uUjo (Links to an external site.)
Lesson 1: Introduction to Epidemiology. (n.d.). Principles of Epidemiology in Public Health Practice, Third Edition, An Introduction to Applied Epidemiology and Biostatistics. Retrieved from https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section10.html (Links to an external site.)
Preventing Health Care–Associated Infections. (2008, April). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2683/ (Links to an external site.)
Prompt
Clearly, the chain of infection can occur anywhere—well beyond the walls of a medical facility. It can help us describe, and prevent, the movement of a disease from place to place, person to person, and population to population.
For this discussion, find a current outbreak in your area. Describe the outbreak in terms of the chain of infection. In your opinion, what is the best precaution health care professionals can take to hinder the spread of the outbreak?
For your citation, you might use articles, such as news articles, that show examples of specific infectious diseases that have affected or touched your community. You can also find articles from experts that discuss how and where bacteria grow and multiply, how they get transmitted, and who is most vulnerable.
You will also complete two peer responses. In each peer response, you will reply to your peers’ posts with thoughtful, substantive ideas. Consider answering some of these questions: Is there anything your peer missed or overlooked? Are there other ideas to consider? Is there a current event or episode that you can bring into the conversation? Expand and deepen the discussion—introduce new concepts or controversies, add thoughtful and insightful questions, and make new connections to your own experiences or the material.
Your initial and reply posts should work to develop a group understanding of this topic. Challenge each other. Build on each other. Always be respectful but discuss this and figure it out together.
Reply Requirements
You must submit:
1 main post of 150+ words with 1 in-text citation and reference (follow the Institution Writing Guidelines)
2 follow-up posts (replies) of 50+ words
Responses can be addressed to both your initial thread and other threads but must be:
Your own words (no copy and paste)
Unique (no repeating something you already said)
Substantial in nature, which means there has to be some meat to the reply not something like: “Good job, Rasha, your post is excellent.” A substantial post will do one of the following:
Extend the conversation deeper,
Challenge the post being responded to, or
Take the conversation in a career-relevant tangent
Remember that part of the discussion grade is submitting on time and using proper grammar, spelling, etc. You’re training to be a professional—write like it.
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