Infection Control

 >> A.U. Bankaitis:  I am vice president of Oaktree products, but first and foremost I am an audiologist.  Although I am not a physical therapist, today's presentation does address infection control which is a topic that has universal applications to any kind of healthcare provider.  The goals of this presentation are as follows.  At the end of today's presentation my hope is that you will be able to answer three very basic questions.  First and foremost, what is infection control?  Secondly, why should you as a physical therapist care about infection control.  Finally, what do you need to do?  I am available throughout this presentation to answer questions, and I will be available at the end as well.  I will provide you with my contact information.  Please feel free to get in touch at any time with any questions that may develop in the future.   What is Infection Control? Prior to diving into this topic full force, it is important for us to basically have an appreciation as to what we mean by infection control.  As defined by Bankaitis and Kemp, infection control refers to the conscious management of the clinical environment for the very specific purposes of the minimizing or eliminating the potential spread of disease, regardless of how remote that possibility may seem.  This definition is very straightforward and as a result, clinicians quickly jump to the conclusion that integrating an infection control plan will be equally as straightforward.  While creating and implementing an infection control plan is really not that difficult. It is a process that involves conscious management of your clinical environment.  Infection control is a cognizant, premeditated process that actually requires thinking through clinical procedures and assessing how those procedures may need to be modified to minimize the potential spread of disease.  It is usually at this point where clinicians become very quickly frustrated because you are suddenly forced to think through clinical procedures that have otherwise become so automatic.  In addition there is a tendency to overthink the process to the point where you conclude that the only way to achieve infection control goals is to essentially come to work wearing a hazmat suit.  Once you get to this point, the path of least resistance naturally leads us to abandon infection control efforts and erroneously interpret them as unnecessary.  The good news is that this is an infection control rollercoaster, and it is a natural progression in the learning process.  Hopefully with the information that is covered today you will have the necessary information and tools to create and integrate an effective infection control plan in your current practice with minimum frustration.  Now that we know what we mean by infection control, we need to focus on the second objective of this presentation which is to recognize why you, as physical therapists, should care about infection control.  It is really important to appreciate why infection control is relevant to your clinical practice, because if you do not, I am not going to be able to get you to the third objective which is basically what you need to do in order to minimize the spread of disease.  In order to appreciate the relevance of infection control to physical therapy, we need to have a basic understanding of how the immune system works.  We also need to recognize how HIV affects the immune system and what lessons healthcare learns from HIV.  Finally, we need to appreciate how all of this practically applies to your clinical environment.    The Immune System Human beings are continually challenged by microorganisms that are readily found throughout the environment as different bacteria, viruses, parasites, what have you. They vigorously pursue a resource for growth and reproduction.  Unfortunately, our bodies serve as the perfect incubators for these potentially infectious microorganisms.  Virtually all cells of the human body remain susceptible and vulnerable to these microorganisms.  As such, it is the job of the immune system to defend and protect us from these microorganisms and associated infections.  Just like your nervous system, the immune system is not comprise of just one organ; rather it is an extremely complex and sophisticated network of organs, bodily fluids, and cells that have to work in a highly orchestrated manner in order to achieve this function.  How does the immune system defend and protect us from infection?  You can think about the immune system as being comprised of two major subsystems.  We have what is referred to as your natural immune system, and we also have what is referred to as your adaptive immune system.  The natural immune system provides us with the first line of defense against any type of microorganism, and is represented by a variety of physical barriers, cells, and other soluble factors that are designed to react to all infectious agents in the same way, each and every time, without any regard to the structural or chemical property of the agent.  For example, your skin serves as a preliminary barrier to any microorganism regardless if that microorganism is a bacterium, an infectious virus, some sort of parasite or fungus.  Because the natural immune system responds in such a nondiscriminatory fashion, it provides us with what are referred to as the nonspecific immune responses.  Although relatively effective, these nonspecific immune responses generated by the natural immune system are not foolproof.  Nearly all microorganisms have these evolved, evasionary mechanisms such that the natural immune system can only effectively provide protection for a few days.  As a result, the human body relies significantly on the adaptive immune system to defend and protect us from infection.  This adaptive immune system actually involves the meticulous recognition of antigens.  Antigen simply refers to any substance or molecule that the adaptive immune system interprets as being foreign.  When the adaptive immune system detects the presence of antigen, it calls upon different groups of immune cells to help neutralize and kill that antigen.  Each group of immune cells is designed to accomplish different and very specific functions.  As such, the adaptive immune system generates what are referred to...