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Portal of exit means how the pathogen is released into
the ambient air.
NOTES FOR SLIDE 29
Portal of exit means how the
pathogen is released into the
ambient air. Examples would be
opening in walls, doors, ductwork,
open ceilings, and plumbing.
Proper barriers and work practices
can reduce or completely break this
link within the chain.
ASK THE CLASS:
Are there other Portals of Exit that have not been mentioned?
Write their responses on a whiteboard or flip chart.
Pathogens are spread by three routes that are a concern
for infection control.
NOTES FOR SLIDE 30
A mode of transmission is the
movement or the transmission of
pathogens from a reservoir to a
susceptible host. Once a pathogen is
released it can be transmitted over
large areas through air current, water
supply, construction equipment,
carts and debris and clothing of
workers.
Pathogens are spread by three routes that are a concern for infection control:
In the air (airborne)
In water (waterborne)
On surfaces (surface transfer)
When pathogens become airborne, meaning moved by or through air, they can
be inhaled into the respiratory system, ingested or enter the body through open
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wounds or sores. Pathogens can become airborne through common activities,
such as tearing out carpet, grinding, moving ceiling tiles, or cutting into a wall.
Pathogens can be waterborne, meaning moved by or through water. With any
source of water, there is potential exposure to waterborne pathogens. A water
supply system can become contaminated in a variety of ways, such as sediment
buildup in plumbing, stagnant water or a backed up sewer.
Pathogens are transferred by skin or clothing coming in contact with a
contaminated surface. Surface transfer
can happen at any time, especially during
construction, renovation, maintenance and demolition because of the amount of
airborne particles that settle out of the air onto a surface.
The Portal of Entry is the opening that allows the
pathogen to enter the host.
NOTES FOR SLIDE 31
The Portal of Entry is the opening
that allows the pathogen to enter the
host. As construction workers we are
not in direct contact with the patients
but how we do our work directly
affects whether we indirectly expose
the patients through the above
portals. Improper control at the
Portal
of Exit is one way the HAI’s are transmitted to the patients via the health
care workers, water and HVAC system. Using proper ICRA controls at the Portal
of Exit has a tremendous impact on HAIs at the Portal of Entry.
Immunocompromised patients are most at risk during
construction activities.
NOTES FOR SLIDE 32
The medical term for a weakened
immune system is
immunocompromised.
A susceptible host is a person who has
little resistance against a particular
pathogen and who, if exposed to this
pathogen, is likely to contract an infection. When healthy people are exposed to
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small amounts of pathogens, their immune systems can fight off the invaders and
prevent an infection. But people with weakened immune systems could catch a
deadly infection, since their defenses are compromised.
Examples of patients who are immune compromised.
NOTES FOR SLIDE 33
Only show the title of the
PowerPoint slide
“
Examples of
patients who are immune
compromised.”
ASK THE CLASS:
Now that we know what a susceptible
host is, can you think of any type of patients in a hospital who would be
considered immunocompromised patients?
Write the participant responses on a whiteboard or flipchart.
Click on the PowerPoint to reveal the examples of immunocompromised patients.
Compare the list the class generated with the list from the PowerPoint.
Ask the class if there are any other groups of patients they have thought of after
seeing the PowerPoint. Add them to your whiteboard or flip chart.
You have completed all of the slides related to the Chain of Infection.
Now ask the participants to take a few minutes to complete Handouts 1
through 6. Review each handout by reviewing the answers to all six sheets.
The answers to the handouts can be found below.
