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Infection Control

You are responsible for eliminating or at least reducing pathogen transmission in clinical practice.

This newly revised and updated 5th edition of Infection Control and OSHA Essentials sets out the methods necessary to help you achieve this goal and will guide you through the challenges facing health care workers today.

The latest OSHA requirements and CDC recommendations are summarized and explained, and topics such as

  • occupational exposure responses
  • personal infection control
  • instrument sterilization
  • disinfection
  • hazard control
  • preventing Infection in the workplace
  • emerging infections and drug-resistant pathogens

receive in-depth coverage, making this edition your infection control handbook of choice for your office and professional library.

Infection Control

How to know what to order? If you would like to receive an electronic copy of the book and test then choose our PDF or eBook options! Does a friend already have the book or do you? Then just order a test that can be delivered either via email or mailed as a hard copy.  All tests can be taken online or via our mail option.

Infection Control

Infection Control
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Last reviewed: January 1, 2017
Expires: January 1, 2020

Infection Control

About the Authors

Barbara S. Russell, RN, MPH, CIC, ACRN, is Director of Infection Control Services at Baptist Hospital of Miami, Florida, and the Co-Chair of Baptist Health South Florida's System Emergency Operations Council. She has specialized in infection control for over 30 years and is Infection Control Certified. She is the 2002 recipient of the City of Miami Chamber of Commerce Health Professional Hero of the Year Award and the Carol DeMille Achievement Award, presented by the Association for Professionals in Infection Control and Epidemiology (APIC), for her outstanding contributions to infection control and patient care.

Barbara was the 1997 recipient of the Association of Nurses in AIDS Care (ANAC) National Leadership Award. In 1994, she was President of the National APIC, and, in 1999, President of the National Federation of Specialty Nursing Organizations (NFSNO). She has also served as Chair of both the Florida Nurses Association and the American Nurses Association HIV Task Forces. In 1988, she was one of 14 U.S. nurses to receive a Certificate of Commendation from the Assistant Secretary of Health and Human Services for her work on AIDS.

Ms. Russell has testified before the Occupational Safety and Health Administration (OSHA), Centers for Disease Control and Prevention (CDC), State of Florida legislators, and three U.S. Congressional subcommittees on behalf of health care worker safety. She actively promotes education and safer work environments, and has written numerous articles for professional newsletters and journals.

Dental Consultant: Wendy S. Hupp, DMD, is an Assistant Professor and the Director of Oral Medicine, Department of Diagnostic Sciences, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida. Dr. Hupp is a Diplomate of the American Board of Oral Medicine.

Dr. Hupp earned her DMD at the University of Pennsylvania School of Dental Medicine. Her numerous presentations on clinical oral diagnosis, medicine, and pathology include those on oral cancer and tobacco cessation, aphthous ulcers, dental pharmacology, viral hepatitis, human immunodeficiency virus, seizure disorders, and women�s health.

Infection Control

Course Objectives

When you complete this course, you will take a written or online test that measures your ability to identify:

  1. The requirements of OSHA's "Occupational Exposure to Bloodborne Pathogens, Final Rule."
  2. Types of pathogen transmission and associated infectious substances.
  3. Standard and Transmission-Based Precautions and their uses.
  4. Appropriate patient isolations and health care worker restrictions.
  5. Persons at high risk of infection and types of preexposure prophylaxis.
  6. Types of postexposure prophylaxis and first aid.
  7. At-work personal infection control procedures and equipment
  8. Recommended sterilization and disinfection practices.
  9. Procedures for dealing with sharps, chemical hazards, and regulated waste.
  10. OSHA-required employee training and record keeping.

Infection Control

Table of Contents

When you complete this course, you will take a written or online test that measures your ability to identify:

  • Introduction
    Current Challenges
    Emerging and Re-emerging Infections
    Drug-Resistant Pathogens
    CDC Guidelines
    General Infection Control
    Preexposure and Postexposure
    Prophylaxis
    Health Care Workers' Responsibilities
    Understanding the Cycle of Infection
    Preventing Infection in the Workplace
    Learning and Sharing Information
  • Chapter 1 The Infection
    Process Cycle of Infection
    Reservoirs
    Exit Vehicles
    Transmission Modes
    Entry Portals
    Susceptible Hosts
    Interrupting the Infection Process
    Standard Precautions
    Transmission-Based Precautions
  • Chapter 2 Overview of Bacteria and Protozoans
    Bacillus anthracis
    Bordetella pertussis
    Chlamydia pneumoniae
    Clostridium botulinum
    Clostridium difficile
    Corynebacterium diphtheriae
    Cryptosporidium parvum
    Escherichia coli Serotype O157:H7
    Giardia lamblia
    Legionella pneumophila
    Mycobacterium tuberculosis
    Mycoplasma pneumoniae
    Neisseria meningitidis (Meningococcus)
    Salmonella enterica
    Shigella sonnei
    Staphylococcus aureus
    Streptococcus pneumoniae (Pneumococcus)
    Streptococcus pyogenes
    Toxoplasma gondii
    Vancomycin-Resistant Enterococcus (VRE)
  • Chapter 3 Overview of Viruses
    Adenoviruses
    Cytomegalovirus
    Hepatitis A Virus
    Hepatitis B Virus
    Hepatitis C Virus
    Other Hepatitis Viruses
    Herpes Simplex Viruses
    Human Immunodeficiency Virus (HIV)
    Influenza Viruses
    Mumps Virus
    Norovirus
    Polioviruses
    Respiratory Syncytial Virus
    Rubella Virus
    Rubeola Virus
    Varicella Zoster Virus
    Variola Virus
  • Chapter 4 Occupational Exposure Responses
    Postexposure Responses
    OSHA Requirements
    Ethical Obligations
  • Chapter 5 At-Work Personal Infection Control
    Handwashing and Hand Antisepsis
    Hand-Cleansing Methods and Agents
    Routine Handwashing
    Hand Antisepsis
    Surgical Hand Scrub
    Hand-Cleansing Products
    Personal Protective Equipment
    Protective Gloves
    OSHA-Required Inhalation and Eye Protection
    Types of Inhalation Protection
    Types of Eye protection
    Special Dentistry Barriers
    Protective Clothing
    Other Personal Infection Control
  • Chapter 6 Sterilizing Instruments
    Susceptibility of Microbes
    Instrument Classifications
    Sterilants and Their Uses
    Dry Heat
    Ethylene
    Oxide Glutaraldehydes
    Hydrogen Peroxide
    Peracetic Acid
    Steam
    Unsaturated Chemical Vapor
    Sterilization Steps
    Presoaking Instruments (Step 1)
    Precleaning Instruments (Step 2)
    Packaging Instruments (Step 3)
    Loading Sterilizers (Step 4)
    Monitoring Sterilization (Step 5)
    Handling and Storing Sterilized Instruments (Step 6)
    Sterilizer Cleaning Chain of Events in Clinical Settings
  • Chapter 7 Disinfection
    High-Level Disinfection
    Intermediate- and Low-Level Disinfection
    Protective Coverings
    Special Disinfecting Procedures
    Endoscope Disinfection
    Dental Unit Water Line Disinfection
    Dental Material Disinfection
    Dental Radiographic Equipment
  • Chapter 8 Hazard Controls
    Sharps: Handle with Care!
    Tips on Sharps in General
    Tips on Use and Disposal of Needles
    Regulated Waste Containers
    Warning and Identification Labels
    Disposal of Regulated Waste
    Liquid Waste
    Hazardous Chemicals
    Hazard Reporting
  • Chapter 9 Planning and Training
    Exposure Control Plan
    Infection Control Manager
    Employee Medical Evaluations
    Employee Training
    Bloodborne Pathogens
    All Contagious Diseases
    Hazardous Chemicals
    Training Methods
    Required Documents
  • Chapter 10 Record Keeping
    Employee Medical Records
    OSHA Logs
    Logs 300 and 301
    Sharps Injury Log
    Training Records
  • Definitions
    Appendix A Information Sources
    Appendix B Preexposure Vaccination Checklist for U.S. Residents
    Appendix C Infection Control Checklist for Outpatient Clinical Practices
    Appendix D Disease Spread in Dental Offices
    Index
    Reference List for Further Study

Infection Control

Introduction

Although many of the approximately 9 million health care workers in the United States are employed in hospitals, more and more are serving in nursing homes, outpatient and emergency care clinics, and patients' homes. Any person providing health care can acquire infections from, or transmit infections to, patients, coworkers, household members, and/or other community contacts. Health care providers can also spread infections from patient to patient.

To protect themselves, their patients, and others from infection, health care workers should consistently use Occupational Safety and Health Administration (OSHA)-required and Centers for Disease Control and Prevention (CDC)-recommended infection control strategies. By doing so, they can interrupt the infection process.

Current Challenges

Emerging and Re-emerging Infections

Infections are caused by pathogens (disease-producing microbes) that enter human bodies via various routes. Health care workers' efforts to prevent infections are often hindered by the pace at which they must work and the numbers and kinds of pathogens they encounter. During recent decades, health care workers have been confronted with: (1) many newly recognized pathogens (e.g., hepatitis C and human immunodeficiency viruses), and (2) many re-emerging infections (e.g., those caused by Escherichia coli serotype O157:H7, Bordetella pertussis, group A streptococcus, and Salmonella enterica). This book provides infection control overviews for these infections, as well as many others, including those caused by Bacillus anthracis (a significant challenge to health care workers since 2001) and Clostridium botulinum and variola virus (which have potential for bioterrorist use).

Drug-Resistant Pathogens
The resistance of many pathogens to antimicrobials has created serious therapeutic dilemmas worldwide. Penicillin-resistant Streptococcus pneumoniae poses problems in treating pneumonia and meningitis caused by this bacterium. Vancomycin-resistant enterococci (especially Enterococcus faecalis) also pose problems, and Staphylococcus aureus, already resistant to methicillin, has the potential to become vancomycin-resistant. The resistance of Mycobacterium tuberculosis to drugs traditionally used to treat tuberculosis makes multidrug regimens necessary for infected patients. Some strains of influenza virus type A are now resistant to amantadine and rimantadine. To prevent development of drug-resistant pathogens, clinicians must prescribe antimicrobials appropriately and urge patients to complete their drug regimens.

CDC Guidelines
Despite these many challenges, progress is being made in the fight against infectious diseases. The CDC constantly raises its infection control standards; new guidelines can be downloaded from the www.cdc.gov/ncidod website. Readers should obtain all relevant documents and keep abreast of future updates.

Health care workers should also be familiar with the American Heart Association's current guidelines for prevention of bacterial endocarditis (available at www.americanheart.org).

Health Care Workers' Responsibilities
Health care workers are obligated to eliminate or at least reduce pathogen transmission in their clinical practices, hospitals, and other health care settings and research laboratories. This book reviews the methods necessary to achieve this goal.

Understanding the Cycle of Infection
Health care workers should understand the cycle of infection and how use of appropriate precautions in the workplace can interrupt this cycle. Basic knowledge about the bacteria, protozoans, and viruses encountered in health care settings is vital to fighting infection.

Workers should also know that fungi (e.g., Aspergillus fumigatus, Candida albicans, Coccidioides immitis, Cryptococcus neoformans, and Histoplasma capsulatum) frequently cause infections in immunocompromised patients. Immunocompetent health care workers are not usually at risk of acquiring such infections, but they should use Standard Precautions when caring for patients with fungal infections.

Other precautions include keeping health care facilities dust- and mildew-free and properly disinfected. For example, fungi can be transmitted in air flowing through ventilation systems, nonsterile water used in medical equipment, and dust emanating from surfaces disturbed during repair or construction work. The CDC 2003 guidelines for environmental infection control in health care facilities addresses these problems.

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