2.5 Identify the key factors that will make it more likely that infection will occur

This guide will help you answer 2.5 Identify the key factors that will make it more likely that infection will occur.

Infection happens when harmful microorganisms, such as bacteria, viruses, fungi or parasites, enter the body and multiply. These microorganisms are sometimes called pathogens. Infection can have serious effects on health, especially for people who are already unwell or have weakened immune systems. Understanding what makes infection more likely helps workers reduce the risk to themselves and others.

This guide covers the key factors that make infection more likely to occur.

The Presence of Pathogens

For infection to happen, pathogens must be present. The number and type of microorganisms in an environment influence the risk. Some pathogens can survive for long periods on surfaces. Others need a living host.

High-risk situations include:

• Caring for someone with a known infection
• Environments where people gather closely, such as hospitals and care homes
• Areas that are not cleaned or disinfected thoroughly

The higher the concentration of pathogens, the higher the risk of infection.

Susceptible Host

Not all people have the same risk of catching infections. Some are more likely to become unwell if they come into contact with pathogens. These people are often called “susceptible hosts”. Several factors make someone more susceptible:

• Weakened immune systems, for example due to illness, age, or medical treatment
• Young children and elderly people, whose natural defences are lower
• People with long-term conditions, such as diabetes or lung disease
• Individuals with open wounds, cuts or broken skin

When working with people who are vulnerable, extra care must be taken to prevent the introduction or spread of infection.

Route of Transmission

For infection to spread, there must be a way for the pathogen to move from one person or place to another. This is called the “route of transmission”.

The main routes are:

• Direct contact, such as touching infected skin or wounds
• Indirect contact, for example by touching contaminated objects (these objects are sometimes called “fomites”)
• Droplet spread, when a person coughs or sneezes and droplets carrying pathogens enter the air
• Airborne spread, where tiny particles remain in the air and can be breathed in
• Blood and body fluids, such as through needlestick injuries or contact with urine, faeces, sputum, or vomit
• Food and water, if these are contaminated

Health and social care workers often come into contact with all of these routes, especially when providing personal care.

Breaches in Standard Infection Control Practices

Standard infection control practices are rules followed to stop infections spreading. These include hand hygiene, use of protective clothing, and proper cleaning. If these practices are ignored or done incorrectly, infection risk rises.

Common breaches include:

• Not washing hands at key times, such as before and after contact with each service user
• Reusing single-use items, such as gloves or aprons
• Failing to clean or disinfect surfaces or equipment properly
• Not changing personal protective equipment (PPE) between different tasks or people

Each lapse increases the chance that microorganisms will move from one person, surface, or object to another.

Environmental Factors

The conditions of the environment play a role in infection risk. Some environments favour the survival and growth of pathogens:

• Poor ventilation allows airborne pathogens to build up indoors
• Warm, damp conditions help bacteria and fungi grow
• Dirty or cluttered environments make cleaning and disinfection harder
• Shared equipment can become contaminated if not cleaned after each use
• Food preparation areas must be kept clean to stop contamination

Healthcare environments, including care homes and community settings, need to be kept as clean and tidy as possible.

Lack of Immunity

Immunity means the body can fight off specific infections. Some people have strong immunity from previous exposure or vaccinations. Lack of immunity means someone is more likely to become infected if exposed to a pathogen.

Groups with low immunity include:

• People who have never had the infection before
• Those not vaccinated against certain diseases
• People on treatments that weaken immune response, such as chemotherapy or high-dose steroids

It’s common to see infections spread quickly in groups where immunity is low, such as in new admissions to a care home who have not been exposed to certain germs before.

Breakdown of the Body’s Natural Barriers

The body has several ways to stop pathogens entering:

• Skin acts as a barrier against most bacteria, viruses and fungi
• Mucous membranes in the nose, mouth, and eyes help trap and remove pathogens
• Stomach acid kills many bacteria

When these natural barriers are damaged, infection risk rises. This can happen because of:

• Cuts, ulcers, or wounds
• Medical devices that break the skin, like catheters, cannulas, or feeding tubes
• Dry, cracked skin
• Eye or mouth infections

People with wounds or medical devices need close monitoring to avoid infection.

Poor Personal Hygiene

Personal hygiene means keeping the body clean to remove dirt, sweat and microorganisms. When personal hygiene is poor, infection risk increases.

Examples include:

• Not washing hands after going to the toilet
• Failure to wash before meals
• Dirty clothing
• Toenails and fingernails not kept clean
• Not showering or bathing regularly
• Not cleaning teeth

Both workers and people receiving care must be encouraged and supported to keep clean.

Overcrowding

In environments where many people share space, there is a greater chance of infectious diseases spreading. This is because:

• People are in close contact for long periods
• Common touch points increase (door handles, toilets, taps)
• Airborne or droplet-spread diseases move faster between individuals

Overcrowding can occur in hospitals, care homes, nurseries or shared accommodation.

Poor Nutrition

Nutrition affects how well the body can defend itself. Malnutrition, which means not getting enough nutrients, weakens the immune system. People who are undernourished may not heal well from wounds and are at higher risk of infection.

Factors leading to poor nutrition:

• Difficulty swallowing
• Loss of appetite
• Illness causing vomiting or diarrhoea
• Medical conditions affecting how food is absorbed

Supporting people to eat well strengthens their resistance to infection.

Stress and Tiredness

Stress and tiredness lower the body’s defences. People under stress produce hormones that reduce immune system function. Lack of restful sleep has similar effects.

Stress and tiredness matter for:

• People receiving care, who may feel anxious about illness or the care environment
• Staff who are overworked, leading to mistakes and lapses in infection control

Support and rest help everyone stay healthier and better able to resist infection.

Unclean Hands and Hands as a Vector

Hands are the most common way infections are spread in health and social care. Our hands pick up microorganisms from surfaces, people, objects and body fluids, moving them to new places.

Risks include:

• Not washing hands at recommended times
• Using gloves as a substitute for hand hygiene
• Touching face, food or wounds with contaminated fingers

Thorough handwashing is the single most effective action to reduce infection spread.

Inappropriate Use of Antibiotics

Misusing antibiotics can lead to the development of resistant bacteria. Resistant bacteria are harder to treat. When these “superbugs” are present, infections are more common and often more severe.

Misuse includes:

• Taking antibiotics for illnesses caused by viruses, such as colds or flu
• Not finishing a full course of antibiotics
• Sharing antibiotics with others

Always follow prescriptions carefully and never demand antibiotics for non-bacterial illnesses.

Poor Waste Disposal

Waste such as used dressings, tissues, gloves, and incontinence pads may carry pathogens. If these items are not disposed of safely, infection can spread to other people or staff.

Key points for safe waste disposal:

• Use the correct disposal bags (for example, yellow bags for clinical waste)
• Never place hazardous waste in normal household bins
• Wrap sharp items such as needles in special containers
• Empty waste bins regularly and clean or disinfect them as scheduled

Safe waste processes protect everyone in the care environment.

Sharing Personal Items

Shared personal items can easily transfer microorganisms. Examples include:

• Hairbrushes and combs
• Towels, flannels or bed linen
• Toothbrushes
• Razors or scissors
• Eating and drinking utensils

Workers should check that people do not share personal belongings and that these items are cleaned or replaced as needed.

Movement Between Different Care Environments

When people move between care settings, infection risks change. Transfers between hospital, care home, or home environments can bring new microorganisms with them. Luggage, clothing, or equipment may be contaminated.

Managing this risk involves:

• Careful assessment when admitting or discharging people
• Isolating those suspected of carrying infections
• Cleaning shared equipment between uses

Clear guidelines help reduce the spread of infection between places.

Lack of Education and Training

People are less likely to prevent infection if they are not trained. Staff who do not know the correct procedures can make mistakes, for example using equipment incorrectly, not wearing PPE, forgetting to clean properly, or not recognising signs of infection.

To improve safety:

• Provide regular, up-to-date training
• Display reminders about hand hygiene, waste disposal and cleaning
• Encourage staff to ask questions and report potential problems

Knowledge gives workers confidence to act correctly.

Final Thoughts

There are many different factors that can make infection more likely.

Each can increase the risk by itself. Often, several factors occur at the same time, further raising the chance of infection. Health and social care workers must stay alert to these risks and follow all organisational policies and procedures.

Everyone’s actions matter in reducing the likelihood of infection. Workers who know what the risk factors are can help protect themselves, colleagues, and the people they support. Being observant and acting quickly when risks are seen makes a real difference in preventing infections.