Asepsis Flashcards
List the parts of the chain of infection cycle
-infectious agent
-reservoir
-portal of exit (reservoir)
-means of transmission
-portals of entry
-susceptible host
Apart of the chain of infection, can be bacterial, viral, or fungal
the infectious agent
what is the natural habitat of the organism called
reservoir
Where the pathogen can escape
portal of exit
how the organism can move and get to another host
means of transmission
what is the portal of entry?
where the pathogen enters the new host
what makes a host susceptible
if the pathogen can overcome the protection the host has (immune system)
What are ways we can break the chain of infection
handwashing, sterilization, antibiotics, PPE, clean wound dressings, proper disposal of supplies
what is the most frequent infectious agent in the hospital, give some examples
bacteria ex. strep and staph
what is the smallest pathogen, Give examples
viruses ex. influenza, hepatitis, HIV
a plant-like infectious agent can get from soil, water and sometimes airborne, give examples
fungi ex. yeast, athlete’s foot
an infectious agent that lives on the host, give examples
parasite ex. malaria
what are the main types of infectious agents
bacteria, viruses, fungi, parasites
define iatrogenic infection and an example of one
results from a therapeutic or diagnostic procedure ex. UTI from catheter placement
and infection from organisms external to the patient, that are not normally present
exogenous infection ex. salmonella
define endogenous infection and give an example
microorganisms that exist as part of the normal flora and become pathogenic ex. strep, E. coli, yeast
why are hospitals concerned about HAI
MONEY, they won’t get paid for treatment, and that pt is taking up a hospital bed
What are some of the most common HAI
-C. diff infections
-VAE (ventilator-associated events, pneumonia)
-CAUTI (catheter-associated urinary tract infection)
-CLABSI (Central line-associated bloodstream infection)
What is a bundle?
preventative practice nurses perform, an if-then process
what is the main way that CAUTIS has been decreased
not using indwelling catheters unless absolutely needed
ex. retention, accurate I&Os, large wound, anatomy
what is an MDRO and give an example
a multi-drug resistant organism
ex. MRSA, VRE, C. diff
what are common blood-borne pathogens
hepatitis B&C and HIV
things to know about C. diff
spreads very easily, good hygiene and PPE practices are needed
What are the modes of transmission
contact
-direct (touching)
indirect: vector: coming from an outside source (Lyme) Fomite: door handle transmission (object)
droplet
airborne
what are the body’s first line of defense to fight infection
intact skin and normal flora
what are the two main protective responses of the body
inflammatory and immune
when does the inflammatory response occur
trauma or infection
what is the goal of the inflammatory response
eliminate an invader and start tissue repair
is the inflammatory response acute or chronic
it is both
signs of inflammation
redness, swelling, pain, heat, loss of function
- if infection… WBC will raise
-note BP levels
how does the vascular cell response work
vasoconstriction and vasodilation, histamine release
why would vasodilation occur during infection, causing a BP drop
bacteria cause holes in blood vessels
how does the cellular response work
WBC will move to the target area
the goal of the immune response
to protect and defend
what is humoral immunity
the body has created an antibody… antigen –> antibody
what is cellular immunity
increased lymphocytes (WBC) that destroy harmful and infected cells
how do vaccines work
by imitating an infection, causing the body to produce t-lymphocytes and antibodies
- after a few weeks the body then has memory t-lymphocytes and antibodies
what are common vaccines that healthy adults will get
COVID, influenza and Tdap
what vaccines may at-risk adults get
zoster, pneumococcal and meningococcal
what is a titer test
blood test to see how many antibodies for an infection you have
what are some examples that make a host compromised?
-skin break
-invasive devices ex. PIC line, catheter, intubation
-statis of body fluid
-inadequate nutrition
-stress
-hyper glycemia
-immune dysfunction
-co-existing medical problems ex. autoimmune, diabetes, COPD
-drug therapy ex. anti-rejection meds, steroids, chemo, antibiotics
asepsis concerns for infants
it takes six months for vaccines and immunity to take effect
asepsis concerns for toddlers
poor hygiene and passing bacteria
asepsis concerns for children
skin issues: lice, eczema, etc
asepsis concerns for adults and older adults
decreases immunity, caused by a variety of things
what is the WHO
World Health Organisation, run by the United Nations
what is the CDC
Center for Disease Control, a federal agency (Department of Health and Human Services) that tracts data and makes recommendations
what is the TJC
The joint commission, needed to bill for Medicare and Medicaid services
-will have unannounced inspections
what is OSHA
Occupational Safety and Health Administration (Department of Labor), is a federal agency that requires employers to have safety plans in place
-conducts inspections without notice
what are standard precautions
treat everyone like they have an infection
- all body fluids may be contaminated (wear gloves)
-respiratory hygiene etiquette
-safe injection practices
what are examples of other asepsis interventions
-Bundles
-needleless devices (screw-on syringes)
-hand hygiene
-PPE
-isolation and reverse isolation
-immunizations
-disinfection
-waste disposal
What is a time-out
a pause before a procedure to ask if
-right patient
-right procedure
important things to note with isolation
- can be mentally isolating and movement-restrictive
- Hourly rounding needs to be made a priority
-make sure appropriate signage and PPE is available
-can cohort when appropriate
what to do for contact precautions
wear PPE
- gloves and gown
precaution that would be used for C. diff
what to do for droplet precautions
wear PPE
-gloves, mask, face shield
-best to stay 3ft away
precaution would be used for influenza, rubella, mumps, diphtheria
what to do for airborne precautions
wear PPE
-N95, gloves, gown
-negative pressure room
precaution would be used for TB, varicella, measles
the goal of medical asepsis
reducing the spread and number of microorganisms
-CLEAN
the goal of surgical asepsis
prevent microorganisms from getting into the patient
-STERILE
Objective data important to asepsis
-Vitals (can change with pain)
-WBC (should be 4,500 to 11,000)
-ESR: erythrocyte sedimentation rate (if elevated, concerned)
-Lactate (if elevated, concerned)
-cultures (prevent resistance and form a plan of care)
-know the pts normal, acute changes and improvement
what are the stages of infection
- incubation (entrance - symptoms)
- prodromal (nonspecific symptoms, most contagious)
- Acute (specific symptoms)
- Convalescence (antibodies are present)
what are the signs of infection
-fever (100.4)
-increases HR and respiratory rate
-inflammation
-pain
-drainage
-enlarged lymph nodes
-rash
-GI
Sepsis is a full-body infection (also known as SIRS: systemic inflammatory response syndrome) , that leads to 1/3 of the deaths in a hospital, what are symptoms to look out for?
-hypotension (Systolic under 90)
This is caused by vasodilation, damaged blood vessels from bacteria
-fever or hypothermia (100.4 and 96.8
hypothermia is more dangerous
-WBC raised or lowered (12,000 or 4,000)
-HR above 90
-respirations above 20
-altered mental status
what is the treatment for sepsis
antibiotics, steroids, and IV fluids
