Chapter 28 Infection Prevention Flashcards
Infection is
the invasion of a susceptible host by pathogens or microorganisms, resulting in disease.
Entry and multiplication of organisms result in
disease
Colonization occurs when
a microorganism invades the host but does not cause infection
Communicable disease is
the infectious process transmitted from one person to another.
symptomatic infection:
pathogens multiply and cause clinical signs and symptoms
asymptomatic infection:
clinical signs and symptoms are not present
Hand hygiene is
the most important technique to use in preventing and controlling transmission of infection
Chain of Infection
Infectious agent or pathogen –> Reservoir or source for pathogen growth –> Portal of exit –> Mode of transmission –> Portal of entry –> Susceptible host
Immunocompromised means
having an impaired immune system
Virulence is
the ability to produce disease
Aerobic bacteria require
oxygen for survival and for multiplication sufficient to cause disease.
Anaerobic bacteria thrive
where little or no free oxygen is available.
bacteriostasis—
prevention of growth and reproduction of bacteria
bactericidal—
destructive to bacteria
Infectious Process: 4 Stages
- Incubation period
- Prodromal stage
- Illness stage
- Convalescence
Infectious Process is a localized
versus systematic infection
Normal flora
Microorganisms
-helps to resist infection by releasing antibacterial substances and inhibiting multiplication of pathogenic microorganisms
Body system defenses
organs
Inflammation:
Vascular and cellular responses
Exudates (serous, sanguineous, or purulent)
Tissue repair
Signs of local inflammation and infection are
identical
Health Care–Associated Infections:
Results from delivery of health services in a health care facility
Patients at greater risk for health-care associated infections (HAIs):
Multiple illnesses
Older adults
Poorly nourished
Lowered resistance to infection
Types of HAI infection:
latrogenic
exogenous
endogenous
Latrogenic:
from a procedure
Exogenous:
from microorganisms outside the individual
Endogenous:
when the patient’s flora becomes altered and an overgrowth results
Risk factors:
Number of health care employees with direct contact with the patient
Types and numbers of invasive procedures
Therapy received
Length of hospitalization
Major sites for HAI infection:
Surgical or traumatic wounds
Urinary and respiratory tracts
Bloodstream
Factors influencing infection:
prevention and control: Age Nutritional status Stress Disease process Treatments or conditions that compromise the immune response
Assessment includes a thorough investigation:
Review of systems, travel history
Immunizations and vaccinations
Nursing Process: Assessment (cont’d)
See through the patient’s eyes. Status of defense mechanisms Patient susceptibility Clinical appearance Laboratory data
Patient susceptibility:
medical therapy
Clinical appearance:
signs and symptoms of infection
Nursing diagnoses for infection:
Risk for infection
Imbalanced nutrition: less than body requirements
Impaired oral mucous membrane
Risk for impaired skin integrity
Social isolation
Impaired tissue integrity
Readiness for enhanced immunization status
Planning: Goals and outcomes:
Preventing exposure to infectious organisms
Controlling or reducing the extent of infection
Maintaining resistance to infection
Verbalizing understanding of infection prevention and control techniques (e.g., hand hygiene)
Planning: Setting Priorities
Establish priorities for each diagnosis and for related goals of care.
Planning: Teamwork and collaboration
Remember to plan care and include other disciplines as necessary.
Implementation:
Health Promotion
Acute Care
Health Promotion:
Preventing an infection from developing or spreading
Acute care:
Treating an infectious process includes eliminating the infectious organisms and supporting the patient’s defenses
When implementing care, consider:
Medical and surgical asepsis Control or elimination of infectious agents Control or elimination of reservoirs Control of portals of entry Control of transmission Hand hygiene Isolation precautions
Asepsis =
Absence of pathogenic (disease-producing) microorganisms.
Aseptic technique =
Practices/ procedures that assist in reducing the risk for infection.
Medical asepsis, or clean technique, includes
procedures for reducing the number of organisms present and preventing the transfer of organisms.
Surgical asepsis or sterile technique prevents
contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery.
Standard precautions help infection and can
Apply to contact with blood, body fluid, nonintact skin, and mucous membranes from all patients.
Hand hygiene includes
using an instant alcohol hand antiseptic before and after providing patient care, washing hands with soap and water when they are visibly soiled, and performing a surgical scrub.
Handwashing is:
the act of washing hands with soap and water, followed by rinsing under a stream of water for 15 seconds.
Disinfection:
- a process that eliminates many or all microorganisms, with the exception of bacterial spores, from inanimate objects
- Disinfection of surfaces
- High-level disinfection, which is required for some items such as endoscopes
Sterilization:
the complete elimination or destruction of all microorganisms, including spores
Patient safety:
Separate personal care items
Handling solid and fluid waste
Wound cleaning
Other infection preventions include:
Patient education
Cough etiquette
Isolation and isolation precautions
Surgical asepsis
Cough Etiquette:
- Cover your nose/mouth with a tissue when you cough, and promptly dispose of the contaminated tissue.
- Place a surgical mask on a patient if it does not compromise respiratory function or is applicable; this may not be feasible in pediatric populations.
- Perform hand hygiene after contact with contaminated respiratory secretions
- Maintain spatial separation greater than 3 feet from persons with respiratory infection
Isolation:
the separation and restriction of movement of ill persons with contagious diseases.
-Standard precautions and isolation precations
Isolation precautions:
airborne, droplet, contact, and protective environment
Isolation includes:
- Psychological implications
- Isolation environment
- Personal protective equipment
- Specimen collection
- Bagging of trash or linen
- Patient transport
Surgical Asepsis includes:
- Patient preparation
- Sterile field: an area free of microorganisms and prepared to receive sterile items
- Principles
- Performing sterile procedures
Principles of Surgical Asepsis: Steps 1-4
- a sterile object remains sterile only when touched by another sterile object
- only sterile objects may be placed on a sterile field
- a sterile object or field out of the range of vision or an object held below a person’s waist is contaminated
- a sterile object or field becomes contaminated by prolonged exposure air
Principles of Surgical Asepsis: Steps 5-7
- when a sterile surface comes in contact, the sterile object or field becomes contaminated by capillary action
- fluid flows in the direction of gravity
- The edges of a sterile field or container are considered to be contaminated
Performing Sterile Procedures:
- Donning and removing caps, masks, and eyewear
- Opening sterile packages
- Opening a sterile item on a flat surface
- Opening a sterile item while holding it
- Preparing a sterile field
- Pouring sterile solutions
- Surgical scrub
- Applying sterile gloves
- Donning a sterile gown
Evaluation:
See through the patient’s eyes
Patient Outcomes
See through the patient’s eyes:
Have the patient’s expectations been met?
Patient outcomes:
- Measure the success of the infection control techniques.
- Compare the patient’s actual response with expected outcomes.
- If goals are not achieved, determine what steps must be taken.
Exposure issues:
- infection from accidental needlesticks
- report immediately
- begins with source patient testing
- stated in the testing law for each state
MDRO:
-Multi-Drug Resistant Organism MRSA - Staph aureus 1 organism VRE - found in family CRE C. difficile (lives in GI)
How do infections spread?
Contact
Airborne
Person to person
Vectors
Antimicrobial Stewardship 5 D’s:
Diagnosis Drug Dose Duration De-escalation
