Infection Control

Question 1

What is included in the Chain of Infection?

Answer 1

1. Infectious agent - pathogens, bacterias, viruses
2. Reservoir - where they grow & live
   — people, animal, any objects, water, food
3. Portal of Exit - how it escapes
   — mouth, cuts in skin, eyes, peeing, vomiting
4. Mode of Transmission - how they travel from one place to another
   A) Contact: Direct vs. Indirect
   B) Droplets: LARGER THAN 5um; speaking, sneezing, coughing
   C) Airborne: SMALLER THAN 5um; covid 19, flu, etc…
   (an even smaller droplet; evaporated droplets)
   D) Vehicle of contaminated food or object – dust, water, blood, improperly handled food
   E) Vectors: contaminated animals that carries it; Mosquitoes, parasites, ticks
5. Portal of Entry: mouth, cuts in skin, eyes
6. Susceptible Host: anyone

Question 2

What are examples of how to break the chain of infection while working with patients?

Answer 2

1. Infectious agent: disinfect, sterilizing equipment
2. Reservoir: hygiene & disposing contaminated things properly (like changing linens, throwing away tissues used for sneezing).
3. Portal of Exit: wearing a mask! sneezing into ur elbows instead
4. Modes of Transmission: hand washing, don’t hug/shake dirty linens
5. Portal of entry: hygiene, sterile technique for wound care, avoiding needle stick
6. Host: immunizations, nutrition, decreasing stress

Question 3

What are our body’s natural defense mechanism and ways that can alter it?

Answer 3

1. Mouth:
   - saliva –> dry mouth, poor hygiene, cuts in mouth
2. Eye:
   - tears –> injury to ur eyeball, dry eye
   - eyelashes –> chemotherapy (if u had this, you lose ur hair)
3. Respiratory Tract:
   - mucus –> decreased humidity/ dry areas
   - cilia linings –> smoking
4. Urinary tract:
   - filtration/ flow of urine –> catheters
   - linings of the urethra & bladder
5. GI Tract:
   - peristalsis –> diet, if ur quickly dehydrated, constipated (blocks the normal pathway)
   - acidity of the stomach
6. Vagina:
   - low pH –> antibiotics, flour consipsation

Question 4

What are the factors influencing infection prevention & control?

Answer 4

• stress
• poor nutrition
• immunity: immunizations
• age –> the older u are, you’ll have a more declining immune
• medical therapy –> being in chemo, antibiotics
• existing disease

Question 5

What does the Inflammatory response look like?

Answer 5

1. Body’s cellular receptors Recognizes the harmful stimuli
2. Inflammatory pathways are Activated
3. Inflammatory markers are released
   - vasodilation –> cause u to have redness and edema
   - histamines –> responds to the injury
4. Recruitment of inflammatory cells

Question 6

What are the stages of infection of activity?

Answer 6

1. vascular/cellular response to injury:
   
   • histamine released –> increased in vascular permeability –> edema!
2. Pain : welling irritates nerve endings
3. Leukocytosis (high WBC count):
   - Normal range: 5-10,000/mm3
   - Infection: 15-20,000 is common
4. Exudates: pus

Question 7

What are the stages of infection?

Answer 7

1. Incubation period- you’ve been exposed but dont feel any symptoms
2. Prodromal period- you experience ur first symptom. Mild and generalized symptoms (weakness, headache, fatigue, tiredness, fever)
3. Invasive stage- symptoms specific to the disease
   - Ex: when u got covid, you experience loss of taste/hear
4. Decline stage- symptoms subside. u feel a bit better
5. Convalescence - no more symptoms

Question 8

What are the Inflammatory response Manifestations (symptoms)?

Answer 8

1. Local response (one-area)
   - red, heat
   - swelling
   - pain
   - loss of function
2. Systematic (full body response)
   - fever
   - high WBC count
   - enlarged lymph node
   - malaise
   - anorexia

Question 9

What are the types of inflammatory exudates?

Answer 9

1. serous –> clear/light yellow
2. serosanguineous –> blood + serum (light red)
3. sanguineous –> blood (thick, clotted blood)
4. purulent –> pus

Question 10

What are the types of Asepsis (practice to reduce infection)? When are each type being used?

Answer 10

1. Medical or Clean Technique:
   - used for:
   
   • medications
   • enemas (injected to ur butt)
   • tube feedings
   • daily hygiene
2. Surgical or Sterile Technique:
   - used for:
   
   • dressing change
   • catheterizations
   • surgical procedures

Question 11

What type of asepsis is used for all patients?? at all times??

Answer 11

Medical or Clean technique! it is the Standard precautions!!

Question 12

What type of asepsis is being used by CDC universal precautions or “standard precautions”?
When is it being used?
What PPE is used?

Answer 12

• Standard precautions is medical asepsis
• use standard precautions for ALL patients!! (hand hygiene)
• clean gloves for contact with any blood fluid (if not, don’t need a glove)
• gowns as needed (if coming in contact w/ commit, liquid stool, etc

Question 13

What is the different prevention isolation guidelines?

Answer 13

1. Airborne –> N-95 mask
   
   • THEY MUST have a private room w/ NEGATIVE (-) pressure air flow!
2. Droplet –> surgical mask if WITHIN 3 FEET
3. Contact –> gloves & gown
4. Immunocompromised patients (those who have weakened immune systems) –> mask
   - THEIR ROOM MUST be in POSITIVE (+) air flow

Question 14

In which order do we Donn PPE?

Answer 14

• gown
• masks
• goggles
• gloves

Question 15

In which order do we Doff PPE?

Answer 15

• gloves
• goggles
• gown
• mask

Question 16

What are the most common Hospital acquired infections?

Answer 16

• Urinary tract:
  
  • CAUTI (catheter associated urinary tract infection)
• Blood stream:
  
  • CLABSI (center line associated blood stream infection)
• Surgical site (SSIs)
• Ventilator associated pneumonias (VAPs)