Infection Control and Isolation Flashcards
What is chain of infection?
How bacteria, virus, fungi, parasites, and prions move from place to place.
What are the 3 modes of transmission?
Contact, droplet, and airborne.
What is the chain of infection in order?
- Infection agent
- Reservoir
- Portal of exit
- Mode of transmission
- Portal of entry
- Susceptible Host
What is an infectious agent?
Something that contains bacteria, fungi, virus, parasite, prion.
What is an example of an infectious agent?
Clostridium difficile
staphylococcus aureus
What is a reservoir?
The habit of the infectious agent, a location where it can live, grow, and reproduce itself or replicate.
What are some examples of a reservoir?
Inanimate reservoirs include contaminated soil, water, food, medical equipment, IV fluids, and feces.
Animate reservoirs include people, insects, birds, and animals.
What is a portal of exit?
Means by which the infectious agent can leave the reservoir.
What is a portal of entry?
Any body orifice–for example, ears, nose, mouth, or skin–that provides a place for an infectious agent to replicate or for a toxin to act.
What is a susceptible host?
Required for the infectious agent to take hold and become a reservoir for infection. Not everyone who is exposed to an infectious agent will get ill. Some people never exhibit manifestations at all but can become colonized (temporarily or permanently) with the infectious agent.
What does virulent mean?
Term to describe how efficient an infectious agent is at making people ill.
What factors increase the susceptibility of a host?
-Age
-Underlying diseaseHIV/AIDS
-Malignancy
-Transplants
-Medications: immunosuppressants, antirejection medications, antineoplastics, antimicrobials, corticosteroids, gastric suppressants (e.g., proton pump inhibitors)
-Surgical procedures
-Radiation therapy
-Indwelling devices: endotracheal tubes, urinary catheters, central venous catheters, arterial catheters, and implants such as pacemakers and artificial joints
What are the two types of contact transmission?
Direct and indirect
What is direct contact transmission?
Occurs when micro-organisms are directly moved from an infected person to another person, rather than through a contaminated object or person.
What is an example of direct contact transmission?
herpes simplex virus [HSV]
Scabies
Multi drug resistant organisms
What is indirect contact transmission?
Occurs when microorganisms are directly moved from the infected person to another person with having a contaminated object or person between these two.
What is an example of indirect contact transmission?
In the hospital setting, Staphylococcus aureus is notorious for spreading through indirect contact transmission. For example, drainage from a client’s wound might get on the bed rail or a bedside table, which others then touch.
Indirect transmission can occur if a nurse cares for a group of clients and continues to wear the same gloves or mask for more than one client, or does not perform hand hygiene in between clients.
What is PPE and what is it used for?
Specially designed equipment that is meant to protect the health care worker from contamination, blood, or body fluids.
Equipment that should be put on (donned) prior to client interactions to prevent the spread of infectious organisms includes?
gloves, gowns, masks, eye and face protection, and shoe covers.
What specially designed equipment is meant to protect the health care worker from contamination, blood, or body fluids?
masks, eye protection, gown, gloves, and hair caps.
What is droplet transmission?
Occurs when droplets from the respiratory tract of a client travel through the air and into the mucosa of a host (ex. nurse, other client, healthcare worker).
What are some examples of pathogens transmitted via droplets?
the influenza virus, diphtheria, mycoplasm pneumonia, pertussis, rubella, mumps
What is airborne transmission?
occurs when small particulates found in the air move into the airspace of another person and carry infectious agents. These particles remain in the air and can travel over relatively long distances, leading to the potential for others outside the client’s room to inhale them.
What are some examples of infections caused by airborne transmission?
tuberculosis, rubeola (measles), and varicella (chickenpox)
What do we do with patients that have an infection that can be transmitted through the airborne route?
placement in a private room with negative air pressure
What is vehicle transmission?
Transmission of infectious agents to various individuals through a common source, such as contaminated food or water.
ex) when produce becomes contaminated with Escherichia coli and is consumed by many different individuals, all of whom become sick.
What is vector borne tranmission?
Transmission of infectious agents through animals, such as an insect or rodent. While they are not infected with the pathogen themselves, they can carry micro-organisms from one location or person to individuals.
What is nonspecific immunity?
Comprised of neutrophils and macrophages and their work as phagocytes.
Both neutrophils and macrophages are released during the inflammatory response.
What are phagocytes?
Eat and destroy micro-organisms, thereby helping to protect the body from harm.
What is specific immunity?
The work of antibodies (also called immunoglobulins) and lymphocytes.
Antibodies bind to infectious agents and activate the white blood cells and complement to destroy the infectious agent.
What is the inflammatory response?
Natural defense of the body when injured, when foreign substances are present or when infectious agents attack.
What are the steps of inflammatory response?
- Recognition of harmful stimuli by pattern receptors (located on the surface of cells)
- Activation of the inflammatory pathway
- Release of inflammatory markers
- Recruitment of inflammatory cells
Infectious inflammatory response triggers?
Viruses, Bacteria, Other micro-organisms
Noninfectious physical triggers?
burns, frostbite, injury, foreign bodies, trauma, radiation
Noninfectious chemical triggers?
glucose, fatty acids, toxins, alcohol, irritants (e.g., fluoride, nickel)
Biological noninfectious triggers?
damaged cells
Noninfectious psychological triggers?
excitement
What is the incubation stage?
First stage of infection in which the client may not feel ill or have visible manifestations, however there may be lab values that are changes or changes in diagnostic tests such as x-rays or CT scans.
How long does the incubation stage last?
Incubation lasts from the time the client is exposed to the infectious agent until the first symptom appears.
What is the prodromal stage?
the client begins having initial manifestations as the infectious agent replicates.
What are the symptoms of the prodromal stage?
nonspecific, such as fever, aches, poor appetite, and malaise.
What is the acute illness stage?
that manifestations of a specific infectious disease process become obvious. This is also the stage where the infection is considered severe.
What is the period of decline?
Symptoms start to decline
What is the period of convalescence?
the client returns to the previous or a new, balanced state of health.
What are the stages of infection in order?
- incubation period
- prodromal
- invasive
- decline
- convalescence
What is a local infection?
confined to one area of the body.
What are local infections treated with?
topical antibiotics and oral antibiotics.
What are systemic infections?
start as local infections and then move into the bloodstream, from which they infect the entire body.
How are systemic infections treated ?
Intravenous antibiotics and careful monitoring
What is hand hygiene?
Washing your hands with antibacterial soap and water, using alcohol-based gel or foam, or surgical scrub.
What is medical asepsis?
Clean technique practices that the reduce the presence of disease-causing micro-organisms on SURFACES.
What is surgical asepsis?
Includes techniques that ensures the sterility of ITEMS that will come in contact with the client, through use of equipment such as sterile gloves, in order to prevent pathogen transfer to the client.
What is sterilaztion?
Cleaning instruments so that ALL micro-organisms, including bacterial spores are eradicated.
What is a sterile field?
Created to assure that the smallest number of microorganisms possible are present; used for procedures where surgical asepsis is indicated.
What is disinfection?
Cleans instruments so that almost all micro-organisms are eradicated, but not all. There are two levels of disinfection: high-level and low-level.
What are standard precautions?
Infection prevention practices and these apply to all clients, whether or not they are known to have an infectious agent.
What are contact precautions?
Precautions used when a client has an infectious agent that can be transmitted by direct or indirect contact with body secretions; requires a minimum of gown and gloves prior to client interactions.
What should nurses wear for droplet precautions?
Don a mask when entering the room or coming into close contact with a client.
How should we go about airborne precautions?
Used when a client has an infectious agent that can be transmitted through the air should don an N95 mask or a high-level respirator when entering the room of a client.
What are airborne infection isolation room?
Single client rooms built with special air handling and ventilation to provide a negative pressure (relative to the surrounding area, such as the hall or neighboring rooms). Also referred to as a negative pressure room.
What is protective isolation?
Used during approximately the first 100 days after the transplant, specific engineering and hospital designs that decrease the risk of environmental fungi to the client who had a transplant.
What are infections that are acquired in a health care facility, such as a hospital, nursing home, or ambulatory care facility called?
Health care-associated infections
What are the four types of HAIs?
-Central line–associated bloodstream infections (CLABSIs)
-Catheter-associated urinary tract infections (CAUTIs)
-Surgical-site infections (SSIs)
-Ventilator-assisted pneumonias (VAPs)
What are Guidelines for practice that are bundled together to help prevent HAIs such as CAUTIs, CLABSIs, VAPs, and SSIs called?
infection control bundles
Bacteria that are resistant to one or more classes of existing antimicrobials are called…
multidrug-resistant organisms (MDRO’S)
What is the closed glove technique?
Used to don sterile gloves using surgical asepsis after the individual has performed a surgical hand scrub and donned a sterile gown; hands are kept inside the sterile gown until gloves are donned.
What is the open-glove technique?
Used to don sterile gloves using surgical asepsis; gloves are touched directly with the hands.
What is sterile gowning and what is it used or?
Gown that is sterile; donned prior to procedures requiring surgical asepsis.
What is independent gowning?
Surgical gowning performed without the aid of another person who has performed a surgical hand scrub and donned their own sterile gown and gloves.
What is the function of neutrophils?
First responder to injury
Eat bacteria (phagocytosis)
What is the function of lymphocytes?
Fight chronic bacterial infections
Fight acute viruses
Phagocytes that clean up tissue damage from injury or infection are called?
monocytes
Cells that release histamine, serotonin, and heparin are called?
basophils
Under what two circumstances do we wear gloves?
Potential for direct contact with blood, body fluids, mucous membranes, nonintact skin, or potentially infectious material.
Direct contact with clients colonized/infected with pathogens listed under contact precautions.
What should you do before opening a sterile field?
perform a surgical hand scrub and don a sterile glove and gown
What are the signs and symptoms of infections?
fever, malaise, increased pulse, loss of energy, anorexia, enlarged lymph nodes, secretions
Objects are considered to be unsterile when?
-After prolonged exposure to air
-When touched by unsterile objects
-When out of vision or below the waist
-Wet sterile field becomes unsterile unless water proof barrier underneath
-Edges of the sterile field are considered unsterile
What are the five moments that hand hygiene is performed?
- before touching a patient
- before clean/aseptic technique
- after body fluid exposure risk
- after touching a patient
- after touching patient surroundings
