Infection Prevention and Control Flashcards
Infection, disease, and colonization definition
invasion of susceptible host by pathogens/microbes resulting in disease
Entry and multiplication of organisms having negative effects
Colonization is when microbes invade host, but don’t cause infection
Communicable, symptomatic, and asymptomatic definitions
What is most imp technique to prevent/control infection?
infectious process transmitted from one person to another
when pathogens multiply and cause clinical signs/symptoms
when clinical signs and symptoms are NOT present
Hand washing
Chain of infection
Infectious agent —> Reservoir —> Portal of exit —> Mode of transmission —> portal of entry —> susceptible host
Immunocompromised Virulence Aerobic bacteria Anaerobic bacteria bacteriostasis bacteriocidal
having impaired immune system ability to produce disease require O2 to survive and multiply to cause disease thrive in little or no free O2 areas prevention of growth of bacteria destructive to bacteria
Microorganisms that cause infections
Bacteria –> respond to antibiotics
viruses –> don’t respond to antibiotics –> need antiviral meds
fungus —> antifungal meds
parasites —> treatment depends on type
Reservoir
pace where microbe survives/multiplies/waits to transfer to host
People can be reservoirs when symptomatic or not
food/water
Insects/animals
Inanimate objects
Modes of transmission
Direct contact: person to person
Indirect contact: with contaminated object
Droplet: big drops that tracel up to 3 ft via coughing, sneezing, talking
Airborne: small droplets or residue carried on dust particles
Vehicle: an object that transports infection (h2o, food, doorknob)
Vector: animal that carries microbe
Infectious process
Incubation period –> Interval between entrance of pathogen into body and appearance of first symptoms
Prodromal stage –> infection present, but no classic signs of illness (nonspecific signs ARE present)
illness stage –> signs/symptoms of disease occurring
convalescence –> recovery stage (symptoms have pretty much resolved)
Can be localized or systemic infections
Defenses against infection
Inflammation!!!
Signs of local inflammation and infection are identical
- pain
- swelling
- redness
- heat
- impaired func.
- ends in “itis”
3 stages of inflammation
Vascular/cellular response
-increased blood flow and vasodilation –> increaced WBC production
Exudate production
- body’s defense works to “wall off” infection and prevent spread0
- exudate can be serous (clear), purulent (light yellowish), hemorrhagic (bloody
Reparative phase
- repair of injured tissue by regeneration or scar formation
- granulation tissue is first step
Exudate
serous = clear like plasma
Sanguineous/ hemorrhagic = bloody
purulent = pus with wbcs and bacteria
health care associated infections (HAIS)
Result from delivery of health services in health care facility
Patients at greater risk for HAIS
- mult illnesses
- older ppl
- poorly nourished
- lowered resistance to infection (immunocompromised)
Types of HAIs
Iatrogenic = from a procedure Exogenous = from microorganisms outside individual Endogenous = when patient's flora is altered and an overgrowth results ---> broad spectrum atibiotic use is required to treat
Risk factors of HAIs
of health care employees with direct patient contact
types and # of invasive procedures
therapy received
length of hospitalization
Major sites of HAIs
surgical or traumatic wounds
urinary and respiratory tracts
bloodstream
Risk factors for any infection
Age
Nutritional status (need protein and carbs)
stress
disease process
treatments or conditions that compromise immune response
Nursing process Assessment of infection
Review of systems –> travel history
Immunizations and vaccinations
Gether info from fam and friends
Status of defense mechs
Susceptibility (other conditions or med therapy)
Clinical appearance (signs/symptoms)
Lab Data (WBC should be 5000-10000 and cultures should be neg)
Hand Hygiene
Soap and water before shift, alc-based hand sanitizer before and after contact with patients
Alc-based cleansers not acceptable if visible dirt or C diff is present (or if on chemo precaution)
Do we clip patient’s nails?
NO!!! IT’D BE BAD IF YOU CUT THEM
What influences hygiene?
Social practices Personal preferences Body image Socioeconomic status health benefits and motivation cultural variables
Developmental stage (affects how to wash dif areas and A&P of those areas)
Physical condition
Safety Guidelines for nursing skills
Perform hygiene from cleanest to dirtiest
Continence issues pose threats to skin integrity, increase fall risk, and increase isolation
wear PPE
Test water temp
keep hygeine items within patient’s reach
give proper direction to AP when delegating
monitor lab findings before giving oral hygiene or shaving patient (e.g. coagulation studies)
determine patient’s or caregiver’s knowledge, experience, and health literacy
Nursing Process: Diagnosis for infection
Risk for infection Imbalanced nutrition Impaired oral mucous membrane risk for impaired skin integrity social isolation impaired tissue integrity readiness for enhanced immunization status
Nursing process: Planning
goals/outcomes
set priorities
work with other disciplines
Common goals of patients with infections include
-preventing exposure to infection
control and reduce infection
maintain resistance
verbilize understanding of infection prevention and control techniques (e.g. hand washing)
Nursing process: implementation
Health promotion
-prevent infection from developing or spreading
Acute care
-treating an infectious process includes eliminating the infectious organisms and supporting the patients defenses
Asepsis and Aseptic techniques
Asepsis = absence of pathogenic microorganisms
Medical asepsis (clean technique) includes procedures for reducing number of organisms present and preventing transfer of organisms
Surgical asepsis (sterile technique) prevents contamination of open wound, serves to isolate operative area from unsterile environment, and maintains sterile field for surgery
Standard precautions
Prevent and control infection and its spread
Applies to contact with blood, body fluit, nonintact skin, and mucous membrane
Hand hygiene nicludes instant alc hand anisseptic before and after patient care
Hand washing is the act of washing hands with soap and water, followed by rinsing under a stream of water for 15 seconds.
Cleaning
Disinfection
Sterilization
Cleaning = removing of visible dirt
Disinfection = eliminates microbes except spores from inanimate objects
Sterilization = complete elimination of microbes including spores
Prevention and control
Patient safety
separate personal care items
handling solid and fluid waster
wound cleaning
patient education
cough etiquette
isolation and isolation precautions
surgical asepsis
Cough etiquetter
- 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 and isolation precautions
Isolation is separation and restriction of mvmnt of ill ppl with contagious diseases
Isolation precautions for contact, droplet, airborne, and protective environment
Isolation Precautions
Contact (VRE, MRSA, C diff)
-private room or cohort patients, gloves, gown
Droplet (droplets >5 microns within 3 ft of patient)
-private room or cohort patients, mask/respirator
Airborne (droplet nuclei <5 microns)
-private room, negative-pressure airflow of at least 6-12 exchanges per hour via high-efficiency particulate air (HEPA) filtration; mask/respiratory protection device; N95 respirator (maybe)
Isolation impacts
psychological impacts
isolation environments
specimen collection
bagging of trash or linene (is red bag needed?)
Patient transport
Masks
Surgical masks: works for protection against most infectious agents –> change when wet or soil
N95 masks for highly contagious respiratory infactions (TB, SARS, flu)
-need to be fitted for this mask
Surgical asepsis 7 principles
- sterile object remains sterile only when touching other sterile objects
- only sterile objects can be placed on sterile field
- a sterile object or field out of range of vision or an object below a person’s waist is contaminated
- sterile object or field becomes contaminated by prolonged exposure to air
- when sterile surface meets wet, contaminated surface, the sterile one is contaminated by capillary action
- fluid flows in direction of gravity
- outer 1-2” of a sterile field are contaminated
