Infection, prevention, and control Flashcards
What are the nurses priorities in infection prevention and control?
- prevent exposure
- early detection
- eliminate or reduce the infection
- educate in infection, prevention, and control
Which one would we most like to achieve ideally?
Prevent exposure
What actions can the nurse take to alter each link in the chain of Infection?
- Hand hygiene sterilization antibiotics/ antimicrobials
- transmission-based precautions/ sterilization or use of disposable supplies
- wear gloves if contact with body fluids/cover nose and mouth when sneezing
-use pesticides to eliminate vectors / adequate refrigeration - use masks and appropriate gear/proper disposal of needles/sharps
- immunizations/ screen health care staff
What are the clients primary defenses against infection?
Skin
eye
mouth
gastrointestinal
respiratory tract
What lifestyle choices and other factors affect a clients risk for infection?
- immunizations
- nutrition and hydration
- hygiene
- rest and sleep
-exercise - stress reduction
What is the difference in medical and surgical asepsis?
Medical asepsis reduces the number and prevents the transfer of organisms.
Surgical asepsis Eliminates microorganisms.
What are the three big components of medical asepsis?
- Hand hygiene
-barrier techniques - clean environment
identify situations in which hand hygiene is indicated.
How does the nurse perform effective hand hygiene in the patient setting?
Situations: When you’re in contact with your patients, After touching fluids; blood; bodily secretions; contaminated items/surfaces, after using gloves
- with soap and water or alcohol-based rubs
What actions are used to support a clean patient environment?
- disposing waste
- single use/ single patient items
- maintain patient environment ( does it need to be clean, disinfected or sterilized)
What are standard precautions?
Prevent contact with blood, body fluids, secretions, non-intact
skin, and mucous membranes with ALL clients.
Gowns- During procedures and patient-care activities
when contact of clothing/exposed skin with
blood/body fluids, secretions, and excretions
Mask
Goggles- patient-care
activities likely to generate splashes or sprays of
blood, body fluids, secretion
Gloves- For touching blood, body fluids, secretions,
excretions, contaminated items; for touching mucous
membranes and nonintact skin
When and how are transmission-based precautions (contact, droplet, airborne) used in patient care?
Transmission-based precautions Droplet
indications: Flu, mumps, diphtheria
Barriers: -Private/ cohort room
encourage visitors to stay 3 ft away
-Don mask on entering the room
-mask on patient when transporting
-patient only leaves room when necessary
Transmission-based precautions airborne
Indications: measles (rubeola), chickenpox (varicella), tuberculosis
Barriers: private room or cohort
-negative air pressure flow
- door closed except when entering or leaving room
- ultraviolet irradiation or air filter
-mask (N95)
-patient only leaves room when necessary
- mask on patient when transporting
Transmission-based precautions contact
Indications: Patients with multi-drug resistant organisms
Barriers: PPE for any contact with patient environment
- gloves & gown
- direct/ indirect
What are the basic principles of sterile technique?
- only sterile objects can be placed in a sterile field
- sterile objects out of vision range or held below a person’s waist is contaminated
-sterile object/field becomes contaminated by prolonged exposure to air
-When a sterile surface comes in
contact with a wet, contaminated
surface, the sterile object or field is
contaminated
-the edges of a sterile field or
container are considered to be
contaminated.
How can the risk for needlestick injuries and other personal exposures be reduced?
Prevent!
* NEVER RECAP
* Safety needles and needleless
systems/ Sharp disposals
Treat (Personal Exposure)
* Wash needlesticks and cuts with soap and water
* Flush splashes to the nose, mouth, or skin with water
* Irrigate eyes with clean water, saline, or sterile irrigants
Report any exposure immediately
Immediately seek medical treatment
Follow-up
* Source patient testing
* Prophylaxis (measures to prevent the spread of disease)
* Monitoring
What steps should be taken if exposure to blood and body fluids
Stop what you’re doing and perform hand hygiene ?
Define and provide examples of these types of infections:
primary and secondary
exogenous versus endogenous
acute versus chronic versus latent
local versus systemic
Exogenous- when the causative organism is acquired from other people
endogenous- infection occurs when the causative organisms comes from microbial life harbored in the person
local- affects only one body part or organ
systemic- infection that affects the entire body
primary infection- usually occur in the skin, if bacterial it will likely be Strap,strep,
secondary infection- occurs during or after treatment of a primary infection bc normal bacterial flora is destroyed allowing yeast to flourish
latent infection- symptomless incubation period; resides in the body of a specific infectious agent (smallpox or measles)
What are healthcare-associated infections (HAIs)?
infections people can get while they are receiving healthcare for another condition
develops as a result of medical care and may occur in many healthcare settings including hospitals, rehabilitation facilities, outpatient settings, and dialysis centers
Examples:
- Catheter-associated urinary tract infections (CAUTI)
- Surgical site infection (SSI)
- Central line-associated bloodstream infection (CLABSI)
- Invasive healthcare-associated and hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) infections
- Clostridioides difficile (C. diff) infections (CDIs) and CDI hospitalizations
What are the basic characteristics of these common multi-drug resistant organisms (MDROs): MRSA, VRE, C. diff?
Methicillin-resistant Staph aureus (MRSA)
Community or hospital-acquired –direct or indirect contact
Skin, bloodstream, and wound infections
Prevent with basic infection control techniques
Vancomycin-resistant enterococci (VRE)
From normal flora in GI and GU tracts
Spreads by contact with infected feces, blood, or urine
Clostridioides Difficile (CDI or “C diff”)
Normal bacteria in intestine that overgrows when balance of normal flora is disrupted
usually by antibiotic use
Watery diarrhea, cramping, fever
Not always an MDRO
Spore-forming; use soap and water hand hygiene
How do you tell the difference in local and systemic infections? What are the clinical manifestations of each?
Local
* Redness, swelling, warmth
* Pain, tenderness
* Loss of function
* Specific to the location
* Wound
* Respiratory
* Urinary
* Gastrointestinal
* Eyes/Ear/Throat
Systemic
* Fever, chills, diaphoresis
* Increased HR and RR
* Malaise
* Anorexia
* Enlarged lymph nodes
* Organ failure
What are the stages of an infectious process that clients typically experience?
Incubation
Microbe enters and multiplies
Prodromal
Vague symptoms
Most infectious
Illness
Clinical manifestations of illness present
Convalescence
Recovery – even if not to previous level of health
Describe nursing actions that support successful treatment of infection (timely administration of medications, obtaining and reporting culture and sensitivity testing, monitoring WBC levels).
Obtain specimens for cultures…
before starting antibiotics if possible
Administer antimicrobial medication at
the correct time.
Monitor level and trends of WBC.
Monitor for and report results of the C&S
WBC
5,000-10,000/mm3
Culture Results
Negative or “No Growth”
Sensitive, Intermediate, or Resistant
How does the nurse provide care for a febrile client?
Administer
antipyretics
antimicrobials
Encourage heat loss
Minimal covers
Cooling cloth or blanket
Alcohol bath? Caution!
Maintain hydration
Provide comfort
measures
Evaluate effectiveness
How can the nurse evaluate whether expected outcomes for reducing infection have been met during nursing care?
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