January 7, 2019 Infection Control: Medical and Surgical asepsis Flashcards
What is an infection
• “a disease state resulting from entry and multiplication of a pathogen in the tissues of a host, causing the body to manifest clinical signs and symptoms”
Nature of infection
a. Entry and multiplication of a pathogen result in disease.
b. Communicable disease is the condition in which the infection can transmitted from one person to another.
c. Resident skin microorganisms are usually nonpathogenic but cause infection after surgery or an invasive procedure.
d. Patients are also at risk when immunocompromised.
Breaking the chain of infection
- Hand hygiene
- Proper PPE
- Proper getting rid of things
- Proper nutrition
- Preventative antibiotics
When to wear and not to wear gloves
- Handling body substances/potential exposure
- Reduce transmission of organisms to client
- Open sores or cracks on hands
- Remember: hand hygiene before gloving
Microorganisms include bacteria, viruses, fungi and protozoa
Two types
a. Resident flora (friction and time to get these off)
b. Transient microorganisms
Potential to cause disease depends on several factors
a. Number
b. Virulence
c. Entry and survival in host
d. Susceptibility of host
What us a reservoir
2 forms
a. Colonization
b. Carriers
Pathogens need a reservoir that has what 5
o Food o Oxygen (or no oxygen) o Water o Appropriate temp and pH o Minimal light
Chain of infection
Infectious agent
Reservoir
Portal of exit
mode of transmission
Portal of entry
Host
What is a portal of exit
forms
- The path by which the pathogen leaves the reservoir
- Body openings (mouth, nose, rectum, vagina, urethra, ostomies)
- Breaks in skin (scrape, cut, or other wound)
- Breaks in mucous membranes (skin in mouth, eyes, nose, vagina, rectum)
- Pathogens carried through portals by blood, body fluids, excretions, and secretions
Modes of transmission 5
• Contact transmission • Droplet transmission (sneezing and coughing)\ o Influenza • Airborne transmission • Vehicle transmission • Vector borne transmission
Portal of entry
Same as exit
Severity of infection depends on? 3
a. Extent: localized or systemic
b. Pathogenicity of the microorganism
c. Host susceptibility
What factors increase susceptibility
- Close contact to other pts
- Nutrition
- Meds
- Immunity
- Medical conditions (diabetes, heart disease)
- Post op
Course of infection by stages 4
• Incubation period o Don’t know if they have it yet o Build up of germs o Varies • Prodromal stage o Onset of non-specific signs and symptoms • Illness stage o Signs and symptoms of specific infection • Convalescence o Recovery phase
Defenses against infection
• Normal flora • Body system defenses • Inflammation (3 part) o Vascular and cellular responses o Inflammatory exudate o Tissue repair • Immunization
Signs of local and systemic infection
• Local o Warm, hot, pus • Systemic o Spreads to other parts o Fever o Nausea o Vomiting o Tired o Large lymph nodes o Elevated white blood cell Elderly don’t show specific signs
Points on sepsis
- From any bacterial infection
- Silent killer
- Difficult to spot
- Sepsis protocols
- Universal screen
Examples of infection control nursing diagnoses
- Disturbed body image
- Risk for infection
- Risk for injury
- Imbalanced nutrition—less than body requirements
- Impaired oral mucous membrane
- Risk for impaired skin integrity
- Social isolation
- Impaired tissue integrity
What is a HAIS
Hospital Acquired infections (HAIs)
Aka: nosocomial, iatrogenic (hospital caused infection)
What causes risk for infection
- Number of HCPs (health care providers)
- Invasive procedures
- Therapies
- Length of stay
Stats
• 1 in 25 pts battles infection
• 1 in 9 people die from infection from hospital
o Pneumonia
o Gi illness
Two forms of aseptic technique and what they are about
Medical Asepsis (clean technique)
• Reduce & prevent the spread of microorganisms
• Standard, routine practices
• Isolation procedures
• Cleaning, disinfecting, sterilizing
• See agency infection control manual
Surgical Asepsis (sterile technique)
• Procedures to eliminate all microorganisms.
• An object or area is considered contaminated when touched by any object that is not sterile.
• Nurses must be aware of breaks in technique.
When is surgical asepsis used
• Sterile dressing change • Insertion of lines that go into the skin o Catheter, IV line o Surgical procedures o Invasive diagnostic tests
Seven principles of surgical asepsis
- 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 to air.
- When a sterile surface comes in contact with a wet contaminated surface, the sterile object or field becomes contaminated by capillary action. Avoid splashing.
- Fluid flows in the direction of gravity
- The edges (2.5 cm border) of the sterile field or container are considered to be contaminated.
Points on maintaining a sterile field
• Check package: expiry date, intact & dry
• If in doubt, throw out…
• Only front of gown and above waist is sterile.
• Do not turn back on field.
• Sterile gloves/instruments in sight, above waist.
• Doors closed, no drafts.
• Avoid coughing, sneezing or talking
• If respiratory infection, refrain from procedure or wear mask.
• Avoid moisture on sterile field.
• 2.5 cm (1inch) margin of field unsterile
• Once sterile field open, work quickly and then dispose.
• Use sterile gloves or forceps to touch sterile objects, TIPS DOWN.
• Short sleeves, hair back.
-LIP THE BOTTLE
-MEMORIZE ME (Conscientiousness, alertness and honesty are essential qualities in maintaining surgical asepsis.)
