January 7, 2019 Infection Control: Medical and Surgical asepsis

Question 1

What is an infection

Answer 1

• “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”

Question 2

Nature of infection

Answer 2

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.

Question 3

Breaking the chain of infection

Answer 3

• Hand hygiene
• Proper PPE
• Proper getting rid of things
• Proper nutrition
• Preventative antibiotics

Question 4

When to wear and not to wear gloves

Answer 4

• Handling body substances/potential exposure
• Reduce transmission of organisms to client
• Open sores or cracks on hands
• Remember: hand hygiene before gloving

Question 5

Microorganisms include bacteria, viruses, fungi and protozoa

Two types

Answer 5

a. Resident flora (friction and time to get these off)

b. Transient microorganisms

Question 6

Potential to cause disease depends on several factors

Answer 6

a. Number
b. Virulence
c. Entry and survival in host
d. Susceptibility of host

Question 7

What us a reservoir

2 forms

Answer 7

a. Colonization

b. Carriers

Question 8

Pathogens need a reservoir that has what 5

Answer 8

o	Food
o	Oxygen (or no oxygen)
o	Water
o	Appropriate temp and pH
o	Minimal light

Question 9

Chain of infection

Answer 9

Infectious agent

Reservoir

Portal of exit

mode of transmission

Portal of entry

Host

Question 10

What is a portal of exit

forms

Answer 10

• 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

Question 11

Modes of transmission 5

Answer 11

•	Contact transmission
•	Droplet transmission (sneezing and coughing)\
o	Influenza 
•	Airborne transmission
•	Vehicle transmission
•	Vector borne transmission

Question 12

Portal of entry

Answer 12

Same as exit

Question 13

Severity of infection depends on? 3

Answer 13

a. Extent: localized or systemic
b. Pathogenicity of the microorganism
c. Host susceptibility

Question 14

What factors increase susceptibility

Answer 14

• Close contact to other pts
• Nutrition
• Meds
• Immunity
• Medical conditions (diabetes, heart disease)
• Post op

Question 15

Course of infection by stages 4

Answer 15

•	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

Question 16

Defenses against infection

Answer 16

•	Normal flora
•	Body system defenses
•	Inflammation (3 part) 
o	Vascular and cellular responses
o	Inflammatory exudate
o	Tissue repair
•	Immunization

Question 17

Signs of local and systemic infection

Answer 17

•	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

Question 18

Points on sepsis

Answer 18

• From any bacterial infection
• Silent killer
• Difficult to spot
• Sepsis protocols
• Universal screen

Question 19

Examples of infection control nursing diagnoses

Answer 19

• 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

Question 20

What is a HAIS

Answer 20

Hospital Acquired infections (HAIs)

Aka: nosocomial, iatrogenic (hospital caused infection)

Question 21

What causes risk for infection

Answer 21

• Number of HCPs (health care providers)
• Invasive procedures
• Therapies
• Length of stay

Question 22

Stats

Answer 22

• 1 in 25 pts battles infection
• 1 in 9 people die from infection from hospital
o Pneumonia
o Gi illness

Question 23

Two forms of aseptic technique and what they are about

Answer 23

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.

Question 24

When is surgical asepsis used

Answer 24

•	Sterile dressing change
•	Insertion of lines that go into the skin 
o	Catheter, IV line 
o	Surgical procedures 
o	Invasive diagnostic tests

Question 25

Seven principles of surgical asepsis

Answer 25

1. A sterile object remains sterile only when touched by another sterile object.
2. Only sterile objects may be placed on a sterile field.
3. A sterile object or field out of the range of vision or an object held below a person’s waist is contaminated.
4. A sterile object or field becomes contaminated by prolonged exposure to air.
5. When a sterile surface comes in contact with a wet contaminated surface, the sterile object or field becomes contaminated by capillary action. Avoid splashing.
6. Fluid flows in the direction of gravity
7. The edges (2.5 cm border) of the sterile field or container are considered to be contaminated.

Question 26

Points on maintaining a sterile field

Answer 26

• 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.)