INFECTION CONTROL

Fundamentals of Nursing NUR 102 Infection Control

Chain of Infection
An infectious agent or pathogen Reservoir Portal of exit Mode of transmission Portal of entry Susceptible host

Infectious agent Reservoir

Ways to break chain of infection

Proper cleaning, disinfection, and sterilization (surgical instruments are autoclaved) Eliminate sources of body fluids that harbor microorganisms

Portal of exit

Ways to break chain of infection

Prevent infectious organisms from exiting the body (eg. avoid coughing over patients) Carefully handle exudate

Mode of transmission
Handwashing personalized items keep soiled items away from you

Portal of entry

Ways to break the chain of infection (contd)

Maintain intact skin and mucous membranes (eg. turn q 2h, good hygiene) Properly handle body fluids

Susceptible host
Good isolation practices

Skin - intact Mouth - intact; saliva Respiratory tract - cilia; cough reflex

NORMAL BODY DEFENSES

 Urinary tract - intact; urine flow GI tract - acidity, peristalsis Vagina - normal flora cause low ph

S/S OF INFLAMMATION
Some Drunk Fools Prefer Red Wine

S/S OF INFLAMMATION
S - swelling DF - decreased function P - pain R - redness W - warmth

The Inflammatory Process

A protective reaction that neutralizes pathogens and repairs body cells. Normal flora Body systems defenses Inflammation Vascular & cellular response Inflammatory exudates Tissue repair General Adaptation Syndrome (GAS)

Alarm reaction stage-rising hormone levels result in increase blood volume, blood glucose levels etc Resistance stage-body stabilizes Exhaustion stage-body can no longer resist the effects of the stressor Asepsis is the absence of pathogenic microorganisms. Medical (clean) technique-includes procedures to reduce and prevent the spread of microorganisms Surgical(sterile)- eliminates all microorganisms

Stages of GAS

Types of Asepsis

Medical Aseptic Procedures

 Hand Hygiene Alcohol-based waterless antiseptic Clean dressing procedures

Used during procedures that intentionally break the skin (IVs) Surgical trauma or burns Procedures that involve involve insertion of catheters into sterile body cavities

Surgical Asepsis

Localized-client may experience localized symptoms such as pain & tenderness at the wound site Systemic-affects the entire body instead of just a single organ. Can be fatal

The Infectious Process

WBC - 5,000 - 10,000 Erythrocyte sedimentation rate - detects inflammation Cultures (C&S)

LAB TESTS TO DETECT INFECTION

Incubation Period-interval between entrance of pathogen into body and appearance of first symptoms Prodromal Stage-interval from onset of nonspecific s/s (tired) Illness stage-client shows s/s (sore throat) Convalescence-acute symptoms disappear

Stages of Infection

PSYCHOLOGICAL IMPLICATIONS OF ISOLATION

Loneliness Altered body image Limitation of sensory input Nursing interventions:
Converse with patient; Listen Comfort measures ; nonjudgemental attitude

Sterile can only touch sterile to maintain sterility Sterile + clean = contaminated Sterile + contaminated = contaminated

KEY POINTS OF SURGICAL ASEPSIS

STERILE FIELDS

An area free of microorganisms Kept at waist level Never talk, cough or reach over this area Avoid prolonged exposure to air and excessive movements Can be contaminated when in contact with wet contaminated surfaces

Universal precautions shall be observed to prevent contact with blood or other potentially infectious material Work practice control to eliminate employee exposure Accessible hand-washing facilities Hand-hygiene practices No food kept where blood products are present

OSHA GUIDELINES FOR HEALTH CARE PROVIDERS

STANDARD PRECAUTIONS
Tier one: Hands are washed Gloves are worn when touching body fluids Masks are worn for splash occurrences Gowns are worn if soiling of clothing is likely Equipment is cleaned properly Discard sharps instruments properly

Standard Precautions Contd

Tier two: Airborne precautions-mask (measles) Droplet precautions- mask (mumps) Contact precautions-gloves & gown (respiratory synctial virus (RSV), scabies)

Gowning- prevents soiling of clothes Full face protection-when splashing may occur Gloves- prevents transmission of pathogens by direct or indirect contact Fire- smoke & fire alarms; plan of action in case of fire Electrical-electrical equipment in good working order Chemicals- out of reach of children & stored properly

Personal Protective Equipment

Measures to Ensure a Safe Environment DOCUMENTATION PROCESSES

Documentation should be accurate, factual, complete, current, organized Material Safety Data Sheet (MSDS)-provide workers & ER personnel with the proper

procedures for handling or working with a particular substance Policies & procedures-conform to state & federal laws

Process for Reporting

Breaches in safety & security Ethics committee Chain of command Incident reports-risk management tool Health Insurance Portability and Accountability Act (HIPPA)