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1. Infection Control
2. Abbreviations CDC – Centers for Disease Control
AIDS – Acquired Immunodeficiency Virus
CBC – Complete Blood Count
C&S – Culture and Sensitivity
HIV – Human Immunodeficiency Virus
PEP – Post Exposure Protocol
3. Asepsis Medical – includes all practices intended to confine a specific microorganism to a specific area, limiting number, growth & transmission – clean vs. dirty
Surgical Asepsis – sterile technique – practices to keep an area free from all microorganisms
4. Types of Infection Local
Systemic
Acute
Chronic
5. Nosocomial Infections Infections that are associated with the delivery of health care services in a health care facility
Point of origin
Endogenous
Exogenous
Iatrogenic
6. Risks for Nosocomial Infection Poor hand washing
Compromised host – surgery/illness
Improper procedure technique – dressing, suctioning, catherization
Improper cleaning/maintenance of invasive devices – foley catheter, IV line
Contamination of closed drainage system – chest tubes
7. Chain of Infection Etiologic Agent
Reservoir
Portal of Exit from Reservoir
Method of Transmission
Portal of Entry into Susceptible Host
Susceptible Host
8. Etiologic Agents Bacteria
Viruses
Fungi
Parasites Resident
Transient
9. Reservoir Environmental
Human
Animal/Insect
10. Portal of Exit from Reservoir Mouth, nose
Urinary tract
Wounds
Device insertion sites
Other orifices
11. Method of Transmission Direct
Indirect
Vehicle-borne
Vector-borne
Airborne
12. Factors Increasing Susceptibility to Infection Age
Heredity
Level of stress
Nutritional status
Medications
Illness – acute/chronic
13. Body Defenses Against Infection Anatomic & Physiologic Barriers
Inflammatory Response
Antibody-Mediated Defenses
Cell-Mediated Defenses
14. Inflammatory Response Five Signs:
Pain
Swelling
Redness
Heat
Impaired Function Three Stages:
Vascular and cellular responses
Exudate production
Reparative phase
15. Antibody-Mediated Defenses Active
Infectious microorganisms
Vaccines
Passive (Acquired)
Natural – breast milk
Artificial – immune serum
16. Cell-Mediated Defenses T-cell system – exposure to antigen causes release into lymph system
Helper
Cytotoxic
Suppressor
17. Course of Infection Incubation period – time between initial contact and appearance of symptoms
Prodromal stage – time from onset of nonspecific symptoms to more specific symptoms – transmission possible
18. Course of Infection Full/Illness stage – time that specific symptoms present – acute – transmission possible
Convalescence – time when symptoms resolve and host returns to pre-illness state
19. Laboratory Tests White blood cell count – Leukocyte – nonspecific unless differential done to break down types of WBC’s – normal 4,500 – 11,000
Erythrocyte sedimentation rate – ESR – increased rate of RBC’s settling in presence of inflammatory process
Culture & Sensitivity – C&S urine, blood, sputum, wound – determines organism and effective medication
20. Nursing Diagnosis Risk for Infection – PRIMARY
Potential Complications of Infection
Impaired Physical Mobility
Imbalanced Nutrition
Acute Pain
Impaired Social Interaction/Social Isolation
Situational Low Self-Esteem
Anxiety
21. Breaking the Chain of Infection Host
Reservoir
Portal of Exit
Transmission
Portal of Entry
22. Interventions to Reduce Risk of Infection
Preventing Nosocomial Infections:
Hand washing
Proper technique
Environmental controls
Management of clients at risk
23. Interventions to Reduce Risk of Infection Supporting Defenses of Susceptible Host:
Hygiene 5. Immunizations
Nutrition 6. Stress
Fluid
Rest and sleep
24. Interventions to Reduce Risk of Infection
Cleaning, Disinfecting, Sterilizing
Cleaning inhibits growth of microorganisms
Disinfecting with chemicals – bacteriostatic vs. bactericidial
Sterilizing – destroys all microorganisms – including spores/viruses – moist heat, gas, boiling water, radiation
25. CDC Isolation Guidelines Tier One
Standard Precautions
Tier Two –Transmission Based Precautions
Airborne
Droplet
Contact
26. Standard Precautions All clients
Apply blood, body fluids, excretions/secretions, non-intact skin, mucous membranes
Designed to reduce risk of transmission from all sources
27. Airborne Precautions Infections spread through air – TB, varicella, rubeola
Private room – negative air pressure/air exchange
Door closed
Respiratory equipment
Mask client in transport
28. Droplet Precautions Large particle droplet infections – rubella, mumps, scarlet fever, some pneumonias
Private room or cohort
Respiratory protective equipment – within 3 feet of client
Transport client with mask
29. Contact Precautions Infections spread by direct/indirect contact – wound infections, scabies, antibiotic resistant infections – MRSA, VRE
Private room or cohort
Gloves entering room – wash hands in room
Personal protective equipment when in direct contact with infected body secretions
Limit movement client outside of room
30. Protective Isolation Protects clients with compromised immune systems
Private room
Protective garb worn in room – gloves, gown, mask – may vary with facility
No fresh fruits, vegetables, flowers
Client mask outside of room
31. Guidelines for Exposure to Bloodborne Pathogens Report – verbal, written
Seek appropriate evaluation and follow-up
Puncture/laceration
Mucous membrane exposure
Post exposure protocols – PEP – HIV and hepatitis B & C