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INFECTION PREVENTION AND CONTROL. SCIENTIFIC KNOWLEDGE BASE. ENTRY AND MULTIPLICATION OF ORGANISM RESULTS IN DISEASE COLONIZATION OCCURS WHEN A MICROORGANISM INVADES THE HOST BUT DOES NOT CAUSE INFECTION (INJURY TO CELLS) PATIENT SAFETY ISSUE. CHAIN OF INFECTION. Infectious agent or pathogen
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SCIENTIFIC KNOWLEDGE BASE • ENTRY AND MULTIPLICATION OF ORGANISM RESULTS IN DISEASE • COLONIZATION OCCURS WHEN A MICROORGANISM INVADES THE HOST BUT DOES NOT CAUSE INFECTION (INJURY TO CELLS) • PATIENT SAFETY ISSUE
CHAIN OF INFECTION • Infectious agent or pathogen • Reservoir • Portal of exit • Mode of transmission • Portal of entry • Susceptible host
Infectious Agent/Pathogen • Microorganisms (bacteria, viruses, fungi, protozoa • Normal flora • Colonization • Virulence • Susceptibility • Review Potter & Perry Table 34-1 (pg. 643) Common Pathogens
Reservior • Animate sources (humans, animals, insects) • Inanimate sources (soil, water, food, medical equipment) • Pathogens need a proper environment to survive (food, oxygen, water, temperature, pH, light) • Carriers • Toxins: (Exotoxins, endotoxins)
Portal of Exit/Entry • Skin and Mucous Membranes • Respiratory Tract • Urinary Tract • Gastrointestinal tract • Reproductive Tract • Blood
Modes of Transmission • Contact (Direct & Indirect) • Droplet • Airborne • Vehicles • Vectors
Susceptible Host • Susceptibility (Resistance to infection) • Factors which influence susceptible: • Age • Nutritional status • Chronic disease history • Trauma • Smoking
The Infectious Process • Incubation Period • Prodromal Stage • Illness Stage • Convalescence • Pathogenicity of organism • Localized vs. systemic
DEFENSES AGAINST INFECTION • Normal flora • Body System Defenses (P&P Pg.647) • Inflammation • VASCULAR AND CELLULAR RESPONSE • EDEMA • PHAGOCYTOSIS • LEUKOCYTOSIS • INFLAMMATORY EXUDATE • SEROUS • SANGUINOUS • PURULENT
SPECIFIC DEFENSES AGAINST INFECTION • CELL- MEDIATED IMMUNITY • ANTIBODY-MEDIATED IMMUNITY
HEALTH CARE ASSOCIATED INFECTION (NOSOCOMIAL) • Infections that are a result of health care delivery, not present at admission • EXOGENOUS • ENDOGENOUS • IATROGENIC Refer to Potter & Perry Table 34-2 Pg. 648 (Sites for Causes of HAI’s)
Common Health-Care Associated Infections • Urinary Tract Infection • Surgical/Traumatic Wound Infection • Respiratory Tract • Bloodstream
The Nursing Process & Infection Control (Assessment) • Status of defense mechanisms • Client Susceptibility • Nutritional Status • Stress • Disease Process • Medical Therapy • Clinical Appearance • Lab Data
Lab Data • WBC Count • Sedimentation Rate • Cultures of sputum, urine, blood • Differential Count
Assessing Risk for Infection • Age • Disease Processes • Lifestyle • Occupation • Diagnostic Procedures • Medications • Travel History • Nutritional Status
NURSING DIAGNOSIS AND PLANNING • NANDA APPROVED DIAGNOSIS • GOALS AND OUTCOMES • MEASURABLE • REALISTIC • PRIORITIES
Acute Care Interventions • MEDICAL AND SURGICAL ASEPSIS • CONTROL/ELIMINATION OF INFECTIOUS AGENTS • CONTROL/ELIMINATION OF: • MODES OF TRANSMISSION • PORTALS OF ENTRY • RESERVOIRS • HAND HYGIENE (HCP, PATIENT, FAMILY)
INTERVENTIONS • ISOLATION PRECAUTIONS • HYPERTHERMIA INTERVENTION • ELIMINATE UNDERLYING CAUSE • FEVER MANAGEMENT • HEALTH TEACHING • ANTIBIOTIC THERAPY • PSYCHOSOCIAL SUPPORT • HEALTH CARE RESOURCES
Isolation Precautions • CDC and OSHA Guidelines • Contact • Droplet • Airborne
Drug Resistant Organism Infections & Colonizations • Methicillin-Resistant Staphylocuccus aureus (MRSA) • Vancomycin-Resistant Enterococcus (VRE) • Extended-Spectrum Beta Lactamase (ESBL) • Multi-drug Resistant Tuberculosis
Personal Protective Equipment • Gowns • Respiratory Masks • Eye Protection • Gloves • Specimen Collection • Bagging Trash & Linen • Transporting Patients
EVALUATION • MEASURE SUCCESS OF INFECTION CONTROL TECHNIQUES • COMPARE PATIENT’S RESPONSE TO ACTUAL OUTCOME • WHAT WILL YOU DO IF GOAL/OUTCOMES NOT ACHIEVED?