Infection Control

Infectious agent: bacteria, viruses, fungi Reservoir: natural habitat of the organism Portal of exit: point of escape for the organism Means of transmission: direct contact, indirect contact, airborne route Portal of entry: point at which organisms enter a new host Susceptible host: must overcome resistance mounted by host's defenses

A. Bacteria

Bacteria: most significant and most prevalent in hospital settings Virus: smallest of all microorganisms Fungi: plant-like organisms present in air, soil, and water

Spherical (cocci), rod shaped (bacilli), corkscrew shaped (spirochetes) Gram positive or gram negative—based on reaction to Gram stain Aerobic or anaerobic—based on need for oxygen

Number of organisms Virulence Competence of person's immune system Length and intimacy of contact between person and microorganism

Other people Animals Soil Food, water, milk Inanimate objects

D. Influenza

Incubation period: organisms growing and multiplying Prodromal stage: person is most infectious, vague and nonspecific signs of disease Full stage of illness: presence of specific signs and symptoms of disease Convalescent period: recovery from the infection

Respiratory Gastrointestinal Genitourinary tracts Breaks in skin Blood and tissue

Intact skin and mucous membranes Normal pH levels Body's white blood cells Age, sex, race, hereditary factors Immunization, natural or acquired Fatigue, climate, nutritional and general health status Stress Use of invasive or indwelling medical devices

Demonstrate effective hand hygiene and good personal hygiene practices. Identify the signs of an infection. Maintain adequate nutritional intake. Demonstrate proper disposal of soiled articles. Use appropriate cleansing and disinfecting techniques. Demonstrate an awareness of the necessity of proper immunizations. Demonstrate stress-reduction techniques.

Redness Heat Swelling Pain Loss of function

Elevated white blood cell count—normal is 5,000 to 10,000/mm3 Increase in specific types of white blood cells Elevated erythrocyte sedimentation rate Presence of pathogen in urine, blood, sputum, or draining cultures

Moment 1 - Before touching a patient Moment 2 - Before a clean or aseptic procedure Moment 3 - After a body fluid exposure risk Moment 4 - After touching a patient Moment 5 - After touching patient surroundings

Transient: attached loosely on skin, removed with relative ease Resident: found in creases in skin, requires friction with brush to remove

Urinary tract infections Surgical site infections Bloodstream infections Pneumonia (USDHHS, 2012b)

Compromised immune systems Recent abdominal or chest surgery Presence of urinary or central IV catheter Prolonged antibiotic use, especially with vancomycin Lengthy hospital stay, especially in an ICU (Riley, 2012; CDC, 2010c)

Prescribe antibiotics cautiously. Use contact precautions for patients confirmed or suspected of having CDI. This includes a private room, and use of gown and gloves when entering the room and during patient care. Use effective hand hygiene. Have room and nondisposable equipment cleaned with bleach or other appropriate disinfectant. Upon transfer out of the facility, notify the new facility about the C. difficile infection (Splete, 2012).

Constant surveillance by infection-control committees and nurse epidemiologists Written infection-prevention practices for all agency personnel Hand hygiene recommendations Infection control precaution techniques Keeping patient in best possible physical condition

Body's normal flora Inflammatory response Immune response

Nature of organisms present Number of organisms present Type of equipment Intended use of equipment Available means for sterilization and disinfection Time

A. true

Gloves Gowns Masks Protective eyewear

A. True

Used in the care of all hospitalized patients regardless of their diagnosis or possible infection status Apply to blood, all body fluids, secretions, and excretions except sweat (whether or not blood is present or visible), nonintact skin, and mucous membranes New additions are respiratory hygiene/cough etiquette, safe injection practices, and directions to use a mask when performing high-risk prolonged procedures involving spinal canal punctures

Used in addition to standard precautions for patients in hospitals with suspected infection with pathogens that can be transmitted by airborne, droplet, or contact routes. The 2007 guidelines include a directive to don personal protective equipment (PPE) when entering the room of a patient on contact or droplet precautions. Previously, PPE was only required when the nurse was delivering care within 3 feet of the patient. These categories recognize that a disease may have multiple routes of transmission: airborne, droplet, contact).

Includes all activities to prevent or break the chain of infection Two categories Medical asepsis: clean technique Surgical asepsis: sterile technique

Operating room, labor and delivery areas Certain diagnostic testing areas Patient bedside For example, for procedures that involve insertion of urinary catheter, sterile dressing changes, or preparing and injecting medicine

Wash hands before preparing or eating food. Prepare foods at high enough temperatures. Use care with cutting boards and utensils. Keep food refrigerated. Wash raw fruits and vegetables. Use pasteurized milk and fruit juices. Wash hands after using bathroom. Use individual care items.

Use techniques of medical asepsis. Identify health habits and lifestyle patterns promoting health. State signs and symptoms of an infection. Identify unsafe situations in the home environment.

Bacteria that require oxygen to live and grow

A process that does not require oxygen

immunoglobin produced by the body in response to a specific antigen

foreign material capable of inducing a specific immune response

antibacterial agent that kills bacteria or suppresses their growth

absence of disease-producing microorganisms; using methods to prevent infection

most significant and most commonly observed infection-causing agents

evidence based best practices that have proven positive outcomes when implemented together to prevent infection

presence of an organism residing in an individuals body but with no clinical signs of infection

A process whereby pathogenic organisms, but not necessarily all microorganisms or spores, are destroyed

something that occurs with predictability in one specific region or population and can appear in a different geographical location

the infection or disease originates within the body

Infection that occurs when causative organism is acquired from outside of the body

plant-like organisms (molds and yeasts) that can cause infection

An infection defined as occurring in a patient in a hospital or healthcare setting in whom it was not present or incubating at the time of the admission

Animal or person on which or in which another organism lives

infection aused by treatment or diagnostic procedures

A disease caused by an invasion of pathogenic microorganisms in or on the body

protective procedure designed to prevent the transmission of specific microorganisms; also called protective aseptic techniques and barrier techniques

practices used to remove or destroy pathogens and to prevent their spread from one person or place to another person or place; clean technique

An infection that is acquired in a hospital setting

An organism that harms that lives inside or on a host for nourishment

disease producing microorganism

Protective clothing, masks, gloves, and eye-wear to protect employees from infectious material

Natural habitat for growth and multiplication of organisms

CDC precautions used in the care of all patients regardless of their diagnosis or possible infection status; this category combines universal and body substance precautions.

1. A process that destroys all microorganisms, including spores and viruses (Examples: moist heat, gas, boiling water, & radiation). 2. surgical procedure performed to render a person infertile

the practices that keep items free from all microbes; sterile technique

Second tier of CDC guidelines that applies to specific categories of patients and that include air, contact, and droplet precautions. Used in addition to Standard Precautions.

non-human carriers - such as mosquitoes, ticks, and lice - that transmit organisms from one host to another

ability to produce a disease

smallest organism; can be seen only by an electron microscope.

B. Prodromal stage pt doesn't realize that they're contaminated