Exam I: Infection Control
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The invasion and reproduction of mircoorganisms in a body tissue that can result in a local (redness at site) or systemic (fever, low WBC) clinical response such as cellulitis, fever, etc..
Nurses are the biggest contributor to creating or preventing infection in the hospital setting
An agent of disease; a disease producer. Most commonly used to refer to infectious organisms.
ie. Bacteria (staph) biggest problem in hospitals, Viruses (HIV), Fungi (yeast)
Why are clients in the healthcare setting more at risk for developing infections?
Lower resistance to infectious microorganisms due to disease or illness
Exposure to an increased number of and more types of disease-causing organisms
The performance of invasive procedures
What are Nosocomial Infections?
Hospital Acquired Infections
Infections which result from the delivery of health services in a healthcare setting
Stages of Infection
Incubation: Initial exposure. No signs or symptoms.
Prodromal: Most infectious. Mild symptoms (still may not know they have an infection). IMPORTANT because they may not know they are infecting other people.
Full Stage: Full blown symptoms of diease
Convalescent: Recovery period.
*last 3 stages are not static*
Body's Defenses Against Infection
Immune Response: WBC detect and react to an invading organism. Antigen/Antibody response, Lymphocyte Response
Inflammatory Response: Activated by Injury or Infection. Protective mechinism responding to help repair tissue for an injury or attacking an invading organism.
Factors affecting risk of Infection
pH of GI/GU tracts
Stress, age, overall health status & nutritional status
methicillin resistant staphylococcus aureus
Easily transmitted by health care workers b/c it frequently colonizes on the skin which is why it's so important to WASH YOUR HANDS.
Patients which MRSA are on contact precautions
White Blood Cell Count with % of all types of WBC
Indicates what is causing a fever/infection
Spike in number of WBC indicate Acute Infection
C & S
Culture and Sensitivity
Bacteria is grown to show which antibiotics it's sensitive to to determine the type of infection.
Sample should be taken before they administration of antibiotics and fever reducers (before treatment of symptoms)
Broad spectrum anitbiotic is administed initally and is adjusted as report comes back.
vancomycin resistant enterococcus
Normally live in the GI/GU area.
Cross-infection is attributed to thermometers, commodes, movement of inadequately cleansed patient furniture (lives "for quite a while")
Important to be aware of what you are bringing in and out of rooms of patients with VRE.
Patients with VRE are put in isolation rooms.
ALL practices used to prevent the spread of infection.
#1 infection control method is washing hands
Procedures used to reduce and prevent the spread of organisms.
Handwashing, using gloves and gowns, etc...
Procedures used to eliminate ALL microoganisms
When inading a sterile area of a patient's body
Principles of Basic Infection Control: Tips for Practice
1. Microorganisms move through space on air currents - avoid shaking or tossing linens. Do not place dirty linen on the floor.
2. Microoganisms are transferred from one surface to another whenever objects touch, a clean item touching a less clean item becomes "dirty" - keeps hands away from face, keep linens away from uniforms, an item dropped on the floor is considered dirty.
3. Microorganisms are transferred by gravity when one item is held above another, avoid passing dirty items over clean items. Clean items on upper shelves - dirty items on bottom shelves (ex. bedpan)
4. Microoganisms are relreased into the air on droplet nuclei whenever a person breathes or speaks - aviod breathing directly in someone's face. When someone coughs or sneezes cover mouth with tissue, discard and wash hands.
5. Microorganisms move slowly on dry surfaces, but very quickly through moisture - use dry paper towl to turn off faucets and dry bath basin before returning it to the bedside table.
6. ALWAYS WASH HANDS BETWEEN PATIENTS.
When should hands be washed or sanitized
When visably soiled (WASH ONLY)
After contact with a source of microoganisms (blood, bodily fluids, mucus membranes, etc..)
Prior to administering invasive procedures
Before and after removing gloves
At the begining and end of every shift
Used on EVERYBODY
Ex. Giving the patient a bath: wash hands, gloves and maybe a gown.
Prevent transmission of infectious agents that remain infectious over long distances when suspended in the air.
e.g., rubeola virus (measles), varicella virus (chickenpox), M. tuberculosis, and possibly SARS-CoV
The preferred placement for patients who require Airborne Precautions is in an airborne infection isolation room (AIIR).
Healthcare personnel caring for patients on Airborne Precautions wear a mask or respirator (N95), gown and gloves that are donned prior to room entry.
Prevent transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions.
e.g., B. pertussis, influenza virus, adenovirus, rhinovirus, N. meningitides, and group A streptococcus
A single patient room is preferred for patients who require Droplet Precautions.
Healthcare personnel wear a mask (a respirator is not necessary) for close contact with infectious patient; the mask is generally donned upon room entry. If contact with secretions, wear a gown, gloves and goggles as well.
Patients on Droplet Precautions who must be transported outside of the room should wear a mask if tolerated and follow Respiratory Hygiene/Cough Etiquette.
prevent transmission of infectious agents, including epidemiologically important microorganisms, which are spread by direct or indirect contact with the patient or the patient's environment
e.g., excessive wound drainage, fecal incontinence, or other discharges from the body or patients infected with MDROs (multi-drug resistant organisms)
A single-patient room is preferred for patients who require Contact Precautions.
Healthcare personnel caring for patients on Contact Precautions wear a gown and gloves for all interactions that may involve contact with the patient or potentially contaminated areas in the patient's environment. Donning PPE upon room entry and discarding before exiting the patient room is done to contain pathogens.
Use patient dedicated disposable equiptment. Clean and disinfect shared equiptment.
What are bloodborne pathogen do healthcare providers need to worry about the most?
Caused by needlestick
What PPE should be used with a patient with VRE in a wound?
Gown and gloves and goggles (for irrigation or possible splash)
What PPE should be used on a patient with pneumonia, productive cough and who requires frequent suctioning?
Standard precautions (maybe gloves and mask) and avoid exposure
What PPE should be used on a patient who has HIV and has a urinary catheter?
Gloves and goggles (possible splash risk)
What PPE should be used on a patient with C.difficil, diarrhea and an open wound?
What PPE should be used on a patient with a history of MRSA admitted to the hospital from a nursing home?
What PPE should be used on a patient with chicken pox?
Droplet precaution (if not immunized or pregnant)
What PPE should be used on a patient who has HepC from IV drug use?
What PPE should be used on a patient complaining of night sweats who has a productive cough and an abnormal CXR?
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