Exam I: Infection Control

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)

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

Hospital Acquired Infections

Infections which result from the delivery of health services in a healthcare setting

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*

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.

Skin Integrity

pH of GI/GU tracts

Immunizations/Acquired Immunity

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

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

Clean technique

Procedures used to reduce and prevent the spread of organisms.

Handwashing, using gloves and gowns, etc...

Sterile Technique

Procedures used to eliminate ALL microoganisms

When inading a sterile area of a patient's body

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 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.

Caused by needlestick

HepB/HPB

Contact precautions

Gown and gloves and goggles (for irrigation or possible splash)

Standard precautions (maybe gloves and mask) and avoid exposure

Gloves and goggles (possible splash risk)

Contact precaution

Contact precaution

Droplet precaution (if not immunized or pregnant)

Standard precautions

Airborne precautions