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• Infection


  The result of an interaction between a susceptible host and an infectious agent (bacteria, viruses, fungi, parasites) - a clinical syndrome caused by the invasion and multiplication of a pathogen in the body
• Types of infections


  • Localized
  • Systemic
• Course of infection


  1. Incubation

  2. Prodromal

  3. Period of clinical illness

  4. Convalescence
• Nosocomial infection


  A hospital-acquired infection
• Iatrogenic infection


  A direct result of treatments
• Primary defenses against infection


  • Skin and mucous membrane
  • Respiratory system
  • Gastrointestinal system
  • Circulatory system
• Secondary defenses against infection


  • Inflammatory response
  • Immunity
• Inflammatory response


  • Local reaction to an infectious agent, serves to localize, destroy, dilute, neutralize, remove a pathogen, signs are redness, heat, swelling and pain
• Immunity


  A measure of a person's ability to fight disease by forming immune globulins (antibodies formed against invading antigens), or producing interferon
• Components of the infection cycle


  • Infectious agent
  • Reservoir
  • Portal of exit
  • Means of transmission
  • Portal of entry
  • Susceptible host
• The chain of infection consists of the source of infection/pathogenic organism, factors affecting an organism's potential to produce disease, and the components of the infection cycle
• Possible reservoirs for microorganisms


  • Other humans
  • Animals
  • Soil
  • Food, water, milk
  • Inanimate objects
• Common portals of exit


  • Respiratory
  • Gastrointestinal
  • Genitourinary tracts
  • Breaks in skin
  • Blood and tissue
• Modes of transmission


  • Direct contact
  • Droplets
  • Vectors
  • Airborne
• Portals of entry to host


  • Eyes
  • Mucous membranes
  • Respiratory tract
  • Placenta
  • Breaks in the host barriers
• Factors affecting host susceptibility


  • Intact skin and mucous membranes
  • Normal pH levels (7.35 – 7.45)
  • 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
• Factors predisposing patients to nosocomial infections


  • Use of invasive medical devices
  • Antibiotic-resistant organisms developed in hospitals
• Measures to reduce incidence of nosocomial infections


  • 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
• Infection control measures used in the hospital


  • Medical Asepsis
  • Standard Precautions
  • Isolation Precautions
• Medical asepsis


  Practices designed to reduce the numbers of pathogenic microorganisms and limit their growth and transmission in the patient's environment
• Hand hygiene


  The first line of defense in medical asepsis, considered the single most effective way to stop the spread of microorganisms and preventing infection
• When should you wash your hands?


  • At the start of each shift
  • After sneezing or coughing
  • After using the bathroom
  • After handling contaminated items
  • Before and after giving patient care and between patients
  • After handling body excretions- even with gloves on
  • Before and after performing any treatments
  • After removing gloves
  • At the end of each shift before leaving the health facility
• Guidelines and principles for medical asepsis


  • Do not touch the sink when washing hands – stand away
  • Keep clean items separate from dirty ones
  • Turn off water with a dry paper towel – wet acts as a wick
  • Friction
  • Cleansing Agent
  • Running Water
  • Jewelry makes it difficult to adequately cleanse the hands. It is best to not wear jewelry in the clinical setting. Wedding bands are acceptable sometimes
  • If using hand lotion—allow hands to dry about 30 minutes before applying. Do NOT apply hand lotion immediately after washing hands
• Alcohol-based hand rubs


  Kill more effectively and more quickly than hand washing with soap and water, less damaging to skin than soap and water, require less time than hand washing with soap and water, bottles/dispensers can be placed at the point of care so they are more accessible
• How to use alcohol-based hand rubs


  Apply to palm of one hand, rub hands together covering all surfaces focusing on fingertips and nails, until dry, use enough to require at least 15 seconds to dry
• Standard precautions


  Set of guidelines developed by the Center for Disease Control and Prevention (CDC) for preventing contact with potentially infectious blood or body fluids that may harbour diseases regardless of whether or not they contain visible blood
• Body fluids, secretions and excretions covered by standard precautions


  • All body fluids, secretions and excretions regardless of whether or not they contain visible blood
  • Sputum
  • Saliva
  • Urine
  • Feces
  • Nasal secretions
  • Tears
  • Vomitus
  • Spinal fluid/ cerebrospinal fluid
  • Synovial, pleural, peritoneal , pericardial, amniotic fluid
  • Blood
• Standard precautions are used for all patients, not just those with known infections, and should be implemented whenever contact with potentially infectious material is anticipated, to protect the caregiver
• Components of standard precautions


  • Hand hygiene
  • Personal protective devices
  • Avoid recapping of needles; dispose of sharp objects appropriately
  • Respiratory hygiene/ cough etiquette
  • Blood and body fluid precautions
• STANDARD PRECAUTIONS ARE USED FOR


  • All body fluids, secretions and excretions regardless of whether or not they contain visible blood
  • Sputum
  • Saliva
  • Urine
  • Feces
  • Nasal secretions
  • Tears
  • Vomitus
  • Spinal fluid/ cerebrospinal fluid
  • Synovial, pleural, peritoneal , pericardial, amniotic fluid
  • All moist body surfaces, mucus membranes
  • Blood
• STANDARD PRECAUTIONS


  • Used for all patient's, not just those with known infections
  • These precautions should be implemented whenever contact with potentially infectious material is anticipated
  • Used to protect the caregiver
• COMPONENTS OF STANDARD PRECAUTIONS


  • HAND HYGIENE
  • PERSONAL PROTECTIVE DEVICES
  • AVOID RECAPPING OF NEEDLES; DISPOSE OF SHARP OBJECTS APPROPRIATELY
  • RESPIRATORY HYGIENE/ COUGH ETIQUETTE
  • BLOOD and BODY FLUID SAFETY
• Contact precautions


  Purpose is to prevent the transmission of disease by direct or indirect contact. Direct contact involves: Touching, Bathing, Skin-to-skin contact. Indirect contact involve: Contact with inanimate objects – doorknobs, light switches, tabletop, telephones
• Examples of diseases


  • staph, herpes, diphtheria, and many others
• Contact precautions


  • Use of barrier precautions such as gloves and impermeable gowns to prevent direct contact with infectious organism
  • Used: With patients who are infected by a multi-drug resistant organism (MDRO), For patient with diarrhea, When coming into contact with draining wounds, Patients with acquired antibiotic resistance infections
  • Place the patient in a private room if possible
  • Wear PPE when entering the room for all interactions that may involve contact with the patient or contaminated areas in the patient's environment
  • Remove PPE before leaving the room and perform hand hygiene
  • Avoid sharing patient-care equipment
• Droplet Precautions


  Organisms that can be spread by large- particle droplets
• Examples of organisms


  • Influenza, Cold, Meningitis, Mumps, Pertussis
• Droplet Precautions


  • Single rooms are preferable
  • Patients with same disease can share the same room
  • Standard surgical masks and gloves must be worn for anyone entering the patients room
  • Gloves should be worn anytime handling tissues or items contaminated with the respiratory secretions
  • Keep visitors 3 feet from the infected patient
• Airborne Precautions


  Used when the organism is capable of remaining in the air for prolonged periods of time and can be transported in the air
• Most common organisms


  • Tuberculosis, Chicken pox, Measles