Question | Answer |
APIC | Association of Practitioners in Infection Control and Epidemiology - 0 tolerance for infections and adverse affects |
CDC | Centers for Disease Control and Prevention |
CMS | Centers for Medicare and Medicaid Services |
INS | Infusion Nurses Society – policies and procedures |
TJC | The Joint Commission – oversee the healthcare facilities |
OSHA | U.S. Occupational Safety and Health Administration – law enforcement agency to protect all emp from harm |
Primary Immune System Organs | Thymus and Bone Marrow |
Secondary Immune System Organs | Lymph nodes, spleen, liver, Peyer's Patches, appendix, tonsils and adenoids, lungs |
Thymus | located in the medial stinal cavity; immune function afterbirth and early in life; t-cells developed here |
Bone Marrow | produces stem cells (precursor to more advanced leukocytes and lymphocytes) done in the sternum, long bones, rib |
Lymph nodes | inner connected system of vessels; b cells, t cells and macrophages are stored; chained pathway of lymph drainage which filters and drains cellular waste |
Spleen | left upper quad - under diaphram, stores red cells, leukocytes, lymphocytes and platelets; forms blood cells; filters out antigens; |
Liver | contains kupffer cells, filter for antigens |
Peyer's Patches | small patches of lymphoid tissue; walls of sm. Intest.; contain b cells and t cells |
Appendix | located where large and sm intestines meet; b cells and t cells as well as good bacteria |
Tonsils and adenoids | contain lymphoid tissue; store b and t cells |
Lungs | respiratory tree; filter out antigenic material and cellular debris; protects lungs from stuff breathed in |
Nonspecific immune responses | present at birth; function without prior exposure to an antigen |
Specific immune responses | Acquired; Functions when there has been prior exposure to antigens; Shot or vaccine |
Physical 1st line mechanisms | Skin, mucous membranes, respiratory tract cillia |
mucous membranes | traps pathogens or antigens ; nose, throat and bronchial |
respiratory tract cilia | traps any debris and prevents them from passing into lungs |
Chemical first line mechanisms | tears, gastric acidity, vaginal secretions |
tears | contains sodium and lipid fat |
gastric acidity | high acid content targets specific bacteria, but allow good bacteria to continue to function |
vaginal secretions | highly acidic; prevent growth in an area which would be suceptable to bac growth |
Mechanical first line mechanism | lacrimation, instestinal peristalsis, urinary flow, coughing and sneezing, |
Lacrimation | releasing tears; flush eyes of antigens; crying |
Intestinal peristalsis | moves stuff in GI; expell foreign organisms |
Urinary flow | similar to peristalsis |
Coughing and sneezing | expel antigens from body |
Phagocytosis | white blood cells engulf and destroy a pathogen directly (pac-man) |
Complement cascade | blood proteins called compliment triggers; attack an antigen cell membrane; cell mem. Ruptures causing basophils to release histamine; histamine causes inflam. And coughing & sneezing; damaged cell releases more chemicals and causes a secondary infection |
Inflammation and fever | when body recognizes it has a foreign invader- increases fever so it can't survive |
Tertiary mechanisms | Specific immunity, Passive acquired immunity, Active immunity |
Specific immunity | exposure to specific antigen |
Passive acquired immunity | occurs when immune cells by gama globulin infusions |
Active Immunity | occurs when a direct contact w/ the disease |
Lymphocytes | Bcells and Tcells; recognizes antigens; find foreign invader; neutralizes or tries to stop antigen long enough to be phagosized (engulfed and eaten) |
Impaired Host | Individuals with major defects related to specific immune responses – every part of immune system doesn't work (late-stage cancer pt on chemo; aids pt) |
Primary | congenital or inherited; missing immunoglobulin (5 immunoglobulins) @ birth |
Secondary | caused from a disease or tx that caused it. |
Four major factors of immune dysfunction | Infections occur frequently Infections are more severe than usual Unusual infecting agents or infections with opportunistic organisms occur Incomplete response to treatment |
Epidemiology | study of epidemics |
Epidemics | occurences widespread r/t health and diseases of people |
Colonization | when microorganism attacks host; grows and multiplies; no S |
Short term transient carrier | carries disease and not affected by it |
Intermediate carrier | only carrier while disease is growing |
Dissemination | shedding of organism into immediate environ. from a carrier or from 1 part of body to another; how diseases can spread |
Chain of Infection | 1. Causative Agent (microorganism) 2. Reservoir (source) 3. Portal of exit from reservoir 4. Method of transmission 5. Portal of entry to host 6. Suseptible host 4. |
Local infection | affects 1 part of body |
Systemic infection | spreads throughout body; becomes septic |
Endogenous | Produce your own infection (within) |
Exogenous | infection comes from outside source |
Stages of infection | 1. Incubation (immed after invasion/ before symptoms) 2. Prodromal (vague symptoms) 3. Illness (specific S&S; ineffective tx may cause death) 4. Decline (microorganisms numbers are declining d/t successful tx) 5. Convulescent (Repair and return |
Health Care Associated Infections (HAIs) | infections that patients acquire during the course of receiving treatment for other conditions or that health-care workers acquire while performing their duties within a health-care setting |
Factors Affecting HAIs | 1. more complicated patients with co-morbidities 2. Increasing number of patients who are immunocompromised 3. devices and procedures used for longer duration 4. short staffing 5. Antimicrobial-resistant pathogens 6. Emerging infectious disease |
Bloodstream infections (BSIs) | least frequently recognized hospital infect. 250,000 cases of central line associated bloodstream infections (CR-BSIs) annually |
Sources of Contaminated Catheters | Skin flora Contamination of catheter hub Contamination of infusate Hematogenous colonization |
Extrinsic contamination | During preparation (ungloved; bad hand hygeine; not using aseptic technique) |
Intrinsic contamination | During manufacturing – not sterile; can cause an epidemic |
What to do if Infusion-Related Infection Suspected | Obtain culture from suspected source of infection; Always clean golves & good hand hygeine |
Infusion related sources of infection | Catheter-skin junction Peripheral infusion catheter Administration set Infusate Patient’s blood |
catheter-skin junction culturing techniques | if suspected is skin, don't cleanse the skin before culture |
infusate culturing technique | sterile needle, remove 5 mL fluid and put in sterile culture tube |
blood culture technique | at least 20 mL to Lab; do not discard 1st draw of blood |
Strategies to Prevent Infection | Follow CDC Standard Precautions Guidelines; hand hygiene; appropriate skin antisepsis prior to procedures; catheter-site dressing regimens; catheter securement devices; antimicrobial/antiseptic-impregnated catheters and cuffs; tissue-interface barriers; I |
tissue-interface barriers | secures central line from inside out; silver ions and collogen cuff – grows onto skin from inside |
Biological Occupational Risks | Bloodborne pathogen exposure (HBV, HIV, HCV – all incurable and caught from pts) |
Physical Occupational Risks | Chemical exposure (Hazardous drugs – ability to cause chromosome breakage in lymphocytes and mutigenic activity and skin necrosis -chemo, radiation (anti-neoplastics) are 2 examples Must have a msds if hazardous drugs are on unit) and Latex exposure |
Isolation precautions | Contact, Droplet, Airborne |
Contact precautions | techniques used in addition standard precautions that decrease infections by microorganisms transmitted thru direct contact with pt or pt care items |
Droplet precautions | Infection d/t inhalation of respiratory pathogens suspended on liquid particles exhaled from someone already infected. |
Airborne precautions | Techniques used to decrease infection by microorganisms by air. |
Aerobic | occuring in the presence of oxygen |
Anaerobic | occuring in the absence of oxygen |
Antibodies | substance produced by B lymphocytes in response to a unique antigen. Neutralizes or destroys antigen. |
Hematogenous | produed by or deried from blood; disseminated through bloodstream or by the circulation |
Host | organism from which a microorganism obtains its nourishment |
Immunosuppression | Interference w/ the dev. of immunologic responses; may be artificially induced by chemical, biologic, or physical agts or may be caused by disease |
Leukopenia | any condition in which the number of leukocytes in the circulating blood is lower than normal. |
Pathogenicity | the state of producing or being able to produce pathological changes and disease |
Phlebitis | Inflammation of a vein |
Reservoir | living or nonliving material in or on which an infectious agt multiplies, develops and is dependent of for its survival in nature |
resident flora | microorganisms that are indigenous to each individual and are present mainly on the skin and in the respiratory, gastrointestinal, and reproductive systems |
Septicemia | presence of pathogenic microorganisms or their toxins in the blood or other tissues |
Transient flora | microorganisms that are picked up, usually on skin, that can be removed fairly easily w/ hand hygiene |
vector-borne transmission | a carrier, usually an insect or other animal, that transmits the causative organisms of disease from infected to noninfected individuals |
vehicle-borne transmission | any substance that serves as an intermediate means to transport and introduce an infectious agt into a suseptible host thru a suitable portal of entry |
Virulence | relative power and degree of pathogenicity posessed by organisms to produce disease |