Infection Control
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| Agents causing infection | Bacteria, viruses, fungi, parasites, prions, multi resistant organisms
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| Infectious diseases | MRSA- Tx Vancomycin. VRE- Tx synercid & zyvox. AIDS. Hepatitis A: fecal oral; hepatitis B: blood. Influenza. TB (Tuberculosis)- Tx combination of antibiotics
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| Modes of transmission | Contact (direct-skin to skin, indirect-touch surfaces others have touched, droplet-large particle). Vehicles. Droplet. Airborne- tiny particles that hang in air. Vectorborne- ex. mosquito
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| Universal Standard Precautions | decrease transmission from blood borne pathogens regardless of diagnosis
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| Body Substance Isolation | Decrease transmission from moist body substances- wear gloves when handling feces, urine, nasal secretions, vomitus, and sputum
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| OSHA (Occupational Safety and Health Admin) | Federal Agency. Requires employers to have a plan which includes: Universal precautions, personal protective equipment, hepatitis B vaccine, exposure follow-up, employee training, monitoring compliance. Has right to conduct work inspections without notice
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| Medical (Clean technique) | Includes all measures aimed at reducing the number or spread of microorganisms. Ex: handwashing, gloving, gowning, disinfecting
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| Surgical (Sterile technique) | Prevent introduction of microorganisms from the environment into pt. Ex: surgical procedures, procedures involving bloodstream, breaking of the skin or mucous membranes, certain dressings, insertion into body cavities, high risk pts
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| Aseptic Practices | Hand hygiene, disinfection, sterilization, PPE- masks, gown, gloves, caps. Isolation rooms- negative airflow.
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| Transmission-based precautions | Additional isolation after an organism has been identified: airborne, droplet, contact, enteric, strict, protective, drainage/secretion
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| Normal resistance to infection | Normal flora. Barriers to infection: skin, WBCs, inflammatory response, fever
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| Specific Acquired Defense: Immunity | Antigens (antibodies), T-lymphocytes (cellular immunity)- cells attack microbe at the site of invasion and/or keep a memory of the antigen. B-lymphocyte (humoral immunity)- occur in bloodstream: produce antibodies which produce resistance.
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| Active immunity | vaccination
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| Passive immunity | mom to baby
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| Lifespan considerations | Newborn and infant: immunity fully functional at 6 months. Toddler and preschooler: needs supervision. Child and adolescent: skin disease, lice, staph infections. Adult and older adult: immunity established, chronic disease, HAI
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| Compromised Host | Breaks in skin and mucous membranes, invasive devices, stasis of body fluids, inadequate nutrition, stress/hyperglycemia, immune system dysfunction, co-existing medical problems, drug therapy
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| Types of infection | Colonization (organism grows in pt). Nosocomial (hospital acquired). Local (infection in one area) vs systemic (entire body). Acute vs chronic. Sepsis.
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| Healthcare-Associated infections Include the following Settings | Acute care settings, extended care facilities, ambulatory care centers, homes, schools
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| Nosocomial Infections | 2 million each year with 90,000 deaths. UTI most common (35%)- followed by surgical site, bloodstream, and resp. HANDWASHING is the key to preventing HAIs
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| Iatrogenic Infection | Results from a therapeutic or diagnostic procedure. Ex: UTI
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| Exogenous Infection | Organisms external to pt not normally present. Ex: salmonella or C diff
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| Endogenous infection | Microorganisms that exist as part of the normal flora become pathogenic. Ex: E-coli, yeasts
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| Factors Predisposing to common infections | urethral/urine, wound, resp
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| Incubation period of infection | time between the pathogen's entrance and appearance of symptoms
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| Prodromal stage of infection | nonspecific symptoms such as nausea, fever, weakness (malaise), or pain
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| Acute Phase of Illness | Specific symptoms occur and lab analysis can identify disease
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| Convalescence Stage of Infection | Completes the progress of an infection- antibodies appear in blood, and body systems return to normal
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| Communicable Diseases | Transmittable between one person and another- contagious. Childhood disease.
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| Manifestations of an Infection | Fever- chill phase, fever phase, crisis phase. Increased pulse and resp rate. Inflammation. Pain. Purulent drainage. Enlarged lymph nodes. Rash. GI symptoms: anorexia, nausea, vomiting, diarrhea.
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| Localized Inflammatory response | Erythema- Blood accumulating in the dilated vessels. Warmth- from heat of blood. Swelling- fluid accumulation. Pain- pressure or injury to local nerves.
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| Ways to reduce or prevent transmission in healthcare | Avoid recapping needles. Immunizations. Needleless systems. Gloves. Handwashing. Proper waste disposal. Work restriction of ill employees. Use of barriers: gloves, gowns, masks, goggles. isolation
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| Subjective Data | Rest and exercise, nutrition, use of herbs and vitamins. Knowledge base, Risk identification: exposure.
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| Objective Data | General Inspection, vital signs, auscultation, lymph node assessment, diagnostic tests and procedures.
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| WBCs | Normal: 5,000-10,000/mm3. Increased during infection (leukocytosis). Leftward shift
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| ESR (Erythrocyte Sedimentation Rate) | Spins blood around. Sees how blood cells settle. More than it should indicates inflammation
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| Nursing Diagnosis | Risk for infection (only one NANDA accepts)
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| Implementation | Comfort measures to relieve pain/fever. Fever managements: antipyretics, tepid baths, cooling blankets. Ambulation & positioning. Pulmonary activities:coughing & deep breathing, incentive spirometer. Pt & family education Antibiotics. Standard precautions
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| Neutropenia Precautions | Neutropemia ANC < 1000. Precautions ANC < 500. ANC = WBC x neutrophil count.
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