HCC 2008 Asepsis
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| what is asepsis? | the absence of disease producing microorganisms
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| why is it important? | to keep patients safe, and prevent stress and assist with adaptation
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| aseptic techniques help prevent... | the spread of infection
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| infection | a disease state that results from presence of pathogens in or on the body
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| infection cycle | infectious agent, reservoir, portal of exit, means of transmission, portal of entry, susceptible host
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| an infectious agent is | a disease producing microorganism; ex. bacteria, virus, fungi; pathogen
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| a reservoir is | a place the supports the multiplication and growth of microorganisms; ex. humans, animals, food, water, objects, soil
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| portal of exit | point of escape from the reservoir; ex.respiratory, GI/GU tract, breaks in the skin, blood and tissues
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| transmission | routs of travel for a microorganism; two types direct and indirect
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| direct contact | touching, kissing, sex
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| indirect contact | contact with a contaminated object; vehicles, vectors, or airborne
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| vehicles | contaminated blood or food; ex. food poisoning
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| vectors | mosquitoes, ticks, fleas
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| airborne | through the air
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| portal of entry | point at which microorganisms enter the host; ex. urinary, respiratory, GI tracts, break in the skin, mucous membranes, vaginal
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| susceptible host | a person with a decreases ability to overcome the pathogen or its effects
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| factors affecting body defenses | age (elderly and children/babies), immune status, illness, physical condition
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| stages of infection | incubation, prodromal, full stage of illness, convalescent period
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| incubation stage | interval btw when the pathogen enters the body and when symptoms appear; there are no symptoms but the organisms are growing and multiplying
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| prodromal stage | early signs and symptoms are present, but they are vague and non specific; ex. fatigue, malaise, low grade fever; person is infectious and the infection can spread most easily
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| local | one part of the body
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| systemic | through out the whole body
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| full stage of illness | specific signs and symptoms of infection are present
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| convalescent period | recovery period from infection; signs and symptoms diminish, then disappear and a healthy state emerges; return to wellness (appetite and strength returning)
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| Normal Flora | bodies natural defenses inhibit the growth of microorganisms
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| Inflammatory response | bodies way of fighting infection, a protective mechanisms that eliminates the pathogen and allows tissues to heal
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| Immune response | specific reactions to invading pathogens; antigen and antibodies interactions
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| Humoral immunity | antigen-antibody reaction
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| antigen | foreign material
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| antibody | attacks the antigen
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| Cellular immunity | an increase in the # of lymphocytes (WBCs) to attack and destroy organisms seen as harmful
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| Factors affecting susceptibility to Infection | intact skin and mucous membranes, pH level in GI and GU tracts, WBCs (resist and attack pathogens), Age sex race heredity, immunization, fatigue stress, nutrition and general health status, # of invasive or indwelling medical devices
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| Assessment | health history should include immunization status and previous or recurring infections, observe for signs and symptoms of infection
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| Local signs of infection | redness, swelling, warmth, pain and loss of function in the affected area
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| Systemic signs of infection | fever, tachycardia, lethargy, anorexia, enlarged lymph nodes
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| Diagnostic Data for Infection | CBC with differential, Culture and sensitivity(wound, blood, sputum), C-reactive protein, Imagery (x-ray, computed tomography, Magnetic resonance imaging)
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| 6 types of WBCs | neutrophils, Bands (immature neutrophils), lymphocytes, monocytes, eosinophils, Basophils
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| Absolute Count | obtained multiplying he differential count by the total WBC count;
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| Response to bacterial infection | increase WBC, Increase Neutrophils, Lymphocytes and Monocytes increase in viral infections, Eosinophils increase in parasitic infection or allergic reaction
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| Culture and Sensitivity (C&S) | insures the client is getting the correct antibiotic for the organism causing the infection, sensitivity is the ability of the antibiotic to inhibit growth of the bacteria
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| Resistant | antibiotic does not kill the bacteria
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| when collecting a culture what must you consider? | collect before antibiotics are given, use a sterile container, special skin prep to prevent contamination, usually drawn in both arms (to make sure no false positives)
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| C-reactive protein is | a special types of protein produced by the liver that is only present during episodes of acute inflammation
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| activities that prevent infection or break the chain of infection | Medical(clean) and Surgical(sterile)
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| Medical/Clean | procedures and practices that reduce the number and transfer of pathogens
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| Surgical/Clean Asepsis | sterilization of items and keeping them clean practices used to render and keep objects and areas free of microorganisms
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| you would be using a clean method when... | washing hands or wearing gloves
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| you would use a sterile method when.... | changing a dressing or inserting a catheter
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| microorganisms grow best in... | a warm, dark, moist environment that provides nutrients; ex. mouth, blood, GI and GU tract
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| microorganisms move from one place to another in a cyclic fashion through... | contact, air currents , or capillary action
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| The larger the quantity of pathogens... | the greater the chance of disease
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| The number of microorganisms affects | disease occurrence
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| the great the pathogens the _______ the rate of getting the disease | higher
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| ___________ is the most effective way to prevent the spread of microorganisms | hand washing
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| every nursing activity requires | medical asepsis
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| keep _________ items away from clothing and keep soiled linen off the ________ | soiled; floor
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| clean ______ soiled first, then ________ area | least; dirtier
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| avoid raising dust... | don't shake linens
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| dispose of soiled items | immediately
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| good hygiene | keep hair, skin, nails and mouth clean, cover mouth when cough or sneeze
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| surgical asepsis is used regularly in | the operating room, delivery room, and labs for invasive studies
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| sterile objects must be held | above the waist
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| never walk away or turn your back on a | sterile field... you never know what could happen to it when you are no looking
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| disinfection | destroys all pathogenic organisms except spore
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| disinfection can be obtained by using | chemical or mechanical means
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| concurrent disinfection is performed | day to day
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| terminal disinfection is performed | at the end of a stay
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| disinfectant solutions | bleach 10% solution or 1 to 10 parts, betadine, alcohol
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| sterilization | destroys all pathogenic organisms including the spores
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| methods for sterilization | autoclave, boiling, dry heat, radiation or Ethylene Oxide gas, free steam
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| autoclave | 250-254 degrees F (all microbe forms)
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| boiling | for 10 min (in home setting) but it cant destroy some viruses and spores
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| dry heat | 350 degrees F for 2 hours
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| radiation or Ethylene Oxide gas | used when heat will destroy equipment
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| Free steam | used to sterilize products that cant handle the pressure of the autoclave
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| body areas that are sterile | bladder, trachea, peritoneal cavity, brain... all internal organs except the gut are considered sterile
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| body areas where microorganisms can normally be found | skin, nose, oral cavity, bowel
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| only a sterile object can touch a | sterile object
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| medical asepsis areas are contaminated if | they have or are suspected to contain pathogens
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| surgical asepsis areas are contaminated if | they are touched by any object that is not also sterile
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| sterile fields must be kept... | dry
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| ________ __________ can cary pathogens to sterile field | air currents
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| Nosocomial Infection | hospital acquired infection- occurs while patient is staying in the hospital
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| Exogenous | pathogen is acquired from other people
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| endogenous | pathogen comes from microbial life harbored in the person
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| Iatrogenic infection | results from a treatment of diagnostic procedure
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| someone gets a central line place and then gets a blood infection. This is an example of | a Nosocomial Iatrogenic Infection
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| Resistant Organisms | pathogens capable of resisting antibiotics
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| some examples of resistant organisms are | Methicillin Resistant Staph Aureus (MRSA), Vancomycin Intermediate Resistant Staph Aureus (VISA), Vancomycin Resistant enterococcus (VRE)
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| Some Policies Regarding Asepsis | Hand washing, cleaning and disinfecting rooms, disinfection or sterilization of equipment, linen in bags before taken to laundry, no sitting on patients beds, Room assignments, staff have proof of freedom of or immunity to disease
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| Isolation techniques are used to... | prevent the spread of infection, contained the organism in a limited area, used in hospitals, outpatient centers, homes, limit the movement and social contacts of a person with a communicable disease
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| Barriers | gloves, gowns, masks, and eye wear
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| body fluids | blood, semen, and vaginal secretions, breast milk, cerebrospinal fluid, synovial fluid, peritoneal fluid, amniotic fluid, tissues
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| standard precaution regulations include | consider all patients potentially infected, wear gloves when in contact with blod and body fluid or objects contaminated with blood or body fluids, cover any draining wounds, use other protective equipment if contamination or splashing of body fluids is p
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| Linen precautions | keep away from nurses skin, soiled linen should go in a red bag
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| Sharps precautions | never recap needles, use needle-less devices, place in sharps container immediately, sweep broken glass if you drop a glass object
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| Airborne transmission | for diseases transmitted by airborne nuclei. ex. measles, TB, varciella
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| Droplet transmission | for diseases transmitted by large particle droplets. ex. pneumonia, strep, H flu, mumps, pertussis, rubella
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| Contact transmission | for diseases transmitted by direct contact with patient or items in their environment. ex. infectious diarrhea, impetigo, wound infections, resistant bacteria, MRSA)
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| PRECAUTIONS for airborne transmission | keep the door closed, patient in a private room with negative air pressure filtration system, wear a filtration mask, minimize patient transport and patient should wear mask outside of the room, dedicate equipment (BP cuff, thermometer) JUST for them
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| droplet PRECAUTIONS | private room, may keep door open, wear mask within 3 feet of patient visitors too (should wear mask when in the room just in case), transport only when necessary and patient wears a mask, dedicate equipment
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| contact PRECAUTIONS | private room if possible, wear gloves when entering room, chang gloves and wash hands often, wear gloves if contact with infectious agent is likely, limit patient movement out of room (if the go out they wear gloves and gown), dedicated equipment
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| infection Control Nurse | educate patient and staff about infection control technique and collects stats about infections
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| neutrophils increase | infection fighting (bacterial)
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| lymphocytes and monocytes increase | in viral infections
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| eosinophils increase | in parasitic infection or allergic reaction
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