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48 Cards in this Set
- Front
- Back
Infection control?
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measures to decrease and or eliminate agents and spread of infection
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Why are hospitalized pts at an increased risk for infection?
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1) lower resistance (they are sick); 2) exposure; 3) invasive procedures and 4) poor hand hygiene of health workers
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What is the chain of infection?
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infectious agent --> reservoir-->portal of exit--> modes of transmission-->portals of entry-->susceptible host
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What factors determine an appropriate reservoir? (6)
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1) food, 2) oxygenic envt 3) water 4) temp 5) pH 6) light/dark
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Name 3 anaerobic bacteria?
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clostridium difficile, gangrene and botulism
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What are portals of entry/exit?
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skin and mucous membrane, respiratory tract, urinary tract, GI tract, Reproductive tract, and blood
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5 modes of transmission
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1) direct contact, 2) indirect contact 3) droplet 4) airborne or 5) vector
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What is droplet transmission?
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5 mcg in size and falls within 3 ft of pt
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What are risk factors for infection susceptibility?
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# of invasive organisms, length of hospitalization, type of injury/trauma, general health/nutrition, heredity, preexisting conditions, medications, age, lifestyle, travel
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Why are older adults more susceptible to disease?
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reduced immune function, poor nutrition, longer life (more chronic conditions), group living, stress/depression/bereavement
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What are 4 stages of infection?
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1) incubation process, 2) prodromal stage 3) illness stage and 4) convalescence
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What is the prodromal stage?
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organisms multiply and symptoms become specific--often most infectious pd
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What are the body's natural defenses to infection?
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normal flora, skin, saliva, tears, mucus, cilia, urine flow, stomach acid, peristalsis, vaginal pH, inflammatory response
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Does inflammation always indicate infection?
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no, inflammation can result from trauma/injury
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When tissue is injured what is released that initiates the inflammatory response?
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bradykinin, serotonin, histamine and prostaglandins
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How does edema happen when tissue is injured?
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vessels dilate and walls thin allowing plasma to leak into surrounding tissue
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what is the normal range for WBC concentration?
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5,000-10,000/mm3
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leukocytosis?
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elevated WBC levels
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What happens to WBCs when there is an infection?
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bone marrow sends out WBCs into the bloodstream. WBC levels can rise to 15,000-20,000/mm3 for overwhelming infection
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pyrogens?
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increase temperature by affecting the hypothalamus
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HCA?
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health care associated infection -nocosomial
1) iatrogenic, 2) exogneous, 3) endogenous |
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Iatrogenic infection?
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infection from diagnostic or therapeutic procedure--surgery
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What are the most common HCA infections?
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UTI, pneumonia, yeast infections
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What are the main HCA infections that need to be reduced according to the Joint Commission?
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pneumonia, influenza, pressure ulcers
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What areas are covered in a nursing assessment for infection prevention?
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History (things affecting natural defenses), factors that increase susceptibiliy, and physical assessment
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Assessment signs and symptoms of local infection?
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local: red swollen, pain,limited movement, purulent/foul-smelling drainage
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Assessment signs and symptoms of systemic infection?
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fever/chills/changes in VS, fatigue/malaise, loss of appetite, n/v/d/, lymph node enlargement
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What are signs of infection in older adults?
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confusion, aggression, incontinence, agitation, fatigue, diminshed pain sensitivity
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What laboratory data are collected for an infection assessment?
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leukocytosis, culture and sensitivity, erythrocyte sedimentation rate, CBC differential
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What are psychosocial considerations for infection control assessment?
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cost of health care, inability to work, inability to return home, rejection by family/friends, resources and support
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What would be in a nursing plan for infection control?
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patient will remain free of infection, temp WNL, wound edges with no redness swelling or drainage, patient/family education, set priorities, collaborate with other HCP
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What are parts of implementation of infection control plan?
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medical asepsis, environmental controls(cleaning and disinfecting), eliminate reservoirs, control portals of exit/entry, control transmission
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How can you eliminate reservoirs for infection control?
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clean excretions, dressing changes, proper disposal of soiled things, sharps disposal, single use items, keep pt envt clean and dry, keep bottle solutions for only 24hr, drains below site of drainage, empty drainage containers often, disposal of PPE,
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How can portals of entry be controlled?
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maintain skin integrity, oral hygiene, perineal care, keep closed systems closed, disinfect ports, clean wounds from inside out
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How can infection susceptibility be reduced?
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adequate fluid, nutrition and rest; immunizations, pt education (e.g. take all of prescribed antibiotics)
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Tier I CDC precautions
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standard precautions: hand hygiene before and after glove removal, no artificial nails, single use items, contaminated linen in leak proof bags, proper sharps disposal, cough etiquette, masks when inserting catheters
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Tier II precautions
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CDC-for patients with known or suspected infection--standard precautions + special precautions based on type of isolation (contact, droplet etc.)
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Contact Isolation Precautions
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private room (or with same infection); PPE=gowns & gloves, patient transport with gown, (e.g. wound infections, c. diff, resistant organisms)
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Droplet Isolation Precautions
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private room, PPE=surgical mask, gloves, gown, patient transport wearing mask (strep, pneumonia, influenza, meningitis)
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Airborne Isolation Precautions
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Private room, door closed, reduce room activity, negative pressure airflow, PPE=special mask or respirator, patient transport wearing mask, (TB, SARS, chickenpox)
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Multi-Drug Resistant Organisms
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MRSA, VRE, VISA (Vanco intermed staph aureus) VRSA( vanco resist staph aur) GNB (gram negative bacilli), ESBL (Extended spectrum beta lactamase)
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Yellow Isolation Caddie
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outside isolation doors (1 per room), gloves, gowns, masks, germicide, sanicloths, virex spray
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Protective Environment
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for immunocompromised pts--stem cell transplants, private room, positive pressure airflow, PPE=masks (respirator), gown, gloves, goggles
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How should pts be educated about infection control?
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handwashing, disinfecting, s/s of infection, reporting, sharps disposal, wound care, separate laundry in hot water
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What should you do if you are exposed to an infectious agent?
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wash area with soap and water, report to supervisor, complete accident form, go to employee health
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Recommended vaccines for health care workers
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Hep B, Annual TB, influenza, MMR, chickenpox, DPT
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How to organize and plan for caring for a pt in isolation?
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bed linens, gown, towel, washcloth, specimen containers, labels, specimen bags, pills and injections.
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Order of care for a pt in isolation
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get supplies, hand hygiene, gown, gloves, enter room and explain to pt, VS, meds, AM care, change bed, urine specimen, equip away, call bell and table, other pt needs, process specimen, dispose of full linen bag, remove gloves, gown, hand hygiene, documentation
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