PROVIDER CARE ACTIVITIES

Copyright, 1996 Dale Carnegie & Associates, Inc.INFECTION PREVENTION AND CONTROL

Miami Dade College

ORGANISMS POTENTIAL TO PRODUCE DISEASENUMBER OR ORGANISMSVIRULENCE OF THE ORGANISM (ability to cause disease)INDIVIDUALS IMMUNE SYSTEMLENGTH Of CONTACT TERMSInfection: a disease state that results from the presence of pathogens in or on the body.Pathogen: a disease producing microorganism.Etiology: cause & ID of pathologyOpportunistic Organisms: bacteria that can be harmful

CHAIN OF INFECTIONInfectious agent- influenced by # & virulenceReservoir- body, plant, inanimate objects, carriersPortal of exit- blood, respiratory, GI tract

CHAIN OF INFECTION CONTDMeans of transmission- air, direct contactPort of entry- blood, skin and mucous membrane, respiratory tract, gastrointestinal tract and transplacental (mother to fetus) MODES OF TRANSMISSIONDirect person to person (fecal, oral), and physical contact between source and susceptible hostIndirect personal contact of susceptible host with contaminate inanimate object (needle, sharp objects, dressings, environment) MODES OF TRANSMISSIONDIRECT & INDIRECTDropletAirbornevehicleVector

Normal Defense Against Infection Intact skinMucous membranesTearsNormal flora GI tractNormal flora urinary tract

Defense Against InfectionInflammationPainSwellingRednessHeatImpaired function

Defense Against InfectionFirst StageVascular and Cellular ResponseIncrease blood flow to areaIncrease permeability (fluid, protein & cells enter interstitial space) edema Pain occur from pressure on the nerve endingFever from release of pyrogens from bacterial cells

Defense Against InfectionSecond StageInflammatory ExudatesAccumulation of fluids and dead tissue cells & WBC form an exudate at the site of inflammationExudate maybeSerous clear like plasmasanguineous containing red blood cellsPurulent containing WBCs and bacteria Defense Against InfectionThird StageTissue RepairHealing involvesDefensiveReconstructiveMaturative stage Damaged cells are eventually replaced by healthy cellsIn chronic infections granulation tissues not as strong as collagen form scar tissueRisk for Infection:Developmental stage Breaks lines of defenseSmokingSubstance AbuseEnvironment

Risk for Infection:Chronic diseaseMedications Illness/InjuryMultiple Sexual PartnersNursing/Medical Procedures

Classification of InfectionsBy Location:Local Occurs in a limited region in the body (e.g., urinary tract infection)

SystemicSpread via blood or lymphAffects many regions (e.g., septicemia)

STAGES OF INFECTION:

Incubation: From time of infection until manifestation of symptoms; can infect othersProdromal: Appearance of vague symptoms; not all diseases have this stageIllness: Signs and symptoms presentConvalescence: Tissue repair, return to health

Preventing Infection: Implementing Medical AsepsisMedical asepsis:A state of cleanliness that decreases the potential for the spread of infectionsPromoted through:Maintaining a clean environmentMaintaining clean handsFollowing Centers for Disease Control (CDC) guidelines

Implementing CDC GuidelinesStandard precautions (universal precautions):Protects health-care workers from exposureDecreases transmission of pathogensProtects clients from pathogens carried by health-care workers Example: PPE

Maintaining a Clean EnvironmentClean spills and dirty surfaces promptlyRemove pathogens through chemical means (disinfect)Remove clutterConsider supplies brought to the client room as contaminatedConsider items from the clients home as contaminated

Promoting Wellness:NutritionHygieneRest/ExerciseStress ReductionImmunizations

Nurses Role in Infection ControlStandard Precaution to prevent onset and spread

Promote measures for treatmentHand WashingHand washing is the act of washing with soap and water, followed by rinsing under a stream of water for 15 secondsThe friction used removes soil and transient organisms from the handHand hygiene includes the use of an alcohol based waterless antiseptic agent Standard PrecautionStandard precaution apply to contact with blood and body fluids except sweat even if blood is not presentNon-intact skinMucous membrane

Cleaning, Disinfection and SterilizationThe decision to clean, disinfect or sterilize depend on the intended use of the itemCleaning is the removal of all soil and inorganic material from objects and surfaces

Cleaning, Disinfection and Sterilization ContdDisinfection describes a process that eliminates many or all microorganisms, with the exception of bacterial spores from inanimate objectsSterilization is the complete elimination or destruction of all microorganism including sporesPersonal Protective Equipment (PPE)PPE include gowns, mask or respirator, protective eyewear, and glovesGowns prevent soiling of clothes during contact with the clientGowns used for barrier protection are be fluid resistant Open at the back and are to be tied or snap closedPersonal Protective Equipment (PPE) contdMask with full face protection should be used when you anticipate splashing of blood or body fluidsN95 mask are required when caring for patients on droplet or airborne infectionMask should fit snugly over the mouth and nose so that pathogens and body fluid can not enter or escape through the sides

Personal Protective Equipment (PPE) contdEye ProtectionUse either special glasses or goggles when performing procedure that generate splash or splatterEye wear is available in the form of plastic glass or gogglesPrescription glasses should be covered with removable or disposable side shield

Personal Protective Equipment (PPE) contdGlovesHelp to prevent the transmission of pathogens by direct and indirect contactClean gloves should be used when touching blood, body fluid, secretions, excretions, (except sweat), moist mucous membranes, non-intact skin and contaminated items or surfacesPersonal Protective Equipment (PPE) contdRemove gloves promptly after use, before touching non-contaminated item and environmental surfacesHand hygiene should be performed immediately to avoid transfer of microorganism to other clients or environmentPersonal Protective Equipment (PPE) contdWhen full PPE is necessaryFirst perform hand hygieneApply a gownApply maskEye wear or goggles (as needed)Apply glovesExposure IssuesUse of puncture resistant box for used needles to prevent accidental needle stickHepatitis B, Hepatitis C and HIV are the infection most commonly transmitted in blood from contaminated needlesExposure IssuesExposure from non-blood borne pathogensAirborne and dropletRecommended vaccinations and immunization include: hepatitis B, TB testing, annual influenza vaccine, MMR, chickenpox vaccine, tetanus, diphtheria, and pertussis.