1.Chapter 28 Infection Prevention & ControlScientific Knowledge Base Nature of infection Infection is the invasion of a susceptible host by pathogens or microorganisms, resulting in disease. Entry and multiplication of organisms result in disease Colonization occurs when a microorganism invades the host but does not cause infection.Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 1

2. Nature of Infection Communicable disease is the infectiousprocess transmitted from one person toanother. If pathogens multiply and cause clinical signsand symptoms, the infection is symptomatic. If clinical signs and symptoms are notpresent, the illness is termed asymptomatic. Hand hygiene is the most importanttechnique to use in preventing and controllingtransmission of infection.Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 2 3. Chain of Infection Infectious agent orpathogen Reservoir or sourcefor pathogen growth Portal of exit Mode oftransmission Portal of entry Susceptible host Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 3 4. Infectious Process Four stages:Incubation period Prodromal stage Illness stage Convalescence Localized versus systemic infection Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 4 5. Defenses Against Infection Normal flora Microorganisms Normal body flora helps to resist infection byreleasing antibacterial substances and inhibitingmultiplication of pathogenic microorganisms. Body system defenses Organs Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 5 6. Defenses Against Infection (contd) Inflammation Vascular and cellular responses Exudates (serous, sanguineous, or purulent) Tissue repair Signs of local inflammation and infection areidentical. Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 6 7. Health CareAssociated Infections Results from delivery of health services in ahealth care facility Patients at greater risk for health-careassociated infections (HAIs) Multiple illnesses Older adults Poorly nourished Lowered resistance to infectionCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 7 8. Health CareAssociated Infection(contd) Types of HAI infection:Iatrogenicfrom a procedureExogenousfrommicroorganisms outside theindividualEndogenouswhen the patientsflora becomes altered and anovergrowth resultsCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 8 9. Health CareAssociated Infection(contd) Risk factors Number of health care employees with directcontact with the patient Types and numbers of invasive procedures Therapy received Length of hospitalization Major sites for HAI infection Surgical or traumatic wounds Urinary and respiratory tracts BloodstreamCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 9 10. Nursing Knowledge Base Factors influencing infection prevention andcontrol: Age Nutritional status Stress Disease process Treatments or conditions that compromise theimmune responseCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 10 11. Nursing Process: Assessment Assessment includes a thoroughinvestigation: Review of systems, travel history Immunizations and vaccinations Early recognition of risk factorsCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 11 12. Nursing Process: Assessment (contd) See through the patients eyes. Status of defense mechanisms Patient susceptibility Medical therapy Clinical appearance Signs and symptoms of infection Laboratory dataCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 12 13. Nursing Process: Nursing Diagnosis Nursing diagnoses for infection:Risk for infectionImbalanced nutrition: less than bodyrequirementsImpaired oral mucous membraneRisk for impaired skin integritySocial isolationImpaired tissue integrityReadiness for enhanced immunization statusCopyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 13 14. Nursing Process: Planning Goals and outcomes Common goals of care applicable to patientswith infection often include the following: Preventing exposure to infectious organisms Controlling or reducing the extent of infection Maintaining resistance to infection Verbalizing understanding of infection preventionand control techniques (e.g., hand hygiene)Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 14 15. Nursing Process: Planning (contd) Setting priorities Establish priorities for each diagnosis and forrelated goals of care. Teamwork and collaboration Remember to plan care and include otherdisciplines as necessary.GO TO : CH 28 Audio Part 2 Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. 15