Infection prevention and control in health care settings

2. SCIENTIFIC KNOWLEDGE
BASE
 ENTRY AND MULTIPLICATION OF
ORGANISM RESULTS IN DISEASE
 COLONIZATION OCCURS WHEN A
MICROORGANISM INVADES THE
HOST BUT DOES NOT CAUSE
INFECTION (INJURY TO CELLS)
 PATIENT SAFETY ISSUE

3. CHAIN OF INFECTION
 Infectious agent or pathogen
 Reservoir
 Portal of exit
 Mode of transmission
 Portal of entry
 Susceptible host

4. Infectious Agent/Pathogen
 Microorganisms (bacteria, viruses,
fungi, protozoa
 Normal flora
 Colonization
 Virulence
 Susceptibility
 Review Potter & Perry Table 34-1 (pg.
643) Common Pathogens

5. Reservior
 Animate sources (humans, animals,
insects)
 Inanimate sources (soil, water, food,
medical equipment)
 Pathogens need a proper environment
to survive (food, oxygen, water,
temperature, pH, light)
 Carriers
 Toxins: (Exotoxins, endotoxins)

6. Portal of Exit/Entry
 Skin and Mucous Membranes
 Respiratory Tract
 Urinary Tract
 Gastrointestinal tract
 Reproductive Tract
 Blood

7. Modes of Transmission
 Contact (Direct & Indirect)
 Droplet
 Airborne
 Vehicles
 Vectors

8. Susceptible Host
 Susceptibility (Resistance to infection)
 Factors which influence susceptible:
 Age
 Nutritional status
 Chronic disease history
 Trauma
 Smoking

9. The Infectious Process
 Incubation Period
 Prodromal Stage
 Illness Stage
 Convalescence
 Pathogenicity of organism
 Localized vs. systemic

10. DEFENSES AGAINST
INFECTION
 Normal flora
 Body System Defenses (P&P Pg.647)
 Inflammation
 VASCULAR AND CELLULAR RESPONSE
 EDEMA
 PHAGOCYTOSIS
 LEUKOCYTOSIS
 INFLAMMATORY EXUDATE
 SEROUS
 SANGUINOUS
 PURULENT

11. SPECIFIC DEFENSES
AGAINST INFECTION
 CELL- MEDIATED IMMUNITY
 ANTIBODY-MEDIATED IMMUNITY

12. HEALTH CARE ASSOCIATED
INFECTION (NOSOCOMIAL)
 Infections that are a result of health care
delivery, not present at admission
 EXOGENOUS
 ENDOGENOUS
 IATROGENIC
Refer to Potter & Perry Table 34-2 Pg. 648
(Sites for Causes of HAI’s)

13. Common Health-Care
Associated Infections
 Urinary Tract Infection
 Surgical/Traumatic Wound Infection
 Respiratory Tract
 Bloodstream

14. The Nursing Process &
Infection Control
(Assessment)
 Status of defense mechanisms
 Client Susceptibility
 Nutritional Status
 Stress
 Disease Process
 Medical Therapy
 Clinical Appearance
 Lab Data

15. Lab Data
 WBC Count
 Sedimentation Rate
 Cultures of sputum, urine, blood
 Differential Count

16. Assessing Risk for Infection
 Age
 Disease Processes
 Lifestyle
 Occupation
 Diagnostic Procedures
 Medications
 Travel History
 Nutritional Status

17. NURSING DIAGNOSIS AND
PLANNING
 NANDA APPROVED DIAGNOSIS
 GOALS AND OUTCOMES
 MEASURABLE
 REALISTIC
 PRIORITIES

18. Acute Care Interventions
 MEDICAL AND SURGICAL ASEPSIS
 CONTROL/ELIMINATION OF
INFECTIOUS AGENTS
 CONTROL/ELIMINATION OF:
 MODES OF TRANSMISSION
 PORTALS OF ENTRY
 RESERVOIRS
 HAND HYGIENE (HCP, PATIENT,
FAMILY)

19. INTERVENTIONS
 ISOLATION PRECAUTIONS
 HYPERTHERMIA INTERVENTION
 ELIMINATE UNDERLYING CAUSE
 FEVER MANAGEMENT
 HEALTH TEACHING
 ANTIBIOTIC THERAPY
 PSYCHOSOCIAL SUPPORT
 HEALTH CARE RESOURCES

20. Isolation Precautions
 CDC and OSHA Guidelines
1. Contact
2. Droplet
3. Airborne

21. Drug Resistant Organism
Infections & Colonizations
 Methicillin-Resistant Staphylocuccus
aureus (MRSA)
 Vancomycin-Resistant Enterococcus
(VRE)
 Extended-Spectrum Beta Lactamase
(ESBL)
 Multi-drug Resistant Tuberculosis

22. Personal Protective
Equipment
 Gowns
 Respiratory Masks
 Eye Protection
 Gloves
 Specimen Collection
 Bagging Trash & Linen
 Transporting Patients

23. EVALUATION
 MEASURE SUCCESS OF INFECTION
CONTROL TECHNIQUES
 COMPARE PATIENT’S RESPONSE TO
ACTUAL OUTCOME
 WHAT WILL YOU DO IF
GOAL/OUTCOMES NOT ACHIEVED?