Infection Control and Hand Hygiene

Chain of Infection

• Infectious agent: A pathogen, like bacteria or viruses, causing infection.
• Reservoir: The place where the pathogens live (e.g., humans, animals, water).
• Portal of Exit: The path pathogens use to leave the reservoir (e.g., respiratory tract, blood).
• Mode of Transmission: How the pathogens spread (e.g., direct contact, airborne).
• Portal of Entry: The path the pathogen uses to enter a new host (e.g., mucous membranes, skin).
• Susceptible Host: A person with weakened immune defenses.

Isolation Precautions

• Standard Precautions: Hand hygiene and gloving when exposed to bodily fluids.
• Contact Precautions: Gowns and gloves for pathogens like MRSA.
• Droplet Precautions: Masks for pathogens like influenza.
• Airborne Precautions: N95 respirators for TB or measles.

Handwashing Steps

• Wet hands with clean water.
• Apply soap, lather for at least 20 seconds.
• Scrub all surfaces, including nails and wrists.
• Rinse thoroughly.
• Dry with a clean towel or air dry.

Cross-Contamination

• Transfer of harmful microorganisms between people or objects.
• Prevention: Proper hand hygiene, cleaning shared equipment, using PPE properly.

Changing a Gown

• Remove contaminated gown inside out.
• Perform hand hygiene.
• Put on clean gown, securing ties.
• Avoid touching outer gown surface.
• Ensure patient privacy and comfort.

Patient-Centered Care

• Ask patient preferences for daily activities (ADLs).
• Adjust care for physical/mental conditions like mobility limitations.

Perineal Care

• Female: Clean front to back to prevent infection, using warm water and mild soap.
• Male: Clean tip first, moving outward in a circular motion, then retract foreskin (if uncircumcised) after cleaning.

Prioritizing Care (ABCs)

• A: Airway.
• B: Breathing.
• C: Circulation.

Oral Care for Unconscious Patients

• Position patient on their side to prevent aspiration.
• Use a padded tongue blade to keep the mouth open.
• Clean teeth, gums, and tongue with a brush.
• Suction saliva if needed.

Modifiable vs. Non-Modifiable Factors

• Modifiable: Lifestyle changes (diet, exercise, smoking).
• Non-modifiable: Genetics, age, sex.

Acute vs. Chronic Illness

• Acute: Sudden onset, short duration (influenza).
• Chronic: Long-term, ongoing (diabetes).

External vs. Internal Variables

• External: Environment, culture, socioeconomic status.
• Internal: Beliefs, emotions, developmental stage.

Levels of Prevention

• Primary: Preventing illness (vaccinations).
• Secondary: Early detection (screenings).
• Tertiary: Managing chronic conditions (rehab).

Contact vs. Indirect Contact Transmission

• Direct Contact: Person-to-person (touching).
• Indirect Contact: Through contaminated objects or surfaces.

Principles of Listening

• Be attentive, avoid interruptions.
• Use verbal/nonverbal cues to show understanding.
• Clarify and summarize what the patient shares.

Caring Process of Knowing

• Understand patient experiences and emotions.
• Develop trust for personalized care.
• Involve family members appropriately.

Involving Family Members in Care

• Involve family in ADLs, patient education, emotional support.
• Teach skills like medication administration and encourage participation in care planning.

Body Mechanics and Alignment

• Keep back straight, bend knees for lifting.
• Hold objects close.
• Use assistive devices if needed.

Body Mechanics for Nurses

• Wide base of support, bend knees, keep objects close.
• Avoid twisting; pivot with feet.
• Use assistive devices (e.g., gait belts, lifts).

Body Alignment for Patients

• Maintain spine's natural curves.
• Use supportive devices.
• Frequent repositioning (every 2 hours).

Risk Factors for Fracture (Different Populations)

• Elderly: Decreased bone density (osteoporosis), falls due to balance/vision issues.
• Children: Higher risk during growth spurts (softer bones).
• Athletes: Stress fractures from repetitive motion.
• Postmenopausal women: Hormonal changes leading to bone loss.

Congenital Conditions Affecting Posture/Alignment

• Scoliosis: Lateral curvature of the spine (often diagnosed in adolescence).
• Kyphosis: Exaggerated thoracic curvature (hunchback).
• Cerebral palsy: Impaired muscle tone and coordination.
• Spina bifida: Neural tube defect causing spinal deformities.

Safety Factors Affecting Mobility

• Environmental hazards (clutter, poor lighting).
• Medications (sedatives, antihypertensives).
• Chronic conditions (arthritis, stroke).
• Assistive devices usage.

Body Systems Affected by Immobility

• Musculoskeletal: Atrophy, contractures, demineralization.
• Cardiovascular: Increased DVT risk, orthostatic hypotension.
• Respiratory: Reduced lung expansion, pneumonia risk.
• Integumentary: Pressure injuries.
• Gastrointestinal: Constipation, decreased appetite.

Musculoskeletal Conditions from Immobility

• Osteoporosis: Loss of bone mass.
• Contractures: Permanent joint stiffness.
• Disuse atrophy: Muscle wasting.

Home Care for Patients (Mobility Alterations)

• Install grab bars, remove home hazards.
• Provide education on assistive device use.
• Encourage PT for strength & mobility.
• Access community resources (home health).

Sleep Disorders & Requirements

• Sleep disorders: Insomnia, sleep apnea, RLS, narcolepsy.
• Sleep requirements vary: newborns (14-17 hours), children (9-11 hours), adults (7-9 hours), older adults (7-8 hours).

Health Promotion for Sleep

• Consistent sleep schedule.
• Limit caffeine and screen time.
• Ensure quiet, dark, cool sleep environment.
• Interventions: CBT-I, sleep aids (as prescribed).

Sensory Alterations Related to Aging

• Vision: Presbyopia (near vision), cataracts.
• Hearing: Presbycusis (age-related hearing loss).
• Touch: Reduced sensitivity to pain, pressure, temperature.
• Taste and Smell: Decline in taste buds and olfactory receptors.