Infection Control and Prevention

Infection Prevention and Control

• Infection prevention and control are crucial in healthcare settings

Infectious Process and Disease

• Infection occurs when pathogenic microorganisms grow in a susceptible host, leading to tissue damage
• Infection development relies on the connection between the host, agent, and environment
• Infections can be communicable or noncommunicable
• A person remains communicable after infection until the host stops shedding infectious organisms
• The period of communicability depends on the pathogen and the host's defense

Factors Influencing Infection and Disease

• Risk of exposure influences infection and disease
• Lifestyle, occupation, and socioeconomic status
• Host characteristics
• Immunologic and nutritional status affects resistance or susceptibility to a pathogen
• Environmental factors play a role

Disease-Producing Pathogens

• Disease-producing pathogens include any microorganisms capable of producing disease
• Transmission modes: airborne, contact, and droplet
• Hand hygiene along with respiratory etiquette, like covering coughs or sneezes, and subsequent hand hygiene, are important

Categories of Microorganisms

• Bacteria: round (cocci), rod-shaped (bacilli), corkscrew-shaped (spirochetes), chain-like (streptococci)
• Viruses
• Protozoa
• Rickettsia and chlamydia
• Fungi
• Mycoplasma
• Others include helminths and prions

Body's Defenses Against Infection

• The four primary defense lines that the body has against infection
• Skin and mucous membranes
• Normal flora
• Inflammatory response
• Immune response

Skin

• Intact skin and mucous membranes protect delicate underlying tissues and create organs
• The skin serves as the portal of exit and entry
• Chemical barriers consisting of acids, lysozymes and celia

Protective and Defensive Mechanisms

• Innate mechanisms are present from birth or natural
• Acquired immunity develops throughout life
• Host susceptibility depends on general health, nutrition, hormone balance, immune status, and chronic diseases like diabetes mellitus

Mechanisms Against Infection

• Antigen and antibodies
• Bone marrow
• Leukocytosis
• Phagocytosis
• Macrophages
• Liver cells

Normal Flora

• Normal flora coexists with the body and controls the growth of harmful pathogens
• If the body's immune system is suppressed, normal flora can overgrow and cause infection

Inflammatory Response

• The basic purposes of the inflammatory response
• Neutralize and destroy harmful agents
• Limit spread to other tissues by walling off organisms
• Prepare the damaged tissues for repair

Inflammatory Changes

• Inflammatory changes involve
• The cells of the damaged tissues and adjacent connective tissues
• The blood vessels in and near the site of injury
• The blood cells, particularly the leukocytes
• The macrophages and phagocyte activity
• The immune system
• The hormonal system

Signs and Symptoms of Inflammation

• Local reactions: redness, heat, swelling, and pain
• Systemic reactions: headache, myalgia, fever, diaphoresis, chills, anorexia, and malaise
• Chemical release and vascular changes
• Immune response acts as the third line of defense
• Hormonal response

Immune Response

• The immune system is built to detect entry by foreign agents as soon as they access body cells
• It immediately recognizes agents as foreign or alien
• The immune system distinguishes between one type of foreign agent from another
• The body can “remember” a particular agent years later

Chain of Infection

• Prevention or control of infection should interrupt any point within the chain of infection
• Agent
• Host
• Mode of transmission

Infection Prevention and Control

• Perform diligent hand hygiene.
• Remove rings, other jewelry, and artificial fingernails or extenders.

Standard Precautions

• Standard precautions prevent microorganism transmission from one patient to another
• The precautions protect health care workers from unnecessary exposure to infection
• They should be used on all patients: the potential for colonization or actual infection is not always known.

Standard Precautions (Barrier Precautions)

• Gloves or isolation techniques is a must
• Proper secretion handling and disposal
• Proper excretion handling and disposal
• Proper exudate handling and disposal
• These prevent pathogen transmission from one person to another.

Transmission-Based Precautions

• Airborne infection isolation
• Contact isolation
• Droplet isolation

Personal Protective Equipment (PPE)

• PPE acts as a barrier to bloodborne pathogens, body fluids, or other potentially infectious materials
• Gloves (consider latex allergy)
• Cover gowns
• Facemasks
• Eye protection
• Respirator masks

Respiratory Hygiene and Cough Etiquette

• Cover mouth when sneezing or coughing
• Turn your head away to prevent coughing into someone's face
• Dispose of soiled tissues in waste containers
• Use effective hand hygiene techniques

Multi-Drug Resistant Organisms (MDRO)

• MDROs are organisms that are resistant to more than one antibiotic
• Overuse of antibiotics has led to mutations of these organisms
• these organisms can resistant to previously effective antibiotics

Health Care-Associated Infections (HAIs)

• Infections can be sourced from a number of settings
• To consider an infection to be considered an HAI, it must meet the criteria
• Length of time in the facility
• Onset or appearance of the infection symptoms

Costs of HAIs

• Human suffering
• Prolonged hospital stays
• Time lost from work

Nursing Interventions to Prevent HAIs

• Hand hygiene
• Reduce vascular catheter-related infections
• Appropriate disposal of soiled or contaminated linens
• Review immunization status

Infection Surveillance and Reporting

• Unexpected temperature elevation
• Malaise
• Cough
• Loss of appetite
• Abnormal urine/diarrhea
• Redness/swelling/pain
• Drainage

Medical Asepsis

• Goal is to reduce microorganisms
• Hand hygiene
• Patient isolation
• Appropriate precautions for handling/disposing of contaminated material
• Cleansing/disinfection

Surgical Asepsis

• Goal is to eliminate microorganisms completely
• Sterilizing linen, skin, and equipment
• Insertion of catheters, tubes and devices
• Maintain surgical environment

Sepsis Vs Septic Shock

• Bacteremia
• Systemic inflammatory response syndrome
• Septic shock
• Multi-organ failure

Assessment (Sepsis)

• Subjective/objective data
• Mental status
• Temperature/edema
• Pulse/BP
• Urine output
• Monitor for septic shock

Older Adult (Sepsis)

• Note the physiologic changes of aging
• Decreased inflammatory response
• Decreased mental alertness + increased fatigue/confusion

Planning Care

• Use body’s defenses/healing processes and ensure adequate rest/nutrition/hydration.
• Ensure pt is free from physical/mental discomfort
• Supply oxygen & blood

Implementation

• Ensure quiet comfortable environment and provide heat
• Relieve discomfort: tepid baths, ice packs, manage fever
• Mild exercise
• Drug administration as ordered
• Monitor labs WBC, ESR, etc.

Implementation for Bacteriologic Test

• Culture + sensitivity (multidrug-resistant) + Intradermal skin and tissue

Patient Teacher

• Teach patient regarding infection treatment diagnostic and precautions

Evaluation

• Evaluation: vitals and WBC within normal limits, able to rest comfortable with no discomfort

Community Care

• Promote sanitary standards
• Identify susceptible parties: immunization programs

Important in Home Care

• Hand hygiene
• Clean surfaces
• Safe food handling
• Get immunized
• Use antibacterial as appropriate
• Be careful with pets
• Avoid contact with pets

Cross Contamination

• Prevented by applying good hygiene (hand and bleaching) and handling properly soiled material
• Washing soiled linens weekly

Long-Term Care

• High risk patient population: implement hand hygiene, cleaning, managing skin, & handling linens.

Explore the critical aspects of infection control, focusing on hospital-acquired infections (HAIs), prevention strategies, and the factors influencing infection risk. Understand the roles of surveillance, reporting, and host characteristics in managing infections. Differentiate between infection and disease.