Infection Control Fundamentals in Nursing Practice

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Questions and Answers

What factors play a part in the susceptibility of a potential host to infection?

Immunizations

Fatigue

Medications

All of the above (correct)

Hand hygiene is the most effective way to prevent the spread of infectious agents.

True

What are the two categories of asepsis mentioned in the text?

medical asepsis and surgical asepsis

______ destroys all microorganisms, including spores.

Sterilization Signup and view all the answers

What is an infection?

The growth of microorganisms in body tissue where they are not usually found. Signup and view all the answers

Asymptomatic infections never cause significant damage.

False Signup and view all the answers

A communicable disease occurs when the infectious agent can be transmitted to an individual by or .

direct contact Signup and view all the answers

What is a pathogen?

a microorganism that causes disease Signup and view all the answers

Match the infection phases with their descriptions:

Incubation period = Interval between pathogen's invasion and symptom appearance Prodromal stage = Most infectious stage with early vague symptoms Full stage of illness = Presence of specific signs and symptoms Convalescent period = Recovery period from the infection Signup and view all the answers

What is the primary purpose of wearing masks in healthcare settings?

All of the above Signup and view all the answers

A mask can be reused after being lowered around the neck.

False Signup and view all the answers

What type of respirator must be worn when entering the room of a patient with known or suspected tuberculosis?

HEPA filter respirator or N95 respirator Signup and view all the answers

For protection of the eyes, ____________ must be worn whenever there is a risk of contaminating the mucous membranes.

protective eyewear Signup and view all the answers

Match the following infection control measures with their descriptions:

Standard precautions = Precautions for all hospitalized individuals regardless of diagnosis Transmission-based precautions = Additional precautions for patients with suspected infections Surgical asepsis techniques = Used in operating rooms and patient bedside care Signup and view all the answers

Study Notes

Fundamentals of Infection Control

Infection is the growth of microorganisms in body tissue where they are not usually found.
An infectious agent is a microorganism that causes infection.
If the microorganism produces no clinical evidence of disease, the infection is called asymptomatic or subclinical.
A detectable alteration in normal tissue function is called disease.

Asepsis

Asepsis is the freedom from disease-causing microorganisms.
Aseptic technique is used to decrease the possibility of transferring microorganisms from one place to another.
There are two basic types of asepsis:
- Medical asepsis: practices intended to confine a specific microorganism to a specific area, limiting the number, growth, and transmission of microorganisms.
- Surgical asepsis: practices that keep an area or object free of all microorganisms.

Nosocomial and Health Care-Associated Infections

Nosocomial infections are classified as infections that originate in the hospital.
Nosocomial microorganisms may also be acquired by personnel working in the facility.
Nosocomial infections are a subgroup of health care–associated infections (HAIs).
The microorganisms that cause nosocomial infections can originate from the clients themselves (an endogenous source) or from the hospital environment.

Components of Infection

An infection occurs as a result of a cyclic process, consisting of six components:
- Infectious agent
- Reservoir
- Portal of exit
- Means of transmission
- Portals of entry
- Susceptible host

Stages of Infection

The stages of infection are:
- Incubation period: the interval between the pathogen's invasion of the body and the appearance of symptoms of infection.
- Prodromal stage: the stage where early signs and symptoms of disease are present, but are often vague and nonspecific.
- Full stage of illness: the stage where specific signs and symptoms indicate the presence of disease.
- Convalescent period: the recovery period from the infection.

The Body's Defense Against Infection

The body's defense against infection includes:
- Normal flora: the body's normal flora helps to keep potentially harmful bacteria from invading the body.
- Inflammatory response: a protective mechanism that eliminates the invading pathogen and allows for tissue repair to occur.
- Immune response: a specific body response to an invading foreign protein.

Factors Affecting the Risk for Infection

Factors that affect the risk for infection include:
- Integrity of skin and mucous membranes
- pH levels of the gastrointestinal and genitourinary tracts
- Integrity and number of white blood cells
- Age, sex, race, and hereditary factors
- Immunizations, natural or acquired
- Level of fatigue, nutritional and general health status
- Presence of preexisting illnesses
- Previous or current treatments
- Certain medications
- Stress level
- Use of invasive or indwelling medical devices

The Nursing Process for Infection Prevention and Control

The nursing process for infection prevention and control includes:
- Assessment: early detection and surveillance techniques
- Diagnosing: accurate nursing diagnoses related to an infectious process
- Outcome Identification and Planning: identifying expected patient outcomes
- Implementing: using asepsis and infection-control techniques
- Evaluating: evaluating the effectiveness of infection-control measures

Preventing Healthcare-Associated Infections

Measures to prevent HAIs include:
- Constant surveillance by infection-control committees and nurse epidemiologists
- Written infection-prevention practices for all agency personnel
- Adherence to hand hygiene recommendations and infection-control precaution techniques
- Practices to promote and keep patients in the best possible physical condition

Sterilizing and Disinfecting

Sterilizing and disinfecting help to break the cycle of infection and prevent disease.
Disinfection destroys all pathogenic organisms except spores.
Sterilization destroys all microorganisms, including spores.
Factors influencing the choice of sterilization and disinfection methods include:
- Nature of organisms present
- Number of organisms present
- Type of equipment
- Intended use of equipment
- Available means for sterilization and disinfection
- Time### Methods of Sterilization
Ethylene oxide gas: destroys microorganisms by interfering with their metabolic processes, effective against spores, good penetration, and effective for heat-sensitive items, but toxic to humans.
Boiling Water: most practical and inexpensive method for sterilizing in the home, effective against spores and some viruses, but has limitations.
Radiation: both ionizing (alpha, beta, and x-rays) and non-ionizing (ultraviolet light) radiation are used for disinfection and sterilization, but ultraviolet light has limited penetration.

Cleaning and Disinfection

Wear waterproof gloves to clean equipment.
Rinse equipment with cold running water to remove organic material.
Wash equipment with warm water and detergent or soap to facilitate emulsification and removal of dirt and debris.
Use a brush with stiff bristles to clean equipment thoroughly.
Friction aids in the removal of organisms and debris from difficult-to-reach areas.
Rinse and dry equipment thoroughly after cleaning.

Personal Protective Equipment and Supplies

Healthcare agencies must provide employees with personal protective equipment (PPE) and supplies to minimize or prevent exposure to infectious material.
Gloves: worn only once, discarded appropriately, and changed prior to moving from a contaminated task to a clean one.
Gowns: worn to prevent soiling of healthcare worker's clothing, provide barrier protection, and are donned immediately before entering the patient's room.
Masks: help prevent the wearer from inhaling large-particle aerosols and small-particle droplet nuclei, and discourage the wearer from touching the eyes, nose, and mouth.
Protective Eyewear: must be available whenever there is a risk of contaminating the mucous membranes of the eyes.

Handling and Disposing of Supplies

Used equipment may be disposed of after use or, if reusable, bagged and sent to a central cleaning area for sterilization or disinfection.
Contaminated items must never be used for another patient.
Double bagging may be required if the single bag is not secure or is soiled on the outside.
When collecting a specimen, take care to prevent the outside of the container from becoming contaminated with any secretions or body fluids.

Standard Precautions

Precautions used in the care of all hospitalized individuals regardless of their diagnosis or possible infection status.
Apply to blood, all body fluids, secretions, and excretions except sweat, non-intact skin, and mucous membranes.
Include Respiratory Hygiene/Cough Etiquette, safe injection practices, and directions to use a mask when performing high-risk prolonged procedures involving spinal canal punctures.

Transmission-Based Precautions

Precautions used in addition to standard precautions for patients in hospitals with suspected infection with pathogens that can be transmitted by airborne, droplet, or contact routes.
Don personal protective equipment (PPE) when entering the room of a patient on contact or droplet precautions.
Use puncture-resistant containers for disposal of all needles and sharps.

Surgical Asepsis Techniques

Used regularly in the operating room, labor and delivery areas, and certain diagnostic testing areas.
Procedures that involve the insertion of a urinary catheter, sterile dressing changes, or preparing an injectable medication.
An object is considered sterile when all microorganisms, including pathogens and spores, have been destroyed.

Opening a Sterile Package and Preparing a Sterile Field

Commercially prepared sterile items may be sealed in paper or packaged in plastic containers.
Sterile packages may be opened on a flat surface or while held in the hands.
A sterile item should be covered if it is not used immediately.

Pouring Sterile Solutions

Care is necessary when pouring sterile liquids onto a sterile dressing or into a sterile basin.
The outer surfaces of the bottle and cap are considered unsterile, whereas the inside areas and the solution are considered sterile.

Adding Sterile Supplies to a Sterile Field

Once a sterile field is established, objects on the field may be handled only by using sterile forceps or with hands wearing sterile gloves.

Putting on Sterile Gloves

Sterile gloves are donned in a way that allows only the inside of the gloves to come in contact with the hands.
After the gloves are on, only sterile items may be handled with the sterile-gloved hands.

Positioning a Sterile Drape

The sterile drape, which ideally is waterproof, may be used to extend the sterile working area.
Using sterile gloves allows the nurse to handle the entire drape surface.

Reporting Accidental Exposure

Nurses are accountable for their own safety.
Any needlestick injury or accidental exposure to blood or body fluids must be reported immediately.
An agency's plan for this type of exposure typically includes washing the exposed area immediately, reporting the incident, and informing the agency of the source and nature of the exposure.

Teaching About Infection Control

Patients should be taught to use basic principles of asepsis at home and in public facilities.
Examples of medical asepsis practices recommended in the home include washing hands before preparing food and before eating, preparing foods at temperatures high enough to ensure that they are safe to eat, and washing hands, cutting boards, and utensils with hot, soapy water before and after handling raw poultry and meat.

Evaluation

Evaluation of the plan of care determines whether the individual's need for safety is being met effectively.
Ongoing systematic evaluation is crucial for nurses who strive to maintain a secure environment for their patients as well as themselves.

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Description

This quiz covers the basics of infection control in nursing practice, including the growth of microorganisms in body tissue and the role of infectious agents. It also touches on asymptomatic and subclinical infections.