Infection Control Practices

Infection Control

• Infection control involves practices to prevent the spread of infections
• Learning outcomes include differentiating the body's natural defenses against infection, identifying factors increasing infection risk, comparing infection stages, and contrasting localized and systemic infections.
• Nurses should know about infection processes to protect patients from healthcare-related infections, meet professional guidelines, protect themselves from diseases, and lower healthcare costs
• Healthcare-associated infections (HAIs) account for 1.7 million infections and 99,000 associated deaths annually in US hospitals.
• Common HAIs include urinary tract infections (UTIs), Surgical site infections, pneumonia, and bloodstream infections.
• Clostridium difficile is a common and serious infection
• Common pathogens include Staphylococcus aureus, Escherichia coli, Enterococci, and Candida.
• Nosocomial infections are acquired in healthcare facilities.

Chain of Infection

• Germs (agent) are bacteria, viruses, and parasites
• Reservoirs are places where germs live (people, animals, food, soil, water)
• Portals of entry are ways germs enter the body (mouth, cuts in skin, eyes)
• Modes of transmission are how germs spread (contact, droplets, airborne)
• Portals of exit are ways germs leave the body (mouth, cuts, bodily fluids)
• Susceptible host are individuals who are at increased risk of developing infections due to compromised defenses (age, weakened immune system, medical conditions, medications).

Infectious Agent

• Normal flora are microorganisms that live on or in the human body without causing harm (transient and resident)
• Pathogens are microorganisms that are capable of causing disease (bacteria, viruses, fungi, opportunistic pathogens).

Factors Determining Infection

• Virulence of the organism (ability to cause disease)
• Ability of the organism to survive in the host
• Number of organisms
• Ability of host defenses to prevent infection

Reservoir

• Reservoir is a place where pathogens survive and multiply
• Common human body, warm moist dark environments
• Carriers don't show symptoms but can pass the disease to others

Portal of Exit

• Pathogens exit through body fluids like blood, mucus, saliva, breast milk, urine, feces, vomit, semen.
• Bodies expel foreign materials.

Mode of Transmission

• Contact is the most frequent mode of transmission (direct or indirect)
• Direct contact is touching, kissing, or sexual contact
• Indirect contact is via fomites.
• Droplet transmission involves water droplets expelled during coughs, sneezing, and talking.
• Airborne transmission involves microorganisms traveling in the air.
• Vector transmission involves transfer by a vector (e.g., insect bites).

Portal of Entry

• Pathogens enter the body through normal or abnormal body openings, mucous membranes.

Stages of Infections

• Incubation stage: time between pathogen invasion and first symptoms (person may be contagious)
• Prodromal stage: early, vague symptoms (e.g., mild throat irritation)
• Illness stage: signs and symptoms appear; may lead to recovery or death (if untreated)
• Stage of decline: pathogen numbers decrease, symptoms fade.
• Convalescence stage: healing phase, duration varies from days to over a year.

Emerging Pathogens & Diseases

• Epidemics are sudden increases in illness and death rates due to specific infection, causing potential health problems
• Pandemics are widespread epidemics that affect multiple countries

Multi-drug resistant organisms (MDROs)

• Bacteria that have developed resistance to multiple types of antibiotics.
• Examples include MRSA, VRE, ESBL, and PRSP.

Body's Defenses Against Infection

• Primary Defenses: Skin, respiratory tract, eyes, mouth, GI tract, and GU tract. Mechanisms include tears, saliva, mucus, cilia, acidic pHs, and normal flora.
• Secondary Defenses: Phagocytosis (engulfing pathogens), complement cascade (enhancing immune response), inflammation, fever, increased blood vessel permeability.
• Tertiary Defenses (Adaptive): Active immunity (body produces antibodies), passive immunity (antibodies from another source like mother), specific immune response via immune cells (recognize and destroy pathogens)

Types of Immunity

• Active Immunity (naturally or artificially acquired through response to infection or vaccination).
• Passive Immunity (naturally or artificially acquired through receiving antibodies from another source such as breast milk or an injection).
• Naturally acquired active immunity develops when a person is exposed to an antigen, becomes ill, and recovers
• Naturally acquired passive immunity involves the natural transfer of antibodies from a mother to her infant, through the placenta and breast milk (especially colostrum).
• Artificially acquired active immunity results from vaccination. It requires injection of antigens (dead or live microorganisms, or inactivated toxins)
• Artificially acquired passive immunity involves the injection of antibodies (from an animal or person already immune to the disease).

Host Susceptibility

• Developmental stage, breaks in the first line of defense, and illness or injury.
• Tobacco and substance abuse
• Multiple sexual partners
• Environmental factors
• Chronic diseases, Medications. Invasice nursing procedures.

Nursing History

• Exposure to pathogens, travel, contact with ill individuals, unusual foods, prior illness, medications, stress levels, immune history, and symptoms

Promoting Wellness

• Nutrition to support body's nutritional needs during acute illnesses
• Hygiene for maintaining intact skin, frequent hand washing
• Stress Reduction to correlate stress and diseases
• Rest and Sleep of 6-9 hours per night
• Immunizations including herd immunity

Practicing Medical Asepsis

• Procedures that reduce the risk of infection spread (good hygiene practices such as handwashing, routine cleaning methods, techniques to reduce microbial contamination, and methods of maintaining aseptic environments).

Practicing Surgical Asepsis

• Procedures to create a sterile environment where no live microorganisms are present (using sterile gloves and supplies, and sterile techniques).

Doffing PPE (Removing PPE) and Donning PPE (Putting on PPE). Step-by-step guide

• PPE removal and donning procedures.
• Gloves ,Goggles, Gown, Mask

Preventing Transmission of Pathogens

• Protective Environment in Special Situations for immunosuppressed patients (e.g., Reverse isolation).
• Control of Potentially Contaminated Equipment and Supplies
• Disposing of Used Isolation Supplies
• Sharps Disposal
• Laboratory Specimens.

Practicing Surgical Asepsis

• Levels of asepsis (sterile technique, modified sterile technique, clean technique).

Additional information

• Infection control includes multiple aspects such as hygiene, wound care, food handling, etc
• Specific examples of pathogenic organisms like bacteria, viruses and fungi.

This quiz covers essential concepts in infection control, including the body's natural defenses, risk factors for infections, and types of healthcare-associated infections (HAIs). It is crucial for healthcare professionals to understand these concepts to ensure patient safety and reduce healthcare costs. Test your knowledge on common pathogens and infection prevention strategies.