Types of Infection and Transmission

Types of Infection

• Nosocomial infections: Acquired in healthcare facilities after admission, typically within 48 hours or later. Examples include UTIs, bacteremia, and skin infections.
• Iatrogenic infections: Acquired during a medical or surgical procedure, regardless of hospitalization status. Examples include post-procedure infections when handwashing protocols are not followed.

Elements Needed for Infection Transmission

• Infectious agent: Pathogenic microorganism.
• Reservoir: Source of the infectious agent (e.g., a patient).
• Environment: Suitable conditions for microbial growth and multiplication.
• Portal of exit: Route by which the agent leaves the reservoir (e.g., secretions).
• Transmission: Method of transfer (e.g., airborne, droplet).
• Portal of entry: Route by which the agent enters a new host (e.g., respiratory tract).

Types of Infection Isolations

• Airborne: Transmission via evaporated droplets or dust particles that can spread through the air. Diseases such as smallpox and chickenpox are spread in this way.
• Droplet: Transmission via droplets produced when an infected person coughs, sneezes, or talks. Examples are influenza and diphtheria.
• Contact: Direct or indirect contact with infected/colonized individuals or surfaces. Examples include contaminated objects and close contact with an infected person.

Colonization

• Colonization: Microorganisms present on the skin or body surface without causing symptoms of disease.

Infection Control

• Goal: Prevent infections in patients and staff through infection control techniques.
• Importance: Up to 50% of infections can originate from exposure to healthcare facilities.
• Techniques: Proper handwashing, aseptic technique, and controlling the environment.

Routine Practices

• Infection prevention and control practices to prevent transmission of microorganisms to all patients.
• Includes standardized procedures and personal protective equipment (PPE).

Additional Precautions

• Used in addition to routine practices for patients with suspected colonization or known diseases.
• Examples include procedures and accommodations for diseases like Tuberculosis.
• Includes specialized accommodation and signage.

Precautions (Additional Measures)

• PPE: Personal protective equipment to prevent the spread of infectious diseases like influenza.
• Dedicated equipment and additional cleaning measures: to disinfect surfaces and minimize contamination.
• Negative pressure rooms: Prevent the spread of airborne pathogens.
• Limited transport: For patients with infectious diseases to contain the spread of disease.
• Communication: Importance of clear communication in conveying information regarding infection control and patient care.

Point of Care Risk Assessments (PCRAs)

• Routine practice by healthcare workers that assesses likelihood of exposure to infectious agents.
• Includes the identification of hazards, patient status, task type and location.
• Important to ensure safety.

Management of Exposures/Contamination

• Accidental exposure to body fluids requires immediate action to prevent contamination.

First-Aid Management for Exposure to Bloodborne Pathogens

• First-aid measures to be followed in case of exposure to blood or bodily fluids for proper medical interventions.

Handwashing Techniques

• Handwashing steps for proper hygiene in the presence of infectious diseases.

Sterile Techniques

• Aseptic practices: Procedures to maintain sterility of equipment and the work environment to eliminate the spread of infectious material and infections.
• Medical vs surgical asepsis: Differences in methods to maintain sterility for different settings.
• Surgical asepsis: Practices used in invasive procedures.

Communication Techniques

• Three-way repeat back: Method for clarifying communication of critical patient information to ensure accuracy and understanding in high-risk situations.
• SBAR: Situation-Background-Assessment-Recommendation for effective communication on critical information to ensure appropriate care for a patient.

Written Documentation

• Documentation format specifications for patient care records in a precise format.
• Requires clear, legible, and accurate records, specifying the details of the situation and the care provided.

Drug Administration Considerations

• All drugs are potentially harmful.
• Always adhere to the five rights of medication administration (patient, drug, dosage, route, time) to prevent errors.

Routes of Drug Administration

• Routes: Enteral, parenteral, intradermal, subcutaneous, intramuscular, intravenous.
• Subtypes: Oral, sublingual, buccal, rectal, etc.

Intravenous Preparation

• Right drug, right amount, right route, right time, right person: Key elements of proper medication administration to prevent medication errors.

Intravenous (IV) Considerations

• Safe flow rate.
• Monitoring for complications in order to determine if there is an issue with a patient.
• Importance of proper care of the patient during procedures.

Selection of equipment for IV drugs

• Considerations about different sizes of drugs and equipment, for correct dosages.

Injection sites for IV insertion

• Selecting appropriate sites for IV insertion and considerations related to avoiding areas with potential complications.
• Proper technique for insertion of devices into a patient.

Removal of IVs

• Proper procedure for the removal of IVs and importance of infection control measures during the procedure.
• Follow steps for removing intravenous devices such as tapes and dressings while taking appropriate precautions.

Venipuncture Complications and Considerations

• Potential complications during venipuncture, including vessel injury, blood clots, and risks associated with the procedure itself.

Unique Considerations for Patients

• Vein selection and procedure-specific considerations for various patient populations e.g., elderly, children, patients with health concerns, and obese patients.
• Importance of understanding and addressing the unique needs and concerns of diverse patients to provide optimal care.

Contrast Media

• Contrast media is a substance used to highlight internal structures in radiological procedures.
• Contrast agents come in various forms, including barium and iodine-based agents.
• Important to be aware of potential reactions.

Risk Factors for Adverse Reactions to Contrast IV

• Identifying and mitigating risk factors to prevent adverse reactions to contrast agents, including allergies, renal issues, cardiac conditions, anxiety, and other factors that compromise the patient's overall health.

Adult Pre-medication Protocols

• Types of protocols, duration, and circumstances.
• Importance of a thorough pre-procedure assessment and the importance of proper steps for preparation.

Patient Interview Process

• Interview protocol, patient information gathering, prior knowledge and experience, and detailed considerations for a patient's overall well-being and needs.
• Patient history and factors used to assess patient's state of health prior to procedures.

Patient Population Considerations

• Diverse patient population characteristics and considerations required for administering medications and venipuncture procedures.