Asepsis & Infection Control-2-1.pptx

Asepsis & Infection Control Chapter 25 Carigan Grino MSN-Ed, RN, Learning Objectives  Explain the infection cycle  List the stages of infection  Identify patients at risk for developing infection  Describe nursing interventions used to break the cycle ...

Asepsis & Infection Control Chapter 25 Carigan Grino MSN-Ed, RN, Learning Objectives  Explain the infection cycle  List the stages of infection  Identify patients at risk for developing infection  Describe nursing interventions used to break the cycle  Identify situations in which hand hygiene is indicated  Identify multi drug-resistant organisms that are prevalent in hospitalized patients  How to implement CDC guidelines for standard & transmission based precautions  How to use medical and surgical asepsis techniques Infection  A disease state that results from the presence of pathogens in or on the body. A six-part process must occur in order for an infection to occur:  Infectious agent  Reservoir  Portal of exit  Means of transmission  Portal of entry  Susceptible host Infectious agents  Bacteria  E.coli, staphylococcus, streptococcus  Virus  HIV, common cold, influenza, COVID-19, hepatitis A,B,C  Fungi  Athlete’s foot, ring worm, yeast infections  Parasites  Malaria occurs from mosquitos infected with a parasite Potential reservoirs  People  Animals  Soil  Food  Water  Milk  Objects Portals of entry for Humans  Respiratory  Gastrointestinal  Genitourinary Tracts  Skin breakdown  Blood & Tissues  What does this mean for nurses?  Means/Mode of Transmission  Contact Transmission  Direct contact  Close proximity  Touching, kissing, sexual intercourse  Indirect contact  Personal contact with  A vector- living creature that transmits a pathogen to humans  A fomite- an inanimate object that harbors a pathogen  What object do nurses use that could potentially act as a fomite?  What objects do we come into contact with that act as fomites? Means/mode of transmission  Droplet transmission  Organisms greater than 5um (micrometer) attach to dust particles  Droplets are heavy enough to land on surfaces  Airborne transmission  Organisms less than 5um (micrometer) attach to dust particles  Airborne particles remain in the air The infection cycle: “Break the chain” What kind of rooms will you be able to enter as a first quarter nursing student? Portals of Exit for Humans  Respiratory  Gastrointestinal  Genitourinary Tracts  Skin breakdown  Blood & Tissues  What does this mean for nurses? Susceptible host  Multiple wounds, poor skin integrity= multiple portals of entry  pH levels of GI and GU tracts and skin= protect body against microbial invasion  White blood cell count  Age, sex, heredity… which age groups are most susceptible?  Immunity… natural vs acquired vs passive  Level of fatigue  Nutritional status, general health  Pre-existing illness  Certain medications  Stress level  Use of invasive or indwelling medical devices Case Study  Jimin is a 27 year old nursing student. He is a biological male of Asian descent. He has received his childhood vaccinations but is unvaccinated for COVID. He is in his 4th quarter and is also working part- time as a pop star. During a rigorous dance number, he fell on stage and sustained a laceration to his left leg. Despite his injury, he continued to go to school as well as perform. During this time, he became hospitalized for COVID-19 and dehydration. Due to his need for IV fluid, he has an IV placed into his left arm. What makes an organism thrive?  Quantity of Organism  Virulence  Patient’s immune system  How long the organism + patient were in contact  What type of contact they had Practice Question The friend of a long-term care client comes to visit despite having an upper respiratory infection. What health teaching will the nurse share with the visitor?  A. “If you wash your hands before coming in contact with your friend you will prevent infection during your visit.” B.“Please get a mask from the staff upon entry and use a mask along with hand hygiene when visiting to prevent the spread of infection to your friend and others.” C. “As long as you cough and sneeze into the bend of your elbow you won’t spread the infection to your friend.” D. “You should not visit your friend if you have an infection of any kind because your friend may also get sick.” Stages of Infection 1. Incubation Period 1. Common cold: 1-2 days 2. Tetanus: 2-21 days 2. Prodromal Stage 1. Hours to days 3. Full Stage of Illness 4. Convalescent Period 1. Maybe a temporary or permanent change in the patient’s previous health  Can a person continuously cycle through the same infectious process?  HSV What is the best way nurses can prevent infection?  Asepsis- methods to prevent infection Medical- Reduce # of Surgical- Eliminate # of pathogens pathogens  “Clean Technique”  “Sterile Technique”  Hand Hygiene  Create and maintain pathogen  Wearing gloves free environment  Do not place dirty, soiled linen on the  Required for procedures such as floor foley catheters and central line  Avoid raising dust placement/dressing changes  Practice “clean to dirty” technique  Sterile gloves, mask, hair net,  Dispose of dirty linens directly into gowns etc hamper  Pour contaminated liquids directly into the drain or into the “hopper” to prevent splashing Five Moments for hand hygiene (World health Org)  Before touching a patient  Hand washing- soap and water  Before a clean or aseptic for 20 seconds procedure  Hand sanitizer- vigorous friction  After body fluid exposure risk until hands are dry  After touching a patient  Which method is more effective?  When is hand sanitizer not  After touching patient appropriate? surroundings Healthcare MULTIDRUG RESISTANT associated ORGANISMS Infections (HAIs)  Vancomycin Resistant Enterococci (VRE)  Also know as hospital acquired/ nosocomial  Feces, urine, blood infections  Methicillin-Resistant Staphylococcus Aureus (MRSA)  Catheter Associated Urinary Tract Infections  Found in the nares, on the (CAUTI) skin, or in the GI tract  Carbapenem-Resistant  Surgical Site Infection (SSI) Enterobacteriaceae (CRE)  Central-Line Associated  Clostridium Difficile (C. Diff) Bloodstream Infection (CLABSI)  feces  Ventilator-Associated Pneumonia (VAP) Critical Thinking pathway  What are some signs/symptoms of infections? If a scenario is presented where a patient is displaying symptoms of infection and there is a medical device present, what can we determine? Personal Protective Equipment  Gloves  Gown  Masks  Protective Eye- Wear Standard Precautions  Used in the care of all hospitalized patients regardless of their diagnosis or possible infection status  Apply to blood, all body fluids, secretions, and excretions except sweat (whether blood is present or visible), non-intact skin, and mucous membranes  New additions are 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  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.  Proper Donning of personal protective equipment (PPE) when entering the room of a patient on contact or droplet precautions.  Proper Doffing of PPE when leaving the room  These categories recognize that a disease may have multiple routes of transmission: airborne, droplet, contact). Droplet  Infection spreads by large particle droplets  Private room  Door can stay open  Surgical mask and gloves Contact  Infected or colonized by a multi drug resistant organism (MDRO)  Private room  Gown and gloves  Change gloves after contacting infective material  Clean all equipment; do not share Airborne  Infections that spread through the air  Private room  Negative air pressure  Door closed, pt remains in room  Respirator mask  Surgical mask on patient for transport What else is airborne?? Practice question  Standard Precautions should be used when caring for a noninfectious-postoperative patient who is vomiting blood.  True  False Practice Question A school nurse is performing an assessment of a student who states, “I’m too tired to keep my head up in class.” The student has a low-grade fever. The nurse would interpret these findings as indicating which stage of infection? a. Incubation period b. Prodromal Stage c. Full Stage of Illness d. Convalescent period