Infection Control and Isolation PDF

1/11/22 Infection Control and Isolation 1 1 The Chain of Infection Ø A sequence of necessary pieces for an infection to occur. Ø Includes an infectious agent,...

1/11/22 Infection Control and Isolation 1 1 The Chain of Infection Ø A sequence of necessary pieces for an infection to occur. Ø Includes an infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. 2 2 1  1/11/22 An infectious agent includes bacteria, fungi, virus, parasite, or prion. 3 3 A reservoir is the habitat of the infectious agent and is where it lives, grows, and reproduces itself or replicates. Can be animate or inanimate objects such as people, insects, soil, food, equipment. 4 4 2  1/11/22 A portal of exit is the means by which the infectious agent can leave the reservoir. Through respiratory tract, GI or GU tract, blood and body fluids, skin, mucous membranes, and transplacental 5 5 Modes of Transmission** Ø Contact: spreads from person to person Ø Droplet: occurs when airborne droplets from the respiratory tract of a client travel through the air and into the mucosa of a host. 1m Ø Vector-borne: occurs from bite from infected mosquito, ticks, fly Ø Vehicle: occurs from soil, water, air carries agent to a new host ex. Contaminated produce. 6 6 3  1/11/22 There are two types of contact transmission: Direct and Indirect. Direct contact Indirect contact transmission occurs transmission occurs when microorganisms when microorganisms are directly moved from are moved from the the infected person to infected person to another person another person with a Ex. Herpes contaminated object or person between the two. Ex. Staph aureus, handrails, phones, call bells 7 7 A portal of entry can be any body orifice (for example, ears, nose, mouth) or can even be through the skin, and it provides a place for the infectious agent to replicate or for the toxin to act. Could be the same as portal of exit –GI/GI 8 8 4  1/11/22 A susceptible host is required for the infectious agent to take hold and become a reservoir for infection. Not everyone who is exposed to an infectious agent gets sick. Level of immunity and the virulence of infectious agent. 9 9 Host Susceptibility is Affected by: Age Underlying disease- diabetes, kidney, liver or lung disease HIV/AIDS Malignancy Transplants Some medications Surgical procedures Radiation Indwelling devices Breaks in skin Poor oxygenation Poor nutrition, hygiene, smoking, living environment 10 10 5  1/11/22 Body Defenses Non-specific immunity, innate, native Physical and Chemical Barriers 1st line of defense Skin Mucous membranes Tears Sweat Urine Cilia Acids and enzymes in GI tract 11 11 Nonspecific Immunity Ø Also includes neutrophils and macrophages and their work as phagocytes. Ø Phagocytes eat and destroy microorganisms, thereby helping to protect the body from harm. Ø Both neutrophils and macrophages are released during the inflammatory response. 12 12 6  1/11/22 Specific immunity refers to the work of antibodies (also called immunoglobulins) from B Lymphocytes and T lymphocytes. Have memory for the next exposure. Antibodies bind to infectious agents and call to the white blood cells and complement to destroy them. 13 13 Inflammatory Response Can be infectious and noninfectious triggers Chemicals from mast cells are released that cause swelling Histamine, Bradykinin, Prostaglandins Treated with medications Antihistamines – block histamine Nonsteroidal anti-inflammatory drugs (NSAIDs) Manifestations of inflammation Heat Redness Swelling Pain Loss of function 14 14 7  1/11/22 1. Incubation: The time between pathogen enters host, begins to multiply Stages of and the first symptoms Infection 2. Prodromal: The time between general symptoms and specific symptoms. 3. Acute illness: Manifestations of the specific infectious disease process are obvious and may become severe. 4. Decline: Manifestations begin to wane as the degree of infectious disease decreases. 5. Convalescence: The client returns to a normal or a “new normal” state of health. 15 15 Local infections are confined to one area of the body. Local infections can be treated with topical antibiotics and oral antibiotics. Systemic infections start as local infections and then spread to the bloodstream to infect the entire body. 16 16 8  1/11/22 Diagnostic Tests Chest xray Urine Sputum Blood WBC ** FAE** Neutrophils Lymphocytes Monocytes Eosinophils Basophils C-Reactive Protein (CRP) Erythrocyte sedimentation rate (ESR) Procalcitonin (PCT) 17 17 Hand hygiene is a broad term to cover any type of cleansing of the hands. This may be using soap and water to wash the hands as in normal handwashing, alcohol-based (>60%) hand sanitizers, using an antiseptic handwash or hand rub, and surgical hand antisepsis. When to perform? ** Special Considerations **Skills 18 18 9  1/11/22 Medical vs. Surgical Asepsis Medical asepsis (clean technique) is a term to describe the reduction of disease-causing microorganisms. Hand hygiene Cleaning equipment PPE Clean linens Cough etiquette 19 19 Surgical asepsis (sterile technique) is a term used to define the elimination of and absence of disease-causing microorganisms. Ex. Surgical procedures, operating room 20 20 10  1/11/22 Sterilization – all micro-organisms are eradicated Sterile fields – help to keep micro-organisms smallest as possible*** Flat surface Away from other objects Sealed items Outer 1 inch unsterile Unwrapping a sterile package Away, Side, Side, Close Only sterile in sterile fields Above chest or below waist is contaminated Don’t reach across sterile field, don’t turn your back to sterile field, add from 6 inches above Disinfection – almost all micro-organisms are eradicated High level – everything except spores Low level – some spores, viruses, fungi may be present – used to clean surfaces, some equipment- bed rails, contact surfaces, keyboards, etc 21 21 Standard precautions is a term used to describe the infection prevention practices applied to all clients, whether or not they are known to have an infectious agent. 22 22 11  1/11/22 Standard Precautions Hand hygiene Alcohol based when hands are not visibly soiled, after removal of gloves Soap and water if visibly soiled, contaminated with spores, Soap and water with C. difficile Gloves – change between clients Use masks, goggles, face shields if care may cause splashing or spraying Clean all equipment Bag all laundry to prevent contamination Proper disposal of sharps 23 23 Contact Precautions- wound infections, RSV, scabies, herpes simplex PPE – gowns and gloves at minimum by caregivers and visitors Private room or cohorting with someone with same infection and 3 feet between clients Remove PPE before exiting room Droplet Precautions- rubella, pertussis, mumps, H. influenza, strep throat PPE - Surgical mask for providers and visitors Private room or cohorting or at least 3 feet between clients Client wear mask when out of room Cough etiquette, hand hygiene Own equipment Airborne Precautions – measles, varicella, tuberculosis, COVID Private room with door closed, negative pressure room PPE – N95 or higher mask, fit testing If splashing expected, wear full PPE Protective Environment Immunocompromised clients For a client for first 100 days or longer after hematopoietic stem cell transplant No plants Positive airflow masks for when out of room 24 24 12  1/11/22 Health Care-Associated Infections (HAIs) The four major HAIs are: 1. Central Line-associated Bloodstream Infections (CLABSIs) 2. Catheter-associated Urinary Tract Infections (CAUTIs) 3. Surgical Site Infections (SSIs) 4. Ventilator-assisted Pneumonias (VAPs) 25 25 Infection Control Bundles To prevent HAIs Protocols to minimize risk of infection Multi-drug Resistant Organisms (MDROs) May only respond to one or two medications Increased attention to prevent transmission to other clients EX. MRSA, VRE, VRSA 26 26 13  1/11/22 It is the nurse’s responsibility to know what type(s) of Personal Protective Equipment *** (PPE) are needed to care for clients and to don (put on) and doff (take off) PPE appropriately. 27 27 Needlestick Injury Prevention Use safety needles Know how they work Engage safety device immediately Use sharps containers for disposal Make sure sharps container is less than ¾ full Needleless systems when available 28 28 14  1/11/22 Engage Fundamentals Features Skills Fundamental Takeaways Flashcards Glossary Posttest 29 29 15