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Basic Nursing:Foundations of Skills & Concepts Chapter 21. INFECTION CONTROL - ASEPSIS. Flora. Microorganisms that occur or have adapted to live in a specific environment. Two types: Resident (always present). Transient (episodic). Pathogens.

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Basic Nursing:Foundations of Skills & Concepts Chapter 21


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basic nursing foundations of skills concepts chapter 21

Basic Nursing:Foundations of Skills & Concepts Chapter 21

INFECTION CONTROL -

ASEPSIS

flora
Flora
  • Microorganisms that occur or have adapted to live in a specific environment.
  • Two types:
    • Resident (always present).
    • Transient (episodic).
pathogens
Pathogens
  • Microorganisms that cause disease.
  • These include:
    • Bacteria.
    • Fungi.
    • Viruses.
    • Protozoa.
    • Rickettsia.
virulence
Virulence
  • The frequency with which a pathogen causes disease.
factors affecting virulence
Factors Affecting Virulence
  • Strength of pathogen to adhere to healthy cells.
  • Ability of pathogen to damage cells or interfere with the body’s normal regulating systems.
  • Ability of pathogen to evade attack of white blood cells.
bacteria
Bacteria
  • Small, one-celled microorganisms that lack a true nucleus or mechanism to provide metabolism.
  • Only small percent of bacteria are pathogenic.
  • Common bacterial infections include diarrhea, pneumonia, gonorrhea, meningitis, impetigo, and urinary tract infections.
viruses
Viruses
  • Organisms that live only inside cells.
  • They cannot get nourishment or reproduce outside cells.
  • Common viral infections include influenza, measles, common cold, chickenpox, hepatitis B, genital herpes, and HIV.
fungi
Fungi
  • Grow in single cells, as in yeast, or in colonies, as in molds.
  • Most are not pathogenic and make up many of the body’s normal flora.
  • Fungi can cause infections of the hair, skin, nails, and mucous membranes.
protozoa
Protozoa
  • Single-celled parasitic organisms with the ability to move.
  • Common protozoan infections include malaria, gastroenteritis, and vaginal infections.
rickettsia
Rickettsia
  • Intracellular parasites that need to be in living cells to reproduce.
  • Spread through fleas, ticks, mites, and lice.
  • Common rickettsia infections include typhus, Rocky Mountain spotted fever, and Lyme disease.
infection
Infection
  • An invasion and multiplication of pathogenic microorganisms that occurs in body tissue and results in cellular injury.
chain of infection
Chain of Infection

Infectious agent

Susceptible Host

Reservoir

Or Source

Portal of Entry to Host

Portal of Exit

from Reservoir or

Source

Mode of Transmission

agent
Agent
  • Biological (bacteria, viruses, fungi, protozoa, Rickettsia).
  • Chemical (pesticides, food additives, medications, industrial chemicals).
  • Physical (environmental factors, like heat, light, noise, radiation, and machinery).

An entity capable of causing disease.

These may be:

reservoir
Reservoir
  • Humans.
  • Animals.
  • Environment.
  • Fomites (objects contaminated with an infectious agent, e.g. bed pans, urinals, linens, instruments, dressings, etc.).

A place where the agent can survive. The most common reservoirs are:

portal of exit
Portal of Exit

The route by which an infectious agent leaves the reservoir to be transferred to a susceptible host. Includes:

  • Sputum from respiratory tract.
  • Semen, vaginal secretions, or urine, from the genito-urinary tract.
  • Saliva and feces, from the gastrointestinal tract.
  • Blood.
  • Draining wounds.
  • Tears.
modes of transmission
Modes of Transmission

The process that bridges the gap between the portal of exit of the infectious agent from the reservoir or source and the portal of entry of the susceptible “new” host.Includes:

  • Contact transmission (direct contact with infected person, indirect contact through fomite, or close contact with contaminated secretions).
  • Airborne transmission.
  • Vehicle transmission (through contaminated substances such as water, milk, drugs, or blood).
  • Vectorborne transmission (through fleas, ticks, lice, and other animals).
slide17
Host
  • A susceptible host lacks resistance to an agent and is vulnerable to disease.
  • A compromised host has impaired defense mechanisms and is susceptible to infection.

A simple or complex organism that can be affected by an agent.

factors affecting susceptibility to infection
Age.

Concurrent diseases.

Stress.

Immunization and vaccination status.

Occupation.

Nutritional Status.

Heredity.

Lifestyle.

Factors Affecting Susceptibility to Infection
breaking the chain of infection
Breaking the Chain of Infection

Between Agent and Resevoir

  • Cleansing.
  • Disinfection.
  • Sterilizing.
cleansing
Cleansing
  • Rinsing the object under cold water.
  • Applying detergent and scrubbing object.
  • Rinsing the object under warm water.
  • Drying the object prior to sterilization or disinfection.

The removal of soil or organic material from instruments and equipment. Four steps:

disinfection
Disinfection
  • Disinfectants are chemical solutions used to clean inanimate objects.
  • Germicides are chemicals that can be applied to both animate (living) and inanimate objects for the purpose of eliminating pathogens.

The elimination of pathogens, except spores, from inanimate objects.

sterilization
Sterilization
  • Instruments used for invasive procedures must be sterilized.
  • Moist heat or steam, radiation, chemicals, and ethylene oxide gas used for sterilization.
  • Autoclaving sterilization, using moist heat, is used in most hospital settings.

The total elimination of all microorganisms including spores.

breaking the chain of infection23
Breaking the Chain of Infection
  • Proper Hygiene.
  • Clean Dressings.
  • Clean Linen.
  • Clean Equipment.

Between Reservoir and Portal

breaking the chain of infection24
Breaking the Chain of Infection

Between Portal of Exit and Mode of Transmission

  • Clean dressings on all injuries.
  • Clients should be encouraged to cover the mouth and nose when sneezing or coughing, as should the nurse.
  • Gloves must be worn whenever necessary.
  • Proper disposal of contaminated items.
breaking the chain of infection25
Breaking the Chain of Infection

Between Mode of Transmission and Portal of Entry

  • Nurses wearing barrier protection (gloves, masks, gowns, goggles).
  • Proper handwashing.
  • Proper disposal of contaminated equipment and linens.
breaking the chain of infection26
Breaking the Chain of Infection

Between Portal of Entry and Host

  • Maintaining skin integrity.
  • Using sterile technique for client contacts.
  • Avoiding needle sticks.
  • Proper disposal of sharps.
breaking the chain of infection27
Breaking the Chain of Infection
  • Between Host and Agent
  • Proper nutrition.
  • Exercise.
  • Immunization.
normal defense mechanisms
Normal Defense Mechanisms
  • A host’s immune system serves as a normal defense mechanism against the transmission of infectious agents.
  • Immune system recognizes presence of antigens, foreign proteins that cause the formation of an antibody.
nonspecific immune defense
Nonspecific Immune Defense
  • Skin and normal flora.
  • Mucous membranes.
  • Sneezing, coughing, and tearing reflexes.
  • Elimination and acidic environment.
  • Inflammation.
inflammation
Inflammation
  • A nonspecific cellular response to tissue injury.
  • Characteristics include:
    • Redness (erythema).
    • Heat.
    • Pain.
    • Swelling (edema).
    • Loss of function.
    • Pus (purulent exudate).
specific immune defense
Specific Immune Defense
  • This is an immune defense mounted specifically against an invading antigen.
    • Skin and normal flora.
    • Mucous membranes.
    • Sneezing, coughing, and tearing reflexes.
    • Elimination and acidic environment.
    • Inflammation.
stages of infection
Stages of Infection
  • Incubation (the time interval between entry of an infectious agent into host and onset of symptoms).
  • Prodromal (from onset of nonspecific symptoms to specific symptoms of illness).
  • Illness (period of specific signs and symptoms of infection).
  • Convalescence (from disappearance of acute symptoms until client returns to previous state of health).
nosocomial infections
Nosocomial Infections
  • An infection acquired in a hospital or other health care facility that was not present or incubating at the time of the client’s admission.
  • Also referred to as hospital-acquired infections.
asepsis
Asepsis
  • The absence of microorganisms.
  • Two types of asepsis:
    • Medical (those practices used to reduce the number, growth, and spread of microorganisms).
    • Surgical (practices that eliminate all microorganisms and spores from an object or area).
medical asepsis
Medical Asepsis
  • Handwashing is the first line of defense against infection and is the single most important practice in preventing the spread of disease.
surgical asepsis techniques
Surgical Asepsis Techniques
  • Surgical handwashing.
  • Sterile field and equipment.
  • Donning surgical attire.
  • Donning sterile gloves.
  • Gowning and closed gloving.
  • Disposal of infectious materials.