punya eva infecti control

8/8/2019 Punya Eva Infecti Control

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INFECTION CONTROL

Evangeline H, SKp


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Essential terms and facts about infections

Microorganism are everywhere in the environment : on the

skin, in the GI tract, in the air, in the soil and on clothes.

Those who produce disease are called pathogens.

Infection invasion and physiological response of the body to

pathogenic organism that multiply and overcome the flora

normally present.

If the infection can be passed on readily to others it is reffered

to as a communicable disease or infectious disease.

Etiology is the study of couses.

Etiology of infectious disease is the identification of invading

microorganisms.


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More medical terms

Asepsis refers to absence of all disease-producing microroganisms.

Sterilization is the absence of all organisms including bacteria, viruses, spores

and fungi. Medical asepsis or clean technique is those practices that limit the number

of microorganisms and their growth and spread. Aseptic measures are

protective measures in that are meant to prevent infections or the spread of

infections.

Surgical asepsis or sterile technique is intended to keep all microorganisms

from a specific area. Includes practices that destroy all microroganismsand

their spores. Ex. : sterile wound dressing technique

Spore is a round or oval stucture , with a tough resistant capsule. This structure

is formed in response to adverse conditions and is highly resistant to

destruction.


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Infections

Infections occur when pathogenic organisms of sufficient

numbers and virulance invade a susceptible host.

Virulance microrganisms vary in their abilities to produce

disease.

Microorganisms also vary in the severity of the diseases theyproduce and their degree of communicability.

Nosocomial infections are those infections contracted in

hospitals.


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Couses of nosocomial infections :

1. Dx or in terapeutic procedures (iatrogenic)

caused by phycisian.2. The presence in the hospital of resistant

strains of such mictoorganisms as serratia

marcescens.

3. The use of antibiotics.

4. Changes in diet and activity of patients

because they are hospitalized.


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Comom sources of infection in the

hospitals

Microroganisms Source Mode of

transmision

Infection or

disease

Bacteria

S.Aureus

S., b-hemolitic group D

S.ViridansToxigenic e.coli

Bacteroides speciesSerratia species

Colon, Nares, skin, hair,

Colon, vagina of adultfemalesNaso-oro-pharynxColon

ColonColon, perineum

Contact, vehicles,airborne, autogenous

Contact, vehicles,autogenousAutogenousContact, vehicles

Contact, autogenousDirect, airborne

Infected eounds,pneumonia, abcesses,food poisoningUTI, wound

Bacterial endocarditisEnteritis

Peritonitis, abcessPneumonia, UTI, etc


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Continued.

Microroganisms Source Mode of

transmision

Infection or

disease

Fungi and yeasts

Candida albicans

Viruses

Herpes viruses

Hepatitis A

Hepatitis B

Mouth, colon, genitaltract, skin

Lessions of mucousmembrane, genital tract,skin

Feces, blood, urine

Feces, blood, bodyexcretions and fluids

Contact,vehicles,outogenous

Contact, vehicles,outogenous

Contact, vehicles

Contac, vehicles,airborne, possibly vectors

Dermatitis

STD, cold sores

Infetious hepatitis

Serum hepatitis,infectious hepatitis


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Six factors are involved in the infectionprocess :

1. Etiologic agent

2. Source of the pathogen or reservoir

3. Method of escape from the source / exit

4. Method of transmission

5. Method of entry6. Susceptibility of the person (host) to the

pathogen.


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Etiologic agent

The extent to which any org., or parasite is capable of producing a

disease depends on these factors :

1. Number of organisms

2. Virulence and potency of organism

3. Source of the organisms

4. Their ability to enter the body

5. Their ability to establish themselves within the body.


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Source of the pathogen or reservoir

The reservoir of the pathogen must have certain characteristics for

the organisms to live and grow. Some of these are :

Food

Water

Oxygen (aerob S.aureus, anaerob - C.tetani)

Temperature

pH Light

Antibiosis


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Method of escape from the source / exit

1. Respiratory tract sneeze, cough, talk,

breathe2. GI tract feces, drainage, vomitus

3. Urinary tract - urine

4. Reproductive tract male- urine, female-

vaginal discharge

5. Blood

6. Tissues infected wounds


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Method of transmission

1. Contact direct contact, indirect contact

2. Vehicles food, water, medications, blood frominfected person.

3. Airborne droplets from infected person/carrier,

contaminated dust, mics. Sheed in to env., from

hair, skin, wounds or perineal area.

4. Vectors contaminated or infected mosquitos,

fleas, flies, etc

5. Auotgenous infection from the patients usual

microbal flora.


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Method of entry

The skin serves as a barrier to infections :

however any break in the sin can readilyserve as a portal of entry.

Microorganisms can enter the body

through the same routes they use toleave the body.


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Course of infection

Incubation period is the time between the entry of the

pathogen into body and the onset of the symptom ofthe infection.

Period of ilness the prodormal stage and full illness

stage.

Convalescent period the symptoms disapear and

there is a return to health.


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Nursing assesment

Susceptibility

1. Stress2. Nutritional status

3. Fatigue

4. Sex

5. Heredity

6. Age

7. Medical treatment and health habits


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Clinical signs

Clinical signs of localized infection are :

1. Swellling2. Redness

3. Pain or tenderness

4. Heat at the infected area5. Loss of function of the body part affected


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Systemic infection

1. Fever

2. Lassitude, malaise3. Anorexia, nausea

4. Headache

5. Lymph node enlargement and terderness6. Vomiting and diarrhea


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The nurses resposibilites forpreventing infection include :

Teaching individual preventive measures

Strengthening the bodys barriers againtsinfection immunization, nutirition, adequate

rest and sleep, normal stress level.

Encourages hygiene hand washing,

perineal care, reguler bathing, brushing teethregularly, blowing the nose, coughing, nail

care.


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Standard precautions

Hand washing and antisepsis (hand hygiene)

Use of PPE when handling blood, body substances,excretions and secretions.

Approriate handling of patient care patient and soiled

linen.

Prevention of needlestick/sharp injuries.

Environmental cleaning and spills-management

Approriate handling of waste.


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Hand washing and antisepsis

Can minimize microorganisms

Acquired on the hands during daily duties.Where is contact with the lood, body fluids,

secretions, excretions and known and

unknown contaminated equipment or

surfaces.


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Wash or decontaminate hands :

After handling any blood, body fluids, secretions,

excretions and contaminated items.

Between contact with different patients.

Between tasks and procedures on the same patient

to prevent cross contamination between different

body site.

Immediately after removing gloves

Using plain soap, antimicrobial agent (alcoholic hand

rub or waterless antieptic agent).


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Use of PPE

Using PPE provides physical barrier between

mo and the wearer. It offers protection byhelping to prevent mo from :

Contaminating eyes, hands, clothing, hair and

shoes.

Being transmitted to other patients and staff


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PPE includes :

Gloves

Goggles Mask

Apron

Gown Boot/shoe cover

Cap/hair cover


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PPE should be used by :

Health care worker who provide direct care to

patients and who work in situation where they may

have contact with blood, body fluids, excretions,

secretions.

Support staff including medical aides, cleaners, and

laundry.

Laboratory staff, who handle patients specimens

Family members who provide care to patients and

are in the situation.


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Principles for use PPE

PPE should be chosen according to the risk ofexposure.

Avoid any contact between contaminated (used)PPE and surfaces, clothing or people outside thepatient care area.

Discard the used PPE in approriate disposal bagsand dsipose of as per the policy of the hospital.

Do not share PPE Change PPE completely and thoroughly wash hands

each time you leave a patient to attend to anotherpatient or another duty.


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Remember !!!!

It is important to use PPE effectively,correctly and at all times where

contact with patients blood, body

fluids. Excretions and secretionsmay occur.


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Gloves

Wear gloves (clesn, non sterile) when

touching blood, body fluids, secretions,excretions or mucous membranes.

Change gloves between contact with

different patient.

Change gloves between tasks/procedures onthe same patient to prevent cross

contamination between different body sites.


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Cont

Remove gloves immediately after use and before

attending to another patient.

Wash hands immediately after removing gloves.

Disposible gloves should not be reused but should

be dsiposed of according to the health care facility

protocol.

Use a plain soap, antimicrobial agent or waterless

antiseptic agent.


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Masks

Wear a masks to protect mucous membrane of the

mouth and nose when undertaking procedures that

are likely to generate splashes of blood, body fluids,

secretions and excretions.

Wear surgical maks rather than cotton material or

gauze masks.

Do not reuse disposible masks. They shoul bedisposed of according to rhe health care facility

protocol.


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Protective eye

wear/goggles/visors/face shield

Wear them to protect mucous membrane of

the eyes when conducting prod.

If possible discard appropriately after used.

If they are reuseable, decontaminate them

according to the manufacturers instructions.


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Gowns and plastic aprons

Wear a gown (clean, non-sterile) to protect

the skin and prevent soiling of clothing duringprocedures that are likely to generate

splashes of blood, body fluids secretions or

excetions. Impermeable gowns are

preferable. Remove a soiled or wet gown as soon as

possible.


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Cont

A plastic apron may be worn on top of the

gown. Launder gowns and apron appropriately if

thay are reusuable, according to the hospital

guidelines.

Do not reuse disposable gowns and aprons.


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Boots/shoe cover

Wear caps/boots/shoecover if necessary.

Launder them if reusable, according to thehospital guidelines.

Do not reuse the disposible ones.

Clean and desinfect reuse boots.


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Patient care equipment

Handle spoiled patient care.

Ensure all reusable equiment is cleaned and

reprocessed appropriately before being used

another patient.


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Linen

Handle, transport and process used

linens that is soiled with blood, etc withcare to ensure that there is no leaking

of fluid.


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Prevention of needle stick/sharps

injuries

Place used sharps items in a puncture-resistant

container with a lid that closes and is located close

to the area in which the item is used.

Take extra care when cleaning sharps items.

Never recap or bend needles.

Sharps must be appropriate disinfect pr destroyed as

per the national santdards or guidelines.


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Additional precautions

Airborne precautions

droplet < 5 micron, TB, chicken pox, etc.1. Implement standard precautions

2. Place pt in a single room that has a monitored

negative airflow pressure.

3. Keep doors closed4. Use N 95 mask

5. Limit movement and transport the patient. If it is

necessary masking the patient.


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Droplet precautions

Droplet > 5 micron, pneumonias, pertussis,

diptheria, mump sneezing, influenza,meningitis.

Coughing, sneezing, talking or when

healthcare workers undertake the

procedures such as tracheal suctioning.


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Cont

Implement standard precautions.

Place pt in a single room or in a room withanother pt infected by the same pathogen.

Wear surgical mask when working within 1-2

m of the patient.

Masking the patient if transport is necessary.


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Contact precautions

Implement standard precautions.

Place pt in a single room or in a room withanother pt infected by the same pathogen.

Wear clean non sterile gloves and gowns

when entering the room

Masking the patient if transport is necessary.


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Protect yourself

Prevention

better thancure

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