Asepsis and Infection Control in Healthcare

Nosocomial infection

Infection acquired in a hospital or healthcare facility.

Iatrogenic infection

Infection resulting from medical treatment or procedures.

Medical Asepsis

Practices aimed at reducing the number and spread of microorganisms.

Surgical Asepsis

Practices that keep an area or object free of all microorganisms.

Disinfection

Process that eliminates many or all microorganisms, except spores.

Sterilization

Process that destroys all forms of microbial life, including spores.

Infectious agent

Pathogen that can cause disease.

Reservoir

Place where infectious agents live and multiply.

Portal of exit

Pathway by which an infectious agent leaves its host.

Means of transmission

How an infectious agent is spread from one host to another.

Portal of entry

Pathway by which an infectious agent enters a susceptible host.

Susceptible host

An individual who is at risk of infection.

Bacteria

Most prevalent infectious agents in hospital settings, can be spherical, rod-shaped, or corkscrew-shaped.

Virus

Smallest microorganisms that cause infections like the common cold and do not respond to antibiotics.

Fungi

Plantlike organisms that can cause infections and are found in air, soil, and water.

Factors Affecting an Organism's Potential to Produce Disease

Includes number of microorganisms, virulence, immune system competence, and contact length.

Possible Reservoirs for Microorganisms

Includes humans, animals, soil, food, water, and inanimate objects.

Common Portals of Exit

Includes respiratory, gastrointestinal, genitourinary tracts, breaks in skin, blood, and tissue.

Body's Defense Against Infection

Includes normal flora, inflammatory response, and immune response.

Factors Affecting Host Susceptibility

Includes intact skin, normal pH, white blood cells, age, sex, race, immunization, fatigue, climate, nutrition, stress, and use of medical devices.

Convalescent period

Recovery from the infection.

Incubation period

Organisms growing and multiplying.

Prodromal stage

Person is most infectious, vague and nonspecific signs of disease.

Full stage of illness

Presence of specific signs and symptoms of disease.

Elevated white blood cell count

4,500 to 10,000/mcL.

Increase in specific types of white blood cells

Neutrophil/eosinophil/monocyte/lymphocyte.

Elevated erythrocyte sedimentation rate (ESR)

0-15mm/hr for males, 0-20mm/hr for females.

Presence of pathogen

In urine, blood, sputum, or draining cultures.

Invasive medical devices

Use of urinary catheter or venous access catheter.

Clostridium difficile (C.Diff)

Causes colitis.

Methicillin-resistant staphylococcus aureus (MRSA)

Antibiotic-resistant organism developed in hospitals.

Vancomycin intermediate staphylococcus aureus (VISA)

Antibiotic-resistant organism developed in hospitals.

Vancomycin-resistant staphylococcus aureus (VRSA)

Antibiotic-resistant organism developed in hospitals.

Vancomycin-resistant enterococci (VRE)

Antibiotic-resistant organism developed in hospitals.

Transient bacteria

Attached loosely on skin, removed with relative ease.

Resident bacteria

Found in creases in skin, requires friction with brush to remove.

Hand hygiene

The most effective way to help prevent the spread of infectious agents.

Handwashing with plain soap and water

A method of hand hygiene.

Use of antiseptic handrubs

Includes waterless alcohol-based products.

Surgical hand antisepsis

A method of hand hygiene.

Infection control Technique

Includes all activities to prevent or break the chain of infection.

Clean Technique

Routine hand washing and using non-sterile gloves when touching intact skin, intact mucous membranes or dirty (contaminated) items.

Appropriate for: Taking blood pressures

Clean technique is appropriate for taking blood pressures.

Appropriate for: Examining patients

Clean technique is appropriate for examining patients.

Appropriate for: Feeding patients

Clean technique is appropriate for feeding patients.

Aseptic Technique

Involves the use of sterile gloves, antiseptic on patient's skin, and is used in clean and dedicated areas.

Appropriate for: placing an intravenous catheter

Aseptic technique is appropriate for placing an intravenous catheter.

Appropriate for: placing a urinary catheter

Aseptic technique is appropriate for placing a urinary catheter.

Standard Precautions (Tier 1)

Used in care of all hospitalized patients including hand hygiene and wearing PPE.

Transmission-Based Precautions (Tier 2)

Used in addition to standard precautions for patients with suspected infection.

Current CDC Guidelines For Isolation Precautions in healthcare setting 2007

Guidelines outlining the precautions necessary to prevent infection transmission.

Personal Protective Equipment (PPE)

Includes gloves, gowns, masks (regular and N95 respirator), and protective eye gear.

Transmission-based precautions

Include contact, droplet, and airborne precautions.

Contact precautions

Private room and PPE for infections by multidrug-resistant organisms.

Droplet precautions

Private room and PPE for infections such as Mumps, Rubella, Diphtheria, Adenovirus.

Airborne precautions

Private room, PPE, negative air pressure, and N95 for infections like Tuberculosis, Measles, Varicella.

Question: Standard precautions should be used when caring for a noninfectious, postoperative patient who is vomiting blood.

A. True; B. False.