Infection Control/Prevention

Infection

Results when a pathogen invades tissues and begins growing within a host

Pathogen

Microorganisms capable of producing disease

Colonization

Presence and growth of microorganisms within a host without tissue invasion or damage

Communicable disease

An infectious disease that can be transmitted directly from one person to another

Symptomatic

Presence of clinical signs and symptoms

Asymptomatic

Clinical signs and symptoms are not present

Infectious Agents

Microorganisms - Bacteria, Fungi, viruses, protozoa, prion; Macro - helminths etc.

Normal flora

Permanent residents of the skin or the body - typically do not cause disease

Transient

Attach to the skin - readily transmissible

Potential For causing disease depends on

Number, Virulence, Ability to live in host, and susceptibility of the host.

Virulence

the degree of pathogenicity or ability of an organism to cause disease.

Chain of Infection

A sequence of events that allows for the transmission of infectious diseases.

Reservoir

Where pathogens survive and multiply, including food, oxygen, water, temperature, pH, light, and living organisms.

Most Pathogens Like

Warm, Dark, and moist environments to grow and thrive.

Nonliving Reservoirs

Soil, Water, Food, Surfaces

Aerobic

Required oxygen

Anaerobic

Thrive without oxygen

Portal of Exit

The path by which a pathogen leaves its host.

Mode of Transmission

The method by which pathogens are spread from one host to another.

Contact Transmission

Direct and Indirect

Direct Contact

Touching, Kissing, Sexual Contact

Indirect Contact

Contact with a fomite

Droplet Transmission

Transmission through expelled materials such as coughing or sneezing.

Airborne Transmission

Spread through the air, such as through air conditioning or sweeping.

Vehicle Transmission

Transmission of pathogens via contaminated inanimate objects or substances, such as food, water, or blood.

Vector Transmission

Transmission through living organisms, typically animals like fleas, ticks, or mosquitoes.

Portal of Entry

Eyes, Nare, Mouth, Vagina, Non-intact Skin. Wounds, surgical Sites, IV or drainage Tube site. Bite From A vector

Susceptible Host

An individual whose degree of resistance to infection is low.

Susceptible Host Rik factors

Age- Very Young and Very Old

Nutrition

Presence of Chronic Illness

Trauma

Stress- Physiological and Psychological

Smoking

Immunocompromised have greater susceptibility to opportunistic infections due to their weakened immune systems.

Classification of Infection

Infections can be classified by location (local vs systemic) and duration (acute vs chronic).

Local Infection

Occurs in a limited region in the body.

Systemic Infection

Spread via blood or lymph, affecting many regions.

Acute Infection

Rapid onset of short duration.

Chronic Infection

Slow development, long duration.

Latent Infection

Infection present with no discernible symptoms.

Stages of Infection

Includes incubation, prodromal, illness, and convalescence.

Incubation

Time between entrance of pathogen into body and appearance of first symptoms; can infect others.

Prodromal Stage

Appearance of vague symptoms; not all diseases have this stage.

Illness Stage

Specific signs and symptoms present.

Convalescence Stage

Tissue repair and return to health.

Emerging Pathogens

Newly identified diseases or those appearing in new geographic areas.

MDRO

Multidrug resistant organisms, such as C-Diff, VRE, MRSA, and CRE.

Innate Defense Against Infection

Normal Floras, Body System Defense, Inflammation.

Vascular and cellular Responses

Inflammatory Exudate

Tissue Repair

Adaptive Defense Against Infection

Humoral Immunity and Cell Mediated Immunity

Humoral Immunity

Involves B cells and circulating antibodies that fight against pathogens.

Cell Mediated Immunity

Involves T cells that act directly to destroy pathogens.

Defense Against Infection

Anatomical Features, Limit Pathogen entry or flush them away.

Intact Skin

Mucous Membranes

Respiratory Tree

Tears

Normal Flora- Skin, GI, GU, Reproductive Tract.

Inflammatory Response

Step 2.

Biochemical Processes activated by chemical released by pathogens.

Phagocytosis

WBCs “seek and destroy”

Complement Cascade

Proteins that trigger the release of “caustic enzymes” that eat through the protective covering of pathogens

Inflammation

Vasodilation Brings in the troops

Fever

Creates a hostile environment

Adaptive Immunity

Step 3

Cell-Mediated Immunity

Acts Directly to destroy pathogens

Phagocytosis

T-cells 4 types

Cytotoxic (Killer) T

Helper T

Memory T

Suppressor T

Cytotoxic Killer T

Directly Attack cells that are infected

Helper T

Supportive role- Secrete Interluekin

Memory T

Faster Response Next Time

Suppressor T

Stop the Immune Response

Adaptive Immunity

Step 3

Humoral Immunity

Circulating Antibodies fight against Pathogens

Neutralization

Disable Pathogens by binding to receptor sites

Agglutination

Clumping pathogens together

Activation of complement and inflammatory Response

Inflammatory Mediators Destroy Antigens

Healthcare-Associated Infection (HAI)

An infection acquired as a result of healthcare.

Invasive Procedures

Multidrug-resistant Organisms

Breaks In infection Prevention and control activities

Exogenous HAI

Pathogen acquired from the healthcare environment.

Endogenous HAI

Normal flora multiply and cause infection as a result of treatment.

Iatrogenic HAI

Caused by invasive diagnostic or therapeutic procedures.

Factors influencing infection risk

Includes age, sex, nutritional status, stress, and disease processes.

UTI in women

More Frequent and due to shorter Urethra

Increased infection risk

Tobacco use interferes with normal respiratory functioning.

Chemicals in tobacco

Paralyze cilia, causing secretions to pool in the lower airways and creating a hospitable environment for bacterial growth.

Substance abuse

The misuse of substances that can lead to harmful effects.

Inhalants

Substances that are inhaled to achieve a psychoactive effect.

ETOH

Common abbreviation for ethanol, a type of alcohol.

Substances that affect cognition

Compounds that can alter mental processes.

Injection of substances

The act of introducing substances into the body using a syringe.

Adequate nutrition

Essential for manufacturing cells of the immune system.

Balanced hygiene

Sufficient to decrease skin bacterial count without causing skin cracking.

Rest/exercise

Restorative practices that help maintain health.

Reducing stress

A factor that supports host defenses.

Immunization

Protection against diseases such as measles, mumps, pneumonia, influenza, COVID-19, smallpox, and shingles.

Nursing History and Physical Assessment

Focus on risk factors and symptoms of infection.

Exposure

Contact with unusual foods, new products, or health status that may increase infection risk.

Medication

Includes prescription (Rx), over-the-counter (OTC), herbal, and complementary alternative medicine (CAM).

Current stress

A factor to consider in assessing infection risk.

Immunization Hx

History of immunizations received by the patient.

General appearance

Observations such as fatigue, diaphoresis, pallor, or flushing.

Skin

Assessment of turgor, pain, redness, swelling, and integrity.

Lymph Nodes

Assessment for enlargement and tenderness.

Temp and Pulse

Assessment for febrile conditions and rapid, thready pulse.

Lab and Diagnostic results

Includes WBC, CRP, ESR, and cultures.

Risk for Infection

Nursing diagnosis indicating increased risk of invasion by pathogenic organisms.

Risk factors for infection

Includes inadequate primary defenses, secondary defenses, acquired immunity, immunosuppression, and environmental exposure.

Readiness for enhanced health management

Immunization status assessed by evidence-based indicators.

Goals of care

Include preventing further exposure to infectious organisms, controlling infection extent, maintaining resistance to infection, and understanding infection prevention.

Nursing diagnosis for existing infection

Once a patient has an infection, the focus shifts to support of healing rather than a specific nursing diagnosis.

Nursing Interventions For Infection control and Prevention

Aimed at breaking the chain of infection

Decrease/limit exposure to pathogens

Use aseptic Technique

Decrease Use of invasive Devices

Asepsis

Absence of pathogens.

Aseptic technique

Practices and procedures that help reduce the risk of infection.

Medical Asepsis

Control and elimination of reservoirs of infection.

Hand Hygiene

Barrier Techniques

Routine Environmental Cleaning

Cleaning

Removal of Organic or inorganic Material From Objects/surfaces