Module 9-11 (Infection Control, Hygiene, Clincial Judgement)

Medical asepsis

clean technique, reducing disease causing microbes but not fully eliminating. Ex. isolation precautions

Surgical asepsis

sterile technique, prevent transmission of pathogens to client

Standard precautions (universal precautions)

infection prevention practices applied to all clients regardless of if they have an infection - standard PPE

Contact precaution

gown and gloves, used for patients that have high risk of transmission via direct or indirect contact. Remove PPE inside the client’s room so as to avoid contaminating outside.

Cohorting

placing patients with the same pathogen in the same room. Used in last resort situations, don’t mix pathogens. Be at least 3 feet apart

when are droplet precautions used

contact patients who have diseases that spread via droplets ex. Covid, cold, TB

Airborne precautions

private room, close doors, prefer airborne infection isolation room AIIR (negative pressure room), use HEPA filter

Protective isolation

protect immunocompromised patient after hematopoietic stem cell transplant from environmental fungi

Infection control bundle (care guideline)

guidelines for practice that are bundled together to prevent HAIs such as CAUTIs, CLABSIs, VAPs, and SSIs.

MDRO

Multidrug resistant organism, resistant to one or more classes of existing antimicrobials

Sterile gowning

donning a gown that must remain sterile

Independent gowning

donning a gown by yourself

Hygiene

the actions and health practices that decrease the spread or transmission of pathogens, thereby decreasing the risk of illness. Ex. washing hands, face, and body, dental care, nail care

Diaper dermatitis

condition where the skin becomes inflamed due to substances in a diaper. Prevented by changing diaper frequently, washing with soap free cleanser, topical ointments

When to use soap and water

visibly soiled, contact with infectious diarrhea, exposure to bacteria spores

When to use hand sanitizer

before touching a client/object, before sterile technique, after contact with a soiled area, after contact with body fluids, after removing gloves

Hygiene practices recommended for those who have had a stroke

oral hygiene, unaffected side then affected side, shower (as opposed to bath), check for fall hazards, adaptive bathroom equipment

Complete bed bath

used for patients who are unable to ambulate to the bathroom

Concerns with soap and water cleansing

contamination with pathogens, skin deterioration

Alternatives to soap and water cleansing

disposable wipes, chlorhexidine gluconate (CHG)

Concerns for feet cleaning

monitor for wounds, hot water could burn, soaking could dry the skin

Supplies needed for perineal care

waterproof pad, skin cleanser, skin protectant cream, washcloths

Chain of infection

infectious agent —> reservoir —> portal of exit —> mode of transmission —> portal of entry —> susceptible host

Direct contact transmission

when microorganisms move directly from infected person to another person

Indirect contact transmission

when microorganisms move from infected person, to some other contaminated person or object, to another person

Vehicle transmission

transmission from contaminated items to multiple persons

Vector borne transmission

transmission via animals

Airborne transmission

transmission via particles moving through the air

Droplet transmission

transmission infectious droplets that come in contact with the mucosa of a host

Steps of the inflammatory response

bacteria invade open wound → histamine, kinins, prostaglandins → plasma → phagocytes → pus

Stages of infection

incubation → prodromal → acute illness → decline → convalescence

Local infection

confined to one area of the body, can be treated with topical and PO antibiotics

Systemic infection

start as local, then move to bloodstream, treated with IV antibiotics and careful monitoring

Antiseptic agents

alcohols, chlorhexidine, chlorine, PCMX, iodophors, quaternary ammonium, triclosan

Sterilization

cleaning instruments so all microorganisms are eradicated → thermal, chemical, radiation

Sterile field

space created to assure that the smallest number of microorganisms possible are present, used for procedures where surgical asepsis is indicated

Disinfection

cleaning instruments so that almost, not all microorganisms are eradicated

CLABSI

central line associated bloodstream infection

CAUTI

catheter associated urinary tract infection

SSI

surgical site infection

VAP

ventilator associated pneumonia

Closed glove technique

Initial gloving technique, keeping hands inside the cuff of a sterile gown while putting on the gloves

Open glove technique

Donning gloves with hands, situations where gowns are not worn

PPE for droplet precautions

just face mask

Mask for airborne precautions

N-95 respirator

Doffing order

gloves, googles, gown, mask

Delegation

assigning a nursing activity or procedure to another person who has the training appropriate for that activity or procedure. We cannot delegate clinical judgement!

SMART Goals acronym

specific, measurable, attainable, realistic, timely

Five rights of delegation

Task, circumstance, person, directions and communication, supervision and evaluation

care supervision

senior clinicians overseeing and providing guidance for novice nurses’ practice, preceptor nurse providing instructions to junior nurses, provides change for professional development and improved client outcomes

Rationing of care

Allocated resources are scarce and not all required needs can be met, use priority setting framework