Infection Control: MRSA CAUTI HIV

infection

disease state that results from teh presence of pathogens (disease droducing microorganisms) in or on the body

infection cycle

infectious agent, reservoir, portal of exity, means of transmission, portal of entry, susceptible host

types of pathogens that cause infections

bacteria: MRSA CAUTI

viruses: HIV, hepatitis

fungi (mold and yeast): athlete’s foot ringworms

stages of infection

incubation, prodromal, full (acute) stage of illness, convalescent period

incubation stage

organism is growing and multiplying

prodromal stage

when the person is the most infectious

symptoms are very vague

sick but don’t know it

full (acute) stage of illness

starts to show s/s

convalescent period stage

recovery period

factors affecting the risk for infection

integrity of mucous membranes and skin

PH levels of gastrointestinal and genitourinary tract

integrity and number of WBCs

age sex and heredity

immunization: natural and acquired

stress level

level of fatigue, nutritional and general health status, pre existing conditions, previous/current treatment, certain medications

use of invasive/indwelling medical devices

how does the body defends itself from infection

inflammatory response and immune response

inflammatory response

helps the body neutralize, control or eliminate the offending agent and prepare the site for repair

occurs in response to infection or injury

immune response

body attempts to protect and defend itself

role of the nurse in infection prevention

assessing, diagnosing, outcome identification and planning, implementing

assessing the patient

fever? history/physical

diagnosing

what is causing the infection

potential health problems and needs

outcome identification and planning

what kind of infection and treatment plan

assessing for infectious diseases

identify who is at risk

type of organism

early s/s of infection (H&P)

who is at risk for infection

older adults and immunocompromised patients: kids and cancer, HIV patients

early s/s of infection

fever, chills, body aches, diarrhea, HR goes up, respiration goes up, malaise (fatigue), anorexia (loss of appetite)

outcome identification and planning

review the assessment data

identify the events that led to the infection

plan on ways to break the chain of infection by focusing on controlling and preventing the infection

measure the outcomes

implementing

focuses on preventing the infection and breaking the chain of infection by practicing aseptic techniques at all times

medical asepsis

used continuously on a day to day basis

clean technique (clean least soiled areas first)

disinfect/sterilize equipment suspected of contamination with pathogens

hand hygiene and wear gloves

surgical asepsis

sterile technique to keep area free from microorganisms

open sterile pachages away from body to avoid contamination

keep sterile field dry and objects above the waist

do not turn back on the field

when in doubt it’s not sterile

examples of hospital associated infections

CAUTI, SSI, CLABSI, mMRSA, C. diff

MRSA

resistant to methicillin

when should you perform catheter and perineal care

every shift

risk factors for MRSA

invasive procedures

immunocompromised

indwelling lines tubes or catheters

treatment of MRSA

linezolid and vancomycin

who is at risk for CAUTI

women, older adults, debilitated clients, malnourished, chronically ill, immunocompromised, diabetes

why are women at risk for CAUTI

they have short urethra

why are older adults at risk for CAUTI

don’t get enough fluids and not enough hygiene

indications for indwelling urinary catheters

acute urinary retention or obstruction

output measurement for critically ill patients

perioperative situation

to assist in healing of perineal/sacral wounds

end of life comfort

how long should the foley be empty

every 8 hours or when it’s half full

what happens if the seal of the foley breaks

take the foley out and replace it

s/s of CAUTI

fever, chills, hematuria (blood in urine), cloudy malodorous urine, anorexia, malaise

what is the most accurate way to assess for CAUTI

urine culture

treatment for CAUTI

antibiotics ciprofloxacin

patient teaching for CAUTI

take all the medication as prescribed

do not stop taking medication even if you feel better

can result in body resistance if not taken as prescribed

alternatives to indwelling catheters

condom catheters, purewick, intermittent bladder scanning and in and out catheterization

how does HIV spread

bodily fluid: semen blood breast milk

prevention of HIV

have protected sex

learn how to use a condom properly

treatment of HIV

educate patient

follow treatment regiment

risk factors of HIV

sharing infected injection drug use equipment

having sexual relations with infected person

infants born to mothers with HIV infection or who are breast fed by HIV infected motehrs

people who received organ transplants, HIV infected blood, or blood production

goals of HIV

increased patient understanding of the natural hisoty and treatment of the infection

reduction in anxiety and stigma

increased compliance with therapeutic and preventive goals

absence of complications

feeding schedules teaching

nursing interventions for HIV

education about STDs and the spread of infection

avoid complications fever chills diarrhea foolow up as soon as possible

feeding schedule, reduce anxiety, increasing adherence

how do you reduce anxiety for an HIV patient

encourage patient to dicuss anxieties and fears

provide factual information and individualized education

assistance in planning discussion with partners

referral to a social worker or other specialists

how to increase adherence for a HIV patient

patient education in group or individual settings

referral to appropriate agencies

how to prevent needlesticks

avoid recapping needles, use devices with safety features, plan for safe handling and disposal of needles before and after use, use needless in safe environment

when to perform hand hygiene

before and after touching a patient, before a clean or aseptic procedure, after a body fluid exposure risk, after touching patient’s surroundings

PPE

gloves, gown, mask, protective eyewear

donning PPE

perform hand hygiene

put on gown, mask/respirator, goggles/face shield, gloves

in that order

doffing PPE

remove gloves, goggles/face shield, gown, mask/respirator, hand hygiene

in that order

standard precautions

used in the care of all hospitalized patients regardless of their diagnosis or possible infection status

use all day everday and with everybody

transmission based precautions

used in addition to standard precautions for patients in hospitals with suspected infection with pathogens that can be transmitted by airborne droplet or contact routes

don PPE when entering the room of a patient on transmission based precautions and to remove only when leaving the room

contact precaution

use for organisms spread by skin to skin contact

droplet precautions

used for organisms transmitted by large particle droplet

airborne precautions

used for illnesses transmitted by airborne droplet nuclei

what should everyone wear for droplet precautions

clean hands when entering and leaving room

wear surgical mask

what should the doctor and staff need to wear for droplet precautions

wear eye protection with respiratory symptoms and standard precautions inf contact with secretions likely

examples of droplet diseases

influenza, pertussis, diphtheria, streptococcal, meningococcus, covid

what should everyone wear for standard precautions

clean hands when entering and leaving the room

cover mouth and nose with arm or tissue when coughing or sneezing

wear gown glove and face protection for any risk of body fluid contact

what should the doctor and staff wear for standard precautions

wear appropriate mask eye cover gown and gloves if contact with body fluids likely

what should everyone wear for contact precautions

clean hands when entering and elaving room

gown and glove up at the door

what should the doctor and staff wear for contact precautions

use patient dedicated or disposable equipment

clean and disinfect shared equipment

example of contact diseases

MRSA VRE, CAUTI, C. diff

what should everyone wear for airborne precautions

restricted visitation enter only if immune

perform hand hygiene wear gown and gloves before enterignt he room

wear PAPR or fit tested N 95 mask and eye protection prior to entering room

patient placement for aiborne precautions

airborne infection isolation room required (negative pressure)

keep doors closed

airborne diseases

TB varicella measles

nursing intervention when caring patients with infectious disease

prevent spread of infection

education about infectious process and the prevention of the spread of infections

assessment and treatment of fever and accompanying discomforts

monitoring and managing potential complications

how to prevent the spread of infection

hand washing, standard precautions, recognition of mode of transmission and establishment of transmission based precautions as indicated

how to break infectious agents

rapid accurate identification or organisms

how to break infection in reservoirs

employee health, environmental sanitation, disinfection/sterilization

how to break infection in portal of exit

hand hygiene, control of excretion and secretion, trash and waste disposal

how to break infection in means of transmission

isolation, food handling, airflow control, standard precautions, sterilization, hand hygiene

how to break infection in portal of entry

wound, catheter care and aseptic technique

how to break infection in susceptible host

recognition of high risk patient

tratment of underlying disease