Concept of infection

cdc estimates that _____ of all hospital admissions results in a health care associated infection

cdc estimates that _____ of all hospital admissions results in a health care associated infection

5%

there are approximately ________ infections per year

722,000

there are _______ deaths a year caused by infections

75,000

infections add about _______ billion dollars in excess costs

28-33

define infection

a disease state that results from the presence of pathogens in or on the body

colonization of bacteria does not always mean

infection

Infections can be

asymptomatic

What is a local infection?

pathogens are limited to a small area of the body

what is a systemic infection?

an infection that affects the entire body

What is an acute infection?

comes on rapidly, with severe but short-lived effects

example: common cold

what is a chronic infection

slow development, long duration

lasts for a long time

what is an example of a local infection?

UTI

Pneumonia

systemic infection examples

cellulitis

sepsis

examples of an acute infection

UTI

Flu

Pneumonia

examples of a chronic infection

TB

HIV

What is the chain of infection?

1. agent

2. portal of exit

3. mode of transmission

4. portal of entry

5. susceptible host

What is a susceptible host in the chain of infection

who can get sick

elderly

infants

immunocompromised

ANYONE IS

What are the pathogens in the chain of infection

what infects the body

bacteria

fungi

virus

parasite

what is a reservoir in the chain of infection

what or who can house the infection

people

animals

soil

food

water

what is the portal of exit in the chain of infection

how does the infection get out of the body and spread to others

coughing

sneezing

bodily secretions

feces

mode of transmission in the chain of infection

how does the infection spread from one host to another

direct contact

indirect contact

vectors

what is vectors

organisms that spread disease from one host to another, dont have to suffer from disease

portal of entry in chain of infection

The path used by an infectious agent to enter a susceptible host.

mouth nose eyes cuts in skin

what is an infectious agent

a pathogen, such as a bacterium or virus that can cause a disease

What is virulence?

the severity of diseases that a pathogen can produce

the capability to produce infectious processes depends on

number of microorganisms present

virulence

how good or bad someones immune system is

length and intimacy between person and microorganism'

What does gram positive mean?

Bacteria containing a lot of peptidoglycan in their cell walls also tend to have less complex cell walls, stain purple.

What does gram negative mean?

Bacteria have less peptidoglycan, but have more complex cell walls, use oxygen and stain pink.

What does aerobic mean?

requires oxygen

What does anaerobic mean?

does not require oxygen

what is the nursing intervention to prevent infectious agents from spreading

hand hygiene

sterilization

antibiotics

antimicrobials

a reservoir is a

location for growth and multiplication for microorganisms and their natural habitat

nursing interventions for stopping the reservoir

transmission based precautions

sterilization

use of disposable supplies

change dressings

brush teeth

common portals of exit

respiratory - sneeze and cough

gastrointestinal- feces

urinary tract- urine

break in skin- blood, drainage, needle puncture

nursing interventions for portal of exit

dry intact dressing

hand hygiene

wear gloves

cover nose and mouth when sneezing and coughing

What is a fomite?

An object that transmits diseases such as a door knob, microphone, etc...

What is indirect transmission?

Person to object

vector

fomite

what is direct transmission

person to person contact

What is an airborne transmission?

the organism is carried through the air on a small droplet or dust particles

less then 5mcm

What is droplet transmission?

This type occurs during exhaling, coughing, and sneezing.

greater then 5mcm

nursing interventions for transmission

hand hygiene

use pesticides to eliminate vectors

adequate refrigeration

proper PPE

nursing interventions for portal of entry

hand hygiene

wear gloves

use masks

use ppe

proper disposal of needles and sharps

sterile technique

Define a susceptible host

degree of resistance the potential host has to pathogens

nursing interventions for susceptible hosts

immunizations

screen health care staff

well balanced diet

stages off infectious process

incubation period

pronominal period

illness

decline

convalescence

What is an incubation period?

The time between infection of the host and the onset of disease symptoms

what is the pronominal phase

vague or general symptoms

what is the illness phase

the most severe signs and symptoms

what is the decline phase

declining signs and symptoms

What is convalescence phase

period of recovery

no s/s

Why do we get inflammatory responses

inflammation helps to neutralize, control, or/and eliminate offending agents and prepare the site for repair

why does inflammation feel hot?

blood flow causes the area redness and heat

why do infections have a higher WBC count

white blood cells rush to the area of infection to engulf and consume pathogens

exudate may form as a response

What is an antigen?

a toxin or other foreign substance that induces an immune response in the body, especially the production of antibodies.

cell-mediated immunity

increases number of wbcs

white blood cells are also called

lymphocytes

factors affecting risk for infection

Integrity of skin and mucous membranes, which protect the body against microbial invasion

pH levels of the gastrointestinal and genitourinary tracts, as well as the skin, which help to ward off microbial invasion

Integrity and number of the body's white blood cells, which provide resistance to certain pathogens

Age, sex, race, and heredity, which influence susceptibility-neonates and older adults appear to be more vulnerable to infection

Immunizations, natural or acquired, which act to resist infection

Level of fatigue, nutritional and general health status, the presence of pre-existing illnesses, previous or current treatments, and certain medications, which play a part in the susceptibility of a potential host

Stress level, which if increased may adversely affect the body's normal defense mechanisms

Use of invasive or indwelling medical devices, which provide exposure to and entry for more potential sources of disease-producing organisms, particularly in a patient whose defenses are already weakened by disease

local manifestations of infection include

edema (swelling)

erythema (redness)

pain

warmth

impaired function

confusion (elderly)

What is purulent drainage?

thick, yellow, green, tan, or brown pus

means there is a bacterial infection

what does clear drainage mean

viral infection

allergies

what are the other types of drainage not related to infection

serous

serosangunious

sanguineous

systemic manifestations of inflammation

nonspecific symptoms shared by other diseases

chills

loss of energy

headache

vomiting

enlarged lymphnodes

confusion (elderly)

what is the most common s/s for elderly patients with an infection

confusion

no chills or fever

RBCs account for

nutrion and anemia

WBC must be

>10.0 mm3 in 11 year olds and older adults

Elevated neutrophils indicate

acute bacterial infection

elevated eosinophils indicate

parasitic infection

Elevated basophils indicate

allergic reaction

hypersensitivity

Elevated monocytes indicate

viral infection

Elevated lymphocytes indicate

chronic bacterial infection or viral infections

bands are _________

immature neutrophils

bands are less then ______ of total neutrophils

6%

define culture and sensitivity

cultures- identify pathogens

sensitivity- helps determine most effective antibacterial treatment

what are some examples of cultures we can collect

wound drainage

blood

urine

stool

sputum

radiological exams of the chest abdomen and urinary system do not

lead to a confirmation of infection or the extent of an infection

Antibiotic peak and trough

Measuring the blood levels of the prescribed medication. Making sure that it reaches it therapeutic range, and a range high enough to kill the microorganism

Antibiotic peak and trough levels

peak

PO-1-2 hours

IM: 1 hour

IV 30 minutes

Trough

few minutes prior to next dose

Medical Aspesis (clean technique)

practice used to remove or destroy germs and to prevent their spread from one person or place to another person or place

REDUCES the number of pathogens

aka hand hygiene, showers, gloves

surgical asepsis (sterile technique)

procedures to completely eliminate the presence of pathogens from objects and areas

keeps objects FREE from microorganisms

aka sterile gloves

What is sterile technique?

outer 1 inch is considered unsterile

do not turn back to sterile field

shoulder to wait

hand wash...

before touching a patient

before cleaning/aseptic procedure

after body fluid risk/exposure

after touching a patient

after touching patient surroundings

what is a health care associated infection

infection acquired during the course of receiving treatment for another condition in a health care institution and was not present/incubating at the time of admission

What is a nosocomial infection?

hospital acquired infection

What is an exogenous infection?

An infection acquired from another person.

what is an endogenous infection

An infection caused by an infectious agent that is already present in the body, but has previously been inapparent or dormant.

What is a latrogenic infection?

infection transmitted from a health care worker to a patient

true or false

medicare and medicaid will NOT reimburse for hospital acquired infections

true

what does SSI mean

surgical site infection

What does CLABSI stand for?

central line associated blood stream infection

what does CAUTI mean

catheter associated urinary tract infection

What does VAP mean?

ventilator associated pneumonia

What is a narrow spectrum antibiotic?

one that is effective against a smaller group of microbes or only the isolated species

What is a broad spectrum antibiotic?

Effective against more types of pathogens

doctor give ________ when they want to start treatment asap but do not know what kind of pathogen the patient has

broad spectrum

what drugs are antibiotic resistant

MRSA

VRSA

CRE

What is a spore?

A tiny cell that is able to grow into a new organism

disinfecting destroys all pathogenic organisms except

spores

sterilizing destroys all microorganisms including

spores

what are the methods of sterilization

chemical: ethylene oxide gas, chemical solutions

physical: boiling water, steam, dry heat, radiation

Standard Precautions

CDC precautions used in the care of all patients regardless of their diagnosis or possible infection

universal precautions

gloves and mask