NURS 344: Infection (slides)

What is THE CHAIN OF INFECTION?

A sequence of necessary pieces for an infection to occur

What does the CHAIN OF INFECTION include?

an infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host

What is a INFECTIOUS AGENT?

What causes the infection

What are the different types of INFECTIOUS AGENT?

Bacteria, fungus, virus, prion,

parasite

What are examples of VIRUSES?

COVID-19, influenza, UTIs, HIV, hepatitis, ebola, dengue

What are examples of BACTERIA?

tuberculosis, cholera, UTIs

What are examples of FUNGI?

athlete's foot, candidiasis, ringworm, fungal pneumonia

What are examples of PARASITE?

malaria, toxoplasmosis, scabies

How can normal flora become an infectious agent?

when it enters an area where it does not belong

What can a cross-contamination infection from NOSE/OROPHARYNX to LUNGS cause?

aspiration

Where does cross-contamination infection from SKIN to VASCULAR SPACE occur during?

IVs

WHY does cross-contamination infection from GUT to URINARY TRACT occur?

poor hygiene, indwelling urinary catheters

What are the normal flora of the PHARYNX?

S. aureus, S. epidermidis, Haemophilus, Influenzae

What are the normal flora of the ORAL CAVITY?

Staphylococcus sp., Neisseria sp., Actinomyces sp., Lactobacillus, some yeasts

What are the normal flora of the ESOPHAGUS?

S. aureus, S. epidermidis, diphtheroids, haemophilus sp., pneumococci

What are the normal flora of the COLON?

bacteroids, fusobacterium, clostrudium sp., escherichia sp., proteus sp., klebsiella so., candida albicans

What are the normal flora of the VAGINA?

lactobacilli, enterococci, candida albicans

What is a RESERVOIR?

the habitat of the infectious agent and is where it lives, grows, and reproduces itself or replicates; PLACE where it can survive

What are examples of RESERVOIRS?

environment, humans, animal, insects

What is a PORTAL OF ENTRY?

any body orifice, or through the skin, and it provides a place for the infectious agent to

replicate or for the toxin to act

What are examples of PORTAL OF ENTRY?

ears, nose, mouth

What patients would be at risk to have PORTALS OF ENTRY?

IV site, surgical incision, medical devices, aspirtation

What are the FIVE MAIN PORTALS OF ENTRY?

integumentary, respiration, genitourinary tract, gastrointestinal tract, transplacental

How can a MAIN PORTAL OF ENTRY in the INTEGUMENTARY SYSTEM?

break in skin or mucous membrane

How can a MAIN PORTAL OF ENTRY in the RESPIRATORY SYSTEM?

inhaling contaminated droplets

How can a MAIN PORTAL OF ENTRY in the GENITOURINARY TRACT?

contamination through infected vaginal secretions or semen

How can a MAIN PORTAL OF ENTRY in the GASTROINTESTINAL SYSTEM?

ingesting contaminated food or water

How can a MAIN PORTAL OF ENTRY in the TRANSPLACENTAL?

microorganisms from mother to fetus via placenta or umbilical cord

What is a PORTAL OF EXIT?

the infectious agent can leave the reservoir

What are SIX examples of PORTAL OF EXIT?

1.) coughing or sneezing

2.) removal of blood

3.) open lesion

4.) in urine

5.) in feces

6.) insect bite

What is a SUSCEPTIBLE HOST?

required for the infectious agent to take hold and become a reservoir for infection

Does everyone who is exposed to an infectious agent get sick?

no

Who/what makes a patient a SUSCEPTIBLE HOST?

Immune system challenged, Openings in skin, Crowded living conditions, Poor ventilation

What are the THREE MODES OF TRANSMISSION?

contact, droplet, airborne

What is CONTACT mode of transmission?

Occurs when microorganisms move from an infected person to another person

What is DROPLET mode of transmission?

occurs when airborne droplets from the respiratory tract of a client travel through the air and into the mucosa of a host

What is AIRBORNE mode of transmission?

occurs when small particulates move into the airspace of another person

What is the TWO types of CONTACT TRANSMISSION?

direct and indirect contact

When does DIRECT CONTACT occur?

when microorganisms are directly moved from the infected person to another person without having a contaminated object or person

between the two

What are ways of DIRECT CONTACT TRANSMISSION?

• Healthcare providers' hands

• Sneezing and coughing

• Inhaling air contaminated with

infectious particulates

When does INDIRECT CONTACT occur?

when microorganisms are

moved from the infected person to another person with a contaminated object or person between the two

What are ways of INDIRECT CONTACT TRANSMISSION?

• Shared medical equipment

• Touching a contaminated

surface/item then touching your

nose, mouth, eyes

What are FOMITES?

Any inanimate objects that can transfer infectious agents to a new host.

What are examples of FOMITES

bacteria, viruses, fungi

What are the FIVE STAGES of INFECTION?

1.) incubation

2.) prodromal

3.) acute illness

4.) decline

5.) convalescence

What is INCUBATION?

FIRST STAGE; An infection enters host and begins to multiply

What is PRODROMAL?

SECOND STAGE; The client begins having symptoms

What is ACUTE ILLNESS?

Manifestations of the specific infectious disease process are obvious and may become severe

What is DECLINE?

Manifestations begin to wane as the degree of

infectious disease decreases

What is CONVALESCENCE?

The client returns to a normal or a "new normal" state of health

What are LOCAL INFECTIONS?

confined to one area of

the body

How are LOCAL INFECTIONS treated?

topical antibiotics and oral antibiotics

What are SYSTEMIC INFECTIONS?

start as local infections and then spread to the bloodstream to infect the entire body

What is HAND HYGIENE?

broad term to cover any type of

cleansing of the hands

What are the different types of HAND HYGIENE?

soap and water, alcohol-based hand sanitizer, antiseptic hand wash or hand rub, surgical hand antisepsis

How must HAND HYGIENE be done?

frequently & thoroughly

How LONG should you WASH YOUR HANDS?

at least 20 seconds

When should you use hand sanitizer versus soap and water?

- hand sanitizer for TIME and bacteria killing EFFECTIVENESS

- soap and water for physically moving spores, dirty, and specific pathogens

How MUCH ALCOHOL should be in HAND SANITIZER?

at least 60%

What FIVE OCCURRENCES should you perform HAND HYGIENE?

1.) before patient contact

2.) before aseptic task

3.) after body fluid exposure risk

4.) after patient contact

5.) after contact with patient surroundings

What is MEDICAL ASEPSIS?

CLEAN TECHNIQUE; used to define the reduction of microorganisms using disinfecting agents

What are materials are used for MEDICAL ASEPSIS?

• Chlorhexidine gluconate

• Betadine

• Alcohol

• Handwashing

• Clean gloves

• Disinfecting work area/medical devices

What is SURGICAL ASEPSIS?

STERILE TECHNIQUE; the elimination of all microorganisms using sterilizing agents

What are materials are used for SURGICAL ASEPSIS?

• Surgical scrub/hand hygiene

• Sterilization of surgical instruments/supplies

• Use of sterile technique

• Masks/sterile gown and gloves

• Positive pressure air flow

• Inspect all sterile packaging for any holes and tears prior to using

What is the nurses responsibility when it comes to PPE?

to know what types of PPE are needed to care for clients and to don and doff PPE appropriately

What type of PPE is GOWN and GLOVES?

basic and sterile

What type of PPE is MASKS?

procedure mask or N-95 respirator

What type of PPE is EYE PROTECTION?

goggles and face shield

What is DONNING?

putting on PPE

What is DOFFING?

taking PPE off

When should GLOVES be DOFFED? Why?

Remove gloves frequently, performing hand hygiene in between, to prevent cross contamination

What is the MOST IMPORTANT RULE of PPE?

never wear PPE in the hallway

What are STANDARD PRECAUTIONS?

used to describe the infection prevention practices applied to all clients, whether or not they are known to have an infectious agent

How should all blood and bodily fluids be treated?

as if they could spread infection

With which patients would you choose STANDARD PRECAUTIONS?

all patients regardless of their known or suspected infection

What are DROPLET PRECAUTIONS?

Protect against droplets larger than 5mcg and travel 3-6 feet from the client

What are the different bacterium for DROPLET PRECAUTIONS?

• Streptococcal pharyngitis

• Influenza

• Rubella

• Pertussis

• Mumps

• Mycoplasma pneumonia

• Pneumonic plague

What is the PPE DROPLET PRECAUTIONS?

Surgical mask, gloves, hand hygiene at minimum

What are CONTACT PRECAUTIONS?

Protect visitors and caregivers when they are within 3 ft of the client against direct client and environmental contact infections

What are the different bacterium for CONTACT PRECAUTIONS?

• Respiratory syncytial virus (RSV)

• Wound infections (e.g. MRSA)

• Herpes simplex

• Scabies

• Multidrug-resistant organisms (MDRO)

What is the PPE CONTACT PRECAUTIONS?

Gloves & gown, hand hygiene at minimum

What are SPECIAL CONTACT PRECAUTIONS?

Protect visitors and caregivers from organisms that can be spread via contact, but usually via the enteric route

What is the bacterium for SPECIAL CONTACT PRECAUTIONS?

Clostridium difficile (C. diff)

What is the PPE SPECIAL CONTACT PRECAUTIONS?

Gloves & gown (at minimum), BLEACH WIPES, HAND WASHING

WITH NONANTIMICROBIAL SOAP AND WATER

What are AIRBORNE PRECAUTIONS?

Protect against droplet infections smaller than 5mcg

What is the bacterium for AIRBORNE PRECAUTIONS?

• Measles (Rubeola)

• Varicella

• Pulmonary or laryngeal tuberculosis (TB)

What is the PPE AIRBORNE PRECAUTIONS?

N95 Mask, gloves, hand hygiene, airborne room

What are HAIs?

Healthcare-Associated Infections

What are the FOUR MAJOR HAIs?

1.) CLABSIs

2.) CAUTIs

3.) SSIs

4.) VAPs

What are CLABSIs?

Central Line-associated Bloodstream Infections

What are CAUTIs?

Catheter-associated Urinary Tract Infections

What are SSIs?

Surgical Site Infections

What are VAPs?

Ventilator-assisted Pneumonias

What can cause HAIs?

Prolonged hospitalization and increased mortality

What are simple interventions to prevent HAIs?

- consistent and

adequate hand hygiene

- disinfecting high touch surfaces

- patient cleanliness

- oral hygiene

-proper use of indwelling medical devices

What is BACTROBAN NASAL used for?

Eradicates the nasal colonization of MRSA (methicillin-resistant Staphylococcus aureus).

What is CEPHALOSPORINS used for?

Gonorrhea, pelvic inflammatory disease, sinusitis, UTIs., Cephalexin, ceftriaxone

What is TETRACYCLINES used for?

Chest, urethral, & pelvic infections. Doxycycline.

What is MACROLIDES used for?

Skin, soft tissue, respiratory infections. Erythromycin, azithromycin.

What are FLUOROQUINOLONES used for?

Prostatitis, epididymorchitis, gonorrhea, TB, UTIs, eye/ear infections. Ciprofloxacin,

levofloxacin