Infection (Class 6)

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Chain of Infection

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76 Terms

1

Chain of Infection

A sequence of events that describes how a pathogen gets from where it is to infecting a susceptible host.

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2

Infectious Agent

Microorganisms capable of causing disease or illness. Ex:

  • Bacteria

  • Fungi

  • Parasites

  • Prions

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3

Reservoirs

Places where infectious agents live, grow, and reproduce. Ex:

  • People

  • Water

  • Food

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4

Portal of Exit

Ways in which infectious agents leave the reservoir. Ex:

  • Blood

  • Secretions

  • Excretions

  • Skin

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5

Mode of Transmission

Ways in which the infectious agents is spread from the reservoir to the susceptible host. Ex:

  • Contact

  • Droplets

  • Airborne

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6

Portal of Entry

Ways in which the infectious agent enters the susceptible host. Ex:

  • Mucous membranes

  • Respiratory system

  • Digestive system

  • Broken skin

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7

Susceptible Host

Individuals may have traits that affect their susceptibility and severity of disease. Ex:

  • Immune Deficiency

  • Diabetes

  • Burns

  • Surgery

  • Age

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8

Direct Contact

Person-to-person

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9

Direct Contact Example

Oral, fecal

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10

Indirect Contact

Contaminated object-to-person

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11

Indirect Contact Example

Contaminated stethoscopes or BP cuffs.

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12

Droplet

Coughing or sneezing drops that are >5-10 um

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13

Droplet Disease Example

Influenza

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14

Airborne

Droplets <5 um suspended in the air.

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15

Airborne Disease Example

Tuberculosis

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16

Vehicles

Contaminated items entering a person.

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17

Vehicle Example

Water, drugs, blood, food

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18

Vector

Living organisms that transmit diseases. (External/internal)

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19

Vector Examples

Mosquitos, ticks, flea bites

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20

Localized Infection

Infection at a specific site. Ex:

  • Wounds

  • Pressure

  • Injuries

  • Lesions

  • Absecess

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21

Localized Infection Symptoms

  • Edema

  • Pain

  • Tenderness

  • Warmth

  • Erythema

  • Yellow, green, and/or brown drainage

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22

Systemic Infection

Infection affecting the entire body, usually occurs when treatment of local infection was unsuccessful, and can be fatal if untreated.

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23

Systemic Infection Symptoms

  • Fever

  • Fatigue

  • Malaise

  • Enlarged, tender lymph nodes

  • Other, more specific, symptoms related to body systems

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24

Stages of Infection

  1. Incubation period

  2. Prodromal stage

  3. Illness stage

  4. Convalescence

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25

Incubation Period

Entrance of a pathogen → When the first symptoms appear

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26

True

True or False: The prodromal sage is the most infectious stage.

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27

Prodromal Stage

Nonspecific S/S → Specific S/S

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28

Illness Stage

Start of the S/S → End of them.

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29

Convalescence Stage

Acute S/S disappear (recovery)

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30

Exogenous

Microorganisms from outside the individual. Ex:

  • Salmonella

  • C. diff

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31

Endogenous

Microorganisms from altered normal flora. Ex:

  • Yeast infections

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32

Iatrogenic

From an invasive or diagnostic procedure. Ex:

  • CAUTI

  • CLABSI

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33

Healthcare-Associated Infections

Infections resulting from the delivery of healthcare services in healthcare agencies.

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34

Populations most at risk for HAI’s

  • Elderly

  • Infants

  • Patients with recent surgeries or procedures

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35

Examples of potential HAI’s sites

Wounds, lesions, and abscesses

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36

False

True or False: Hospitals are reimbursed by insurance for HAI’s.

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37

Risk factors for infection in older adults

  • Deteriorating immune system (less thymus function and less lymphocytes)

  • Poorer nutrition

  • Sedentary lifestyle

  • Greater likelihood of multiple comorbidities

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38

Ways to decrease HAI’s

  • Hand hygiene

  • Immunization

  • Nutrition

  • Rest and exercise (balanced lifestyle)

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39

Asepsis

The absence of pathogens or disease-producing microorganisms. Techniques break the chain of infection and should be done on all patients.

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40

Medical Asepsis

Used for everyone. Cleaning, disinfecting, and sterilizing equipment.

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41

Surgical asepsis is used for:

  • Perforations in the skin

  • Broken skin integrity

  • Invasive procedures

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42

Disinfection

Eliminates many or all microorganisms with the exception of bacterial spores.

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43

Sterilization

Eliminates all forms of microbial life including spores.

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44

True

True or False: Steam, dry heat, hydrogen peroxide, and ethylene oxide are all ways to disinfect or sterilize equipment.

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45

Eliminating an Infectious Agent

  • Clean

  • Disinfect

  • Sterilize

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46

Eliminating a Reservoir

  • Change dressings

  • Empty drainage

  • Proper storage

  • Antiseptic wipes on ports or equipment

  • Discard open bottles within 24 hours

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47

Control Portal of Exit/Entry

  • Cough etiquette

  • Standard precautions

  • Maintain skin integrity

  • Wipe front to back after urinating

  • Keep drainage sets intact and closed

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48

Controlling Transmission

  • Don’t share personal care items (Ex. Bedpans)

  • Wipe stethoscope between patients ]Dedicated equipment for contact precautions

  • Wear gloves and protective eyewear

  • Biohazard bags

  • Carry soiled items away from your body

  • Never put clean or soiled linens on the floor

  • HAND HYGIENE

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49

Hand hygiene should be performed:

  • Before touching a patient

  • Before a clean/aseptic procedure

  • After touching a patient

  • After touching the patient’s surroundings

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50

Protect Susceptible Hosts

  • Protect normal body defenses

  • Isolation precautions

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51

Standard Precautions

Apply to all patients and any situation involving blood, blood products, all body fluids, secretion, excretions (except sweat), nonintact skin, and mucous membranes.

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52

Necessary PPE/Precautions for Standard Precautions

  • Perform hand hygiene

  • Don’t wear artificial nails

  • Wear gloves

  • Discard all sharp instruments and needs in a puncture-resistant container.

  • Proper respiratory hygiene and cough etiquette.

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53

Airborne Precautions

  • Used when droplets are <5 um

  • Private room with negative-pressure airflow

  • N95 Mask or respiratory protection device

  • The patient only leaves room for essential reasons.

  • The patient must wear a mask when leaving the room.

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54

Droplet Precautions

  • Droplets are >5 um and land within three feet of the patient.

  • Private room

  • Mask or respiratory device

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55

Contact Precautions

  • Direct contact with patient or indirect via environmental contact

  • Patients must have a private room, but they may cohort patients with the same infection.

  • Gloves

  • Gown

  • Disposable equipment

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56

Protective Environment

  • Used for allogeneic hematopoietic stem cell transplant patients.

  • Private room with positive airflow

  • Mask

  • Gloves

  • Gown

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57

Airborne Diseases

  • Measles

  • Varicella

  • Tuberculosis

  • Rubeola

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58

Droplet Diseases

  • Influenza

  • Pertussis

  • Pneumonia

  • Diphtheria

  • Rubella

  • Mumps

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59

Contact Diseases

  • MRSA

  • C. diff

  • Shigella

  • Scabies

  • Herpes simplex

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60
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61

Surgical Asepsis

Prevents contamination of an open wound, serves to isolate an operative or procedural area from an unsterile environment and maintains sterile field.

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62

Principles of Surgical Asepsis

  • A sterile object remains sterile only when touches by another sterile object.

  • Only sterile objects may be placed on a sterile field. A package that is torn, punctured, wet, or open is considered unsterile.

  • A sterile object or field out of the range of vision or an object held below a person’s waist is contaminated.

  • A sterile object or field becomes contaminated by prolonged exposure to air.

  • When a sterile surface comes in contact with a wet, contaminated surface, the sterile object or field becomes contaminated by capillary action.

  • Fluid flows in the direction of gravity. A sterile object becomes contaminated if gravity causes a contaminated liquid to flow over the surface of the object.

  • The edges of a sterile field or container are considered contaminated.

    • The one-inch border is considered contaminated.

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63

Normal Flora

Good bacteria that secrete antibacterial substances within the intestine and on the skin as well as provide competition to harmful bacteria.

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64

Inflammatory Process

A protective vascular reaction that delivers fluid, blood, and nutrient to an area of injury. It neutralizes pathogens or necrotic tissue.

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65

Factors that influence a patient’s susceptibility to infection

  • Age

  • Sex

  • Nutritional Status

  • Stress

  • Disease Process

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66

Age

Immune responses decline as the thymus slows down.

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67

Sex

Estrogen can promote immune responses during infection/after vaccination.

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68

Nutritional Status

Lack of this reduces wound healing and limits the body’s defenses.

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69

Stress

Elevated cortisol levels lead to a decreased infection resistance.

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70

Disease Process

Diseases of the immune system compromise them as their defenses are weakened.

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71

Drugs that compromise a patient’s immune system

  • Adrenal corticosteroids

  • Cytotoxic and antineoplastic drugs

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72

Normal White Blood Cell Count

5,000-10,000/mm^3

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73

Indication of infection

White blood cells increase during an acute infection, but decrease in certain viral or overwhelming infections.

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74

Normal Urine, Blood, or Wound Culture

Normally sterile, no microorganism growth.

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75

Normal Gram Stain of Wound, Sputum, or Throat

No WBCs on gram stain, but possible normal flora present.

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76

Members of the healthcare team that collaborate to prevent infection

  • Nurses

  • Experts in infection control

  • Case managers

  • Patient’s family or caregiver

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