Infection Control and Patient Safety in Healthcare

Six links in the chain of infection

Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host

Most effective way to break the chain of infection

Hand hygiene

Medical asepsis

Clean technique used to reduce and prevent the spread of microorganisms

Surgical asepsis

Sterile technique used to eliminate all microorganisms from an area

Types of transmission-based precautions

Contact, droplet, airborne

When is an N95 respirator required?

For airborne precautions (e.g., TB, measles, varicella)

Order to remove PPE

Gloves → goggles/face shield → gown → mask

Difference between localized and systemic infection

Localized is confined to one area; systemic affects the whole body

Examples of healthcare-associated infections (HAIs)

Catheter-associated urinary tract infections, surgical site infections

Nurse's role in infection prevention

Use aseptic technique, monitor for signs of infection, educate patients, apply appropriate precautions

PPE for droplet precautions

Surgical mask, gown, gloves (within 3 feet of patient)

Body systems acting as natural barriers against infection

Skin, respiratory tract, gastrointestinal tract, immune system

Examples of normal flora

Skin bacteria (e.g., Staphylococcus epidermidis), intestinal flora (e.g., E. coli)

Signs of inflammation

Redness, swelling, heat, pain, and sometimes loss of function

Cleaning method for surgical instruments

Sterilization

Basic needs that influence safety

Oxygen, nutrition, temperature

Leading causes of unintentional injury

Motor vehicle accidents, falls, poisoning

Safety event report

A confidential document that describes any patient accident or incident in a healthcare setting

Types of safety risks in healthcare

Falls, patient-inherent accidents, procedure-related accidents, equipment-related accidents

Nursing interventions to prevent falls

Bed in low position, call light within reach, non-skid socks, hourly rounding

Purpose of RACE in fire safety

Rescue, Activate alarm, Confine fire, Extinguish

Standard safety measures for oxygen use at home

No smoking, keep away from open flames, use 'Oxygen in Use' sign

Levels of accident prevention

Primary (education), secondary (screening), tertiary (rehabilitation)

Six rights of medication administration

Right patient, right drug, right dose, right route, right time, right documentation

Three checks of medication administration

Before removing from drawer, when preparing, at bedside before giving

PRN medication order

As needed based on patient condition

Difference between generic and trade name of a drug

Generic is the official name; trade is the brand name given by the manufacturer

Common routes of medication administration

Oral, sublingual, intramuscular, subcutaneous, intravenous, topical

Pharmacokinetics

The study of how drugs move through the body (absorption, distribution, metabolism, excretion)

Signs of medication toxicity

Nausea, vomiting, confusion, tremors, organ damage depending on drug

Black box warning

FDA's strongest warning about a medication's serious or life-threatening risks

Factors affecting personal hygiene

Culture, socioeconomic status, spiritual practices, developmental level, health state

Key areas assessed during hygiene care

Skin, oral cavity, eyes, ears, nose, hair, nails, feet, perineal area

Purpose of bathing a patient

Cleanse body, promote circulation, provide comfort, assess skin condition

Complete bed bath

Nurse performs all hygiene care for the patient

Recommended oral care frequency for unconscious patients

Not provided in the notes

Foot care in diabetic patients

Prevents infection, ulceration, and amputation due to decreased circulation and sensation

Cleaning eyes during hygiene care

Wipe from inner to outer canthus with moistened washcloth

Perineal care

Cleaning the genital and anal areas to prevent infection

Phases of wound healing

Hemostasis, inflammatory, proliferative, maturation

Types of wound drainage

Serous, sanguineous, serosanguineous, purulent

Pressure injury

Localized damage to skin from pressure or shear, often over bony prominences

Stage 2 pressure injury

Partial-thickness loss of skin with exposed dermis; shallow open ulcer

Braden Scale

Assess risk for pressure injury development

Signs of wound infection

Redness, swelling, warmth, purulent drainage, foul odor, fever

Dehiscence

Partial or total separation of wound layers

Dressing that promotes a moist healing environment

Hydrocolloid

Body mechanics

Using proper body movement to prevent injury and conserve energy

Effects of immobility on cardiovascular system

Orthostatic hypotension, increased risk for thrombus formation

Benefits of regular exercise

Improves cardiovascular health, muscle tone, mental health, bone strength

Range of motion (ROM)

Extent of movement of a joint

Types of ROM exercises

Active, passive, active-assistive

Device that helps prevent foot drop

Footboard or high-top sneakers

Logrolling

Turning the patient while keeping the spine in alignment, often used with spinal injury

Orthostatic hypotension

A drop in blood pressure when standing up, causing dizziness or fainting

Stages of NREM sleep

Stage 1 (light), Stage 2, Stage 3 (deep sleep)

Importance of REM sleep

Memory consolidation, mood regulation

Hours of sleep adults need

7-9 hours per night

Factors affecting sleep

Illness, medications, environment, lifestyle, emotional stress

Sleep apnea

A sleep disorder where breathing repeatedly stops and starts

Insomnia

Difficulty falling or staying asleep

Sleep diary

Tracking sleep patterns and identifying disturbances

Nurse's role in promoting sleep

Cluster care, reduce noise/light, comfort measures, bedtime routines

Types of pain

Acute, chronic, nociceptive, neuropathic

Components of a pain assessment

Location, intensity, quality, duration, aggravating/relieving factors

Common pain scales

Numeric rating scale, Wong-Baker FACES, FLACC (for children/nonverbal)

Goal of pain management

Reduce pain to acceptable level for patient function and comfort

Nonpharmacologic pain relief methods

Relaxation, distraction, guided imagery, heat/cold therapy, massage

Difference between tolerance and addiction

Tolerance is needing more drug for same effect; addiction is psychological dependence

PCA

Patient-controlled analgesia: patient administers their own pain medication within limits

Breakthrough pain

Temporary flare-up of moderate to severe pain that occurs even when patient is on scheduled pain meds

5 major senses

Vision, hearing, taste, smell, touch

Sensory deprivation

Lack of meaningful sensory input; leads to confusion, depression, hallucinations

Sensory overload

Too much sensory input; causes anxiety, restlessness, fatigue

Interventions for sensory deprivation

Increase meaningful stimuli, provide social interaction, ensure orientation

Presbyopia

Age-related loss of the eye's ability to focus on close objects

Presbycusis

Age-related hearing loss, especially high-pitched sounds

Aphasia

Impairment of language, often after stroke (expressive, receptive, or global)

Proprioception

Sense of body position and movement