LEC 8.1: Asepsis & Infection Prevention

Asepsis, Infection, Chain of Infection, Factors Increasing Susceptibility, NANDA

Infection

Growth of microorganisms in the body tissue where they are not usually found

Infection

The following is an example of what?

E. Coli is a normal flora in the small intestine but there’s a bacteria that limits it’s growth. However, when one takes antibiotics, that limiting bacteria decreases, allowing E. Coli to increase. When one has poor hygiene in cleaning their perineum, E. Coli may be able to enter through the urethral orifice and cause UTI.

Asymptomatic/Subclinical Infection

Microorganism produces no clinical evidence of disease

Disease

Detectable alteration in normal tissue function

Virulence

Severity or harmfulness of a microorganism

Virulence

The following is an example of what?

Comparing the common cold and COVID, COVID has more severe effects.

Communicable Disease

Condition resulting from transmission of an infectious agent from one individual to another

Communicable Disease

The following is an example of what?

COVID is airborne, enabling it to stay in the air for long time periods and allow for easy transmission.

Pathogenicity

Ability to produce disease

Pathogen

A microorganism that causes disease

Opportunistic Pathogen

Causes disease only in a susceptible individual

Opportunistic Pathogen

The following is an example of what?

Candida albicans is a normal bacteria in the oral cavity that is normally limited by another bacteria. However, if one takes antibiotics that reduces that limiting bacteria, the candida albicans is able to increase and results in the formation of Candidiasis.

1. Bacteria

2. Viruses

3. Fungi

4. Parasites

4 Types of Microorganisms that cause Infection

Bacteria

A microorganism that causes infection

Most common

Live and can be transported through air, water, food soil, body tissues & fluids & inanimate things

Virus

A microorganism that causes infection

Consist primarily of nucleic acid

Needs to enter living cells in order to reproduce

Virus

The following is an example of what type of microorganism that causes infection?

Helper T-Cells normally help in detecting foreign bodies and calling other immune cells to destroy such bodies. However, HIV attaches to the Helper T-Cell, causing the Helper T-Cell to be unable to call other immune cells, allowing the HIV to reproduce.

Fungi

A microorganism that causes infection

Include yeast and molds

Fungi

The following is an example of what type of microorganism that causes infection?

Candida albicans is a normal flora in the vaginal canal which becomes opportunistic when the good bacteria that controls it is lessened.

Parasites

A microorganism that causes infection

Live on other living organisms

Include protozoa (ex. malaria) and arthropods (mites, fleas, ticks)

1. Local vs. Systemic

2. Acute vs Chronic

2 MAIN Types of Infection

Local Infection

Type of infection

Limited to a specific part of the body where the microorganisms remain

Local Infection

The following is an example of what type of infection?

One is experiencing a runny nose.

Systemic Infection

Type of infection

Microorganisms spread and damage different parts of the body

Systemic Infection

The following is an example of what type of infection?

One is experiencing a fever.

Bacteremia

Part of Systemic Infection

Culture of the person’s blood reveals microorganisms

Septicemia

Part of Systemic Infection

Bacteremia results in a systemic infection

Acute Infection

Type of infection

Appear suddenly or last a short time

Chronic Infection

Type of infection

Occur slowly, over a long period, and may last months or years

Chronic Infection

The following is an example of what type of infection?

A person with Tuberculosis needs to drink antibiotics for 3 months.

Acute or Chronic Infection

The following is an example of what type of infection?

For some, COVID is only experienced for a week. For others, COVID causes remnant symptoms even after a year of initial symptom experience.

Asepsis

Freedom from disease-causing microorganisms

Aseptic Technique

The way to decrease the possibility of transferring microorganisms from one place to another

1. Medical Asepsis

2. Surgical Asepsis

2 Types of Aseptic Technique

Medical Asepsis

One of the types of Aseptic Technique

Includes all practices intended to confine a specific microorganism to a specific area, limiting the number, growth & transmission of microorganisms

Clean

Part of Medical Asepsis

Absence of almost all microorganisms

Dirty

Part of Medical Asepsis

Likely to have microorganisms

Surgical Asepsis/Sterile Technique

One of the types of Aseptic Technique

Refers to activities that keep area or object free of all microorganisms

Spores

Microscopic dormant structure formed by some microorganisms that are very hardy and often survive common cleaning techniques

When suitable environment is found, it “hatches” and replicates

Destroyed in sterile technique

False (Surgical Asepsis destroys spores.)

True or False: Medical Asepsis destroys spores.

Nosocomial Infections

Infections that originate in the hospital

Develop during a client’s stay in a facility or manifest after discharge

May also be acquired by a personnel working in the facility

48 Hours

How many hours after discharge should an infection manifest to be considered a Nosocomial Infection?

Health Care-Associated Infections (HAIs)

What are Nosocomial Infections a sub group of?

Endogenous Source

Nosocomial infection that originated from the client themself.

Endogenous Source

The following is an example of what source of Nosocomial Infection?

Human skin has normal flora on the epidermis. If sterile technique is not done when performing an intravascular insertion, the patient potentially may have an infection through the puncture or cannula.

Exogenous Source

Nosocomial infection that originated from the client’s environment and hospital personnel.

Exogenous Source

The following is an example of what source of Nosocomial Infection?

The hospital room, like the telephone, call light, linens, and walls can introduce microorganisms.

A nurse with poor hygiene may introduce microorganisms to the patient.

1. Latrogenic Infections

2. Compromised Host

2 Possible Factors in Nosocomial Infections

Latrogenic Infections

One of the possible factors in nosocomial infections

Direct result of diagnostic or therapeutic procedures

Compromised Host

One of the possible factors in nosocomial infections

Normal defenses have been lowered by treatment or illness

1. Etiologic Agent

2. Reservoir (includes Carriers)

3. Portal of Exit

4. Mode of Transmission

5. Portal of Entry

6. Susceptible Host

6 Links of Chain of Infection

Etiologic Agent

One of the links of chain of infection

Any microorganism capable of producing infection

Will depend on the following:

• Number present (the more microorganism present, the more it causes an infection)

• Virulence (ability to produce disease) and potency

• Ability to enter the body

• Susceptibility of the host

• Ability to live in the host’s body

Reservoir

One of the links of chain of infection

Sources of microorganisms

Common Examples:

• Other humans

• Client’s own microorganisms

• Plants

• Animals

• General environment

Carrier

Reservoir of a specific infectious agent that usually does not manifest any clinical signs of disease

Portal of Exit

One of the links of chain of infection

Where the microorganisms leave the reservoir

Method of Transmission

One of the links of chain of infection

Means of transmission to reach another host

3 mechanisms

• Direct transmission

• Indirect transmission

• Airborne transmission

1. Direct transmission

2. Indirect transmission

3. Airborne transmission

3 Methods of Transmission

Direct Transmission

One of the methods of transmission

• Involves immediate & direct transfer of microorganisms from person to person

• E.g. touching, biting, kissing or sexual intercourse

• Droplet Spread

Droplet Spread

Specific type of Direct Transmission

• Occurs if source & host are within 3 feet of each other

• Sneezing, coughing, spitting, singing & talking

Indirect Transmission

One of the methods of transmission

Includes

• Vehicle-borne transmission

  • Vehicle: any substance that serve as an immediate means to transport & introduce an infectious agent into a susceptible host through a suitable portal of entry

  • E.g. fomites (inanimate objects), water, food, blood & plasma

• Vector-borne transmission

  • Vector: an animal or insect that serves as an intermediate means of transporting the infectious agent

Vehicle

Part of Indirect Transmission

Any substance that serve as an immediate means to transport & introduce an infectious agent into a susceptible host through a suitable portal of entry

E.g. fomites (inanimate objects), water, food, blood & plasma

Fomites

Another word for inanimate objects

Vector

Part of Indirect Transmission

An animal or insect that serves as an intermediate means of transporting the infectious agent

E.g. Mosquitoes, rats, birds, chickens, bats, dogs

Airborne Transmission

One of the methods of transmission

Transmitted by air currents

May involve droplets or dust

Droplet Nuclei

Form of Airborne Transmission

• Residue of evaporated droplets emitted by an infected host

• Can remain in the air for long periods

• Can cause virions that can remain in the air for a long time

Dust

Form of Airborne Transmission

• May contain infectious agents such as spores of C. difficile

Airborne Transmission: Dust

The following is an example of what Method of Transmission?

Anthrax

Portal of Entry

One of the links of chain of infection

• Where microorganisms enter a body

• Often, the microorganisms enter the body of the host by the same route they used to leave the source

Susceptible Host

One of the links of chain of infection

• Any person who is as risk for infection

• Compromised Host: A person at increased risk, an individual who for one or more reasons is more likely than others to acquire an infection

Compromised Host

A person at increased risk, an individual who for one or more reasons is more likely than others to acquire an infection

1. Age

2. Hereditary

3. Level of Stress

4. Nutritional Status

5. Current Medical Therapy

6. Preexisting Disease

6 Factors Increasing Susceptibility

Age

One of the factors increasing susceptibility

The younger and older the host, the poorer the immune system

With the younger clients, their immune system is not fully developed

With older clients, their immune system also becomes older.

Hereditary

One of the factors increasing susceptibility

Sometimes, there are clinical presentations wherein the patient has low or poor antibodies, increasing susceptibility to infection.

Level of Stress

One of the factors increasing susceptibility

In stress, there is an increased production of cortisol - a hormone produced by the adrenals. When cortisol is too much, also makes the immune system weak.

Cortisol

What hormone released when stressed weakens the immune system?

Nutritional Status

One of the factors increasing susceptibility

The nutrients , vitamins and minerals needed for the reproduction of good cells in the immune system are lacking, of course, the immune system could not function properly as expected.

Current Medical Therapy

One of the factors increasing susceptibility

Chemotherapy and radiation therapy tends to affect the function of the immune system. The purpose of killing cancer cells can also kill normal white blood cells that are very important in fighting infections.

Preexisting Disease

One of the factors increasing susceptibility

There are certain disease that would actually place the person at risk or susceptible to having an infection.

Examples: Chronic Obstructive Pulmonary Disease (COPD), Diabetes Mellitus, Leukemia

Risk for Infection

NANDA Nursing Diagnosis

State in which an individual is at increased risk for being invaded by pathogenic microorganisms

1. Inadequate primary defenses

2. Inadequate secondary defenses

Risk factors for Risk for Infection