Infection Control

Infection Control

Chapter 28: Infection Prevention

Nature of Infection

  • Infection: Invasion of a susceptible host by pathogens or microorganisms leading to disease.

  • Colonization: Presence and growth of microorganisms within a host; no tissue invasion or damage.

  • Communicable Disease: Infectious process transmitted from one person to another.

  • Symptomatic: Clinical signs and symptoms are present.

  • Asymptomatic: Clinical signs and symptoms are absent.

Mode of Transmission

  • Direct Contact: Person-to-person transmission.

  • Indirect Contact: Personal contact with contaminated inanimate objects (e.g., needles, soiled linen).

  • Droplet Transmission: Respiratory droplets spread through the air.

  • Airborne Transmission: Pathogens spread through air currents.

  • Vehicles: Inanimate objects that carry pathogens.

Chain of Infection

  • Infectious Agent or Pathogen: Microorganisms that cause infections.

  • Reservoir: Place where pathogens reside.

  • Portal of Exit: Exit route for pathogens from the reservoir.

  • Mode of Transmission: How pathogens are transmitted.

  • Portal of Entry: Entry point to the host.

  • Susceptible Host: Individual lacking effective resistance to the pathogen.

Stages of Infection

  • Localized Infection: Infection restricted to a specific area.

  • Systemic Infection: Widespread throughout the body.

Stages of Infectious Process

  • Incubation Period: Time between pathogen entry and the appearance of symptoms.

  • Prodromal Stage: Initial subtle symptoms appear.

  • Illness Stage: Disease reaches its peak; symptoms are most severe.

  • Convalescence: Recovery period following illness.

Inflammation

Response to Injury/Infection

  • Vascular and Cellular Response: Increased blood flow and immune response as a reaction to injury.

  • Inflammatory Exudate: Fluid that leaks from blood vessels during inflammation.

  • Tissue Repair: The healing process that occurs post-inflammation.

Natural Defenses Against Infection

  • Normal Flora: Microorganisms that maintain body balance, preventing infections.

  • Disruption of Balance: Factors disturbing flora increase the risk of infections.

  • Body System Defenses: Unique defense mechanisms in different organs to combat infections (refer to Table 28.2).

Health Care-Associated Infections (HAIs)

  • Risk Factors:

    • Patients with multiple illnesses.

    • Older adults.

    • Poorly nourished individuals.

    • Compromised immune systems.

  • Types of HAIs:

    • Iatrogenic: Resulting from medical procedures.

    • Exogenous: Arising from microorganisms outside the patient.

    • Endogenous: Result from alterations of the patient’s flora leading to overgrowth.

Factors Influencing Infection Prevention and Control

  • Age, Sex, Nutritional Status, Stress, Disease Processes: All factors affecting susceptibility to infections.

  • Treatments or Conditions: Compromising the immune response.

Assessment in Infection Control

  • Thorough Investigation:

    • Evaluates defense mechanisms and susceptibility of the patient.

    • Reviews systems and travel history.

    • Investigates vaccinations and immunizations.

  • Early Recognition of Risk Factors:

    • Includes age, stress, chronic conditions.

Nursing Diagnoses for Infection

  • Risk for Infection: Increased likelihood of developing an infection.

  • Imbalanced Nutrition: Less than body requirements due to effects of infection.

  • Impaired Oral Mucous Membrane: Risk due to infection or treatment.

  • Social Isolation & Impaired Tissue Integrity: Common in infection patients.

  • Readiness for Enhanced Immunization Status: Assess willingness to vaccinate.

Nursing Process: Planning Goals and Outcomes

  • Common goals include:

    • Preventing exposure to infectious organisms.

    • Controlling or reducing the extent of infections.

    • Maintaining resistance to infection.

Implementation Strategies

  • Health Promotion:

    • Preventing infections through hygiene, vaccination, adequate rest, and exercise.

  • Acute Care:

    • Treating infections effectively by eliminating organisms and supporting body defenses.

Asepsis Techniques

  • Medical Asepsis: Preventing the spread of disease-producing microorganisms.

    • Standard Precautions: Hygiene practices to minimize infection risk.

    • Hand Hygiene: Frequent thorough washing or use of alcohol-based hand rubs.

    • Cleaning: Removal of organic and inorganic material; may require personal protective equipment (PPE).

    • Disinfection: Elimination of many microorganisms, not including spores.

    • High-Level Disinfection: Essential for medical equipment like endoscopes.

    • Sterilization: Complete elimination of all microorganisms, including spores.

Patient Safety Practices

  • Health Care Precautions:

    • Separate personal care items to prevent cross-contamination.

    • Appropriate handling of exudates and wound cleaning.

    • Maintain cough etiquette and skin integrity.

    • Proper care of urinary catheters and drainage sets.

Isolation Practices

  • Isolation: Separation of ill persons to prevent further disease spread.

    • Barrier Precautions: Use protective gear to minimize contact with pathogens.

    • Isolation Precautions: Include airborne, droplet, contact, and protective environments.

Psychological Implications of Isolation

  • Impact on Mental Health: Concerning emotional states of patients during isolation phases.

Evaluation of Nursing Process

  • Patient Outcomes: Evaluate if patient expectations regarding infection control have been met.

  • Measure Success of Techniques: Compare actual patient responses to expected outcomes and adjust care plans as necessary.