Infection Control

Unit 4: Infection Control

  • Course: Adult Health I at Galen College of Nursing

Chain of Infection

  • Six Elements Necessary for Infection:  

  •  - Causative Organism: Pathogenic microorganisms that cause disease.  

  •  - Reservoir: The natural habitat of the organism where it lives and multiplies. Examples include:     - People     - Equipment     - Water  

  •  - Portal of Exit: Pathway by which the organism leaves the reservoir. Examples include:     - Excretions     - Secretions     - Skin     - Droplets   

  • - Route of Transmission: Method by which the organism spreads to a susceptible host. Examples include:     - Direct contact     - Ingestion     - Fomites (inanimate objects)     - Airborne transmission  

  •  - Susceptible Host: An individual likely to contract the infection due to various factors such as:     - Immunosuppression     - Diabetes     - Surgery     - Burns     - Elderly age  

  •  - Portal of Entry: Pathway through which the organism enters a susceptible host. Examples include:     - Mucous membranes     - Gastrointestinal (GI) tract     - Genitourinary (GU) tract     - Respiratory tract     - Broken skin

Breaking the Chain of Infection

  • Strategies to Break the Chain Include:  

  •  - Aseptic Technique: Using sterile techniques in handling patients and procedures.  

  •  - Hand Hygiene: Critical to prevent transmission of pathogens.  

  •  - Wound Care: Proper management and care of open wounds to prevent infection.   

  • - Employee Health: Ensuring healthcare workers are healthy and vaccinated.  

  •  - Environmental Sanitation: Regular cleaning and disinfection of healthcare environments.   

  • - Disinfection/Sterilization: Processes to eliminate pathogens from equipment.  

  •  - Control of Excretions and Secretions: Proper disposal and management of bodily fluids.  

  •  - Food Handling: Ensuring safe food preparation to avoid infection spread.

Isolation Precautions

  • Two Tiers of Isolation Precautions:  

  •  - Standard Precautions: Basic level of infection control applicable to all patients:     - Hand hygiene     - Use of personal protective equipment (PPE)     - Cough etiquette     - Handling of soiled equipment and linen     - Environmental control     - Needlestick and sharps safety     - Appropriate patient placement   

  • - Transmission-Based Precautions: Used for patients known or suspected to be infected or colonized with infectious agents:    

  •  - Airborne Precautions     

  • - Contact Precautions     

  • - Droplet Precautions

Elements of Standard Precautions

  • Components:   - Hand hygiene   - Proper PPE and cough etiquette   - Handling soiled equipment and linen properly   - Environmental control measures   - Safety protocols for needles and sharps   - Appropriate patient placement to mitigate infection risks

Contact Precautions

  • When to Implement Contact Precautions:   - For infections like Clostridium difficile, MRSA, VRE, Pediculosis, Scabies, RSV, etc.

  • PPE Used Under Contact Precautions:   - Gloves and gowns
        - Clean hands before and after entering/exiting the patient room.     - Use dedicated or disposable equipment; clean and disinfect shared equipment.     - Do not wear the same gown and gloves for multiple patients.

Scenario Questions

  • Scenario with Nursing Assistant:   - Situation: A nursing assistant left the room of a client with Clostridium difficile without washing hands.   - Priority Action for Nurse:     - c) Have the nursing assistant wash hands with soap and water.

Transmission-Based Precautions

  • Client with Influenza:   - Required Precautions:     - c) Droplet precautions

Organizational Guidelines for Isolation Precautions

  • Contact Enteric Precautions for C. difficile:   - Visitors must check in before entering.   - Wash hands before entering, use soap and water after leaving.   - Wear a gown and gloves; use patient-dedicated equipment.

Droplet Precautions Guidelines

  • Requirements for Droplet Precautions:   - Check in with Nursing before entering.   - Wear a mask and eye protection.   - Clean and disinfect shared equipment.

  • Pertussis, Influenza, Mumps, Meningitis, Pneumonia

Aerosol Contact Precautions

  • Guidelines for Visitors and Staff:   - Approved visitors only; wear N95 respirators.   - Keep the door closed during patient care unless impacting patient safety.

  • Pt needs to be in a negative pressure room and door should remain closed at all times

  • TB, Varicella/chickenpox, Measles

Preventing Infection in the Community

  • Collaborative Efforts:   - Involvement of CDC, state, and local health departments.

  • Methods:   - Sanitation techniques and regulated health practices   - Safe food preparation and immunization program

Vaccination Programs

  • Key Points:   - Existence of over 50 licensed vaccines in the U.S.   - Reduction in incidences of many infectious diseases.   - Importance of following CDC guidelines for vaccinations.

Common Vaccines and Their Contraindications

  • Examples of Common Vaccines:   - Measles, Mumps, Rubella (MMR)   - Varicella   - Influenza   - HPV -shingles

  • Prior to Immunizations:   - Nurses must obtain further history regarding any past reactions.

Hospital-Acquired Infections (HAIs) Potential Organisms

  • Common Organisms Associated with HAIs:   - C. difficile (most common)   - Methicillin-resistant Staphylococcus aureus (MRSA)     - Distinction between healthcare-associated and community-associated MRSA   - Vancomycin-resistant Enterococcus (VRE)   - Multidrug-resistant organisms (MDROs)

Prevention of Infections Protocols

  • Key Concepts:   - Standard precautions and the bundle approach.   - Importance of hand hygiene.

  • Key Initiatives for Specific Infections:   - Bacteremia/Fungemia prevention protocols such as chlorhexidine skin prep, occlusive dressing protocols, and early removal of catheters when indicated.

Managing Infections

  • Antibiotic Therapy Options:   - Common Antibiotics: PCN, cephalosporins, antifungals, erythromycin, gentamicin, vancomycin.

  • Considerations:   - Cultures must be collected prior to starting antibiotics.   - Assess for potential reactions like nausea/vomiting (N/V), wheezing, itching, or anaphylaxis (symptoms: hypotension, cardiac arrest, laryngeal edema).

Class Reflection and Summary

  • Discussion Questions for Students:   - What are three things you already knew about today’s content?   - What are two things you learned today?   - What is one question you still have?

Reference

  • Hinkle, J. L., Cheever, K. H., & Overbaugh, K. (2026). Brunner & Suddarth’s textbook of medical-surgical nursing (16th ed.). Wolters Kluwer.