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 symptoms.

  • Prodromal Stage: Initial symptoms appear.

  • Illness Stage: Disease is at its peak; symptoms are severe.

  • Convalescence: Recovery period after illness.

Inflammation

• Response to Injury/Infection: The body's cellular response includes:

  • Vascular and Cellular Response: Increased blood flow and immune response.

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

  • Tissue Repair: Healing process post-inflammation.

Natural Defenses Against Infection

• Normal Flora: Microorganisms that balance the body, preventing infection.

• Disruption of Balance: Factors disrupting flora increase infection risk.

• Body System Defenses: Unique defenses in different organs to fight 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: From microorganisms outside the patient.

  • Endogenous: Alteration of the patient's flora leads to overgrowth.

Factors Influencing Infection Prevention and Control

• Age, Sex, Nutritional Status, Stress, Disease Processes: All affect susceptibility.

• Treatments or Conditions: Those that compromise the immune response.

Assessment in Infection Control

• Thorough Investigation: Evaluates:

  • Defense mechanisms and susceptibility.

  • Review of systems and travel history.

  • Immunizations and vaccinations.

• Early Recognition of Risk Factors: Including age, stress, chronic illness.

Nursing Diagnoses for Infection

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

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

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

• Social Isolation & Impaired Tissue Integrity: Needed for infection patients.

• Readiness for Enhanced Immunization Status: Assessing the client’s willingness to vaccinate.

Nursing Process: Planning

• Goals and Outcomes: Common goals include:

  • Preventing exposure to infectious organisms.

  • Controlling or reducing infection extent.

  • Maintaining resistance to infection.

  • Educating on infection control techniques (e.g., hand hygiene).

• Setting Priorities: Establishing priorities for diagnoses and related care goals.

• Teamwork & Collaboration: Planning care involving multiple disciplines.

Implementation Strategies

• Health Promotion: Preventing infection through hygiene, vaccination, rest, and exercise.

• Acute Care: Treating infections by eliminating organisms and supporting body defenses.

Asepsis Techniques

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

  • Standard Precautions: Hygiene practices to minimize infection.

  • Hand Hygiene: Frequent and thorough washing or using alcohol-based rubs.

Cleaning and Disinfection

• Cleaning: Removal of organic and inorganic material, requiring personal protective equipment.

• Disinfection: Process that eliminates many microorganisms but not spores.

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

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

Patient Safety Practices

• Health Care Precautions:

  • Separate personal care items.

  • Appropriate handling of exudates and wound cleaning.

  • Cough etiquette and maintaining skin integrity.

  • Proper care for urinary catheters and drainage sets.

Isolation Practices

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

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

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

Psychological Implications of Isolation

• Impact on Mental Health: Consideration of the patient’s emotional state during isolation phases.

Evaluation of Nursing Process

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

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