prevention of communicable diseases.

CARE OF PATIENTS WITH COMMUNICABLE (INFECTIOUS) DISEASES

  • Presented by Mrs. Sweety Veerjayantee Chikhooree, Assistant Lecturer, Nursing/Midwifery PML, June 2023

WHAT IS AN INFECTIOUS DISEASE?

  • Definition: A communicable disease is caused by microorganisms (bacteria, virus, or fungus) that can be passed from one organism to another.

  • Examples:

    • 2019-nCoV

    • Avian Flu

    • Ebola

    • Influenza (Flu)

    • Hepatitis A

    • Methicillin-resistant Staphylococcus aureus (MRSA)

THE ROLE OF CDC

  • The CDC (Centers for Disease Control and Prevention) is crucial in protecting public health.

  • Main Aims:

    • Detect and respond to emerging health threats.

    • Address significant health issues causing morbidity and mortality.

    • Employ science and technology to prevent disease.

    • Promote healthy behaviors and community environments.

    • Train public health workforce, including disease detectives.

    • Assess the health status of the nation.

UNDERSTANDING THE INFECTION TRANSMISSION CHAIN

  • To prevent and control infectious diseases, understanding the chain of infection is essential. This involves recognizing the six links necessary for an agent to colonize:

    • Infectious Agent

    • Reservoir

    • Portal of Exit

    • Mode of Transmission

    • Portal of Entry

    • Susceptible Host

  • Note: Breaking any link in this chain prevents the spread of infection.

BREAKING THE CHAIN OF INFECTION

  • Strategies to break the chain include:

    • Immunizations

    • Diagnosis

    • Cleaning and disinfection

    • Treatment of underlying disease

    • Antimicrobial stewardship policies

    • Patient education

    • Pest control

Key Terms in Infection Chain

  • Infectious Agent: Pathogens such as bacteria, fungi, viruses, and parasites.

  • Reservoir: Environments where pathogens live (humans, animals, contaminated surfaces, etc.).

  • Portal of Exit: How the agent exits the reservoir (e.g., through wounds, respiratory droplets).

  • Mode of Transmission: How the agent spreads (contact, ingestion, inhalation).

  • Portal of Entry: How the agent enters a new host (e.g., through mucous membranes, broken skin).

  • Susceptible Host: Individuals who are vulnerable, especially those in healthcare settings.

INFECTION CONTROL IN HOSPITALS

  • Infection control focuses on minimizing or preventing transmission:

    • Based on risk management and the mode of transmission of pathogens.

PATIENT PROTECTION STRATEGIES

  • 10 Ways to Protect Patients:

    • Clean your hands before and after patient care.

    • Stay Home if you're sick.

    • Understand appropriate use of antibiotics.

    • Follow posted precautions.

    • Wear personal protective equipment (PPE).

    • Ensure safe injection practices (one needle, one syringe, only one time).

    • Keep patients informed about infection prevention.

PRINCIPLES OF CARE DURING AN OUTBREAK

  • Isolation and Quarantine: Fundamental practices include disinfection and educating about infection control measures.

MANAGEMENT OF INFECTIOUS DISEASE

  • Preventive Measures:

    • Practice hand hygiene, wear PPE, isolate when necessary, and manage waste properly.

    • Provide education about disease, cause of infection, and prevention measures.

  • Medical Management:

    • Include diagnostics, medication therapy, blood sampling, and vaccines.

  • Nursing Management:

    • Ensure admission to isolation wards, maintain hand hygiene, clean patient care equipment, and handle linens properly.

OTHER CARE ASPECTS

  • Rehabilitative Aspect: Monitor activity and nutrition for recovery.

PRECAUTIONS IN INFECTIOUS DISEASES

  • Airborne: Wear fit-tested N-95 masks, maintain hand hygiene, keep doors closed.

  • Droplet: Protect eyes, nose, and mouth; maintain hand hygiene.

  • Contact: Wear gloves and gowns, use dedicated equipment, and perform thorough cleaning.

POTENTIAL COMPLICATIONS

  • Risks include septicemia, bacteremia, sepsis, septic shock, dehydration, abscess formation, and endocarditis.

HEALTH EDUCATION

  • Educate families and patients on:

    • Importance of prophylactic immunization.

    • How infectious illnesses spread and prevention methods.

    • The importance of hygiene and environmental cleanliness.

    • The need for medical advice for health issues.

IMMUNIZATION

  • Types of Immunity:

    • Active Acquired Immunity: Antibodies are produced within an individual.

    • Passive Acquired Immunity: Antibodies received from another individual (e.g. mother to baby).

EXPECTED PATIENT OUTCOMES

  • Patients should:

    • Use appropriate methods to prevent infection spread.

    • Acquire knowledge about the infectious process.

    • Show no elevated body temperature.

CONCLUSION AND STATISTICS

  • Report from CDC indicates:

    • 1 in 25 hospitalized patients in the U.S. develop healthcare-associated infections (HAIs).

    • Approximately 75,000 hospital deaths are attributed to these infections annually.

CARE OF PATIENTS WITH COMMUNICABLE (INFECTIOUS) DISEASES

Presented by Mrs. Sweety Veerjayantee Chikhooree, Assistant Lecturer, Nursing/Midwifery PML, June 2023

WHAT IS AN INFECTIOUS DISEASE?

Definition: An infectious disease, also known as a communicable disease, is caused by microorganisms such as bacteria, viruses, or fungi that can be transmitted from one host to another.

Examples:

  • 2019-nCoV: The virus responsible for COVID-19, characterized by respiratory symptoms and has led to a global pandemic since late 2019.

  • Avian Flu: Influenza type A virus affecting birds, with potential transmission to humans, can lead to severe respiratory illness.

  • Ebola: A serious viral infection with a high fatality rate, primarily affecting humans and nonhuman primates, causing severe hemorrhagic fever.

  • Influenza (Flu): A contagious respiratory illness caused by influenza viruses, leading to seasonal epidemics affecting multiple populations.

  • Hepatitis A: A vaccine-preventable liver infection caused by the hepatitis A virus, typically spread through ingestion of contaminated food and water.

  • Methicillin-resistant Staphylococcus aureus (MRSA): A type of staph bacteria that is resistant to many antibiotics, making infections difficult to treat.

THE ROLE OF CDC

The Centers for Disease Control and Prevention (CDC) is a critical federal agency aimed at enhancing public health.

Main Aims:

  • Detect and respond to emerging health threats: Regular surveillance and response planning.

  • Address significant health issues causing morbidity and mortality through research and interventions.

  • Employ science and technology to prevent disease outbreaks and promote health initiatives.

  • Promote healthy behaviors through public health campaigns and community engagement.

  • Train public health workforce, including epidemiologists and communicable disease specialists.

  • Assess the health status of the nation through health data collection and analysis.

UNDERSTANDING THE INFECTION TRANSMISSION CHAIN

To effectively prevent and control infectious diseases, a comprehensive understanding of the chain of infection is essential. This involves recognizing the six links necessary for an infectious agent to successfully colonize and spread:

  1. Infectious Agent: Pathogens like bacteria, viruses, fungi, and parasites that cause disease.

  2. Reservoir: The place where the pathogen lives and multiplies, which can include humans, animals, or contaminated surfaces.

  3. Portal of Exit: The method by which the pathogen exits the reservoir (e.g., through respiratory droplets, blood, or bodily fluids).

  4. Mode of Transmission: The route through which the pathogen spreads to a new host (e.g., direct contact, airborne, vector-borne).

  5. Portal of Entry: The way the pathogen enters a new host (e.g., mucous membranes, respiratory tract, broken skin).

  6. Susceptible Host: Individuals who are at risk of infection due to factors such as age, health status, or weakened immune systems.

Note: Breaking any link in this transmission chain can effectively prevent the spread of infectious diseases.

BREAKING THE CHAIN OF INFECTION

Strategies to break the chain of infection encompass a variety of methods:

  • Immunizations: Vaccinations are vital in preventing diseases like measles, flu, and hepatitis.

  • Diagnosis: Early identification of infections can help in timely management.

  • Cleaning and disinfection: Proper sanitation practices to reduce pathogen reservoirs.

  • Treatment of underlying disease: Addressing chronic conditions that may predispose individuals to infections.

  • Antimicrobial stewardship policies: Promoting appropriate use of antibiotics to combat resistance.

  • Patient education: Informing patients about hygiene practices and infection prevention measures.

  • Pest control: Eliminating vectors and reservoirs from healthcare environments.

KEY TERMS IN INFECTION CHAIN

  • Infectious Agent: Pathogens causing infectious diseases.

  • Reservoir: Habitats where pathogens naturally reside.

  • Portal of Exit: Exit routes for pathogens to leave their reservoir.

  • Mode of Transmission: The mechanism by which pathogens travel from host to host.

  • Portal of Entry: Routes through which pathogens enter a new host.

  • Susceptible Host: Individuals with increased risk factors for infection.

INFECTION CONTROL IN HOSPITALS

Infection control in healthcare settings is paramount for minimizing or preventing transmission. This is guided by:

  • Risk Management: Assessing and managing risks associated with pathogens.

  • Mode of Transmission Understanding: Tailored approaches based on how an infection spreads.

PATIENT PROTECTION STRATEGIES

Ten effective strategies to protect patients include:

  1. Hand hygiene: Consistent hand washing or sanitizing before and after patient care.

  2. Stay home if sick: Preventing the spread of infection by staying away from patients and healthcare settings.

  3. Understanding appropriate use of antibiotics: Avoiding misuse to prevent antimicrobial resistance.

  4. Follow posted precautions: Adhering to established safety protocols.

  5. Wear personal protective equipment (PPE): Utilizing gloves, gowns, masks when necessary.

  6. Ensure safe injection practices: One needle, one syringe, for only one patient to avoid cross-contamination.

  7. Keep patients informed about infection prevention: Educating patients on protective measures they can take.

PRINCIPLES OF CARE DURING AN OUTBREAK

Isolation and quarantine are fundamental practices during infectious disease outbreaks. Key practices include:

  • Disinfection: Regular cleaning of contaminated surfaces affected by the outbreak.

  • Education on infection control: Providing information on prevention and management during outbreaks.

MANAGEMENT OF INFECTIOUS DISEASE

Preventive Measures:

  • Practice hand hygiene: Consistent washing/sanitizing of hands to reduce pathogen spread.

  • Wear PPE: Adequate protective gear during care and interactions with infected patients.

  • Isolate when necessary: Managing patients in isolation to prevent cross-infection.

  • Manage waste properly: Following protocols for the disposal of biohazardous waste.

  • Educate about disease: Providing information about modes of transmission, symptoms, and preventive measures.

Medical Management:

Involves diagnostics to identify infection, specific medication therapy targeting pathogens, blood sampling for laboratory testing, and administration of vaccines where applicable.

Nursing Management:

Includes actions such as ensuring patients are placed in isolation wards, maintaining hand hygiene protocols, cleaning and sterilizing patient care equipment, and properly handling linens to prevent cross-contamination.

OTHER CARE ASPECTS

Rehabilitative Aspect:

Care involves monitoring patient's activity levels and nutritional needs to aid recovery from infectious diseases and support overall health during and after illness.

PRECAUTIONS IN INFECTIOUS DISEASES

Airborne: Use fit-tested N-95 masks, maintain strict hand hygiene, and keep patient area doors closed to limit airborne pathogens. Droplet: Protect face (eyes, nose, mouth) from droplets through appropriate PPE and maintain hand hygiene. Contact: Wear gloves and gowns during direct interaction and use dedicated equipment for infected patients to avoid transmission.

POTENTIAL COMPLICATIONS

Infections can lead to severe complications, including:

  • Septicemia: Blood poisoning due to pathogens in the bloodstream.

  • Bacteremia: Presence of bacteria in the blood, potentially leading to sepsis.

  • Sepsis: A life-threatening response to infection with systemic inflammation.

  • Septic shock: A critical state from sepsis characterized by hypotension and organ failure.

  • Dehydration: Resulting from diarrhea or vomiting associated with infections.

  • Abscess formation: Localized collections of pus that may require drainage.

  • Endocarditis: Infection of the heart lining which can be life-threatening.

HEALTH EDUCATION

Educating families and patients is crucial in combatting infections. Key areas include:

  • Importance of prophylactic immunization: Preventive vaccinations to protect from diseases.

  • Understanding transmission: How infectious illnesses spread and ways to prevent infections.

  • Hygiene and environmental cleanliness: Advocating for maintaining clean environments to reduce transmission risk.

  • Need for medical advice: Encouraging seeking medical assistance early for health concerns.

IMMUNIZATION

Types of Immunity:

  • Active Acquired Immunity: Produced antibodies within the individual after exposure to a pathogen or via vaccination.

  • Passive Acquired Immunity: Antibodies gained from another individual, such as maternal antibodies transferred to an infant during breastfeeding or pregnancy.

EXPECTED PATIENT OUTCOMES

Patients should:

  • Utilize appropriate methods to prevent the spread of infections.

  • Acquire a thorough understanding of the infectious process and its implications.

  • Demonstrate no elevated body temperature or other signs of infection during care.

CONCLUSION AND STATISTICS

According to a report from the CDC, it is noted that:

  • Approximately 1 in 25 hospitalized patients in the U.S. develop healthcare-associated infections (HAIs).

  • Annually, there are about 75,000 deaths attributed to these infections, highlighting the significant impact on patient safety and healthcare outcomes.