Infection control & Isolation

Infection Control and Isolation

  • Description: Infection control and isolation are essential components in managing patient care, especially in healthcare settings where the risk of infection transmission is heightened.

Objectives

  • Understand the relationship between the chain of infection, transmission of infection, and the body's normal defenses against infection.

  • Learn about the inflammatory process, local and systemic infections, and associated diagnostic testing.

  • Identify how infection can be prevented at each link in the chain of infection.

  • Recognize patients most at risk for infection.

  • Explain conditions that foster the transmission of healthcare-associated infections.

  • Compare medical and surgical asepsis in client care.

  • Discuss principles of hand hygiene and compare standard precautions with transmission-based precautions.

  • Outline nursing interventions for protecting clients and nurses from infection and provide client education about infection prevention.

  • Understand the process following accidental exposure to bloodborne pathogens.

Evolving Case Study: Infection Control

  • Case Context: E.B., a 72-year-old female recovering from hip surgery, has a Foley catheter that needs replacement. This sterile procedure requires two RNs.

  • Key Questions:

    • What constitutes "sterile"?

    • Why are two nurses necessary for this procedure?

The Chain of Infection

  • Definition: A sequence of events required for the occurrence of an infection, which includes:

    • Infectious agent

    • Reservoir

    • Portal of exit

    • Mode of transmission

    • Portal of entry

    • Susceptible host

Susceptible Hosts

  • Populations at higher risk include:

    • Babies and young children

    • Elderly individuals

    • Those with weakened immune systems

    • Unimmunized individuals

    • Anyone exposed to infectious agents.

Infectious Agents

  • Common infectious agents include bacteria, viruses, and fungi.

  • Prions: Abnormal proteins capable of inducing normal proteins in the brain to misfold, leading to diseases.

Reservoirs for Infectious Agents

  • Definition: Environments where infectious agents live, grow, and reproduce. Common reservoirs include:

    • People and animals

    • Soil and water

    • Contaminated equipment.

Mode of Transmission

  • Transmission modalities include:

    • Contact (direct and indirect)

    • Droplet

    • Airborne

    • Vector-borne (e.g., from insects like ticks and mosquitoes).

Portal of Entry and Exit

  • Portals of Exit: Routes by which the infectious agent exits the reservoir include:

    • Respiratory tract (saliva, sputum)

    • Blood (cuts, wounds)

  • Portals of Entry: Varying body orifices, including:

    • Skin breaches

    • Mucous membranes (eyes, nose, mouth).

Factors Affecting Host Susceptibility

  • Includes:

    • Skin integrity

    • Normal body pH levels

    • Condition of white blood cells

    • Immunization status

    • General health, stress levels, and use of invasive devices.

Assessment for Infection

  • Conduct risk assessments, physical assessments, and diagnostics/lab tests focusing on symptoms and vital signs:

    • Monitoring for fever, changes in baseline, and other systemic responses is essential.

    • Early nutritional interventions are crucial in supporting recovery from infection.

Types of Infections

  • Localized Infection: Characterized by swelling, redness, pain, heat, and loss of function. Treatment may involve topical or oral antibiotics.

  • Systemic Infection: Symptoms include fever, malaise, increased pulse and respiratory rate, and weight loss.

Inflammatory Response

  • Initiated by tissue injury, leading to:

    • Capillary widening

    • Increased permeability and blood flow

    • Release of fluids into tissues resulting in heat, redness, swelling, and pain.

Diagnostic Tests for Infection

  • Common tests include:

    • WBC counts

    • Cultures and sensitivities

    • Erythrocyte sedimentation rate (ESR)

    • C-reactive protein (CRP).

Infection Control Practices

  • Hand Hygiene: Essential for preventing the spread of infection using various methods (soap, water, or alcohol-based hand sanitizers).

  • Personal Protective Equipment (PPE): Vital in protecting healthcare workers and patients alike. Proper sequence for donning and doffing PPE is critical.

  • Standard and Transmission-Based Precautions: Utilize appropriate measures based on patient’s infectious status.

Healthcare Associated Infections (HAIs)

  • Infections contracted in healthcare settings, primarily due to medical devices, surgical procedures, or transmission between patients and healthcare professionals. Common types include:

    • Catheter-associated urinary tract infections (CAUTIs)

    • Surgical site infections (SSIs)

    • Ventilator-associated pneumonia (VAP).

Prevention and Client Education

  • Emphasis on proper hand hygiene, respiratory etiquette, and understanding personal and public health practices to mitigate infection spread.

  • Importance of immunizations and adherence to precautionary measures to protect both the individual and public health.