Concept Of Nursing

Introduction

• Recognizing essential concepts related to nursing education and infection control.
• Key considerations for becoming a licensed nurse practitioner (NLPN):
  • Understanding different nursing programs: ADN vs. BSN.
  • ADN (Associate Degree in Nursing) and BSN (Bachelor of Science in Nursing) lead to registered nurse (RN) credential.
  • Differences in duration and emphasis:
    • ADN, a two-year program, focuses on clinical experience.
    • BSN includes additional research and management coursework, but may offer less bedside clinical exposure.
• Personal anecdote regarding nursing education choices:
  • The speaker completed BSN right away due to previous knowledge of personal commitment level.
  • Comparison to a friend who completed ADN first before progressing to BSN.

Theorists in Nursing

• Importance of understanding foundational nursing theorists.
• Key figure:
  • Jean Watson:
  • Developed the theory of caring, which is pivotal in modern nursing practice at the bedside.

Core Concepts of Infection Control

• Overview of the chapter focused on medical sepsis and infection control.
• Objectives:
  • Understand pathogens and the body's natural defense mechanisms against infections.
  • Learn about aseptic technique, standard precautions, and transmission-based precautions.

Pathogens

• Definitions: Microorganisms visible only under a microscope are called pathogens,
  • Pathogens also referred to as antigens.
  • Antibodies are produced to combat pathogens (antigens).
  • Normal flora: beneficial microorganisms living in or on the human body that typically do not cause infection but can lead to disease if they become imbalanced.

Types of Pathogens:

1. Bacteria:
   • Single-celled microorganisms without a nucleus or organelles.
   • Classified by shape:
     • Cocci (sphere-shaped)
     • Bacilli (rod-shaped)
     • Spirilla (spiral-shaped).
   • Differentiated by Gram staining:
     • Gram-positive (absorb dye) vs. Gram-negative (do not absorb dye).
2. Viruses:
   • Composed of genetic material (DNA or RNA) with a protective protein coat (capsid).
   • Required to live in a host to survive.
   • Examples: Zika virus, chickenpox, Ebola.
3. Protozoa:
   • Single-celled microorganisms with a nucleus; often parasitic.
   • Examples: Amoebas, giardia, malaria.
4. Fungi:
   • Microorganisms that can be single-celled or multicellular.
   • Examples: Yeast infections, molds.
5. Helminths:
   • Parasitic worms that inhabit the gastrointestinal tract.
   • Examples: Pinworms, tapeworms.

Infection Examples and Treatments

• Bacterial Infections:
  • Staphylococcus aureus: Causes boils, toxic shock syndrome. Treatment:
  • Mild infections treated with nafcillin, oxacillin, or cefazolin.
  • MRSA (Methicillin-resistant Staphylococcus aureus): Treated with vancomycin.
  • Streptococcus (Group A):
  • Causes strep throat and scarlet fever. Treatment:
    • Penicillin, azithromycin, or clindamycin if allergic.
  • Complications include rheumatic fever.
  • Clostridium perfringens:
  • Causes gas gangrene and food poisoning. Treatment involves surgical management (amputation, supportive care).
  • Clostridium difficile (C. Diff):
  • Associated with antibiotic use, leading to an overgrowth. Treatment:
    • Oral vancomycin or metronidazole for severe cases.
• Viral Infections:
  • Influenza (A & B):
  • Symptoms include fever, congestion, and muscle aches. Treatment: Tamiflu within 48 hours of symptom onset.
  • Ebola Virus:
  • Initial flu-like symptoms that progress to severe outcomes. Treatment: Supportive care.

Chain of Infection

• Understanding the chain of infection:
  • Infectious agent: The pathogen.
  • Reservoir: The location where the pathogen resides (e.g., body fluids).
  • Portal of exit: How the pathogen exits the reservoir (e.g., blood, respiratory secretions).
  • Transmission mode: How the pathogen spreads (e.g., airborne, direct contact).
  • Portal of entry: How the pathogen enters a new host.
  • Susceptible host: An individual who is at risk of infection.

Body Defenses Against Infections

Primary Defenses:

1. Skin
2. Mucous membranes (trap pathogens with mucus)
3. GI tract (acidic environment helps kill pathogens)

Secondary Defenses:

1. Inflammatory process (redness, warmth, swelling)
2. Fever (body's response to elevate temperature to combat pathogens)
3. Complement cascade (proteins that aid in destroying invaders)
4. White blood cells (phagocytes and lymphocytes).

Factors Affecting Defenses:

• Age, chemical exposures, chronic illness, lack of rest, stress, poor nutrition, non-intact skin.

Medical Sepsis or Aseptic Technique

• Definition: Techniques to reduce the risk of infections.
• Consists of:
  • Standard precautions and transmission-based precautions.
  • Maintaining a clean environment (disinfection, timely cleaning).

Standard Precautions:

• Always used, regardless of patient's known infection status.
• Includes hand hygiene, proper use of PPE, safe needle handling.
• PPE donning order: gloves, gown, mask, face shield.
• Removal order: gloves, gown, face shield, mask, hand hygiene.

Transmission-Based Precautions:

• Used for known or suspected infections.
• Examples include airborne (tuberculosis), droplet (influenza), and contact precautions (MRSA).

Nursing Considerations

• Importance of patient assessment and communication with patients in isolation.
• Clustering cares can minimize PPE removal, reducing cross-contamination risk.
• Understanding incidence and prevalence data for education on infection risks.
• Therapeutic communication and active listening are vital in patient interaction.

Care Plans and Implementation

• Use of nursing diagnosis to guide patient care.
• Example Care Plan: Hospital-acquired MRSA.
  • Assess wound appearance, vital signs, pain levels, and lab values.
  • Nursing diagnoses crafted from data collected and patient needs.
  • Interventions aimed at infection control, pain management, and patient support.
  • Evaluation to reflect outcomes achieved against planned goals.

Conclusion

• Thorough understanding of infection control procedures and the application in nursing practice is critical for effective patient care.
• Continuous updating of knowledge regarding best practices in nursing education and infection prevention is important.
• Commitment to teamwork and ongoing communication enhances care and patient outcomes.