Infection prevention and control (ch. 28)
Donning is when you put PPE
on
Factors influencing infection prevention and control
-access to clean water Mental status Other illnesses (HIV, diabetes, etc) Nutrition Stress Age
What can impact a person's susceptibility to a disease?
-age -immunodeficient -pregnancy
What increases infection risk?
-increased exposure to pathogens (traveling, work environment, etc) -invasive procedures (IVs, surgery, Foley catheters)
When is peak drawn?
1 hour after the drug is done infusing (infusion is estimated an hour after giving medicine, so two hours after giving drug)
WHO's five moments for hand hygiene
1. Before touching a patient 2. Before clean/aseptic procedure 3. After body fluid exposure risk 4. After touching a patient 5. After touching patient surroundings
Key points in surgical asepsis (4)
1. Hands stay above waist (anything below waist is contaminated) 2. Anything you turn your back on or take your eyes off is considered contaminated 3. Outer 1 inch of field is considered contaminated (ex. Utensil on sterile field is at the edge) 4. Have everything you need to perform or have someone on standby to get things
To reduce transmission of infection, arrange steps for applying PPE in correct order
1. Perform hand hygiene 2. Apply gown 3. Put on mask 4. Put on eyewear 5. Put on gloves
When the nurse leaves an isolation room, arrange steps of PPE removal in order
1. Remove gloves 2. Remove eyewear 3. Remove gown 4. Remove mask 5. Perform hand hygiene
Normal range for procalcitonin
<0.05
*Modes of transmission* particles become suspended in the air. Could literally just take breathing in the wrong spot
Airborne
— —: •using antibiotics appropriately and cautiously •microorganisms can evolve and become resistant. Over using makes this worse
Antibiotic stewardship
You should get cultures from patient before giving them first dose of — because it can alter results
Antibiotics
Antifungal therapy is also known as
Antimycotic drugs
Microorganisms include
Bacteria Fungus Viruses Protozoa
What does antibacterial therapy treat?
Bacterial infections
Broad spectrum vs. narrow spectrum
Broad: effective against many species Narrow: one restricted group of microorganisms
*hospital acquired infections* You are not to use sanitizer with —- (won't get rid of spores). Must wash hands thoroughly May be related to antibiotic use S/S: foul smelling, watery diarrhea
C. Diff
*hospital acquired infections* 75% of HAIs May be related to unsterile insertions, frequent catheterizations, poor peri care, improper drainage management S/S: fever, AMS, change in urine
Catheter-associate urinary tract infection (CAUTI)
*hospital acquired infections* may be related to unsterile insertion or frequent manipulation S/s: depends on severity. Lethargy, fever, chills, AMS (altered mental status), hypotension
Central line-associated bloodstream infection (CLABSI)
Medical asepsis to control/eliminate infectious agents includes
Cleaning Disinfection/sterilization Protection of susceptible host Control reservoirs of infection Control portals of exit/entry Control transmission
Pathogens are just kind of "hanging out". Not causing symptoms, disease, etc.
Colonization
— disease: transmitted from one person to another
Communicable
Infections acquired in the hospital
Healthcare acquired infection
*hospital acquired infections* may be related to altered LOC, aspiration, tracheostomy, PEG tube, post operative mobility S/S: fatigue, fever, chills, cough, dyspnea, hypoxia
Hospital-Acquired Pneumonia (HAP)
Body can't fight off pathogens that it normally could
Immunosuppression
*Modes of transmission* contaminated objected (can live on objects for months)
Indirect contact
Pathogens are invading, multiplying, causing illness, etc
Infection
— —: •control/elimination of infectious agents •cleaning •disinfection/sterilization •protection of susceptible host •control reservoirs of infection •control portals of exit/entry •control transmission
Medical asepsis
Normal bacteria that doesn't cause harm and is always on you
Normal flora
You are caring for a patient who underwent surgery 48 hours ago. On physical assessment, you notice that the wound looks red, swollen, and has purulent drainage. The patient's WBC are 15,000. You should:
Notify the provider
Health promotion to prevent infection
Nutrition Hygiene Immunizations
Docking is when you put PPE
Off
Highest level of medication in blood stream
Peak
PCT means
Procalcitonin
>10 procalcitonin means
Severe bacterial sepsis, septic shock
— — syndrome: •rare reaction to antibiotics (serious) •flu like symptoms. Like purple colored rash, skin can peel, 1-3 days after antibiotic therapy
Steven-Johnson
*hospital acquired infections* may be related to breach in sterile technique, improper skin prep, contamination during dressing change S/S: warmth, erythema, purulent drainage, separation of tissues
Surgical site infection
How likely a person is to get a disease or illness
Susceptibility
If there are no WBCs, pathogens
Take over (illness)
*Modes of transmission* living organisms that transmit the pathogens (ticks, mosquitoes, fleas, etc)
Vectors
*Modes of transmission* contaminated items (remote, pen, water, etc)
Vehicles
Can a localized infection become systemic?
Yes
Opportunistic infection:
an infection that causes disease when the immune system is compromised for other reasons Ex. Patients on multiple antibiotics are susceptible to yeast infections
Localized vs systemic infection
localized: in one specific area, symptoms usually include pain, tenderness, warmth, redness around site. Systemic: infection affects entire body. symptoms may be fever, malaise, change in LOC, muscle ache.
Defenses against infection
normal flora, body system defenses, inflammation
*Modes of transmission* person to person contact
Direct contsct
*Modes of transmission* coughing, sneezing, snotty nose, etc (can spread up to about 6 ft.)
Droplets
You can't make people get vaccinations but you can
Educate them *document the education given*
