Infection prevention and control (ch. 28)

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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*


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