PNP - Infection Control

Modes of Transmission - Contact [Direct]

- Person-to-person (fecal, oral) physical contact between source and susceptible host (e.g., touching patient feces and then touching your inner mouth or consuming contaminated food)

Defenses against infection

- normal flora - body system defenses (organs - like skin) - inflammation

4 Stages of the Infectious Process

1. Incubation Period 2. Prodromal Stage 3. Illness Stage 4. Convalescence

Chain of infection

1. Portal of exit 2. Portal of entry 3. Reservoir 4. mode of transmission 5. host 6. infectious agent

What will the nurse do first when preparing to apply personal protective equipment (PPE) before caring for a patient in isolation? A. Perform hand hygiene B. Put on the gown C. Put on clean gloves D. Apply eyewear

A. Perform hand hygiene Rationale: Before applying PPE, the nurse should perform hand hygiene.

The nurse is discussing the guidelines for proper use of PPE by nursing assistive personnel (NAP). Which statement made by the NAP requires follow-up by the nurse? A. "When in doubt, I wear gloves." B. "I really dislike wearing a mask, so it's the first thing I take off." C. "I always do hand hygiene when entering and leaving a patient's room." D. "I wear a mask whenever I am caring for a patient who's coughing."

B. "I really dislike wearing a mask, so it's the first thing I take off." Rationale: This statement requires follow-up because the gloves should be removed first when removing PPE, to minimize the chance of contaminating both the mask and the face.

5. When delegating patient care that requires nursing assistive personnel (NAP) to use personal protective equipment (PPE), it is necessary for the nurse to do what first? A. Discuss what equipment and supplies to bring into the patient's room B. Document that the care was delegated to the NAP C. Review the patient's need for a specific isolation precaution D. Observe the NAP donning the appropriate PPE

C. Review the patient's need for a specific isolation precaution Rationale: A first action the nurse will do is review with the assistive personnel (NAP) the patient need for a specific isolation precaution and the necessary personal protective equipment (PPE).

When removing a gown worn as personal protective equipment (PPE) while caring for a patient in isolation, why does the nurse avoid touching the outside of the gown? A. To ensure that the gown can be reused B. To protect the nurse's uniform C. To prevent touching contaminated material with unprotected hands D. To fold the gown correctly for reuse by the same nurse

C. To prevent touching contaminated material with unprotected hands Rationale: The nurse will avoid touching the outside of the gown to ensure that an ungloved hand does not touch the contaminated gown.

Which personal protective equipment (PPE) will the nurse wear if there is a risk of a blood splash when caring for a patient? A. Gown B. Gown and gloves C. Gown, gloves, and mask D. Gown, gloves, mask, and eye protection

D. Gown, gloves, mask, and eye protection Rationale: Wearing a gown, gloves, mask, and eye protection is the correct PPE to don. The eyes must be protected if there is risk of a blood splash.

Modes of Transmission - Contact [Airborne]

Droplet nuclei or residue or evaporated droplets suspended in air during coughing or sneezing or carried on dust particles

Portal of exit

How the bug leaves the body (where the organism leaves the reservoir e.g. respiratory tract, bodily fluids)

Communicable disease

Infectious process transmitted from one person to another.

Course of Infection by Stage - Incubation Period

Interval between entrance of pathogen into body and appearance of first symptoms (e.g., chickenpox, 14 to 16 days after exposure; common cold, 1 to 2 days; influenza, 1 to 4 days; measles, 10 to 12 days; mumps, 16 to 18 days; Ebola 2 to 21 days (CDC, 2015b).

Course of Infection by Stage - Prodromal Stage

Interval from onset of nonspecific signs and symptoms (malaise, low-grade fever, fatigue) to more specific symptoms. (During this time microorganisms grow and multiply, and patient may be capable of spreading disease to others.) For example, herpes simplex begins with itching and tingling at the site before the lesion appears.

Course of Infection by Stage - Convalescence

Interval when acute symptoms of infection disappear. (Length of recovery depends on severity of infection and patient's host resistance; recovery may take several days to months.)

Course of Infection by Stage - Illness Stage

Interval when patient manifests signs and symptoms specific to type of infection. For example, strep throat is manifested by sore throat, pain, and swelling; mumps is manifested by high fever, parotid and salivary gland swelling.

Modes of Transmission - Contact [Droplet]

Large particles that travel up to 3 feet during coughing, sneezing, or talking and come in contact with susceptible host

asymptomatic infection/illness

No clinical signs and symptoms during infection/illness

Colonization

Occurs when a microorganism invades the host but does not cause infection.

Modes of Transmission - Contact [Indirect]

Personal contact of susceptible host with contaminated inanimate object (e.g., needles or sharp objects, dressings, environment)

Hand hygiene

The most important technique to use in preventing and controlling transmission of infection.

Infection control

break the chain of infection via - prevention (immunizations, good hygiene, good health [sleep, diet, exercise]) - medical asepsis (universal precautions: gloves, hand-washing, treating all bodily fluids as infectious) - keep clean and sterile surfaces

Bactericidal

destructive to bacteria

Immunocompromised

having an impaired immune system.

Mode of transmission

how the bug travels (how the organism transfers from one carrier to another via direct or indirect transmission)

Symptomatic infection

multiplication of pathogens causing clinical signs and symptoms.

Bacteriostasis

prevention of growth and reproduction of bacteria.

Aerobic bacteria

require oxygen for survival and for multiplication sufficient to cause disease.

Infectious agent

the "invader"/ agent that causes the infection such as the virus/bacteria/protozoa

Virulence

the ability to produce disease.

reservoir

the bugs home (the place where the microorganism resides, thrives and reproduces)

(susceptible) Host

the person at risk for developing an infectious disease

Anaerobic bacteria

thrive where little or no free oxygen is available.

Portal of entry

where the organism enters the body (usually the same place as the portal of entry)

Modes of Transmission - Vehicles

• Contaminated items • Water • Drugs, solutions • Blood • Food (improperly handled, stored, or cooked; fresh or thawed meats)

Modes of Transmission - Vector

• External mechanical transfer (flies) • Internal transmission such as parasitic conditions between vector and host such as: - Mosquito - Louse - Flea - Tick