Chapter 29: Infection Prevention And Control Flashcards Preview

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Flashcards in Chapter 29: Infection Prevention And Control Deck (88)
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1
Q

Patients are at risk for acquiring infections due to:

A
  1. Lower resistance to pathogens
  2. Increased exposure to pathogens-some of which are resistant to most antibiotics
  3. Invasive procedures
2
Q

Health care workings are at risk for acquiring infections due to:

A

Contact with patient blood, body fluids and contaminated equipment and surfaces.

3
Q

Infection

A

Invasion of a susceptible host by pathogens or microorganism resulting in disease.

4
Q

Colonization

A

The presence and growth of microorganisms with a host but without tissue invasion or damage.

5
Q

Non-communicable disease

A

Illness that is serious for patient but have a low/no risk for transmission (pneumonia, viral meningitis)

6
Q

Communicable disease

A

Can be transmitted from one person to another

7
Q

Chain of infection

A
  1. Infectious agent
  2. Reservoir
  3. Portal of Exit
  4. Mode of Transmission
  5. Portal of Entry
  6. Susceptible Host
8
Q

Infectious Agent

A
  • bacteria, viruses, fungi, Protozoa
  • resident or transient flora
  • virulence-ability to produce disease
  • their ability to enter and survive in the host
9
Q

Reservoir

A

-place where microorganisms survive, multiply and await transfer to susceptible host.

10
Q

Host’s include

A

Insects, food, water, organic matter or inanimate surfaces

11
Q

Common reservoirs for health care-associated infections (HAI’s) include:

A

Health care workers hands, patients, equipment and the environment.

12
Q

Optimal Conditions of the Reservoir: Food

A

Nourishment in the form of organic or inorganic matter

13
Q

Optimal Conditions of the Reservoir: Oxygen

A

Aerobic-requires O2 (s. Aureus), Anaerobic-requires little or no O2

14
Q

Optimal Conditions of the Reservoir: Water

A

Moist environment. May form a “spore” which is resistant to drying (C-diff)

15
Q

Optimal Conditions of the Reservoir: Temperature

A

Cold tends to prevent growth

16
Q

Optimal Conditions of the Reservoir: pH

A

The acidity of the environment

17
Q

Optimal Conditions of the Reservoir: Light

A

Thrive in dark environments

18
Q

Portal of Exit includes sites such as

A
  1. Blood: normally sterile. With Hep B, C r HIV becomes a reservoir/portal
  2. Skin and mucous membranes: any break in the skin or mucous membranes allows pathogens to exit the body
  3. Respiratory Tract: cough and sneeze
  4. GI/GU tract: mouth, stool, urine, saliva, sputum, wound drainage.
  5. Reproductive tract: mother to fetus, sexual contact
19
Q

Mouth is the most

A

Bacterial lay contaminated parts of the body

20
Q

Modes of Transmission

A
  1. Direct
  2. Indirect
  3. Droplet
  4. Airborne
  5. Vehicles
  6. Vector
21
Q

Direct Transmission

A

Person to person

22
Q

Indirect Transmission

A

Person touching contaminated inanimate object

23
Q

Droplet Transmission

A

Large particles that travel up to 3 feet during coughing, sneezing or talking

24
Q

Airborne

A

Smaller droplets suspended in air for longer periods of time

25
Q

Vehicle Transmission

A

contaminated items: food, drugs, blood, food

26
Q

Vector Transmission

A

Flies, mosquitos, louse, fleas, ticks either external or internal transmission (between parasite and host)

27
Q

Depressed immune system reduces the body’s defenses therefore

A

increasing the chance of pathogens entering the body.

28
Q

Portals of Entry

A
  1. Skin
  2. Respiratory tract
  3. GI tract (mouth)
  4. GU tract (poor peri are, Foley catheters)
29
Q

Host

A

A susceptible individual to the strength and numbers of microorganisms

30
Q

Factors that make people susceptible to infection include

A

Age, nutritional status, presence of chronic disease, trauma and smoking.

31
Q

Frequent and inappropriate use of antibiotics over the years is associated with an

A

Increased resistance to microorganisms.

32
Q

The chain of infection can be interrupted by following the standard precautions/infection prevention:

A
  1. Hang hygiene
  2. Education using cough etiquette
  3. Proper use of PPE (Personal Protective Equipment)
  4. Proper use of isolation procedures
33
Q

Localized infection

A

Localized symptoms: pain, tenderness, redness at the site, edema, heat, and loss of function in the affected body part.

34
Q

Systemic infection

A

Affects the entire body’ fever, leukocyte sits, malaise, n/v, organ failure(sepsis)

35
Q

Sepsis

A

Fatal if untreated

36
Q

Some of the body’s natural defenses include

A

Normal floras and inflammation

37
Q

Normal floras

A

Participate in maintaining health when residing in their usual area’ skin, wall of the intestine

38
Q

Use of ____________________ disrupt the normal floras. This can lead to __________________.

A

Use of BROAD SPECTRUM ANTIBIOTICS disrupt the normal floras. This can lead to A SUPRAINFECTION BY KILLING OFF THE BODY’S OWN NORMAL FLORA IN ADDITION TO THE INVADING ORGANISMS.

39
Q

Inflammation

A
  • Cellular response of the body to injury, infection or irritation.
  • Protective vascular reaction that delivers fluid, blood products and nutrients to an injured area of the body.
40
Q

Phagocytosis

A

Destruction and absorption of bacterial neutrophils and monocytes (WBC’s) ingest and destroy microorganisms.

41
Q

Inflammatory Exudate

A

Serous (clear), sanguine out (containing blood, purulent (contain WBC’s and bacteria-Puss)

42
Q

HAI’s (Health Care Associated Infections)

A

-Aka Nosocomial infections

43
Q

What causes HAI’s?

A
  • invasive procedures
  • antibiotic administration
  • presence of multi-drug resistant organisms
  • breaks in infection prevention and control measures.
44
Q

Patients at risk for HAI’s include

A

Usually older adults, poorly nourished and have multiple illnesses/co-morbidities (diabetes, malignancies) causing a lowered resistance to infection.

45
Q

Latrogenic Infections

A

Inadvertent adverse effect or complications directly resulting from a diagnostic or therapeutic procedure such as a surgical infection.

46
Q

HAI’s are considered what type of infection

A

Exogenous

47
Q

Exogenous infection

A

Infection from organisms found outside the body (salmonella, tetanus)

48
Q

Endogenous Infection

A

Infection from the patient’s own flora (C-diff)

49
Q

Major sites for HAI’s include:

A
  • Surgical or traumatic wounds
  • urinary and respiratory tracts
  • bloodstream infections
50
Q

How does HAI’s affect health care?

A
  • Significantly increases the cost of health care.
  • often costs for HAI’s are not reimbursed by CMS/insurance centers
  • Prevention of infection has a beneficial financial impact.
51
Q

Factors Influencing Infection Prevention and Control

A
  1. Age
  2. Nutritional Status
  3. Stress
  4. Disease Process
52
Q

How Age influences infection prevention and control?

A

Very young and older adults.

  • immunizations at all ages
  • education on healthy/risky behaviors
  • mothers breastfeeding infants. (Infant receives mothers antibodies though the breast milk)
53
Q

How Nutritional Status influences infection prevention and control?

A
  • Direct influence on susceptibility.

- Poor intake of protein, nutrients, carbs, impairs wound healing and body defenses against infection.

54
Q

How stress influences infection prevention and control?

A

Includes emotional and physical stress.

-general adaptation syndrome/stress response: cortisone levels increase resulting in decreased resistance to infection.

55
Q

How does the disease process influence infection prevention and control?

A

Diseases of the immune system present the greatest risk.

56
Q

How does diseases like Leukemia, AIDS, lymphoma, and cancer influence infection prevention and control?

A

Inability to produce enough WBC to fight infection.

General debilitation and nutritional impairment.

57
Q

How do chronic diseases such as diabetes influence infection prevention and control?

A

Poor nutritional status and general debilitation.

58
Q

How does diseases such as emphysema and bronchitis influence infection prevention and control?

A

Impairs ciliary action.

Thickens secretions.

59
Q

How does peripheral vascular disease and burns influence infection prevention and control?

A

Decreases blood flow to injured tissues and increases susceptibility to infection.

60
Q

Always make ___________ clinical decisions

A

Patient-centered

61
Q

Conduct a thorough physical assessment including:

A
  • travel history, immunization/vaccination history
  • medication history/therapy: meds that compromise immunity, OTC/herbals
  • status of defense mechanisms: breaks in the skin, ability to cough
  • patient susceptibility: age, nutritional status, stress, disease process
  • laboratory findings, WBC’s, blood cultures
62
Q

Clinical Appearance-Assessment

A

Look for S&S of localized and/or systemic infection:

Localized and systemic

63
Q

Nursing Diagnosis

A

The accuracy of the diagnosis depends on the accuracy of the R/T factors (clusters of assessment data), which then influences establishing a measurable outcome and individualized nursing interventions.
*ALWAYS PRIORITIZE YOUR NURSING DIAGNOSIS

64
Q

Types of Outcomes include

A
  1. Realistic
  2. Purposeful - uses action verbs
  3. Measurable
  4. Time Specific - ex) by discharge, by the end of my teaching session
65
Q

Interventions

A

Collaborate with patient, family and interdisciplinary health care team.

66
Q

Health Promotion (Implementation)

A
  • Use critical thinking skills to prevent infection from developing or spreading
  • encourage immunization so
  • eliminate reservoirs of infection including ports of exit and entry
  • prevent transmission
  • implement techniques/procedures to prevent spread of infection to yourself and others
  • maintain the patients skin integrity
67
Q

Implement

A

By choosing the appropriate individualized diagnosis, outcome and interventions, you can then implement measures to effectively reduce the risk of infection

68
Q

Evaluate

A

Were outcomes achieved?

  • Document patient responses to treatments
  • Revise what isn’t working
  • Marks as “complete” the nursing diagnosis that are solved and no longer applicable (saves the time of your peers in re-asking the patient about resolved issues.)
69
Q

Asepsis

A

Absence of disease-producing microorganisms. Refers to the techniques/procedures to help reduce infection

70
Q

Standard Precautions

A

All precautions used as a general rule to help prevent the spread of infection: hand hygiene, the use of PPE

71
Q

Medical Asepsis

A

“Clean technique”. Procedures used to REDUCE the number of microorganisms.
Ex) hand hygiene, Barriers, PPE, routine environmental cleaning.

72
Q

Surgical Asepsis

A

(Sterile Technique) considered FREE of microorganisms.
Ex) during the insertion of IV’s, central lines, Foley Catheters, and any procedure that requires intentional perforation of the patient’s skin.

73
Q

_____________ are a primary source of transmitted infection.

A

Contaminated hands of health care workers.

74
Q

Washing with soap and water

A

Using friction followed by rinsing underwater for 15 sec.
Used when hands are visibly dirty, soiled from blood/body fluids.
Also when dealing with c-diff, before and after using the toilet.

75
Q

Alcohol based hand antiseptic is used when

A
  • hands are not visibly soiled
  • routine decontamination before, after and between patient contact.
  • moving from a contaminated to clean body site during patient care
  • before donning sterile gloves
  • after removing gloves
  • before caring for patients with severe neutropenia/immune suppression
76
Q

Information regarding PPE

A
  • don’t wear outside of patients room
  • do not wear gloves outside of a patients room unless you are carrying waste to a dirty utility room.
  • a mask that has become moist does not provide a barrier to microorganisms and is ineffective
  • N95 respirators are specially fit annually. No students are to care for patients that require the use of an N95 mask.
  • eye glasses are not the same as protective goggles
  • Change gloves as many times as necessary in the patient’s room
  • any sterile surface that becomes wet is no longer sterile
  • wear as much PPE as you want anytime you want
77
Q

Patient teaching

A

-do not forget to teach the patient and family the proper techniques for the spread of infection including:
Hand hygiene, use of PPE, the reason for isolation practices and cough etiquette.

78
Q

Isolation Precautions

A

The restriction of movement for ill persons with contagious diseases.

79
Q

CDC (2007) Two-tier approach

A
  1. Standard Precautions

2. Isolation Precautions

80
Q

Isolation precautions is based on

A

The mode of transmission of a disease. Diligent use of infection prevention principles.

81
Q

Isolation Precautions against airborne

A

TB, negative airflow rooms, and N95 respirator mask

82
Q

Isolation Precautions for Protective Environments

A

(Reverse isolation-immune compromised positive air flow) No plants or flowers.

83
Q

Psychological Implications of Isolation

A

-Isolation may leave patient feeling lonely, depressed, rejected, embarrassed, etc.

84
Q

Tips for the Psychological Implications of Isolation

A
  • explain the reason for isolation measures to patient and family; explain the nature of the disease and importance of carrying out procedures
  • when performing patient care, don’t rush in and out of the room-may leave patient feeling more isolated
  • teach the patient and family the correct isolation practices.
85
Q

Exposure Issues

A

-all health care workers are at an increased risk for acquiring infections

86
Q

Needlestick Safety and Prevention Act

A
  • all sharp boxes need to be available at the site of use
  • implementation of safety needle devices
  • report exposure to contamination/needle sticks immediately (exposure to eyes, open skin areas, mouth, nares)
87
Q

Patient Source Testing

A

Patients are tested upon the report of a needle stick or contamination by a health care worker; depending on the state, may be required or may require patient consent.

88
Q

If patient tests positive for a pathogen or if the source patient is unknown,

A

Prophylactic treatment is recommended for employee.