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Nursing Therapeutics I > Infection Control > Flashcards

Flashcards in Infection Control Deck (40):

Infectious Agent

-microorganism such as fungi, protozoa, bacteria, virus
-major pathogens: resident flora and transient flora


resident flora

-reside in deep layers of skin and resistant to removal
-normal body flora resists infection


transitent flora

-attach with contact, colonize on superficial layers of skin
-easily removed with hand washing
-most associated with health care acquired infection and may cause disease if: sufficient in number
-must be virulent, have the ability to produce disease (virulence)
-have the ability to enter and survive in a host
- if the host is susceptible (immunosupressed, malnourished, chronic illness)



-where pathogen exists but may or may not multiple: may or may not cause disease
-most common reservoir is the human body, others include animals, insects, food, shellfish, inanimate objects
-carrier: the pathogen exist and may be transmitted, but the person does not have the disease
-example pertinent to nursing is Hepatitis B



-the pathogen exist and may be transmitted, but the person does not have the disease
-example pertinent to nursing is Hepatitis B


Microorganisms need an environment to survive....

-generally multiply in dark, moist, alkaline, warm environments
1. food: depending on organism, need or inorganic material (Ecoli: undigested food in the colon)
2. oxygen: most require O2 and are called aerobic (staph and strep); other microorganisms in deep tissues (joints, sinus tracts, lungs) are anaerobic (tetanus, gangrene) do not require O2.
3. water: moisture such as drainage. However, some form spores so that they are resistant to drying such as anthrax, tetanus and botulism
4. temperature: generally survive in least 95 degrees
5. PH: grow in alkaline environments 5-8. Acid generally kills bacteria such as in the stomach...but antacids make this environment more alkaline
6. light: dark body cavities, under dressings. Ultraviolet light used with many products to kill bacteria (meats, milk)


Portal of Exit

1. break in the skin where drainage is discharged
2. respiratory tract (cough and sneeze, even normal breathing, trachs)
3. urinary tract (urine is normally sterile)
4. GI tract (saliva from mouth, vomit, bowel elimination, and GI drainage)
5. Reproductive tract (vaginal discharge, semen)
6. Blood (normally sterile, but blood from break in the skin ... Hep B or C


mode of transmission

1. airborne by droplet in air or carried on dust
2. direct, indirect, or droplet contact, direct touching (staph, Herpes, Ecoli), contact with contaminated object (needles, Hep B) or by close contact (flu, measles...viruses)
3. vehicles: non-living, contaminated sources such as water, blood, food, solutions and drugs
4. Vector: mosquito, louse, flea, another living thing
-in healthcare, most often transmission is by hands and contaminated equipment (stethoscope, thermometers, diagnostic equipment)


portal of entry

enters a person in the same manner that it exists


susceptible host

-may enter a person, but that person must be susceptible/ weakened resistance


breaking the chain of infection

1. control or eliminate infectious agents (clean, disinfect)
2. reduce/eliminate reservoirs (bathing, dressing changes, proper disposal of equipment, empty drainage tubes, tubes kept below level of site
3. Control Portals of Exit (cover sneeze and cough, wear mask, wear gloves)
4. control transmission (individual equipment, avoid direct, indirect contact with soiled items, hand washing
5. control portals of entry (skin intact by using lotion, cleanse patient appropriately, avoid needle sticks, and handle equipment appropriately)
6. protect host (isolation precautions if necessary, maintain normal body flora)
Key concept: break chain of infection by breaking chain between portal of exit and transmission
-hand washing is the most important factor in controlling the transmission of infection. Cleansing requires friction/mechanical action for at least 10-15 seconds


factors that contribute to a patient's susceptibility to infection

1. age: infants and elderly are most susceptible
2. skin: broken vs. intact. function of skin is to protect, reduce H2O loss, barrier
3. mouth: poor oral hygiene
4. Respiratory Tract: smoking, allergies
5. Urinary Tract: catheter, tumor, obstruction, irritation from clothing
6. GI tract: overuse of antacids, delayed motility from drug use, constipation
7. vaginal: overuse of douche, birth control devices/foams, jellies, tampons
8. lifestyle factors/ stress
9. nutritional status / heredity
10. presence of disease, chronic or acute/ medical therapy (drugs)
11. compromised immune status (chemo, radiation, low WBC, low hemoglobin)
12. lack of recommended immunizations



absence of pathogenic microorganism



contains or is suspected of containing pathogens (something dropped on the floor)


medical asepsis

-clean technique, does not eliminate all microorganisms but does reduce and prevent spread of microorganisms.
-surgical asepsis eliminates all microorganisms



organism capable of producing disease


standard precautions

generic barrier techniques when caring for clients (formerly known as universal precautions)
-same care for everyone


protective isolation

-room that has an ante-room, positive pressure airflow to keep out microorganisms, special infection prevention techniques utilized including Personal Protective Equipment (PPE)
-protecting patient from us


Health Care- Associated Infection (HAIs)

-an infection that results from delivery of health services in a health care setting
-it can be exogenous (from external sources and are not normal floras such as salmonella from food) or endogenous (from inside the person where normal flora is altered such as ecoli: hand to mouth)
-formally called nosocomial infections or health care acquired infections


Iatrogenic infections

are a type of HAIs that result from diagnostic or therapeutic procedures (colonoscopy, antibiotic therapy)


Factors involved in occurrence of health care associated infections

-hospitals harbor a high population of virulent microorganisms
-transmission occurs primarily by health care workers
-invasive procedures/presence of open wounds/drainage
-high use of antibiotics contributes to development of resistant forms of microorganisms


major sites for HAIs

1. urinary tract (it is normally sterile)
2. respiratory tract
3. bloodstream
4. wounds


research shows that HAIs increase with

1. invasive procedures (catheterization is highest incidence)
2. long term hospitalization
3. contact with health care workers...more contact more infection



entry multiplication of infectious agents (bacteria, virus, fungi or protozoa) in living tissues of host


localized infection

contained in one body organ or area
-wound infection, urinary tract infection


systemic infection

affects entire body and can be fatal



- a protective response to the immune response to injury or infection
-works to eliminate pathogens (bacteria, viruses) and repair damaged tissues
-localized signs: redness, swelling, pain or tenderness of the affected body part, warmth
-systemic signs: fever, fatigue, malaise, decreased appetite, nausea and or vomiting



- produce immunity to diseases by stimulating the immune response with dead or weakened viruses or bacteria


Acquired immunity

-produced by vaccination or illness
-person makes their own antibodies
-(get vaccine, getting the disease )


Passive immunity

-produced by administration of immunoglobulin (antibodies) to protect against disease, offers protection for limited time
- get someone else's antibodies
-baby gets maternal antibodies from the umbilical/breast milk
-exposed to the disease then get a shot like rabbies
-not long lasting protection



prevents the development, growth and reproduction of bacteria


bactericidal agents

destroy all bacteria (high temperature)
-antimicrobial soaps are recommended
-plain soap is not as effective and becomes contaminated
-Chlorhexidine is considered the most effective
-Iodine is rarely used anymore
-addition of silver polymers (Surfacin) most recent development
-alcohol (62-95% concentration) denatures proteins and work on resistant bacteria (MRSA)


Circumstances that necessitate washing of the hands

1. visibly soiled hands require washing with soap and water
-alcohol-based hand rub may be used when hands are not visibly soiled
2. soap and water used after using restroom, after eating, after accidental contact with body fluids
3. prior to contact with a patient
4. decontaminate hands after direct contact with a patient's intact skin, such as taking pulse, blood pressure, or lifting a patient
5. before donning gloves: use of gloves does not replace washing hands
6. after removing gloves: do not reuse gloves
7. Prior to invasive procedures
8. after contact with blood, fluids, non intact skin
9. when moving from a contaminated body site to a clean body site during care
10. after contact with medical equipment in the vicinity of the patient


Correct hand washing technique

-wet hands first, warm water used (hot water coagulates protein)
-use antimicrobial soap to decrease surface tension
-vigorous mechanical friction for at least 15 seconds on all hand and finger surfaces
-rinse hands and dry thoroughly with a disposable towel
-do not wear artificial nails when having direct contact with high risk patients
-keep natural nails trimmed to 1/4 inch. research shows that most colonized micro-organisms are where the nail and skin meet
- jewelry: research shows that rings are substantial factor for carrying gram negative bacteria and staph under the ring. the concentration of the organisms increases with the number of rings. However, it is not conclusive that nurses then transmit these organisms to patients at a higher rate than nurses who do not wear rings
-if using an alcohol-based rub, use sufficient product so that hands remain moist for at least 10 seconds while rubbing all surfaces vigorously


Standard Precautions

-used for all client contact with blood, body fluids, secretions, excretions, non-intact skin, and mucous membranes
-gloves, gowns, eye wear used when there is potential for contact with the above fluids


Tier Two (precautions)

-3 categories based on client infection diagnosis: airborne, droplet, or contact
- also termed transmission based precautions
-al require hand washing, gloving, masks, use of dedicated equipment, and disposal of equipment in a manner to prevent transmission, protection of other clients and visitors and/or private rooms


Protective isolation

-use of gowns, gloves, masks, dedicated equipment, private room to protect client from outside microorganisms


Procedures to prevent the spread of infection by equipment and nurses

1. practice good hand hygiene
2. carry soiled equipment away from the body to prevent contamination
3. do not place objects on the bed or floor. both are contaminated
4. avoid raising dust. do not shake linens. clean items away from yourslef
5. clean from least soiled to most soiled areas
6. dispose of equipment in appropriate containers or bags. Use waterproof containers for items soiled with drainage
7. avoid splattering of fluids such as bath water, irrigation solutions. Wear appropriate gowns, gloves, eyewear to prevent contamination
8. maintain personal grooming. Fingernails short, skin intact (avoid broken cuticles), no rings with stones trap microorganisms
9. sterilize equipment with chemicals or heat. clean stethoscope with alcohol between clients


medical asepsis

-"clean technique" that results in reduction of microorganisms


sterile technique

-use of procedures to eliminate all pathogens, including spores