Definition of Terms

Parasite microorganism that lives in or on another

and obtains its nourishment from it Pathogenecity virulence and potency of microorganism Colonization presence of organisms in body secretions or excretions that does not cause illness Carrier person or animal that harbors a specific infectious agent and serve as potential source of infection yet does not manifest signs of disease

Definition of Terms
Susceptible host any person who is at risk for

infection Compromised host person at increased risk, who for one or more reason more likely than others to acquire an infection Bactericidal agents that destroys bacteria Bacteriostatic agents that prevents the growth and reproduction of some bacteria Sterilization process that destroys all microorganisms, including spores and viruses Spores round or oval structure enclosed in a tough capsule

Definition of Terms
Infection invasion of body tissue by any

microorganism Antiseptics agents that inhibit the growth of some microorganisms Disinfectants agents that destroy pathogens other than spores and sterilization

Types of Infection
1. Local Infection- Is limited to specific part of

the body where the microorganisms remain. 2. Systemic Infection Microorganisms spread and damage different parts of the body. 3. Bacteremia When a culture of the persons blood reveals a microorganisms. 4. Septicemia When bacteremia results in systemic infection.

Types of Infection
Acute Infection Generally appear and suddenly or

last a short time. Chronic Infection- may occur slowly, over a long period, and may last months or years. Nosocomial Infection are classified as infections that are associated with the delivery of health care services in a health care facility
Endogenous source microorganism causing disease

originates from the client Exogenous source Coming from the hospital environment or hospital personnel. Iatrogenic infection - are the direct result of diagnostic or therapeutic procedures

Chain of Infection
Etiologic agent microorganism
Reservoir Portal of exit from the reservoir Method/mode of transmission Portal of entry into a host Susceptibility of the host

Chain of Infection
INFECTIOUS AGENT
A microbial organism with the ability to cause

disease. The greater the organism's virulence (ability to grow and multiply), invasiveness (ability to enter tissue) and pathogenicity (ability to cause disease), the greater the possibility that the organism will cause an infection Infectious agents are bacteria, virus, fungi, and parasites.

Chain of Infection
RESERVOIR A place within which microorganisms can thrive and reproduce For example, microorganisms thrive in human beings, animals, and inanimate objects such as water, table tops, and doorknobs. PORTAL OF EXIT A place of exit providing a way for a microorganism to leave the reservoir For example, the microorganism may leave the reservoir through the nose or mouth when someone sneezes or coughs Microorganisms, carried away from the body by feces, may also leave the reservoir of an infected bowel.

Chain of Infection
MODE OF TRANSMISSION Method of transfer by which the organism moves or is carried from one place to another The hands of the health care worker may carry bacteria from one person to another. PORTAL OF ENTRY An opening allowing the microorganism to enter the host. Portals include body orifices, mucus membranes, or breaks in the skin Portals also result from tubes placed in body cavities, such as urinary catheters, or from punctures produced by invasive procedures such as intravenous fluid replacement.

Chain of Infection
SUSCEPTIBLE HOST
A person who cannot resist a microorganism

invading the body, multiplying, and resulting in infection The host is susceptible to the disease, lacking immunity or physical resistance to overcome the invasion by the pathogenic microorganism.

Mode of Transmission
Direct immediate and direct transfer of

microorganisms from person to person

Touching, biting, kissing, sexual intercourse
Droplet (within 3 feet)

Indirect vehicle-borne or vector-borne Vehicle-borne substance that serves as an intermediate means to transport and introduce an infectious agent into a susceptible host through a suitable portal of entry Vector-borne animal or insect that serves as an intermediate means of transporting the infectious agent Airborne occurs when droplet nuclei emitted by an

infected host are transmitted by air currents to a suitable portal of entry

Breaking the Chain of Infection

Etiologic agent Correctly cleaning, disinfecting or sterilizing articles before use Educating clients and support persons about appropriate methods to clean, disinfect, and sterilize article

Reservoir (source)
Changing dressings and bandages when soiled or wet Appropriate skin and oral hygiene Disposing of damp, soiled linens appropriately Disposing of feces and urine in appropriate receptacles Ensuring that all fluid containers are covered or capped Emptying suction and drainage bottles at end of each shift or

before full or according to agency policy

Breaking the Chain of Infection

Portal of exit Avoiding talking, coughing, or sneezing over open wounds or sterile fields Covering the mouth and nose when coughing or sneezing Method of transmission Proper hand hygiene Instructing clients and support persons to perform hand hygiene before handling food, eating, after eliminating and after touching infectious material Wearing gloves when handling secretions and excretions Wearing gowns if there is danger of soiling clothing with body substances

Breaking the Chain of Infection

Method of transmission
Placing discarded soiled materials in moisture-proof

refuse bags Holding used bedpans steadily to prevent spillage Disposing of urine and feces in appropriate receptacles Initiating and implementing aseptic precautions for all clients Wearing masks and eye protection when in close contact with clients who have infections transmitted by droplets from the respiratory tract Wearing masks and eye protection when sprays of body fluid are possible

Breaking the Chain of Infection

Portal of entry Using sterile technique for invasive procedures, when exposing open wounds or handling dressings Placing used disposable needles and syringes in puncture-resistant containers for disposal Providing all clients with own personal care items Susceptible host Maintaining the integrity of the clients skin and mucous membranes Ensuring that the client receives a balanced diet Educating the public about the importance of immunizations

Stages of Infectious Process

Incubation period time between the entry of the microorganism into the body to the onset of symptoms
Prodromal period time from the onset of nonspecific symptoms to onset of specific symptoms Illness period Convalescence time the symptoms start to abate until the person returns to normal state of health

Signs of Inflammation
1. Redness (rubor)
2. Heat (calor or color) 3. Swelling (tumor) 4. Pain (Dolor) 5. Impaired function of the part (functio

laesa)

Signs of Systemic Infection

Fever
Increased pulse and respiratory rate if the fever high Malaise and loss of energy Anorexia and, in some situations, nausea and vomiting Enlargement and tenderness of lymph nodes that

drain the area of infection

Signs of Infection
Laboratory data
Elevated WBC count Increase in specific WBC types

Elevated ESR
Cultures of urine, blood, sputum, or other

drainage

SOURCE 1. Active Antibodies are produced by the body in response to an antigen Long

a. Natural

Antibodies are formed in the Lifelong presence of active infection in the body
Antigens (vaccines or toxoids) are administered to stimulate antibody production Antibodies are produced by another source, animal or human Antibodies are transferred naturally from an immune mother to her baby through the placenta or in colostrum Immune serum (antibody) from an animal or another human is injected 6 months to 1 yr Many years; the immunity must be reinforced by booster

b. Artificial

2. Passive

a. Natural

b. Artificial

2 to 3 weeks

FACTORS INCREASING SUSCEPTIBILITY TO INFECTION

Age
Heredity Nature, number and duration of physical and

emotional stressor Resistance to infection Some medical therapies Any disease that lessens the bodys defense against infection

NANDA Diagnosis
Risk for Infection
State in which an individual is at increased risk

for being invaded by pathogenic microorganisms Risks factors Inadequate primary defenses Inadequate secondary defenses

ASEPSIS
Freedom from infection or infectious materials 2 types: MEDICAL ASEPSIS all practices intended to confine a specific microorganisms to a specific area limiting the number, growth and transmission of microorganism

CLEAN denotes the absence of microorganisms DIRTY (SOILED/CONTAMINATED) denote the likely presence of microorganisms, some of which may be capable of causing infection

SURGICAL ASEPSIS (sterile technique) practices that

keep an object or area free of all microorganisms; includes practices that destroy all microorganisms and spores

Sterilization
Sterilization Is a process that destroys all

microorganisms, including spores and viruses. Four commonly methods of sterilization:

Moist Heat For sterilizing, moist heat (steam) can be

employed in two ways Gas Ethylene oxide gas destroys microorganism interfering with their metabolic processes. It is also effective against spores. Boling water Most practical and inexpensive method of sterilizing in the home Radiation Both ionizing ( such as alpha, beta, and xrays) and non-ionizing (ultraviolet light) radiations are used for disinfection and sterilization.

Isolation
Isolation measures designed to prevent the spread of infections to health personnel, clients, visitors
Category-specific Isolation Precaution

Strict isolation Contact isolation Respiratory isolation Tuberculosis isolation Enteric precautions Drainage/secretions precautions Blood/body fluid precautions

Isolation
Disease-specific isolation precaution
Use of private rooms with special ventilation Cohorting clients infected with the same

organism Gowning to prevent gross soilage of clothes

Universal Precautions (UP)

Used with all clients
Decrease the risk of transmitting unidentified pathogens Obstruct the spread of bloodborne pathogens (hepatitis B and C viruses and HIV) Used in conjunction with disease-specific or

category-specific precautions

Body Substance Isolation (BSI)

Employs generic infection control precautions for all

clients Body substances include:

Blood

Urine
Feces Wound drainage Oral secretions Any other body product or tissue

Standard Precautions
Used in the care of all hospitalized persons regardless of their diagnosis or possible infection status
Apply to
Blood All body fluids, secretions, and excretions except sweat

(whether or not blood is present or visible) Nonintact skin and mucous membranes

Combine the major features of UP and BSI

Transmission-based Precautions
Used in addition to standard precautions
For known or suspected infections that are spread in

one of three ways:

Airborne Droplet Contact

May be used alone or in combination but always in

addition to standard precautions

Personal Protective Equipment

Gloves worn to protect the hands when the nurse is

likely to handle body substances Gown worn when the nurses uniform is likely to become soiled Face masks worn to reduce the risk of transmission of organisms by droplet contact, airborne routes, splatters of body substances Eye wear protection from body substances that may splatter

HANDWASHING
Most effective infection control measures
Done before eating, after using toilet/bedpan/urinal,

after coming in contact with any body substances, before and after giving care

Hand washing Procedure

Determine the location of the running water and soap

or soap substitutes Assemble all the equipments needed

Soap

Running water
Disposable or sanitized towels

Assess the hands Nails should be kept short Remove all jewelry Check for breaks in the skin

Hand washing Procedure

Turn on the water and adjust the flow Wet the hands thoroughly by holding them under the

running water
Hold the hands lower than the elbows so that the water flows

from the arms to the fingertips

Apply soap and do the following strokes: Palm to palm Palm over dorsum Palm to palm with fingers interlaced Back of fingers to opposing palms Rotate thumbs in palm Rotate fingers in palm Rub the fingertips against the palm of the opposite hand

Hand washing Procedure

Rinse the hands
Thoroughly dry the hands and arms
Discard disposable towels in the appropriate

container Turn off the water In the hand operated control faucet, use the paper towel to turn off the faucet

Sterile Technique
Sterile free of all microorganism
Sterile field microorganism-free area
Ensure that sterile items remain sterile

Sterile gloves