1. Chapter 27 Asepsis and Infection Control

2. Components of the Infection Cycle
Infectious agent—bacteria, viruses, fungi
Reservoir—natural habitat of the organism
Portal of exit—point of escape for the organism
Means of transmission—direct contact, indirect contact, airborne route
Portal of entry—point at which organisms enter a new host
Susceptible host—must overcome resistance mounted by host’s defenses

3. The Infection Cycle

4. Infectious Agents
Bacteria—most significant and most prevalent in hospital settings
Virus—smallest of all microorganisms
Fungi—plantlike organisms present in air, soil, and water

5. Classification of Bacteria
Spherical (cocci), rod shaped (bacilli), corkscrew shaped (spirochetes)
Gram positive or gram negative—based on reaction to Gram stain
Aerobic or anaerobic—based on need for oxygen

6. Factors Affecting an Organism’s Potential to Produce Disease
Number of organisms
Virulence
Competence of person’s immune system
Length and intimacy of contact between person and microorganism

7. Possible Reservoirs for Microorganisms
Other humans
Animals
Soil
Food, water, milk
Inanimate objects

8. Common Portals of Exit Respiratory Gastrointestinal
Genitourinary tracts
Breaks in skin
Blood and tissue

9. Laboratory Data Indicating Infection
Elevated white blood cell count—normal is 5000 to 10,000/mm3
Increase in specific types of white blood cells
Elevated erythrocyte sedimentation rate
Presence of pathogen in urine, blood, sputum, or draining cultures

10. Aseptic Technique
Includes all activities to prevent or break the chain of infection
Two categories
Medial asepsis—clean technique
Surgical asepsis—sterile technique

11. Factors Predisposing Patients to Nosocomial Infections
Use of invasive medical devices
Antibiotic-resistant organisms developed in hospitals

12. Measures to Reduce Incidence of Nosocomial Infections
Constant surveillance by infection-control committees and nurse epidemiologists
Written infection-prevention practices for all agency personnel
Hand hygiene recommendations
Infection control precaution techniques
Keeping patient in best possible physical condition

13. Bacterial Flora
Transient—attached loosely on skin, removed with relative ease
Resident—found in creases in skin, requires friction with brush to remove

14. Stages of Infection
Incubation period—organisms growing and multiplying
Prodromal stage—person is most infectious, vague and nonspecific signs of disease
Full stage of illness—presence of specific signs and symptoms of disease
Convalescent period—recovery from the infection

15. Body’s Defense Against Infection
Body’s normal flora
Inflammatory response
Immune response

16. Factors Affecting Host Susceptibility
Intact skin and mucous membranes
Normal pH levels
Body’s white blood cells
Age, sex, race, hereditary factors
Immunization, natural or acquired
Fatigue, climate, nutritional and general health status
Stress
Use of invasive or indwelling medical devices

17. Personal Protective Equipment and Supplies
Gloves
Gowns
Masks
Protective eye gear
Hair bonnets
Shoe covers

18. Evolution of Specialized Infection Control Precautions
Early CDC guidelines
Specific isolation techniques
Disease-specific isolation
Universal precautions
OSHA regulations for universal precautions
Body substance precautions
Current CDC guidelines

19. Current CDC Guidelines
Standard precautions—used in care of all hospitalized patients
Apply to blood, body fluids, secretions, excretions, non-intact skin, mucous membranes
Transmission-based precautions—used in addition to standard precautions for patients with suspected infection
Include airborne, droplet, or contact precautions
Box 27-4 pg 717

20. Current CDC Guidelines (cont’d)
Neutropenic precautions-use for a patient whose immune system is compromised
Examples: one recovering from a transplantation surgery or receiving chemotherapy
Standard precautions are needed (as with all patients)
Provide a healthy caregiver
Restrict visits from friends or family members with colds or contagious illnesses
Avoid standing collections of water in the room

21. Type N95 Particulate Respirator

22. Use of Surgical Asepsis
Operating room, labor and delivery areas
Certain diagnostic testing areas
Patient bedside
e.g., for procedures that involve insertion of urinary catheter, sterile dressing changes, or preparing and injecting medicine

23. Patient Teaching for Medical Asepsis at Home
Wash hands before preparing or eating food
Prepare foods at high enough temperatures
Use care with cutting boards and utensils
Keep food refrigerated
Wash raw fruits and vegetables
Use pasteurized milk and fruit juices
Wash hands after using bathroom
Use individual care items

24. Evaluating Patient Goals
Use techniques of medical asepsis
Identify health habits and lifestyle patterns promoting health
State signs and symptoms of an infection
Identify unsafe situations in the home environment

25. What is the most important thing to remember about Infection Control?

26. Skills
Handwashing
Don and Doff PPE