1. Lines of Defense against nfxn.
    • Primary Defenses: Skin. Keep moisturized. Intact. GI flora, tears.
    • Secondary Defenses: Immunity and symptoms of immune response.
    • Tertiary Defenses: Antibodies, B-Cells, etc.
    • Factors that Increase Infection Risk: Age, exposure, immunocompromised, environment, fatigue, nutrition, stress, artificial portal of entry.
  2. 6 Links in Chain of nfxn
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    • All have to be present for nfxn to occure. Nurse's job is to break the chain.
  3. What is a fomite?
    Inanimate object that carries pathogens to the next host/carrier.
  4. Inflammatory Response
    • Stage 1: Local Infection. What does it look like? Erythema, localized
    • Stage 2: Exudate appears, sanginous (bloody), purulent (yellow, pus), serous (straw/white)
    • Stage 3: Tissue replacement. Keloids.
  5. Stages of nfxn
    • Incubation: Are you infectious before you have symptoms? Yup. Pathogens replicating but not enough to cause symptoms.
    • Prodromal: “ I don’t feel so good.” Immune response has started.
    • Illness: “ Please stay away from me.” Gloves off, knock down drag out fight pathogen vs immune response.
    • Decline: Not too fast now. Relax. Take it easy. Let body repair.
    • Convalescence: “Oh, if we only knew how long it would take.” Can take a really long time.
  6. Identifications of Classifications
    • Local
    • Systemic: through blood or lymph.
    • Primary infection
    • Secondary infection
  7. Local or systemic?
    • Fever (S)
    • Edema (L)
    • Pain or tenderness (L)
    • Malaise (S)
    • Warmth of the area on palpation (L)
    • Increased pulse and respiratory rate (S)
  8. Healthcare Associated nfxn (HAIs)
    • Acquired in the hospital
    • $$$$$ because insurance will not pay hospital for treatment of pt who acquires nocicomial nfxn. Hospital cannot charge pt either. On the hook for their own bill.
    • Exogenous nosocomial infection – yuk!
    • Pathogen acquired from healthcare environment
    • Endogenous nosocomial infection – we all have it! Normal flora multiply and cause infection as a result of treatment
    • Iatrogenic infection: usually due to physician or some type of therapy where sterile technique was not complete. Transfered from inanimate object.
    • What can you do to prevent HAI’s?
  9. HAI prevention
    • NPSG’s (National Patient Safety Goals): Use of appropriate hand hygiene
    • Prevention of multi-drug resistant organism infection
    • Prevention of central line associated blood stream infection
    • Prevention of surgical site infection
  10. Drug Resistant Pathogens
    • MDRO’s (Mutli Drug Resistant Organism):
    • MRSA
    • VRE
    • C-diff: Spore forming, sanitizing gels won't work.

  11. Nursing interventions to promote asepsis
    • Medical Asepsis:
    • REDUCES the number of organisms
    • REDUCES the growth and spread of microorganisms
    • Objects are considered CLEAN

    • Surgical Asepsis:
    • Sterile
    • Preservation of STERILE field.
    • It's either sterile or it's not. No organisms = sterile.
  12. Handwashing
    • Soap
    • Water
    • Friction

    Need at least 15 seconds with all of the above. Combined action --> reduction of microbes.
  13. Implementing CDC guidlines for hygiene.
    • Tier I:
    • Standard Precautions
    • Protects healthcare workers from exposure
    • Decreases transmission of pathogens
    • Protects clients from pathogens carried by healthcare workers
  14. Types of Tier I standards of precautions.
    • Hand washing
    • Gloves
    • Mask and eye protection
    • Gown
    • Disposal of sharps: never thrown in trash, never recapped
    • Containment
    • Decontamination
  15. Tier II precautions
    • Contact Precautions: direct or indirect contact.
    • Droplet Precautions: Gloves, gown, mask. Mask can also be worn by you to prevent nfxn to pt.
    • Airborne Precautions: Gloves, gown, better (N95) mask (ie for pt with TB).
  16. Basic principles of Isolation cases and hygiene
    • Wash hands before entering or leaving an isolation room
    • Dispose of contaminated supplies in a manner that will prevent the spread of microorganisms
    • Apply knowledge of disease process and mode of transmission when protective barriers are used
    • Protection of all persons during transport.
    • Pt. will typically be in negative pressure room. TB can be exposure, nfxn, and active. Can also be latent.
  17. Other Isolation precaustions
    • MRSA
    • VRE
    • C. diff
    • EBSL (another resistant organsim)
  18. Personal protective equipment (PPEs)
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Card Set
Promoting Asepsis, Preventing Infection