ASEPSIS

Six Components in the infectious cycle

Infectious Agent

 Bacteria  Categorized acc to shape    Spherical (cocci) Rod shaped (bacilli) Corkscrew (spirochetes)   Gram Positive-thick wall that resists decolonization and are stained violet Gram Negative chemically more complex cell walls and can be decolonized by alcohol  Important in determining antibiotics

Antibiotics are either…

 Effective against only gram positive organisms or  Broad spectrum and can be effective with a # of microorganisms

Bacteria

  Aerobic: require O 2 to live and grow Anaerobic can live without O 2

VIRUS

 Smallest of all organisms  Causes many infections including AIDS, and the common cold

FUNGI

   Plant like organism (mold and yeast) that can also cause infection.

Present in soil, air and water.

Many are resistant to TX

Organisms

 Potential to cause disease depends on       # or organism Virulence of the organism Competence of persons immune system Length of intimacy of the contact Normal flora – microorganism that commonly inhabits various body sites Opportunistic – Bacteria that may potentially be harmful Escherichia coli stool not in urine

RESEVOIR

  The natural habitat of the organism=m Possible reservoir – human, animals, food , water, mile, inanimate objects  Example..

   Humans –HIV Animals – rabies Soil – gas gangrene, tetanus

PORTAL OF EXIT

   The exit from the reservoir.

Point of escape for the organism Example – respiratory tract, GI, GU, Skin breaks, blood, tissue

MEANS OF TRANMISSION

   DIRECT CONTACT INDIRECT CONTACT  VEHICLES-BLOOD, FOOD, WATER, INANIMATE OBJECTS VECTORS – NON HUMAN MOSQUITOS, TICKS  AIRBORNE ROUTE- BY NUCLEI COUGHING, SNEEZING

PORTAL OF ENTRY

 May be the same as the portal of exit from the prior reservoir  Point where it enters the host

SUSEPTIBLE HOST

  ACCEPTS THE ORGANISM SUSCEPTIBILITY – HOW SUSCEPTIBLE IS THE HOST TO THE ORGANISM

Stages of Infections

    Incubation-the interval between the invasion of the body by the pathogen & the appearance of S/S Prodromal Stage – most infectious – early S/S of the disease but are vague and non specific Full Stage Illness – the presence of specific S/S Convalescent Period – recovery for the infection S/S disappear

Body’s Defense Against Infection

 Inflammatory Response-protective mechanism that eliminates the invading pathogen  Immune response-involves specific reaction in the body as it responds to an invading foreign protein   antigen-foreign material body initiate s an immune response Antibody-body produces antibody in response to antigen

Factors that affect the risk of infection

           Intact skin and mucous membranes Normal ph of gastric and GU WBC Age, sex, hereditary factors Immunization Fatigue Nutrition Preexisting illnesses Previous or current TX Stress Invasive devices

Assessing

     Immunization status Previous or recurring infections Nonverbal cues Hx of current disease process labs

Diagnosing

   High risk for infection Social Isolation Altered oral mucous membrane

Planning

 Expected Outcomes

Implementing

  Medical Asepsis- clean technique reduces the # of pathogens Surgical Asepsis – Sterile technique – practices used to render and keep objects and areas free from organisms  Breaking the chain of infection is the nurses responsibility

Preventing Nosocomial Infections

 Nosocomial – hospital acquired    Exogenous infections –causative organism is acquired from other people Endogenous infections – the causative organism comes form microbial life the person himself harbors Iatrogenic – occurs as a result of a TX or diagnostic procedure.

 Most hospital acquired infection from bacteria  E-coli, staph aureus, strep

Strategies to protect the patient

    Infection control committees Written infection prevention practices Hand washing Healthy lifestyles

Hand washing

 2 types of bacteria on hands  Transient bacteria  Resident bacteria

Cleaning Agents

 Antiseptic – inhibits the growth of bacteria  Antibacterial – kill bacteria or suppresses their growth AKA -antimicrobial

Sterilization and Disinfection

 Disinfection – destroys all pathogenic organism except spore  Sterilization – The process by which all microorganisms including spores are destroyed

Factors in Selecting Method

     Nature of Organism Number Type of equipment Intended use of equipment Available means of sterilization

Universal Precautions

 Recommended HCW’s to use gloves, gowns, mask, and protective eyewear when exposure to blood or body fluids is likely and to consider that all clients might be potentially infected.

 Blood, semen, vaginal secretions, and possibly breast mil, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, amniotic fluid.

Do not include

 Feces, nasal secretions, sputum, sweat, tears, urine, and vomitus, unless they contain visible blood

OSHA

 Guidelines establishes minimum health safety standards for workers  1991 issued regulations for use of universal precautions in all situations and settings in which occupational exposures to blood and other potentially infectious material made violations punishable with severe fines.

 Requires employers to offer HBV vaccines free of charge

Body Substance Precautions

 This is an extension  Considers all body fluids potentially infected  Stop sign alert

Current CDC recommendations

  Standard precautions – precautions used in the care of all hospitalized persons. Applies to blood, all body fluids, secretions and excretions except sweat, nonintact skin, and mucous membranes Transmission based precautions – precautions used in addition to standard precautions for clients in hospitals with suspected infection with pathogens that can be transmitted by airborne droplet or contact routes

Meeting Patient Needs

 Sensory Deprivation  Loss of self esteem