Infection Control Ch 14 1 pptx

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Information about Infection Control Ch 14 1 pptx
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Published on March 16, 2016

Author: dwanfai

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Slide1: Chapter 14 Infection Prevention and Control Slide2: Objectives 1. Identify the body’s normal defenses against infection. 2. Discuss the development of the inflammatory response. 3. Describe the signs and symptoms of a localized and a systemic infection. 4. Describe characteristics of each link of the infection chain. 5. Assess patients at risk for acquiring an infection. 6. Explain conditions that promote development of health care–associated infections. 2 Slide3: Objectives cont 7. Describe strategies for standard precautions. 8. Identify principles of medical and surgical asepsis. 9. Describe nursing interventions designed to break each link in the infection chain. 10.Perform proper barrier isolation techniques. 11.Perform proper procedures for hand hygiene. 12.Apply and remove a surgical mask and gloves using correct technique. 3 Scientific Knowledge Base: Scientific Knowledge Base Nature of infection Infection is the invasion of a susceptible host by microorganisms (pathogens), resulting in disease. Colonization occurs when a microorganism invades the host but does not cause infection. An infectious disease transmitted directly from one person to another is considered a contagious or communicable disease. If pathogens cause clinical signs and symptoms, the infection is symptomatic; if it does not, it is asymptomatic. Chain of Infection: Infectious agent Reservoir Portal of exit Modes of transmission Portal of entry Susceptible host Chain of Infection Course of Infection: Course of Infection Defenses Against Infection: Defenses Against Infection Normal flora Microorganisms that reside in the body The number and variety of flora maintain a sensitive balance with other microorganisms to prevent infection. Body system defenses Organs have specialized defense mechanisms Defenses Against Infection (Cont.): Defenses Against Infection (Cont.) Inflammation The cellular response of the body to injury or infection Signs include swelling, redness, heat, pain or tenderness, and loss of function in the affected body part Immune response The body’s response to foreign material (antigens) A ntibodies bind to antigens and neutralize, destroy, or eliminate them Health Care–Acquired Infections (HAI) : Health Care–Acquired Infections (HAI) Result from delivery of health services in a health care facility HAI risk factors include: Invasive procedures, medical therapies, long hospitalizations, and contact with health care personnel L owered resistance to infection due to underlying medical conditions Invasive treatment devices Treatments with multiple antibiotics for long periods of time Health Care–Acquired Infections (Cont.): Health Care–Acquired Infections (Cont.) Types of HAI infection: Exogenous—from microorganisms outside the individual Endogenous—when the patient’s flora becomes altered and an overgrowth results Common sites for HAI infection: Urinary tract Surgical or traumatic wounds Respiratory tract Bloodstream Asepsis: Asepsis Aseptic technique is an effort to keep patients as free from exposure to infection-causing pathogens as possible. Medical asepsis (clean technique) includes procedures used to reduce the number and prevent the spread of microorganisms . Surgical asepsis (sterile technique) includes procedures to eliminate all microorganisms from an area . Nursing Knowledge Base: Nursing Knowledge Base H ealth care workers are at risk for exposure to microorganisms in the hospital, long-term care, and home settings. Infection prevention practices reduce the risk for cross-contamination and transmission to other patients when caring for a patient with a known or suspected infection. Nursing Process: Assessment: Factors influencing infection prevention and control: Age Heredity Cultural practices Nutritional status Stress Rest and exercise Personal habits Nursing Process: Assessment Environmental factors Immunizations/ disease history Medical therapies Clinical appearance and data Nursing Process: Assessment (Cont.): Nursing Process: Assessment (Cont.) Older adult considerations Decreased immunity Dry mucous membranes Decreased secretions Decreased elasticity in tissues Patient expectations Identify patient expectations I nvolve patients in planning care Nursing Process: Nursing Diagnosis: Nursing Process: Nursing Diagnosis Nursing diagnoses for infection: Disturbed Body Image Risk for Falls Risk for Infection Imbalanced Nutrition: Less Than Body Requirements Acute Pain Impaired Skin Integrity Social Isolation Impaired Tissue Integrity Nursing Process: Planning: Nursing Process : Planning Goals and outcomes Common goals of care applicable to patients with infection often include the following: Preventing exposure to infectious organisms Controlling or reducing the extent of infection Maintaining resistance to infection Verbalizing understanding of infection prevention and control techniques (e.g., hand hygiene ) Nursing Process: Planning (Cont.): Nursing Process: Planning (Cont.) Setting priorities Establish priorities for each diagnosis and for related goals of care. Teamwork and collaboration Remember to plan care and include other disciplines as necessary. Implementation: Implementation Health promotion Nutrition Hygiene Immunization Adequate rest and regular exercise Implementation (Cont.): Implementation (Cont.) Acute care Monitor the patient carefully Select the best measures to maintain or restore patient health Practice preventive care Standard precautions Transmission-based precautions Identify and eliminate the organism Support patient defenses Implementation (Cont.): Implementation (Cont.) Medical asepsis Control or elimination of infectious agents Cleaning Disinfection and sterilization Implementation (Cont.): Implementation (Cont.) Control or elimination of reservoirs Control of portals of exit Control of transmission Implementation (Cont.): Implementation (Cont.) Hand Hygiene Handwashing Antiseptic hand wash Antiseptic hand rub Surgical hand antisepsis Implementation (Cont.): Standard precautions Isolation precautions Airborne Droplet Contact Implementation (Cont.) Implementation (Cont.): Multidrug-resistant organisms (MDROs ) Methicillin-resistant Staphylococcus aureus (MRSA) Vancomycin-resistant enterococcus (VRE ) Clostridium difficile Implementation (Cont.) Implementation (Cont.): Implementation (Cont.) Isolation principles Understand how certain diseases are transmitted and which barriers you need to prevent transmission. Take care to avoid exposing an article brought into a patient’s room to any infectious material. Before you institute isolation measures, explain the purpose of isolation to the patient and family. Provide for a patient’s sensory stimulation during isolation. Implementation (Cont.): Implementation (Cont.) Protective environment Personal protective equipment Gowns Mask or respirator Gloves Eyewear Implementation (Cont.): Implementation (Cont.) Suggestions to avoid latex allergy Whenever possible wear powder-free gloves. Wear gloves only when indicated. Wash with a pH-balanced soap immediately after removing gloves. Apply only non–oil-based hand care products (oil-based products break down latex allergens). If a reaction or dermatitis occurs, report to employee health service and/or seek medical treatment immediately Implementation (Cont.): Implementation (Cont.) Specimen collection Use sterile equipment Collect fresh material Seal containers tightly Properly label specimens Place specimens in labeled, leak-proof biohazard bags for transport Implementation (Cont.): Implementation (Cont.) Bagging Follow agency policy Biohazardous waste Cultures Pathological waste Blood and blood products Sharps Selected isolation material Implementation (Cont.): Implementation (Cont.) Removal of protective equipment If you wear all four protective items, remove the gloves first to avoid contaminating your hair or uniform Transporting patients on isolation precautions O nly transport patients for essential purposes Give the patient appropriate barrier protection Personnel should practice appropriate precautions Notify personnel in diagnostic areas or the operating room Implementation (Cont.): Implementation (Cont.) Control portals of entry Protection of the susceptible host Role of the infection prevention and control department Health promotion in health care workers and patients Implementation (Cont.): Implementation (Cont.) Surgical asepsis Requires more precautions than medical asepsis Commonly used in the operating room Also used at the patient’s bedside Implementation (Cont.): Implementation (Cont.) Preparation for sterile procedures A ssess the patient’s understanding of sterile procedures Explain the procedure and what the patient can do to avoid contaminating sterile objects: Avoid sudden movements of body parts covered by sterile drapes. Do not touch sterile supplies, drapes, or your sterile gloves and gown. Avoid coughing, sneezing, or talking over a sterile area. Principles of Surgical Asepsis: A sterile object remains sterile only when touched by another sterile object. Only place sterile objects on a sterile field . A sterile object or field out of the range of vision or an object held below a person’s waist is contaminated. Principles of Surgical Asepsis Principles of Surgical Asepsis (Cont.): Principles of Surgical Asepsis (Cont.) A sterile object or field becomes contaminated by prolonged exposure to air. A sterile object or field becomes contaminated by capillary action when a sterile surface comes in contact with a wet contaminated surface . A sterile object becomes contaminated if gravity causes a contaminated liquid to flow over the surface of an object. The edges of a sterile field or container are considered to be contaminated. Restorative Care: Restorative Care Long-term care Older adults are at greater risk for HAIs. Infections are among the most frequent causes of transfer from long-term care facilities ( LTCFs) to acute care hospitals and 30-day hospital readmissions. Pneumonia, urinary tract infections, and pressure ulcer infections are the three most common infections in LTCFs. Evaluation: Evaluation Patient care Measure the success of the infection control techniques. Compare the patient’s actual response with expected outcomes. If goals are not achieved, determine what steps must be taken. Patient expectations Ask your patient if he or she perceives that the symptoms of an infection are under control Slide38: A patient is admitted to a medical unit for a home-acquired pressure ulcer. The patient has Alzheimer’s disease and has been incontinent of urine. The nurse inserts a Foley catheter. You will identify a link in the infection chain as A. Restraints. B . Poor hygiene. C . Foley catheter bag. D . Improper positioning. Quick Quiz! Quick Quiz!: Quick Quiz! You are caring for a patient who underwent surgery 48 hours ago. On physical assessment, you notice that the wound looks red and swollen. The patient’s WBCs are elevated. You should A. Start antibiotics. B . Notify the physician. C . Document the findings and reassess in 2 hours. D . Place the patient on isolation precautions.

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