Infection Control
Explain the
relationship
Identify the body’s
between the chain
normal defences
of infection and the
against infection.
transmission of
infection.
Describe the signs
Discuss the events and symptoms of a
in the inflammatory localized infection
response. and a systemic
Learning
infection.
Objectives Explain conditions
that promote the
Identify patients
transmission of
most at risk for
health care–
infection.
associated
infection.
Explain the
difference between
medical and
surgical asepsis.
Give an example of preventing
infection for each element of the
infection chain.
Perform proper procedures for
hand hygiene.
Learning Explain the rationale and
components of routine practices
for additional (isolation)
Objectives precautions.
Explain how infection-control
measures in the home may differ
from those in the hospital.
Properly don a surgical mask,
sterile gown, and sterile gloves.
Good health depends in part on a
safe environment.
Practices that control or prevent
Infection transmission of infection help create
an environment that protects
Control patients and health care workers.
Patients are at risk because they
often have lower resistance and
increased exposure to infectious
microorganisms and because they
sometimes undergo invasive
procedures.
Nature of infection
Entry and multiplication of a pathogen
result in disease.
Scientific
Communicable disease is the condition
Knowledge in which the infection can transmitted
from one person to another.
Base
Resident skin microorganisms are
usually nonpathogenic but cause
infection after surgery or an invasive
procedure.
Patients are also at risk when
immunocompromised.
Infectious agent or pathogen
Reservoir or source for pathogen
growth
Portal of exit from the reservoir
Chain of
Infection Modes of transmission
Portal of entry to a host
Susceptible host
Chain of Infection
Microorganisms Resident
include bacteria, flora
Transient
viruses, fungi, microorgani
sms
and protozoa.
Infectious
Number
Agents
Potential to Virulence
cause disease Entry and
survival in
depends on host
several factors: Susceptibili
ty of host
A reservoir is a place where
a pathogen can survive but
may or may not multiply.
• Colonization
• Carriers
Pathogens require a
Reservoir reservoir that provides all
of the following:
• Food
• Oxygen (or no oxygen)
• Water
• Appropriate temperature and pH
• Minimal light
The path by which the pathogen leaves
the reservoir
Body openings (mouth, nose, rectum,
vagina, urethra, ostomies)
Portal of Breaks in skin (scrape, cut, or other
wound)
Exit
Breaks in mucous membranes (skin in
mouth, eyes, nose, vagina, rectum)
Pathogens carried through portals by
blood, body fluids, excretions, and
secretions
Microorganisms can be
transmitted in many ways.
Modes of Certain diseases tend to be
transmitted more
Transmissio
commonly by specific
n modes.
Transmission is possible via
multiple modes.
Contact transmission
• Direct
• Indirect
Modes of Droplet transmission
Transmissio
n Airborne transmission
Vehicle transmission
Vectorborne
transmission
Organism may enter
by the same route as
that through the
portals of exit
Portal of
Entry
Factors that reduce
the body’s defences
enhance pathogens’
chances of entering
the body.
Degree of
resistance/susceptibili
ty to a pathogen
Susceptible
Host
Resistance increased
by immunizations and
actual contracting of
the disease
Severity of infection
depends on
Extent: localized or
systemic
Infectious
Process
Pathogenicity of the
microorganism
Host susceptibility
Incubation period
Prodromal stage
Course of
Infection
by Stage Illness stage
Convalescence
Normal flora
Body system
Defences defences
Against Inflammation
Infection • Vascular and cellular
responses
• Inflammatory exudate
• Tissue repair
Hospital-acquired
infections (HAI)
• Also known as nosocomial
or iatrogenic infections
Health • Example: Clostridium
Care– difficile infection
Associated
Infections Exogenous infection
Endogenous infection
Assessment
Nursing Status of defence mechanisms
Process Patient susceptibility
• Age, nutritional status, stress, disease process,
in medical therapy
Infection Clinical appearance
Control Laboratory data
Health problems of patients with
infection
Examples of nursing diagnoses:
Disturbed body image
Nursing Risk for infection
Process Risk for injury
in Imbalanced nutrition—less than body requirements
Infection Impaired oral mucous membrane
Risk for impaired skin integrity
Control Social isolation
Impaired tissue integrity
Nursing Process in Infection Control
01 02 03 04
Planning Goals and Setting Continuit
outcomes priorities y of care
Implementation
Nursing When implementing care,
the nurse should consider
Process • Health promotion
in • Acute care measures
• Asepsis
Infection • Medical and surgical asepsis
Control • Control or elimination of
infectious agents
• Cleaning
• Disinfection
• Sterilization
When implementing care, the
nurse should consider
Control or elimination of
Nursing reservoirs
Process
Control of portals of exit
in
Infection
Control of transmission
Control
• Hand hygiene
Control of portals of entry
Hand
Hygiene
Apply a
small
amount of
soap,
lathering
thoroughly.
Soap
granules
and leaflet
preparations
may be
used.
Hand hygiene is the most
important and most basic
skill to reduce spread of
microorganisms.
The nurse should wash for at
Hand least 15 seconds to remove
most transient
Hygiene microorganisms from the
skin.
If the hands are visibly
soiled, more time may be
needed for washing.
Routine hand hygiene may
be performed with plain
soap.
The use of alcohol-based
Hand waterless antiseptics is
recommended (PIDAC,
Hygiene 2013).
• Improves hand hygiene practices
• Protect health care worker’s hands
• Reduces transmission of pathogens
to patients and personnel in health
care settings
Implementation
Nursing
Process
in Protection of the
Infection susceptible host
Control • Isolation guidelines
• Routine practices
• Isolation
procedures
Tier 2: airborne,
droplet, or contact
precautions
Isolation
Psychological
Precautions
implications of
isolation precautions
Protective
environment
Personal protective
equipment (PPE)
Specimen collection
Isolation
Precautions
Bagging waste or
linen
Transporting patients
Isolation
Precautions
B. TIE BAGS SECURELY AT THE
TOP IN A KNOT (SEE STEP 12B
ILLUSTRATION).
Role of the infection
control professional
Infection Infection prevention
and control for
Control hospital personnel
Patient education
Includes procedures
used to eliminate all
microorganisms,
including spores, from an
object or area
Surgical Patient preparation
Asepsis
Principles of surgical
asepsis
Surgical Asepsis
Sterile procedures
Protective clothing
Opening sterile packages
Sterile field
Pouring sterile solutions
Surgical hand scrub
Gowning and gloving
With gloved dominant hand, slip fingers
underneath second glove’s cuff (see Step 8
illustration).
Evaluation
Nursing Monitoring for signs and
Process symptoms of infection
in
Infection Patient education
Control
Documenting patient’s
response to therapies for
infection control
Infection control
Chain of infection
Stages of infection
Defences against infection
Summary Health care–associated infections
Nursing process in infection control
Hand hygiene
Routine practices and isolation procedures
Surgical asepsis