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Asepsis
Related terms
Normal resident flora (bacteria) the collective vegetation in a given area, yet produce infection in another.
Infection : invasion and proliferation of microorganisms in certain body tissues.
Disease : a detectable alteration in normal tissue function
Related terms
Virulence (Pathogenicity): the ability of microorganism to produce disease.
Opportunistic pathogen
CDC (Centre for Disease Control)
Asepsis
The freedom from disease-causing microorganisms
Medical asepsis all practices used to limit the number of microorganisms, growth and transmission.
- Clean objects: absence of almost all microorganisms.
- Dirty (Soiled, Contaminated) : have microorganisms, some of which capable of causing infection.
Surgical asepsis (Sterile Technique): practices that keep area or object free from all microorganisms (sterilization by using autoclave).
Sepsis : the state of infection, may includes septic shock.
Microorganisms causing infections
Bacteria (Staphs, Streptococci)
Viruses (Hepatitis, Herpes..)
Fungi (Candida albicans)
Parasites (Malaria) (mites, flees, ticks).
Types of infections
Colonization : microorganisms become resident flora, they may grow and multiply, but do not cause disease.
Local Infection : infection limited to specific area of the body.
Systemic Infection : spread to different parts of the body.
Bacteremia : Blood culture reveals microorganisms
Septicemia : when bacteremia results in systemic infection.
Acute infection : sudden and in short time.
Chronic infection : slow and in very long period.
Nosocomial Infections
Infections associated with delivery of health care services in a health care facility (during stay or after discharge)
Examples : UTI’S, URTI’S, Surgical site infection, Blood stream infections.
It may originates as Endogenous or Exogenous.
Iatrogenic (IV insertion) (Dx. or Rx.).
Chain of Infection
Example on Chain of InfectionHepatitis B Virus
HBV
Method of transmission
1. Direct transmission : droplet, touch, bite, sexual intercourse.
2. Indirect transmission:
- Vehicle-borne (handkerchiefs, toys, soiled clothes)
- Vector-borne (animals, flies)
3. Airborne transmission (Tuberculosis) (droplet nuclei).
Body Defense against infection(Susceptible Host)
Nonspecific Defenses :
- anatomic & Physiologic Barriers
- inflammatory response : vascular and cellular response, exudates
production, reparative phase
Specific Defenses :
- antibody-mediated (active & passive immunity)
- cell-mediated (HIV)
FACTORS INFLUENCE SUSCEPTIBILITY OF THE HOST
Age HeredityStressorsNutritional statusMedical therapy
Nursing Diagnoses
Risk for infection Potential complication of
infection: fever Impaired physical mobility Imbalanced nutrition: less
than body requirementsAcute pain Impaired social interaction
or social isolationSituational low self-esteemAnxiety
Nursing interventions in infection control and prevention of NCI’S.
1. Hand washing: - before and after eating - after using toilets, bedpan - contact with body substance (sputum, drainage, wound exudates).• use: antimicrobial foam, hand gel, water (10 min.) with soap, antimicrobial
liquid soap.• When using antimicrobial agent: - multiple resistant bacteria - invasive procedures - SCBU, ICU’S - immune-compromised patients.• Frequent use may induce: dryness, contact dermatitis → lotions, moisturisers
Nursing interventions in infection control and prevention of NCI’S. (Hand washing)…..
Nails should be kept short
Remove jewelrySkin breaks
Nursing interventions in infection control and prevention of NCI’S.
2. Supporting defense:
- Hygiene (bathing and shampooing)
- Nutrition (well-balanced diet) to maintain healthy tissues.
- Rest and sleep
- Immunization
Nursing interventions in infection control and prevention of NCI’S.
3. Cleaning objects - use gloves
- rinse with cold water
- wash with hot water and soap
- use brushes in cleaning
- dry up equipments
- clean used utensils by disinfectant.
Nursing interventions in infection control and prevention of NCI’S.
4. Disinfection - using chemical preparations such
as phenol or iodine compounds. - used on inanimate objects as it is
toxic to tissues. - more concentrated than
antiseptics. - bactericidal (destroy bacteria) and
bacteriostatic (prevent growth and reproduction of some
bacteria) agents. - concentration, duration, temp,
organic materials are important to consider when using
disinfectants.
Nursing interventions in infection control and prevention of NCI’S.
5. Sterilization
- is the process of destroying all microorganisms, including spores and viruses.
- Moist heat: steam+ pressure or free steam (autoclaving: 15-17pound/121-123˚ c/ 20-30 min.
Nursing interventions in infection control and prevention of NCI’S. (sterilization)….
Gas sterilization
Ethylene oxide gas (interferes with metabolism of microorganisms) for sensitive objects and more penetration.
Boiled water
100 ˚ c/ 15 min
Radiation
using ionizing and non-ionizing radiation (UV rays). It is very expensive.
Nursing interventions in infection control and prevention of NCI’S.
6. Isolation Precautions: measures designed to prevent spread of infections to health
personnel, clients and visitors.
Standard precautions: - for all clients in hospital. - blood, body fluids and secretions, broken skin, mucous
membranes. - includes: hand washing, wearing clean gloves, wearing
mask, eye protection, face shield, wearing a clean non-sterile gown, correct disposals and prevent injuries
Nursing interventions in infection control and
prevention of NCI’S. (Isolation Precautions…..
Transmission-based precautions (airborne-precautions):
- private room, negative air pressure, 2-same infected clients.
- respiratory device - NO entry in cases (rubella, measles, chickenpox- varisella) - limited movement of the
patient (surgical mask).
Nursing interventions in infection control and
prevention of NCI’S. (Isolation Precautions…..
Droplets precautions
- Used in droplet-transmitted D’s (diphtheria-pertussis-mumps)
- private room
- mask
- limit patient’s movement (surgical mask).
Nursing interventions in infection control and
prevention of NCI’S. (Isolation Precautions…..
Contact precautions
- used in serious illnesses and immune-compromised patients (wound infections, MRSA)
- private room
- wear gloves
- wear gown
- limit movement
Nursing interventions in infection control and prevention of NCI’S.
7. Personal protective equipments (medical asepsis)
- Gloving
- Gowns
- Eyewear
Nursing interventions in infection control and prevention of NCI’S.
Disposal of soiled equipment and supplies:
- Bagging
- Linens
- lab. Specimens
- Dishes
- BP equipments
- Thermometers
- Sharps
Nursing interventions in infection control and prevention of NCI’S.
9. Sterile technique (surgical asepsis)
- can be used in OR, LR, and special Dx. Procedures
- sterile field: a microorganism- free area
- ensure package intact and dry, and check for sterilization expiry.
- double packed objects
- using forceps, drape, sterile solutions.
- wearing sterile gloves by open and closed methods
- wearing sterile gown