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SCIENTIFIC KNOWLEDGE BASE ENTRY AND MULTIPLICATION OF ORGANISM RESULTS IN DISEASE COLONIZATION OCCURS WHEN A MICROORGANISM INVADES THE HOST BUT DOES NOT CAUSE INFECTION (INJURY TO CELLS) PATIENT SAFETY ISSUE CHAIN OF INFECTION Infectious agent or pathogen Reservoir Portal of exit Mode of transmission Portal of entry Susceptible host Infectious Agent/Pathogen Microorganisms (bacteria, viruses, fungi, protozoa Normal flora Colonization Virulence Susceptibility Review Potter & Perry Table 34-1 (pg. 643) Common Pathogens Reservior Animate sources (humans, animals, insects) Inanimate sources (soil, water, food, medical equipment) Pathogens need a proper environment to survive (food, oxygen, water, temperature, pH, light) Carriers Toxins: (Exotoxins, endotoxins) Portal of Exit/Entry Skin and Mucous Membranes Respiratory Tract Urinary Tract Gastrointestinal tract Reproductive Tract Blood Modes of Transmission Contact (Direct & Indirect) Droplet Airborne Vehicles Vectors Susceptible Host Susceptibility (Resistance to infection) Factors which influence susceptible: Age Nutritional status Chronic disease history Trauma Smoking The Infectious Process Incubation Period Prodromal Stage Illness Stage Convalescence Pathogenicity of organism Localized vs. systemic DEFENSES AGAINST INFECTION Normal flora Body System Defenses (P&P Pg.647) Inflammation VASCULAR AND CELLULAR RESPONSE EDEMA PHAGOCYTOSIS LEUKOCYTOSIS INFLAMMATORY EXUDATE SEROUS SANGUINOUS PURULENT SPECIFIC DEFENSES AGAINST INFECTION CELL- MEDIATED IMMUNITY ANTIBODY-MEDIATED IMMUNITY HEALTH CARE ASSOCIATED INFECTION (NOSOCOMIAL) Infections that are a result of health care delivery, not present at admission EXOGENOUS ENDOGENOUS IATROGENIC Refer to Potter & Perry Table 34-2 Pg. 648 (Sites for Causes of HAI’s) Common Health-Care Associated Infections Urinary Tract Infection Surgical/Traumatic Wound Infection Respiratory Tract Bloodstream The Nursing Process & Infection Control (Assessment) Status of defense mechanisms Client Susceptibility Nutritional Status Stress Disease Process Medical Therapy Clinical Appearance Lab Data Lab Data WBC Count Sedimentation Rate Cultures of sputum, urine, blood Differential Count Assessing Risk for Infection Age Disease Processes Lifestyle Occupation Diagnostic Procedures Medications Travel History Nutritional Status NURSING DIAGNOSIS AND PLANNING NANDA APPROVED DIAGNOSIS GOALS AND OUTCOMES MEASURABLE REALISTIC PRIORITIES Acute Care Interventions MEDICAL AND SURGICAL ASEPSIS CONTROL/ELIMINATION OF INFECTIOUS AGENTS CONTROL/ELIMINATION OF: MODES OF TRANSMISSION PORTALS OF ENTRY RESERVOIRS HAND HYGIENE (HCP, PATIENT, FAMILY) INTERVENTIONS ISOLATION PRECAUTIONS HYPERTHERMIA INTERVENTION ELIMINATE UNDERLYING CAUSE FEVER MANAGEMENT HEALTH TEACHING ANTIBIOTIC THERAPY PSYCHOSOCIAL SUPPORT HEALTH CARE RESOURCES Isolation Precautions CDC and OSHA Guidelines 1. Contact 2. Droplet 3. Airborne Drug Resistant Organism Infections & Colonizations Methicillin-Resistant Staphylocuccus aureus (MRSA) Vancomycin-Resistant Enterococcus (VRE) Extended-Spectrum Beta Lactamase (ESBL) Multi-drug Resistant Tuberculosis Personal Protective Equipment Gowns Respiratory Masks Eye Protection Gloves Specimen Collection Bagging Trash & Linen Transporting Patients EVALUATION MEASURE SUCCESS OF INFECTION CONTROL TECHNIQUES COMPARE PATIENT’S RESPONSE TO ACTUAL OUTCOME WHAT WILL YOU DO IF GOAL/OUTCOMES NOT ACHIEVED?