NURSE-3101 Lecture Notes - Lecture 3: Sharps Waste, Avocado, Genitourinary System

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1 Sep 2016
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Chapter 23 Asepsis and Infection Control
Infection Cycle
Infectious agent
oBacteria
Gm (+)/Gm (-); aerobic vs. anaerobic.
oVirus, fungus, parasite.
oPotential to produce disease
Number of organisms; virulence (ability to cause disease); immune
competence; length, intimacy of contact with organism.
oNew disease vs. endemic
Occurs with predictability in one specific region or population
oColonization
Organism present but no clinical signs of infection.
Reservoir
oNatural habitat of the organism.
oCarrier
Person infected with the disease who does not exhibit any disease
manifestations; can transmit disease to others.
oHuman host
Staphylococcus aureus; hepatitis B; HIV; tuberculosis.
oAnimal host
Rabies (dog, squirrel, bat); West Nile virus (bird).
oOther reservoirs
Soil, water, food.
Portal of exit
oPoint of escape for the organism from the reservoir.
oCommon portals of exit from human host
Respiratory, gastrointestinal, genitourinary tracts.
oExamples:
Tuberculosis carrier coughs.
Blood-borne pathogens (hepatitis B/C, HIV disease).
Clostridium difficile-infected diarrhea.
Means of transmission
oDirect contact
Proximity between carrier and non-infected person
Touch, sexual intercourse
oIndirect contact
Contact with an inanimate object
Touching a contaminated instrument or bacteria on the nurse’s
scrubs
oFomite
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Contaminated inanimate object.
oVector
Non-human carrier that transmits organisms from an infected host by
injecting salivary fluid when a human bite occurs
Mosquitoes, ticks; bubonic plague transmitted by flea bite
Portal of entry
oPoint at which organisms enter a non-infected host.
oPortal of entry often similar to organism’s portal of exit from reservoir.
TB patient coughs; someone inhales TB organisms
oCommon portals of entry
Non-intact skin; respiratory tract; GI tract.
Susceptible host
oMust overcome host defense mechanisms.
oSusceptibility
Degree of resistance the potential host has to the pathogen.
oHospital patient in poor health and has less resistance; more susceptible to
infection.
oFactors which affect risk of infection: non-intact skin; normal WBC production;
neonates/old people more vulnerable; immunizations; fatigue; nutritional status.
Inflammatory Response
Eliminates invading pathogen and allows for tissue repair.
Cardinal signs of acute infection
oHeat, redness
Small blood vessels constrict in the area, followed by vasodilation of
arterioles and venules that supply the area increasing blood flow to the
area.
oPain, swelling, loss of function
Histamine released = increased vessel permeability = protein-rich fluid
pours into the area.
White blood cells (leukocytes)
oMove quickly into the area.
Increase in number of circulating WBCs (leukocytosis).
Neutrophils (the primary phagocytes)
oEngulf organism, consume cell debris/foreign material.
Exudate (fluid, cells, inflammatory byproducts)
oReleased from wound.
oTypes of exudate are:
Serous (clear).
Sanguinous (contains red blood cells; pink to red).
Purulent (contains pus).
Asepsis
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Asepsis
oAll activities to prevent infection or break the chain (cycle) of infection.
Medical asepsis (clean technique)
oProcedures and practices that reduce the number and transfer of pathogens.
Hand hygiene and wearing gloves
Surgical asepsis (sterile technique)
oPractices used to render and keep objects and areas free from microorganisms.
Inserting an indwelling urinary catheter and inserting an IV catheter
Medical Asepsis in Patient Care
Practice good hand hygiene.
Keep soiled items and equipment from touching the clothing.
Do not place soiled bed linen or any other items on the floor, which is grossly
contaminated.
Avoid allowing patients to cough, sneeze, or breathe directly on others. Provide them
with disposable tissues.
Move equipment away from you when brushing, dusting, or scrubbing articles.
Avoid raising dust. Do not shake linens.
Clean the least soiled areas first and then the more soiled ones.
Dispose of soiled or used items directly into appropriate containers.
Pour liquids to be discarded, such as bath water or mouth rinse, directly into drain to
avoid splashing in sink and onto you.
Use practices of personal grooming that help prevent spreading microorganisms: keep
hair short or pinned up; keep fingernails short; avoid wearing rings with grooves and
stones.
Follow guidelines conscientiously for standard/transmission-based precautions.
Handwashing with Soap and Water
Hands visibly soiled.
Hands contaminated with blood/body fluids.
Before eating.
After using the rest room.
Preferred handwashing method after care of patient with C. difficile infection.
oAlcohol doesn’t kill C. difficile spores
At least a 20 second scrub with soap and warm water!
oLonger Scrub may be necessary if visible soling
Handwashing with Alcohol-Based Products
Before direct contact with patient.
After direct contact with patient skin.
After contact with body fluids/mucous membranes/non-intact skin/wound dressings if
hands not visibly soiled.
After removing gloves.
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