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Chapter 12
Medical-Surgical Asepsis and Infection Prevention and Control
Question | Answer |
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Microorganisms | any tiny, usually mircoscopic entity capable of carrying on living processes ; Microorganisms are naturally present on and in the human body, as well as in the environment. (nonpathogenic) does not produce disease in most individuals. |
Infection Prevention and control | consists of the implementation of polocies and procedures in hospitals and other health care facilities to minimize the spread of health care-associated or community acquired infections to patients and other staff members. |
Asepies | absence of pathogenic microorganisms; divided into two categories, medical asepsis also known as clean technique and surgical asepsis |
Medical Asepsis | consists of techniques that inhibit the growth and spread of pathogenic microorganisms. Medical asepsis is also known as clean technique and is used in many daily activities, such as hand hygiene and changing patient's bed linen. |
Surgical asepsis | destroys all microorganisms and their spores. Known as sterile technique and is used in specialized areas or skills, such as care of surgical wounds, urinary catheter insertion, invasive procedures, and surgery. |
Spores | the reproductive cell of some microogranisms, such as fungi or protozoa. Is roundbody that is formed by the bacterium when conditions are unfavorable for growth or bacterium. Spores have a high degree of resistance to heat and disinfectants. |
What are 6 elements necessary for infection to occur? | (1) The infectious agent (2) Reservoir (3) Exit Route from reservoir (4) Method or vehicle of transportation, such as exudate, feces, air droplets, hands, and needles (5) Entrance through skin, mucous lining, or mouth (6) Host- another person or animal |
Infectious Agent | pathogenic microoganisms are infectious agents. These pathogens vary among bacteria, viruses, yeasts, fungi, and protozoa. |
Disinfection | the use of a chemical that can be applied to objects to destroy microorganisms |
antiseptic | a substance that tends to inhibit the growth and reproduction of microorganisms- may be used on humans |
Bacteria | three basic shapes- round, oblong, and spiral. Bacteria has different chemical compositions, require different nutrients, and form different waste products. |
Aerobic bacteria | grows only in the presence of oxygen |
Anaerobic bacteria | gows only in the absense of oxygen |
Mucilaginous | thick, sticky, slimy substance that envelopes is unfavorable; it is believed that the formation may be defensive mechanism to protect the bacteria. |
Streptococcus bacterium | is responsible for more diseases than any other organism, but methicillinresistant Staphylococcus aureus (MRSA) is growing in number and responsible for a number of serious and sometimes fatal infections, such as necrotizing MRSA pneumonia. |
Bacillus anthracis | causes the acute infectious disease of anthrax. Are able to live in the soil for many years. |
Anthrax occurs in what three forms? | - cutaneous - Inhalation - Gastrointestinal |
Viruses | smallest known agents to cause disease. Composed of RNA or DNA |
fungi | fungla (mycotic) infections are among the most common diseases found in humans. Fungi are among the most plentiful forms of life. include- fuzzy black, green, or white growth on stale bread, decayed fruit, or damp clothing. |
Mycotic diseases | diseases that are caused by yeasts and molds. |
Protozoa | are single-celled animals; in some form, they exist everywhere in nature. Some of the parasitic forms of protozoa are found in the intestinal tract, the genitourinary tract, the respiratory tract, and the circulatory system of humans and other animals. |
Exit Route | secretions, feces, blood, urine...in humans are the gastrointestinal, respiratory, and genitourinary systems; tissue; blood; and wounds. (nurse must perform hygiene,teach to cover nose and mouth) |
Method of transmission | hands, contaminated food, air droplets, contaminated needle |
Resevoir | infected individual or animal |
vehicle | the means by which microorganisms are carried about and transported to the next host, once they have left the reservoir. |
Contamination | a condition of being soiled, stained, touched by, or otherwise exposed to harmful agents; an example is the entry of infectious or toxis materials into a previously clean or sterile environment, making an object potentially unsafe for use. |
Vector | if the vehicle is a living carrier |
Fomite | is nonliving, if the vehicle is an inanimate object. |
Entrance of microorganisms | mouth, break in skin, and mucous membrane |
Host | is an organism in which another, usually parasitic, organism is nourished and harbored |
Factors Affecting Immunologic | -increasing age and extreme youth - stress -nutritional status -hereditary factors -disease processes -environmental factors -medical therapy - chemotherapy -radiation -lifestyle -occupation -diagnostic procedures -travel history -trauma |
What are the stages of the infectious process? | -incubation -prodromal stage -illness stage -convalescence |
incubation period | interval between entrance of pathogen into body and appearance of first symptoms (chickenpox,1-3 weeks;common cold, 1 to 2 days; influenza, 1 to 3 days; mumps, 12-26 days) |
Prodromal stage | interval from onset of nonspecific signs and symptoms to more specific symptoms. For example, herpes simplex begins with itchin and tingling at the site during the prodromal stage, before the lesion appears. |
illness stage | interval when patient manifests signs and symptoms specific to type of infection |
convalescence | interval when acute symptoms of infection disappear (length of recovery depends on severity of infection and patient's general state of health; recovery takes from several days to months) |
localized | if infection is localized (a superficial wound infection) proper care controls the spread and minimizes the illness. |
Systemic | An infection that affects the entire body instead of just single organ or part is systemic and has potential to become fatal. |
Inflammatory response | the body's response to injury or infection at the cellular level is imflammation. |
Skin | Body defense mechanism : intact mulilayered surface (body's first line of defense against infection) Action: Provides barrier to microorganisms Factors: Cuts, abrasions, puncture wounds, areas of maceration |
Respiratory tract | Defense mechanism: cilian lining upper airway coated by mucus Action: rap inhaled microbes and sweep them outward in mucus to be expectorated or swallowed Factors: smoking high concentration of oxygen and carbon dioxide, decreased humidity and cold air |
Gastrointestinal tract | Defense mechanism: acidity of gastric secretions Action: chemically destroys microorganisms incapable of surviving low pH Factors: use of antacids |
Health Care-Associated infection | an infection that manifests at least 48 hours after hospitalization or contact with another health agency. |
Virulent | of or pertaining to a highly pathogenic or rapidly progressive condition |
Exogenous | growing outside the body |
Endogenous | growing within the body |
OSHA | The Occupational Safety and Health Administration, The Joint Commission risk management, and hospital administration place an ever-increasing emphasis on infection prevention and control. |
CDC | The Centers for Disease Control and Prevention- part of the US Department of Health and Human Services, provides facilities and services for investigation, prevention, and control of disease. |
Standard precautions | In the past, the CDC recommended that health care workers use "universal blood and body fluid precautions," or "universal precautions," and body substance isolation when caring for all patients. Now have been incorporated into 1 standard set of guidelines |
Hand Hygiene | Essentials: - when hands are visibly soiled - before and after caring for patient - after contact with organic material, such as feces, wound drainage and mucus - before dressing or having contact with open wounds. |
Gloves | Wear clean , unsterile gloves when the potential for touching blood, body fluids, secretions, excretions and contaminated items exists. Put on gloves just before touching mucous membranes and non intact skin |
Mask, Eye Protection, Face Shield | Wear a mask and eye protection or a face shield to protect mucous membranes of the eyes, the nose and the mouth during procedures and patient care activities that are likely to generate splashes or sprays of blood, body fluids, secretions and excretions. |
Gown | Wear a fluid resistant gown ( a clean unsterile gown is adequate) to protect skin and prevent soiling of clothing during procedures and patient care activities that are likely to generate splashes. |
Miscellaneous Guidelines | - place used sharps in a designated sharps disposal container - do not bend or break or recap needles - place disposable wastes and articles contaminated with blood or large amounts of body fluids in a biowaste container for trash pick up |
Double Bagging | an infection control practice that involves placing a bag of contaminated items into another, clean bag that is held outside an isolation room by other personnel - keeps the outer surface of a single bag free from contamination |
Standard Precautions | desire to care for all patients regardless of their diagnosis or presumed infectiousness |
Transmission Precautions - airborne precautions | (tier 2) in addition to standard precautions, use airborne precautions for patients known or suspected to have serious illnesses transmitted by airborne droplet nuclei (ex: of such illness include the following: measles, varicella, tuberculosis |
Droplet Precautions | in addition to standard precautions, use droplet precautions for patients known or suspected to have serious illness transmitted by large particle droplets. examples: invasive Haemophilus influenzae inlcuding meningitis, pneumonia, epiglottitis, sepsis |
Contact Precautions | in addition to standard precautions use contact precautions for patients known or suspected to have serious illnesses easily transmitted by direct patient contact or by contact with items in the patients environment. Examples- gastrointestinal |
Surgical Asepsis | consist of maintaining the absence of all microoganism, including pathogens and spores from an object. |
Bacteriostatic | also known as antiseptics which are a means to inhibit the growth of microorganisms although killing them this way is not possible. Bacteria means microorganisms and static means referring to that which cannot move or grow. |
Cleaning | is the removal of foreign materials such as soil and organic material from objects. generally, cleaning involves use of water and mechanical action with or without detergents. |
Disinfection | is used to destroy microorganisms. However it does not destroy spores. |
disinfectants | solutions or possible bactericidal solutions |
Bactericidal solutions | solutions are too strong from human skin to tolerate and are used only on inanimate objects. |
Sterilization | refers to methods used to kill all microorganisms including spores. There ar two types of sterilization methods: physical and chemical |
Physical method | destroys microorganisms - steam under pressure or moist heat - boiling water - radiation |
Chemical Method | destroys microorganisms - gas destroys spores formed by bacteria - chemical solutions are used to disinfect instruments because they are effective in destroying microorganisms. |