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Infection Control
Infection Control
Infection Control
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A model used to understand the infection process is the chain of infection, a circle of links, each representing a component in the cycle. Each link must be present and in sequential order for an infection to occur. The links are: infectious agent, reservoir, portal of exit from the reservoir, mode of transmission, and portal of entry into a susceptible host. Understanding the characteristics of each link provides the nurse with methods to support vulnerable patients and to prevent the spread of infection. An awareness of this cycle also provides the nurse with knowledge of methods of selfprotection.
Definition:
INFECTIOUS AGENT A microbial organism with the ability to cause disease. The greater the organism's virulence (ability to grow and multiply), invasiveness (ability to enter tissue) and pathogenicity (ability to cause disease), the greater the possibility that the organism will cause an infection. Infectious agents are bacteria, virus, fungi, and parasites. RESERVOIR A place within which microorganisms can thrive and reproduce. For example, microorganisms thrive in human beings, animals, and inanimate objects such as water, table tops, and doorknobs. PORTAL OF EXIT A place of exit providing a way for a microorganism to leave the reservoir. For example, the microorganism may leave the reservoir through the nose or mouth when someone sneezes or coughs. Microorganisms, carried away from the body by feces, may also leave the reservoir of an infected bowel.
MODE OF TRANSMISSION Method of transfer by which the organism moves or is carried from one place to another. The hands of the health care worker may carry bacteria from one person to another. PORTAL OF ENTRY An opening allowing the microorganism to enter the host. Portals include body orifices, mucus membranes, or breaks in the skin. Portals also result from tubes placed in body cavities, such as urinary catheters, or from punctures produced by invasive procedures such as intravenous fluid replacement. SUSCEPTIBLE HOST A person who cannot resist a microorganism invading the body, multiplying, and resulting in infection. The host is susceptible to the disease, lacking immunity or physical resistance to overcome the invasion by the pathogenic microorganism.
An elderly patient, hospitalized with a gastrointestinal disorder, was on bed rest and required assistance for activities of daily living. The patient had frequent uncontrolled diarrhea stools and the nurse provided excellent care to maintain cleanliness and comfort. Following one episode of cleaning the patient and changing the bed linen, the nurse immediately went to a second patient to provide care. The nurse's hands were not washed before assisting the second patient. Let's examine the chain of infection as it applies to this situation.
Escherichia coli
Large intestine E. coli, bacteria in the large intestine of humans forms the greater part of the normal intestinal flora.
The nurse removed the contaminated linen from the bed. The E. coli organism contaminated the hands of the nurse who then provided morning care to another patient.
The second patient receiving care had a Foley catheter. The nurse manipulated the tubing attached to the catheter. The E. coli organism on the nurse's hands contaminated the catheter tubing and ascended to the patient's meatus and then into the urinary bladder.
The second patient with a Foley catheter. This patient was elderly and had a chronic illness necessitating complete bed rest. The Foley catheter contaminated by the E. coli organism provided a direct route into the urinary bladder.
1. 2. 3. 4. 5. 6. 7.
Hands washed Gloves worn Each side of the soiled linen ends folded towards the middle of the bed Soiled linen held away from the nurse's clean uniform Soiled linen placed in the linen bag for later discard Protective gloves removed Hands washed
The nurse applied principles of medical asepsis and standard precautions with the use of body substance isolation to contain the infectious organism at many points in the chain of infection.
Patient's infected wound BREAK IN THE CHAIN Nurse used proper hand washing techniques, wore protective gloves and properly handled the linen.
BREAK IN THE CHAIN Proper hand washing, gloving and handling of linen BREAK IN THE CHAIN Organisms isolated with use of medical asepsis and body substance isolation PROTECTED
Discuss: Mode of transmission Proper waste disposal Biodegradable Non-biogredable Infectious Objective for Beginning Nursing Students 1. Identify the six links in the chain of infection. 2. Describe factors that increase the susceptibility of an individual to an
infection.
3. Explain specific ways a nurse, while providing patient care, can decrease
the incidence of contamination by an infectious agent.
6. Identify frequently occurring patient care situations that require the nurse
to wear protective barrier gloves.
7. Demonstrate appropriate handling of bed linen, soiled and clean. 8. Explain the primary components of standard precautions: universal
precautions and body substance isolation.