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?