Science of Nursing: ASEPSIS AND INFECTION CONTROL

• Single most important intervention
• Water or alcohol-based hand sanitizer

• Infection agent→reservoir→portal of exit→mode of transmission→portal of entry→host→infectious agent→etc
• Example:
• Someone has TB:
o Agent-TB
o Reservoir-person who has TB
o Portal of exit-coughing
o Mode of transmission-through air
o Portal of entry-you inhaling
o You→host

• Microorganisms
o Bacteria
o Viruses
o Fungi
o Protozoa
• Transient

• Sufficient number/dose exposed
• Virulence
• Ability to enter and survive in host
• Susceptibility to host (host resistance)

• Normal flora
• are protective-good!
• BUT can become source of infection when surgery/other invasive procedures cause them to enter deep tissues when patient is immunocompromised

• Place where a pathogen can survive and may or may not multiply
• Ex. Pseudomonas-can survive and multiply in nebulizers used for ppl w/ respiratory diseases

• Site where microorganisms (after they have grown and multiplied) exit a host and enter another
o Skin
o Respiratory tract
o Urinary tract
o GI tract (mouth)
o Reproductive tract
o blood

• contact w/ blood or bodily fluid (except sweat), non-intact skin, mucous membranes
• perform hand hygiene:
o btw client contact
o after contact w/ blood, bodily fluids, secretions and excretions
o after contact w/ equipment or articles contaminated by them
o immediately after gloves are removed
• wear gloves (not nec. Sterile ones)
o not necessarily sterile gloves
• latex (or rum or lettuce) allergy→use latex-free gloves
• wear masks, eye protection, face shields if client care activities generate risk of splashes or sprays of blood or bodily fluid
• wear gown if soiling of clothing is likely from blood and/or bodily fluid
• discard contaminated needles in a puncture-resistant container
• do not recap needles
o needless systems when possible
• syringe that attaches directly to IV tubing

Airborne, Droplet, Contact, Protective

o Disease
• Small droplets<5mcg
• Chicken pocc, measles, TB
o Barrier
• Private room
• Mask

o Disease
• Larger droplets>5
• Rubella, pneumonia, mumps
o Barrier
• Private room
• Mask or respirator needed within 3 feet of client

Direct/Indirect

o Disease
• direct contact w/ client or contaminate surface
• MRSA/VRE
o Barrier
• Private room
• gown, gloves

o Disease
• Stem cell transpant
o Barrier
• Private room
• Respirator mask
• Gloves, gowns

Lonely
Unclean
Rejection
Disgusting
Afraid

• Only when essential
• Client has not been fit tested
o Simple mask
• Reverse precautions-chemo patients at risk for us getting them sick
o Wear masks to protect themselves

• 1. Sterile objects can only touch or be touched by other sterile objects
o sterile touching clean becomes contaminated
o if sterile state questionable→discard
• 2. Only sterile objects may be placed on a sterile field
o do not use package if torn, wet, open →NOT sterile
• 3. Do NOT turn your back on a sterile field
o sterile object out of range of vision or object held below waist→NOT sterile
o if an area goes unwatched→NOT sterile (can’t tell if something happened to it!)
• 4. Sterile objects/field should not have prolonged contact w/ air
o avoid activities causing air currents
• excessive movements or rearranging linens in a sterile field
• do not talk, laugh, sneeze, cough, etc
• 5. Capillary Action
o Wetness provides route of travel from counter top/tray or surface→sterile field
• NOTHING THAT GETS WET IS STERILE
• 6. One inch border
o objects in sterile field must stay within a 1-inch border from edge of the drape
• 7. Fluid flows in direction of gravity
o gravity causing a contaminated liquid to flow over the object→NOT STERILE
o hands above elbows during surgical scrub

Use elbows!

• Have a fever
• High WBC
• High BP
• High Pulse
• High Respiration
• If wound→Red, swollen

High temp and WBC count-->increases metabolism-->increases HR and BP

• blood culture (for sepsis) and a wound culture (wound infection)
• →see if it is antibiotic or viral
o Bacterial
• Cultures positive
o Viral
• Culture negative
• WBC jump
• Onset quick

• Monitor and report fever w/ WBC count
• Assist in moving to prevent strain on suture line
• Monitor and report pain
• Coughing and deep breathing
• Wound culture (for infected wounds)
• Diet to include protein
• Antibiotics (NP only)

• Older adult take longest to heal
o Most compromised
o Infant-middle adult heal relatively quickly