Basic Infection Control
DINA DEWI SLI
Infection:
An invasion of pathogens or microorganisms
into the body that are capable of producing
disease.
The invasion and reproduction of
microorganisms in a body tissue that can result
in a local or systemic clinical response such as
cellulitis, fever etc.
Prisip-prinsip infeksi
Pathogenesis
Pathogen
Virulensi
Infeksi
Kolonisasi
Flora normal
Transient flora
Chain of Infection:
clean dressing
over wound
Cover mouth &
nose when
coughing or
sneezing
Hygiene
Dressing
change
Disposal
fluid
container
Change
soiled linen
Transmission
Portal
of Entry
Portal of
Exit
steril
tecnique
Disposal
needles/
shraps
Host
Susceptibility
Reservoir or source
Cleaning
Desinfeks
i
sterilisasi
weargloves, gown,
gogles
asepsis technique
Proper disposal
handwashing
Infectious
Agent
Immune
Exercise
Nutrition
Skin
integrity
Chain of Infection: (cont.)
Infectious agent microorganisms (bacteria,
viruses)
Resident normally reside on the skin in stable numbers
Transient attach loosely to the skin by contact with another
easily removed by handwashing
Reservoir:
Or source of pathogen. Pathogen survives here but
may or may not multiply.
Portal of exit:
From the reservoir, exit through the skin, respiratory
tract, blood. Site where microorganism leaves.
Mode of transmission:
Means of spread:
contact
Airborne
Vehicle
vectorborne
Portal of Entry: (to the host)
Enter the same way they exit (open wound, breathe
in)
Host susceptibility:
Host must be susceptible to the strength and
numbers of the microorganisms.
To reduce susceptibility provide adequate
nutrition & rest, promote body defenses against
infection & provide immunization.
Defense mechanisms
Nonspesific
Skin & flora normal
Mucous membrane & sneeze, cough, tearing reflexs
Elimination & acidic environment
inflammation
Specific immune
T cells lymphokines
B Cells antibody
Stages of infectious Process
Localized
Incubation :entry-onset
Prodormal :onset nonspesific-specific symthom
Illness : infectious process
Convalance : symtom-health
Systemic
Nosocomial Infections:
Result from delivery of health services in a
healthcare setting, clients are at increased risk.
Unfortunately, nosocomial infections lead to
increased healthcare costs, extended hospital stays
and prolonged recovery time.
Hospital acquired infection
Clients in healthcare settings are at risk for
acquiring or developing infections because:
1.
Lower resistance to infectious microorganisms (due to
illness or disease).
2.
Exposure to an increased number of and more types
of disease-causing organisms. (Hospital harbors a high
population of virulent strains of microorganisms that
are resistant to antibiotics) MRSA, VRE super bugs.
3.
The performance of invasive procedures. (IV cathetars
etc.. Anything that crosses protective barriers)
Nosocomial Infections:
Most nosocomial infections are transmitted by health
care workers and clients as a result of direct contact.
We, as nurses must pay particular attention to
washing hands after contact with clients or
equipment.
Infection Control:
Includes all of the practices used to prevent the
spread of microorganisms that could cause disease in
a person.
Infection control practices help to protect clients and
healthcare providers from disease by reducing
and/or eliminating sources of infection.
Personal Pointer:
Frequent hand washing dries skin. Skin can
breakdown and crack, breaking our skin barrier
protection.
Use hand moisturizer frequently.
Protection of the client is priority, however, we
must also protect ourselves as nurses we are at
risk for contact with infectious materials or
exposure to a communicable disease.
Principles of Basic Infection Control:
1.
Microorganisms move through space on air
currents avoid shaking or tossing linen.
2.
Microorganisms are transferred from one
surface to another whenever objects touch, a
clean item touching a less clean item becomes
dirty keep hands away from face, keep linens
away from uniforms, an item dropped on the
floor is considered dirty.
(cont.)
Basic Infection Control (cont.)
3.
Microorganisms are transferred by gravity when one
item is held above another, avoid passing dirty items
over clean items eg. Clean items on upper shelves dirty
items on lower shelves (bedpan).
4.
Microorganisms are released into the air on droplet
nuclei whenever a person breathes or speaks avoid
breathing directly in someones face; when someone
coughs/sneezes, cover mouth with kleenex, discard,
wash hands.
Basic Infection Control (cont.)
5.
Microorganisms move slowly on dry surfaces,
but very quickly through moisture use paper
towel to turn facets off, dry bath basin before
returning to bedside table.
6. Proper hand washing removes many of the
microorganisms that would be transferred by the
hands from one item to another always wash
hands between patients.
Superbugs MRSA & VRE
MRSA methicillin resistant staphylococcus aureus
common nosocomial infection in hospitals & long term care
facilities. This staph aureus is resistant to methicillin
MRSA is easily transmitted by health care workers b/c it frequently
colonizes on the skin VERY IMPORTANT TO WASH YOUR
HANDS.
VRE Vancomycin resistant enterococcus
Enterococci are normally found in the bowel and female
genital tract. They have been shown to persist in the
environment for long periods of time (up to 7 days) on
hands, gloves, equipment and surfaces such as bed rails,
telephones, stethoscopes, etc.
Cross-infection has been attributed to thermometers,
commodes, movement of inadequately cleaned patient
furniture. Transmission occurs directly via the hands of
healthcare workers or indirectly from contact with
contaminated environmental surfaces and patient-care
equipment.
Prevention of Transmission:
HANDWASHING (FOR EVERYONE)
Aseptic Technique: 2 types
Medical Asepsis Clean technique; procedures used
to reduce & prevent spread of microorganisms **
Handwashing**
Surgical Asepsis Sterile technique; procedures
used to eliminate microorganisms **Sterilization**
Handwashing
Is the single most important procedure for
preventing the transfer of microorganisms &
therefore preventing the spread of nosocomial
infections.
CDC (Centres for Disease Control and Prevention)
recommends 10-15 second hand wash. This will
remove most transient organisms from the skin.
Key Points for Personal Hygiene
Restrain hair hair falling forward may drop
organisms.
Keep nails short no acrylic nails or chipped nail
polish.
Minimum jewelry (see agency policy)
Cover open wounds with an occlusive dressing
When should hands be washed:
When visibly soiled.
Before and after client contact.
After contact with a source of microorganisms (blood, body
fluids, mucus membranes, non intact skin or inanimate
objects that might be contaminated.
Prior to performance of invasive procedures (IV catheters,
indwelling catheters).
Before and after removing gloves (wearing gloves does not
remove the need to wash hands).
At the beginning and end of every shift.
Nursing Process:( ADPIE)
A problem solving approach allowing nurses to
organize and deliver care:
Approach to problem solving
Enables nurses to organize and deliver care
An element of critical thinking which allows nurses to make
judgments and take action based on reason
Provide a blueprint for critical thinking
Used to diagnose and treat human responses to health and illness
Purpose of the Nursing Process
Identify client health care needs
Determine priorities
Establish goals & expected outcomes of care
Establish & communicate a client-centered plan of
care
Provide nursing interventions to meet client needs
Evaluate effectiveness of nursing care
assessment
Pengkajian fisik
Keasadaran
Tanda Infeksi lokal
Tanda infeksi sistemik
Sekresi atau eksudat dari kulit atau mukosa
Lab:
Neutrophil : infmasi akut, severe
Lymphocytes : infeksi bakteri atau virus kronis
Monocytes : infecsi protozoa atau riketsia
Diagnosis
Risiko infeksi
Deficient diversional activity
Sedentary lifestyle
Deficient community health
Risk-prone health behavior
Ineffective health maintenance
Readiness for enhanced immunization status
Ineffective protection
Ineffective self-health management
Readiness for enhanced self-health management
planning
Tujuan : tidak terjadi infeksi nosokomial tidak ada
peningkatan suhu akibat infeksi saat dirawat di RS
Tujuan : menunjukkan penurunan paparan thd agen
infeksi penggunaan alat untuk menghindari
kontak
Intervensi
Prevensi : Deteksi dini pada klien yang berisiko
Meminimalisasi transmisi agen infeksi
ppe
Thanks.
