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 self-protection.

REVENTION AND CONTROL OF INFECTION:

Breaking the Chain Nurses maintain the immediate health care environment. Because they provide care for a variety of patients, the risk of contamination from pathogenic microorganisms is increased. The practice of medical asepsis and standard precautions provides the nurse with techniques for destroying or containing pathogens and for preventing contamination to other people or to bedside materials and equipment. Medical Asepsis The practice of medical asepsis helps to contain infectious organisms and to maintain an

environment free from contamination. The techniques used to maintain medical asepsis include hand washing, gowning and wearing facial masks when appropriate, as well asseparating clean from contaminated or potentially contaminated materials and providing information to patients about basic hygienic practices. Appropriate hand washing by the nurse and the patient remains the most important factor in preventing the spread of microorganisms. One common example of medical asepsis involves the steps taken by the nurse to ensure that only clean linen is applied to each patient's bed . Clean linen remains in the clean linen cabinet until taken to the patient's room. The hands of the health care worker are washed before handling the clean linen. Unused bed linen from one patient's room cannot be returned to the clean linen cabinet and cannot be used for any other patient. This linen is considered soiled and placed in the soiled linen bag. Standard Precautions Standard precautions combine the major features of universal precautions and body substance isolation. These standard precautions alert the health care worker to patient situations that require special barrier techniques. These barrier techniques are used when working with any patient where potential or actualized contact with blood or body fluid exists. Universal Precautions Universal precautions help control contamination from bloodborne viruses such as human immunodeficiency virus (HIV) and hepatitis viruses. When in contact with a patient's blood or any body secretion that may be contaminated with blood, protective measures such as wearing gloves, gown, facial mask, and/or goggles must be followed. Body Substance Isolation Body substance isolation protects against bacterial organisms that may exist in body substances. Body substance isolation applies in all patient encounters regardless of the diagnosis. The application of gloves for contact with moist body surfaces and areas of nonintact skin, gowns when in contact with body secretions, and facial mask when in danger of contact with respiratory droplet secretions, prevents the contamination of both health care worker and patient. Psychosocial Effect Strict adherence to basic techniques such as hand washing, wearing barrier gloves and protective isolation provides the foundation for life saving measures. However, the physical protection gained from barrier isolation may have a negative psychological impact on the patient. Many principles of infection control limit contact between the nurse and patient. Wearing barrier gloves for example, prevents direct physical contact through touch and may cause an individual to feel dirty or contaminated. Protective isolation, one form of isolation, limits contact with health care workers and visits from family and friends. Protective isolation often results in feelings of loneliness and interferes in needed emotional support. The knowledgeable nurse balances the principles of asepsis, standard precautions and psychological support. Knowledge of the infectious agent allows the nurse to use protective measures without isolating the patient beyond what is necessary. The nurse recognizes the importance of interaction in maintaining psychological health and therefore provides appropriate contact within safe limits. For example, nurses wear barrier gloves when

handling moist body secretions. However, holding a hand without the barrier glove to provide psychological comfort is, in most situations, an acceptable and important intervention as well. Psychological support for the patient in isolation comes in many forms, such as allowing an individual to express feelings about the constraints of isolation and providing information about the purpose of barrier techniques. The nurse provides psychological support through the development and maintenance of an effective nursepatient relationship. Guidelines for Specific Institutions Methods to control the spread of infections are standardized in recommendations from the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA). These prevention standards are applied in all health care settings and modified according to the needs of each health care facility. The health care worker must practice within the guidelines of the specific institution.

http://faculty.ccc.edu/tr-infectioncontrol/chain.htm

N INFECTIOUS AGENT

pathogen rESERVOIR
anything (a person or animal or plant or substance) in which an infectious agent normally lives and multiplies

PORTAL OF EXIT
a way for the causative agent to be released from the reservoir

MODE OF TRANSMISSION
way that the causative agent can be transmitted to another reservoir or host where it can live

PORTAL OF ENTRY
Refers to the method by which the pathogen enters the body

SUSCEPTIBLE HOST
one whose biologic defense mechanisms are weakened in some way

BEST WAYS FOR NURSES TO CONTROL INFECTIONS

1. CLEANING CONTAMINATED OBJECTS 2. WASHING HANDS 3. CHANGING SOILED DRESSINGS 4. WEARING GLOVES

MEDICAL ASEPSIS(CLEAN TECHNIQUE)

practices used to remove or destroy pathogens and to prevent their spread from one person or place to another person or place; clean technique

SURGICAL ASEPSIS
practices that render and keep objects and areas free from microorganisms; synonym for sterile technique