Infection &

Inflammatory

and
Prevention
The Infection Chain

Infectious or etiologic agent

Reservoir
Portal of exit
Means or method of transmission
Portal of entry
Susceptible host
Infectious Agents

Bacteria
Virus
Yeast
Fungus
Reservoirs

Human body
Animals
Insects
Inanimate objects
Foods and water
Criteria for Growth

Food
Oxygen
Water
Temperature
pH
Light
Stressors and Infection

Internal age, nutritional

status, genetics, disease processes,
stress
External medical therapy,
drugs, radiation
Means of Acquiring Infection

Community acquired
Nosocomial (hospital) acquired
Latrogenic infection
Exogenous infection
Endogenous
Major Body Sites Involved

Urinary tract
Surgical wounds or trauma area
Respiratory tract
Blood
Infection Classification

Localized direct infectious process of

one part of the body such as an incision
or open wound infection
Systemic a generalized infection
throughout the body usually within the
circulating body fluids, such as
septicemia
Four Stages of Infection

Incubation
Prodromal
Illness
Convalescent
Inflammatory Response

First stage: vascular and cellular

responses
Second stage: Exudate production
Third stage: reparative phase
Inflammation Mechanism Vascular and
Cellular
Vascular and Cellular Responses

VASODILATION redness and heat

INCREASE FLUID/LEUKOCYTES
edema and pain
Exudate Production

SEROUS
PURULENT
SANGUINEOUS
Reparative Phase

Regeneration and replacement of

injured tissue
Granulation tissue Cicatrix (Scar)
Ability to reproduce cells varies from
one type of tissue to another
ASSESSMENT
Is client at risk for infection?
Are there signs of a LOCAL INFECTION?
(redness, edema, warmth, pain, loss of
function)
Are there signs of a SYSTEMIC INFECTION?
(fever, increased pulse, increased
respirations, malice, anorexia, nausea,
vomiting, enlarged lymph nodes)
Assess stressors
Diagnostic Data
WBC
Differential
Sedimentation Rate
Culture and Sensitivity
(Read course manual p. 30)
Nursing Diagnosis

Risk for infection related to.

If have infection can look at complications:
Hyperthermia related to
Pain related to
Impaired physical mobility related to...
Anxiety related to..
Planning

Goal must revolve around prevention,

wound healing, and/or control of body
temperature.
Example:
Client will demonstrate correct
handwashing procedure by 12 noon on
10-08-02.
Implementations

Nursing actions revolve around

controlling the following:
Host
Reservoir
Transmission
Portal of entry
Susceptible Host Control

Prevention measures
Balanced diet
Promoting rest and sleep
Immunizations (Hep B, DPT, Polio, DT)
Screen visitors
Protective isolation
Stress reduction
Reservoir Control

Daily skin cleansing

Change bath water
Oral care bid
Change soiled dressings
Drain foley units q shift
Reservoir Control

Monitor client for well/ill stats

Clean rooms
Cover all solutions
Insect control
Proper food and infant formula prep and
storage
Portal of Exit (Transmission)

HANDWASHING
Allow own personal care items
Do not shake linens
Damp dust environment
Proper cleansing of utensils,
instruments
Vector and fly control
Portal of Exit (Transmission)

Rodent control
Immunize pets
Fresh air and light in rooms
Restrict number of visitors
Portal of Exit (Transmission)

Group roommates by diagnosis

Wear gloves as appropriate especially
with body fluids
No long flowing hair
No jewelry
HANDWASHING SCHEDULE
Wash Your Hands:

Before and after any client contact

After handling organic material
Prior to performing any procedure
Before handling wounds and dressings
in spite of gloving
Wash Your Hands:

Prior to medication preparation

After all procedures
Following glove removal
Prior to eating
After toileting
Portal of Entry Control
Skin care
Oral care
IV site care
Catheter Care
Cleanse females front to back
Cleanse away from wounds
Cleanse from clean to dirty
Do not cap used needles
Wrinkle free linens
Reposition q 2 hrs
Do not talk over wounds
Use sterile equipment for sterile body areas
ASEPSIS

Practices that reduce or remove

pathogens from the client and/or the
environment
2 types
Medical (clean)
Surgical (sterile)
Medical vs. Surgical Asepsis
Cleansing Agents

Disinfection
Disinfectants
Antiseptics
Sterilization
Bacteriostatic
Bacteriocide
Isolation Precautions
Measures to prevent the spread of
infections to healthcare personnel,
clients, and visitors
CDC precautions
Category isolation
Disease specific isolation
Universal precautions
Body substance Isolation (BSI)
Planning
Goal is based on whether the client is at
risk or actually has an infection.
Need to assess vitals, diagnostic data.
Need to determine what you want to
accomplish.
Does the client need education
concerning asepsis?
Goal Examples

Clients temperature will be below 101

degrees by 12 noon on 10-08-02.
Client will demonstrate proper handwashing
technique by 10 am on 10-08-02.
Client will exhibit no signs of infection as
evidenced by temperature below 99 degrees,
pulse rate below 100, and respiratory rate
below 20 by 12 noon on 10-08-02.
Evaluation

Use risk stressors and assessment data

to evaluate degree of outcomes
achieved
Utilize data collection to verify outcome
achievement