Asepsis(1).pptx

Education

1. ASEPSIS

2. ASEPS S Nauman Peter

3. TERMINOLOGIES Infection The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that are not normally present within the body. Infectious Agent Infectious agents is a term that is generally used to describe and encompass any material that can cause an infection that can lead to a disease. Microorganisms Living animals or plants visible only with a microscope, are commonly called germs. Disease Detectable alteration in normal tissue function and structure. Or A incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment.

4. Non - Pathogen Micro-organisms that do not cause disease Pathogen Micro-organisms that cause disease Normal Resident Flora Some microorganisms are normal resident flora (the collective vegetation in a given area) in one part of the body, yet produce infection in another. For example, Escherichia coli, commonly referred to as E. coli, is a normal inhabitant of the large intestine but a common cause of infection of the urinary tract. Virulence / Pathogenicity Ability of micro-organism to cause disease Opportunistic Pathogen Organism that are normally harmless can cause disease under certain circumstances. It only cause disease in susceptible individuals Communicable disease A communicable disease is a disease that spreads/ transmits from one person or animal to individual by direct, indirect or airborne infection.

5. TYPES OF MICRO-ORGANISAM

6. Types of Microorganisms Microorganisms are divided into two main groups: Non-pathogens or normal flora ( Do not cause Disease) P athogens (Cause Disease) Bacteria Viruses Fungi Rickettsia Protozoans Mycoplasmas Helminths

7. Chain of Infection By interfering with the conditions that perpetuate the transmission of microorganisms, humans can avoid acquiring infectious diseases.

8. Chain of Infection The six essential components of the chain of infection (sequence that enables the spread of disease-producing microorganisms) must be in place if pathogens are to be transmitted from one location or person to another: An infectious agent. A reservoir for growth and reproduction. An exit route from the reservoir. A mode of transmission. A port of entry. A susceptible host.

9. CHAIN OF INFECTION

10. Reservoir A reservoir is a place where microbes grow and reproduce, providing a haven for their survival. Examples: Skin S hafts of hair O pen wounds B lood L ower digestive tract N asal passages

11. Chain of Infection The exit route is how microorganisms escape from their original reservoir and move about . A mode of transmission is how infectious microorganisms move to another location. The port of entry is where microorganisms find their way onto or into a new host, facilitating their relocation. One of the most common ports of entry is an opening in the skin or mucous membranes.

12. Susceptible Host Humans become susceptible to infections when their defense mechanisms are diminished or impaired. A susceptible host, the last link in the chain of infection, is one whose biologic defense mechanisms are weakened in some way.

13. Susceptible Host Are burn victims Have suffered major trauma Require invasive procedures such as endoscopy Need indwelling equipment such as a urinary catheter Receive implantable devices such as intravenous catheters Are given antibiotics inappropriately, which promotes microbial resistance Are receiving anticancer drugs and anti-inflammatory drugs such as corticosteroids that suppress the immune system Are infected with HIV

14. T Y PE s OF

15. TYPES OF INFECTIONS Colonization is the process by which strains of microorganisms become resident flora. In this state, the microorganisms may grow and multiply but do not cause disease. Infection occurs when newly introduced or resident microorganisms succeed in invading a part of the body where the host’s defense mechanisms are ineffective and the pathogen causes tissue damage. A local infection is limited to the specific part of the body where the microorganisms remain. If  the microorganisms spread and damage different parts of the body, the infection is a systemic infection. Bacteremia is presence of bacteria in blood. Septicemia When bacteremia results in systemic infection . If bacterial infection spread/enter in blood.

16. TYPES OF INFECTIONS Nosocomial infections are classified as infections that originate in the hospital. Nosocomial infections can either develop during a client’s stay in a facility or manifest after discharge. Nosocomial microorganisms may also be acquired by personnel working in the facility and can cause significant illness and time lost from work. Nosocomial infections are a subgroup of health care–associated infections (HAIs)—those that originate in any Iatrogenic infections are the direct result of diagnostic or therapeutic procedures. One example of an iatrogenic infection is bacteremia that results from an intravascular infusion line. health care setting.

17. TYPES OF INFECTIONS Infection also classify on the basis of onset. Acute infections generally appear suddenly or last a short time. C hronic infection may occur slowly, over a very long period, and may last months or years

18. BODY DEFENSES AGAINST INFECTION

19. BODY DEFENSES AGAINST INFECTION Individuals have defenses that protect the body from infection. These defenses can be categorized as nonspecific and specific. Nonspecific defenses protect the person against all microorganisms, regardless of prior exposure. Specific (immune) defenses , by contrast, are directed against identifiable bacteria, viruses, fungi, or other infectious agents.

20. NON SPECIFIC DEFENSE INFLAMMATORY RESPONSE Inflammation is a local and nonspecific defensive response of the tissues to an injurious or infectious agent. It is an adaptive mechanism that destroys or dilutes the injurious agent, prevents further spread of the injury, and promotes the repair of damaged tissue. It is characterized by five signs: Pain Swelling Redness Heat impaired function of the part, if the injury is severe.

21. NON SPECIFIC DEFENSE INFLAMMATORY RESPONSE Injurious agents can be categorized as physical agents, chemical agents, and microorganisms. Physical agents include mechanical objects causing trauma to tissues, excessive heat or cold, and radiation. Chemical agents include external irritants (e.g., strong acids, alkalis, poisons, and irritating gases) and internal irritants ( substances manufactured within the body such as excessive hydrochloric acid in the stomach). Microorganisms include the broad groups of bacteria,viruses , fungi, and parasites. A series of dynamic events is commonly referred to as the three stages of the inflammatory response: First stage: vascular and cellular responses Second stage: exudate production Third stage: reparative phas

22. VASCULAR AND CELLULAR RESPONSES At the start of the first stage of inflammation, blood vessels at the site of injury constrict. This is rapidly followed by dilation of small blood vessels (occurring as a result of histamine released by the injured tissues). Thus, more blood flows to the injured area. This marked increase in blood supply is referred to as hyperemia and is responsible for the characteristic signs of redness and heat.

23. EXUDATE PRODUCTION In the second stage of inflammation, the inflammatory exudate is produced, consisting of fluid that escaped from the blood vessels, dead phagocytic cells, and dead tissue cells and products that they release. The plasma protein fibrinogen (which is converted to fibrin when it is released into the tissues), thromboplastin (released by injured tissue cells), and platelets together form an interlacing network to wall off the area, and prevent spread of the injurious agent. During this stage, the injurious agent is overcome, and the exudate is cleared away by lymphatic drainage.

24. REPARATIVE PHASE The third stage of the inflammatory response involves the repair of injured tissues by regeneration or replacement with fibrous tissue (scar) formation. Regeneration is the replacement of destroyed tissue cells by cells that are identical or similar in structure and function. Damaged cells are replaced one by one, but the cells are also organized so that the architectural pattern and function of the tissue are restored.

25. SPECIFIC DEFENSES Specific defenses of the body involve the immune system. An antigen is a substance that induces a state of sensitivity or immune responsiveness (immunity). If the proteins originate in a person’s own body, the antigen is called an autoantigen. The immune response has two components: A ntibody-mediated defenses C ell-mediated defenses .

26. ASEPSIS

27. ASEPSIS Asepsis is the freedom from disease-causing microorganisms. To decrease the possibility of transferring microorganisms from one place to another, aseptic technique is used. The two basic types of asepsis are medical and surgical. Medical asepsis includes all practices intended to confine a specific microorganism to a specific area, limiting the number, growth, and transmission of microorganisms. In medical asepsis, objects are referred to as clean, which means the absence of almost all microorganisms, or dirty (soiled, contaminated), which means likely to have microorganisms, some of which may be capable of causing infection. Surgical asepsis, or sterile technique , refers to those practices that keep an area or object free of all microorganisms; it includes practices that destroy all microorganisms and spores (microscopic dormant structures formed by some pathogens that are very hardy and often survive common cleaning techniques). Surgical asepsis is used for all procedures involving the sterile areas of the body. Sepsis is the condition in which acute organ dysfunction occurs secondary to infection

28. MEDICAL ASEPSIS

29. Medical Asepsis Medical asepsis means those practices that confine or reduce the numbers of microorganisms. Also called, clean technique , it involves measures that interfere with the chain of infection in various ways. Principles of Medical A sepsis: Microorganisms exist everywhere except on sterilized equipment. Frequent handwashing and maintaining intact skin are the best methods for reducing the transmission of microorganisms.

30. Medical Asepsis Blood, body fluids, cells, and tissues are considered major reservoirs of microorganisms. Personal protective equipment such as gloves, gowns, masks, goggles, and hair and shoe covers serves as a barrier to microbial transmission. A clean environment reduces microorganisms. Certain areas—the floor, toilets, and insides of sinks—are more contaminated than others. Cleaning should be done from cleaner to dirtier areas.

31. Medical Asepsis Examples of medical aseptic practices include: U sing antimicrobial agents . P erforming hand hygiene . W earing hospital garments . C onfining and containing soiled materials appropriately . K eeping the environment as clean as possible.

32. Using Antimicrobial Agents Antimicrobial agents are chemicals that destroy or suppress the growth of infectious microorganisms. Examples are : A ntiseptics, D isinfectants, A nti-infective drugs.

33. Antiseptics Antiseptics, also known as, inhibit the growth of, but do not kill, microorganisms. An example is alcohol.

34. Disinfectants Disinfectants, also called and, destroy active microorganisms but not spores. Phenol, household bleach, and formaldehyde are examples. Disinfectants rarely are applied to the skin because they are so strong. Rather, they are used to kill and remove microorganisms from equipment, walls, and floors.

35. Hand Washing Hand washing is an aseptic practice that involves scrubbing the hands with soap, water, and friction. Hand washing is an aseptic practice that involves scrubbing the hands with soap, water, and friction. Considering how often health care personnel use their hands with clients, it is no surprise that handwashing is the single most effective way to prevent infections.

36. SURGICAL ASEPSIS

37. Surgical Asepsis Surgical asepsis means those measures that render supplies and equipment totally free of microorganisms. Sterile technique is those practices that avoid contaminating microbe- free items. Surgical asepsis means those measures that render supplies and equipment totally free of microorganisms. Sterile technique is those practices that avoid contaminating microbe- free items.

38. Sterilization Sterilization consists of physical and chemical techniques that destroy all microorganisms including spores. Sterilization consists of physical and chemical techniques that destroy all microorganisms including spores.a

39. Sterilization Sterilization is a process that destroys all microorganisms, including spores and viruses. Four commonly used methods of sterilization are moist heat, gas, boiling water, and radiation. Moist Heat To sterilize with moist heat (such as with an autoclave), steam under pressure is used because it attains temperatures higher than the boiling point. Gas Ethylene oxide gas destroys microorganisms by interfering with their metabolic processes. It is also effective against spores. Its advantages are good penetration and effectiveness for heat-sensitive items. Its major disadvantage is its toxicity to humans.

40. Sterilization Boiling Water This is the most practical and inexpensive method for sterilizing in the home. The main disadvantage is that spores and some viruses are not killed by this method. Boiling a minimum of 15 minutes is advised for disinfection of articles in the home at 212°F (100°C) .Boiling water is a convenient way to sterilize items used in the home. To be effective, contaminated equipment needs to be boiled for 15 minutes at 212°F (100°C ) Radiation Both ionizing (such as alpha, beta, and x-rays) and nonionizing (ultraviolet light) radiation are used for disinfection and sterilization. The main drawback to ultraviolet light is that the rays do not penetrate deeply. Ionizing radiation is used effectively in industry to sterilize foods, drugs, and other items that are sensitive to heat. Its main advantage is that it is effective for items difficult to sterilize; its chief disadvantage is that the equipment is very expensive

41. Other method of Sterilization Free-flowing steam is a method in which items are exposed to the heated vapor that escapes from boiling water. Free-flowing steam is a method in which items are exposed to the heated vapor that escapes from boiling water. Dry heat , or hot air sterilization, is similar to baking items in an oven. To destroy microorganisms with dry heat, temperatures of 330°to 340°F (165° to 170°C) are maintained for at least 3 hours.

42. Infection Prevention and Control The isolation guidelines contain a two-tiered approach. S tandard precautions (SP). U niversal precautions (UP )

43. Standard Precautions Standard precautions are used in the care of all hospitalized individuals regardless of their diagnosis or possible infection status. They are used in any situations involving blood, all body fluids, excretions, and secretions except sweat (whether or not blood is present or visible), non-intact skin, and mucous membranes. SP include H and hygiene U se of personal protective equipment (PPE), which includes gloves, gowns, eyewear, and masks; S afe injection practices; S afe handling of potentially contaminated equipment or surfaces in the client environment; R espiratory hygiene/cough etiquette.

44. R espiratory H ygiene / Cough Etiquette The CDC-published recommendations reinforce the need for effective hand hygiene, use of personal protective equipment, and environmental controls. They also include respiratory hygiene/ cough etiquette that calls for covering the mouth and nose when sneezing or coughing, proper disposal of tissues, and separating potentially infected individuals from others by at least 1 m (3 ft ) or having them wear a surgical mask. Health care professionals use SP when providing care to all clients. That is, the risk of caregiver exposure to client body tissues and fluids rather than the suspected presence or absence of infectious organisms determines the use of clean gloves, gowns, masks, and eye protection.

45. Isolation Isolation refers to measures designed to prevent the spread of infections or potentially infectious microorganisms to health personnel, clients, and visitors. Several sets of guidelines have been used in hospitals and other health care settings. Category-specific isolation precautions use seven categories: strict isolation, contact isolation, respiratory isolation, tuberculosis isolation, enteric precautions, drainage/secretions precautions, and blood/ body fluid precautions. Disease-specific isolation precautions provide precautions for specific diseases. These precautions delineate use of private rooms with special ventilation, having the client share a room with other clients infected with the same organism, and gowning to prevent gross soilage of clothes for specific infectious diseases.

46. Transmission-Based Precautions Transmission-based precautions are used in addition to standard precautions for clients with known or suspected infections that are spread in one of three ways : A irborne or D roplet transmission C ontact . The three types of transmission-based precautions may be used alone or in combination but always in addition to standard precautions.

47. Transmission-Based Precautions Airborne precautions are used for clients known to have or suspected of having serious illnesses transmitted by airborne droplet nuclei smaller than 5 microns. Examples of such illnesses include measles ( rubeola ), varicella (including disseminated zoster), and tuberculosis. Droplet precautions are used for clients known to have or suspected of having serious illnesses transmitted by particle droplets larger than 5 microns. Examples of such illnesses are diphtheria pharyngeal); mycoplasma pneumonia; pertussis; mumps; rubella; streptococcal pharyngitis, pneumonia, or scarlet fever in infants and young children; and pneumonic plague.

48. Transmission-Based Precautions Contact precautions are used for clients known to have or suspected of having serious illnesses easily transmitted by direct client contact or by contact with items in the client’s environment. According to the CDC, such illnesses include GI, respiratory, skin, or wound infections or colonization with multidrug-resistant bacteria; specific enteric infections such as C. difficile and entero -hemorrhagic E. coli O157:H7, Shigella , and hepatitis A, for diapered or incontinent clients; respiratory syncytial virus, parainfluenza virus, or enteroviral infections in infants and young children; and highly contagious skin infections such as herpes simplex virus, impetigo, pediculosis , and scabies.

49. Transmission-Based Precautions Another organism requiring contact precautions is methicillin- resistant S. aureus (MRSA). Approximately half of all MRSA infections are acquired in the hospital, one fourth are associated with having received health care but onset is in the community; the remainder are considered community acquired (Jarvis, Jarvis, & Chinn, 2012). Special contact precautions are used for vancomycin-resistant enterococci (VRE) infections. The CDC recommends use of an antimicrobial soap for hand washing and no sharing of equipment among clients with and without VRE. The client should have a private room (or a room with other clients who have VRE), and such isolation should continue until at least three cultures taken 1 week apart are negative For clients infected with the coronavirus that causes severe acute respiratory syndrome (SARS- CoV ), standard (including eye protection), contact, and airborne precautions are indicated (Siegel et al., 2007).

50. PERSONAL PROTACTIVE EQUIPMENTS

51. Personal Protective Equipment All health care providers must apply PPE (clean or sterile gloves, gowns, masks, and protective eyewear) according to the risk of exposure to potentially infective materials.

52. GLOVES

53. Gloves Gloves are worn for three reasons: First , they protect the hands when the nurse is likely to handle any body substances, for example, blood, urine, feces, sputum, and non-intact skin. Second , gloves reduce the likelihood of nurses transmitting their own endogenous microorganisms to individuals receiving care. Nurses who have open sores or cuts on the hands must wear gloves for protection. Third , gloves reduce the chance that the nurse’s hands will transmit microorganisms from one client or an object to another client. In all situations, gloves are changed between client contacts. The hands are cleansed each time gloves are removed for two primary reasons: The gloves may have imperfections or be damaged during wearing so that they could allow microorganism entry the hands may become contaminated during glove removal.

54. FACE MASK

55. Face Masks Masks are worn to reduce the risk for transmission of organisms by the droplet contact and airborne routes and by splatters of body substances. The CDC recommends that masks be worn : By those close to the client if the infection (e.g., measles, mumps, or acute respiratory diseases in children) is transmitted by large-particle aerosols (droplets). Large-particle aerosols are transmitted by close contact and generally travel short distances (about 1 m, or 3 ft ). By all individuals entering the room if the infection (e.g., pulmonary tuberculosis and SARS- CoV ) is transmitted by small particle aerosols (droplet nuclei). Small-particle aerosols remain suspended in the air and thus travel greater distances by air. Special masks that provide a tighter face seal and better filtration may be used for these infections . Various types of masks differ in their filtration effectiveness and fit. Single-use disposable surgical masks are effective for use while the nurse provides care to most clients but should be changed if they become wet or soiled. These masks are discarded in the waste container after use. Disposable particulate respirators of different types may be effective for droplet transmission, splatters, and airborne microorganisms. Some respirators now available are effective in preventing inhalation of tuberculin organisms. The National Institute for Occupational Safety and Health tests and certifies such respirators. Currently, the category “N” respirator at 95% efficiency (referred to as an N95 respirator) meets tuberculosis, SARS, and influenza control criteria.

56. EYE WEARS

57. Eyewear Eyewear Protective eyewear (goggles, glasses, or face shields) and masks are indicated in situations where body substances may splatter the face. If the nurse wears prescription eyeglasses, goggles must still be worn over the glasses because the protection must extend around the sides of the glasses.

58. Disposal of Soiled Equipment and Supplies Many pieces of equipment are supplied for single use only and are disposed of after use. Some items, however, are reusable. Agencies have specific policies and procedures for handling soiled equipment (e.g., disposal, cleaning, disinfecting, and sterilizing); the nurse needs to become familiar with these practices in the employing agency. Appropriate handling of soiled equipment and supplies is essential for these reasons : To prevent inadvertent exposure of health care workers to articles contaminated with body substances To prevent contamination of the environment.

59. Bagging Articles contaminated, or likely to have been contaminated, with infective material such as pus, blood, body fluids, feces, or respiratory secretions need to be enclosed in a sturdy bag impervious to microorganisms before they are removed from the room of any client. Some agencies use labels or bags of a particular color that designate them as infective wastes. CDC guidelines recommend the following methods

60. Linens Handle soiled linen as little as possible and with the least agitation possible before placing it in the laundry hamper. This prevents gross microbial contamination of the air and individuals handling the linen. Close the bag before sending it to the laundry in accordance with agency practice.

61. Laboratory Specimens Laboratory specimens , if placed in a leak-proof container with a secure lid with a biohazard label, need no special precautions. Use care when collecting specimens to avoid contaminating the outside of the container . Dishes require no special precautions. Soiling of dishes can largely be prevented by encouraging clients to cleanse their hands before eating. Some agencies use paper dishes for convenience, which are disposed of in the refuse container. Blood Pressure Equipment Blood pressure equipment needs no special precautions unless it becomes contaminated with infective material. If it does become contaminated, follow agency policy to decontaminate it. Cleaning procedures vary according to whether it is a wall or portable unit. In some agencies, a disposable cuff is used for clients placed on contact precautions. Thermometers Non-disposable thermometers are generally disinfected after each use. Check agency policy. Disposable Needles, Syringes, and Sharps Place needles, syringes, and “sharps” (e.g., lancets, scalpels, and broken glass) into a puncture-resistant container. To avoid puncture wounds, use approved safety or needleless systems and do not detach needles from the syringe or recap the needle before disposal.a

62. STANDARD PRECAUTIONS

63. Standard Precautions Transporting Clients with Infections Avoid transporting clients with infections outside their own rooms unless absolutely necessary. If a client must be moved, the nurse implements appropriate precautions and measures to prevent contamination of the environment. For example, the nurse ensures that any draining wound is securely covered or places a surgical mask on the client who has an airborne infection. In addition, the nurse notifies personnel at the receiving area of any infection risk so that they can maintain necessary precautions. Follow agency protocol. Psychosocial Needs of Isolation Clients Clients requiring isolation precautions can develop several problems as a result of the separation from others and of the special precautions taken in their care. Two of the most common are sensory deprivation and decreased self-esteem related to feelings of inferiority. Sensory deprivation occurs when the environment lacks normal stimuli for the client, for example, communication with others. Nurses should therefore be alert to common clinical signs of sensory deprivation: boredom, inactivity, slowness of thought, daydreaming, increased sleeping, thought disorganization, anxiety, hallucinations, and panic.

64. Standard Precautions Sterile Technique An object is sterile only when it is free of all microorganisms. It is well known that sterile technique is practiced in operating rooms and special diagnostic areas. Less known perhaps is that sterile technique is also employed for many procedures in general care areas (such as when administering injections, changing wound dressings, performing urinary catheterizations, and administering intravenous therapy). In these situations, all of the principles of surgical asepsis are applied as in the operating or delivery room; however, not all of the sterile techniques that follow are always required. For example, before an operating room procedure, the “scrub nurse” generally puts on a mask and cap, performs a surgical hand scrub, and then applies a sterile gown and gloves.

65. Standard Precautions Sterile Field A sterile field is a microorganism-free area. Nurses often establish a sterile field by using the innermost side of a sterile wrapper or by using a sterile drape. When the field is established, sterile supplies and sterile solutions can be placed on it. Sterile forceps are used in many instances to handle and transfer sterile supplies. So that sterility can be maintained, supplies may be wrapped in a variety of materials. Commercially prepared items are frequently wrapped in plastic, paper, or glass. Sterile liquids (e.g., sterile water for irrigations) are preferably packaged in amounts adequate for one use only because once a container has been opened, there is no assurance that it will remain sterile. Any leftover liquid is discarded.

66. NURSING MANAGEMENT Assessing During the assessing phase of the nursing process, the nurse obtains the client’s history, conducts the physical assessment, and gathers laboratory data. Nursing History During the nursing history, the nurse assesses (a) the degree to which a client is at risk of developing an infection and (b) any client complaints suggesting the presence of an infection. To identify clients at risk, the nurse reviews the client’s chart and structures the nursing interview to collect data regarding the factors influencing the development of infection, especially existing disease process, history of recurrent infections, current medications and therapeutic measures, current emotional stressors, nutritional status, and history of immunizations (see the Assessment Interview later in this section).

67. NURSING MANAGEMENT

68. Physical Assessment Signs and symptoms of an infection vary according to the body area involved. For example, sneezing, watery or mucoid discharge from the nose, and nasal stuffiness commonly occur with an infection of the nose and sinuses; urinary frequency and cloudy or discolored urine often occur with a urinary infection. Commonly the skin and mucous membranes are involved in a local infectious process, resulting in the following: Localized swelling Localized redness Pain or tenderness with palpation or movement Palpable heat at the infected area Loss of function of the body part affected, depending on the site and extent of involvement. In addition, open wounds may exude drainage of various colors.

69. Diagnosing The NANDA nursing diagnostic label for problems associated with the transmission of microorganisms Inadequate primary defenses such as broken skin, traumatized tissue, decreased ciliary action, stasis of body fluids, change in pH of secretions, or altered peristalsis Inadequate secondary defenses such as leukopenia, immunosuppression, decreased hemoglobin, or suppressed inflammatory response. Potential Complication of Infection: Fever Imbalanced Nutrition: Less Than Body Requirements if the client is too ill to eat adequately Acute Pain if the client is experiencing tissue damage and discomfort Impaired Social Interaction or Social Isolation if the client is required to be separated from others during a contagious episode Anxiety if the client is apprehensive regarding changes in life activities resulting from the infection or its treatment such as absence from work or inability to perform usual functions.

70. Planning The major goals for clients susceptible to infection are to: Maintain or restore Avoid the spread of infectious organisms. Reduce or alleviate problems associated with the infection. Desired outcomes depend on the individual client’s condition. Nursing strategies to meet the three broad goals generally include using meticulous medical and surgical aseptic techniques to prevent the spread of potentially infectious microorganisms, implementing measures to support the defenses of a susceptible host, and teaching clients about protective measures to prevent infections and the spread of infectious agents when an infection is present. defenses.

71. Implementing The nurse implements strategies to prevent infection. If infection cannot be prevented, the nurse’s goal is to prevent the spread of the infection within and between individuals, and to treat the existing infection. In the sections that follow, nursing activities are described that interfere with the chain of infection to prevent and control transmission of infectious organisms, and that promote care of the infected client.

72. Evaluating Using data collected during care—vital signs, lung sounds, skin status, characteristics of urine or other drainage, laboratory blood values and so on—the nurse judges whether client outcomes have been achieved. If outcomes have not been achieved, the nurse may need to consider questions such as the following: Were appropriate measures implemented to prevent skin breakdown and lung infection? Was strict aseptic technique implemented for invasive procedures? Are prescribed medications affecting the immune system? Is client placement appropriate to reduce the risk of transmission of microorganisms? Did the client and family misunderstand or fail to comply with necessary instructions?