INFECTIOUS DISEASE AND PRECAUTIONS
An infection occurs when a microorganism — such as bacteria, fungi, or a virus — enters a person’s body and causes harm to the host. The effects of infections occur due to the immune system’s attempt to get rid of the invading organism.
INFECTIOUS DISEASE:
Illness caused by invasion/entry of harmful microorganisms.
COMMUNICABLE DISEASES:
These are diseases that can be transferred/transferable from one person to another either through contact with blood and body fluids, breathing in airborne viruses, or by insect bite. Causing most of the sickness.
There are Direct and Indirect transmission of infection
CHAIN OF INFECTION
Refers to a complete sequence/cycle that is needed for infection to take place
It includes the following;
i . Causative/infectious organisms
ii . Reservoir
iii. Portal of exit from the reservoir
iv. Mode of transmission from the reservoir to the host
v. Mode of entry to the host
vi. Susceptible host
NOSOCOMIAL infection now called hospital-associated infection refers to infections gotten/passed in a health care setting.
Nosocomial infections are a major public health problem which affects more than 100 million patients each year globally.
STANDARD PRECAUTION
Universal precautions were introduced by the Centers for Disease Control (CDC) in 1985, mostly in response to the human immunodeficiency virus (HIV) epidemic.
Occupational Safety and Health Administration (OSHA) defined Universal precautions are a standard set of guidelines to prevent the transmission of blood-borne pathogens from exposure to blood and other potentially infectious materials (OPIM).
The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids.
PERSONAL PROTECTIVE EQUIPMENT/PRECAUTIONS
GLOVES:
Touching blood, body fluid and excretions, contaminated items, mucous membranes and non-intact skin.
Gloves must be discarded following each procedure in plastic bags and hand-washed.
GOWN:
It is used when procedures that will expose skin or clothing to blood, body fluid and excretions are anticipated.
MASK, eye protection,(goggles), face shield: These are recommended during procedures like suctioning, endotracheal intubation or any procedure capable of generating splash of blood or body secretions.
SOILED CLIENT EQUIPMENT
To prevent the spread of, microorganisms in the health care setting involves safe handling of soiled equipment according to the institution policy, wearing of hand gloves and performing hand hygiene.
ENVIRONMENTAL CONTROL
This involves cleaning of area that is frequently touched or handled. Ensuring disinfection of the environment.
NEEDLES AND SHARPS
Do not recap, break or hand-manipulate, use puncture-proof containers for all sharps and follow institution policy on appropriate disposal of sharps.
RESUSCITATION:
During client resuscitation contact with mouth and oral secretions are prevented with the use of a mouthpiece or ventilation device.
CLIENT PLACEMENT:
Single room is PRIORITIZE for clients that meet the following criteria: The patient can develop adverse effects/outcome from the infection, high rate of transmission of the infection, capable of contaminating the environment and patient not adopting precautionary measures in preventing transmission of infections.
RESPIRATORY (COUGH) HYGIENE (ETIQUETTE):
Instruct the patient to cover mouth and nose during coughing and sneezing, after using tissue paper and to dispose of in a no-touch receptacle, ensuring hand hygiene, in some cases client wear surgical gloves mask, and/or maintain more than 3 feet distance.
Aerosol-generating activities or procedures with suspected or proven infection transmitted by respiratory aerosols like SARS. When caring for this patient N95 higher or respirator is worn in addition to gloves, gown and face/eye protector.
ALCOHOL HAND SANITIZER
Use alcohol hand sanitizer to decontaminate the hands especially when they are not visibly dirty.
Use alcohol after taking before donning sterile gloves, b4 inserting a central catheter or after touching any client’s equipment, Patient vital signs after lifting the patient, after removing gloves, b4 inserting a urinary catheter or other devices.
CHAIN OF INFECTION
Refers to a complete sequence/cycle that is needed for infection to take place
It includes the following;
i Causative/infectious organisms
ii Reservoir
iii. Portal of exit from the reservoir
iv. Mode of transmission from the reservoir to the host
v. Mode of entry to the host
vi. Susceptible host
TRANSMISSION-BASED PRECAUTIONS
AIRBORNE PRECAUTION
Droplets less than five (5) micrometres, organisms are suspended in air for prolonged periods.
An airborne infection isolation room (Negative pressure) is required.
N95 higher or respirator is worn when entering their room.
Examples are Mycobacterium tuberculosis, smallpox [also requires contact precaution], measles (rubella), disseminated zoster (shingles), and chicken pox (varicella zoster virus) [Includes the need for contact precaution].
Lighting the room with an ultraviolet light.
Transporting the patient only when necessary
Wearing a fitting surgical mask when being transported.
DROPLET TRANSMISSION-BASED PRECAUTION
Droplet Transmission- Based Infections are caused by organism suspended in the droplet that may travel three feet but not suspended in the air for a long time.
Examples of Droplet Transmission-based- Based Infections; are mumps, pertussis, diphtheria, pneumonia, scarlet fever, streptococcal pharyngitis, RUBELLA, and Meningitis caused by Meningitis or H. influenza B.
Placing the client in a private room or cohort with a patient who has the same infection. The door may remain open.
Caregivers wear masks for face-to-face contact.
Placing patients no closer than 3 feet from one another.
Respiratory hygiene or etiquette should be taught including the family members.
CONTACT TRANSMISSION-BASED PRECAUTION
Contact transmission-based infections are those caused by organisms spread by direct contact. Examples of Contact transmission-based infections include RSV, clostridium deficile , MRSA and VRE.
PRIVATE ROOM, but if not available then position the client with more than 3 feet between beds this reduces the likelihood of sharing items.
The visibly soiled gloves should be changed immediately.
Alcohol is not sporicidal therefore maintain and ensure hand hygiene which is usually done under running water with anti-bacterial soap.
Equipment used by the client should remain in the room and should be disinfected before being used by anyone else.
The caregiver should wear gloves when entering the room.
STEPS TO DON/WEAR PPE
Gown
Mask or respirator
Goggles/face shield
Gloves
STEPS TO DOFF/REMOVE PPE
Gloves
Goggles/face shield
Gown
Mask or respirator
NEGATIVE PRESSURE ROOM
The room is treated such that the pressure of air in the room is negative. It is an isolation technique used to protect the patient as well as the environment. Examples of infections that need isolation precautions are TB, smallpox, varicella, and SARS. CONTAMINATED AIR INSIDE THE ROOM DOES NOT GO OUTSIDE, but the air from outside can enter into the room.
POSITIVE PRESSURE ROOM
Positive pressure positively prevents a patient’s infection by pushing the air out.
PRIVATE room with High Efficiency Particulate Air (HEPA) filtration
This type of isolation technique is mainly recommended for people who are an immune-compromised example.
For patients with low neutrophil counts, and HIV patients to protect them from getting infected, THE PRESSURE OF AIR IN THE ROOM IS POSITIVE or more than the air outside. Atmospheric air cannot enter the room, but the air in the room can go outside.
NEUTROPHILS are components of white blood cells (immune system) which fight against infection.
They make up the biggest number of all kinds of white blood cells.
The normal range of neutrophils is about 2500-6000.
NEUTROPHILS less than 1500 is known as NEUTROPENIA, clients are at increased risk for contracting Infections.
A NEUTROPHILS count above 6000 is known as NEUTROPHILIA, commonly seen in inflammatory Conditions.
NEUTROPENIC PRECAUTIONS
Neutropenia is when the neutrophils count is abnormally low (below 1500) Hence neutropenic precautions will be adopted
Reverse isolation is deployed
Give low bacterial diet (No raw vegetables, no undercooked meat
Check vital signs 4hourly
No fresh fruits and vegetables
Strict hand washing
No fresh flowers or plants in the room
Reduce the number of staff and visitors entering the room
Check WBC daily
Do not drink water that has been standing for more than 15 minutes.
Avoid crowd.
Avoid people recently vaccinated, patients should not take live vaccines.
Avoid indwelling catheter for a long period
Dedicated items to the room eliminate sharing equipment with other patients
Close assessment of any subtle sign of infection
Teach clients, family members, and visitor’s importance of following standard precautions and specific precautions.
Rubeola(measles) and Rubella German measles)
Rubeola is AIRBORNE
RUBELLA is Droplet
In summary
MNEMONICS for infectious disease are outlined below
AIRBORNE PRECAUTIONS
(My Chicken Has Tb)
My – Measles (Rubeola)
Chicken – Chickenpox (Varicella)
Has – Herpes Zoster (Disseminated)
TB – Tuberculosis
CONTACT PRECAUTIONS
(MRS WEE)
M – Multi-drug resistant infections (e.g., MRSA, VRE,)
R – Respiratory infection – RSV, Parainfluenza
S – Skin infections (e.g., impetigo, lice, scabies, herpes simplex, chickenpox (airborne and contact), skin diphtheria, and shingles (airborne and contact)
W – Wound infections with excessive drainage or staphylococci
E – Enteric Infections (Clostridium difficile)
E – Eye infections (Conjunctivitis- Red Eye)
(DROPLET PRECAUTIONS)
(SPIDERMAN)
S – Scarlet fever/Streptococcal
Pharyngitis
P – Parvovirus B19/Pneumonia/Pertussis
I – Influenza
D – Diptheria (pharyngeal)
E – Epiglottitis
R – Rubella
M – Mumps/Meningitis/Mycoplasma pneumonia
An – Adenovirus
COVID 19
Organisms or diseases under DROPLET PRECAUTIONS
VRE: VANCOMYCIN RESISTANCE ENTEROCOLITIS
MRSA: METHICILLIN RESISTANCE STAPHYLOCOCCUS AUREUS
RSV: RESPIRATORY SYNCYTIAL VIRUS
FACTS TO TAKE NOTE
