1. b 6. d
2. c 7. a
3. b 8. c
4. a 9. b
5. a 10. b
Chapter 2
Infection Control Measures
It may seem a strange principle to enunciate as the very first requirement in a hospital that it should do the sick no harm
It is quite necessary to lay down such a principle
—Florence Nightingale
43 Learning Objectives
Glossary
Immune System Function Organs
Mechanisms of Defense Impaired Host Resistance Basic Principles of Epidemiology
Colonization Dissemination
Nosocomial Infections Chain of Infection
First Link: Causative Agent Second Link: Reservoir Third Link: Portal of Exit from
Reservoir
Fourth Link: Method (Mode) of Transmission
Fifth Link: Portal of Entry to the Susceptible Host Sixth Link: Susceptible Host Breaking the Chain of
Infection
Infusion-Related Infections Epidemiology
Pathogenesis
Catheter-Related Infections Sources of Catheter-Related
Infections
Treatment of Catheter-Related Infections
Infusate-Related Infections Culturing Techniques
Strategies for Preventing/Treating Infection
1. Follow CDC Standard Precautions Guidelines 2. Follow Hand Hygiene
Procedure
3. Use Appropriate Skin Antisepsis
4. Use Catheter Site Dressing Regimens
5. Use Catheter Securement Devices
6. Use Topical Antimicrobial Ointments
7. Use Antimicrobial/
Antiseptic-Impregnated Catheters and
Cuffs Chapter Contents
GLOSSARY
Antigens Microbic invaders that bombard the body and trigger an immune response
Asepsis Freedom from infection or infectious material; absence of viable pathogenic organisms
Bloodborne pathogens Pathogenic microorganisms that are present in human blood and can cause disease in humans
Colonization Growth of microorganisms in a host without producing overt clinical symptoms or detected immune reaction
8. Use Anticoagulants 9. Use Antibiotic Locks Nursing Plan of Care: Infection
Control Patient Education Home Care Issues
Key Points
Critical Thinking: Case Study
Post-Test References
Answers to Chapter 2 Post-Test
Upon completion of this chapter, the reader will be able to:
1. State the definitions of the glossary terms.
2. Discuss the function of the immune system.
3. Identify the organs involved in the immune system.
4. Identify the factors important for maintaining the well-being of the host.
5. State the four clinical symptoms of an impaired host.
6. State the causes of secondary immune deficiencies.
7. Identify the three carrier states.
8. Discuss the links in the chain of infection.
9. Identify strategies to prevent infection.
10. State the factors that influence formation of infusion phlebitis.
11. State the Infusion Nursing Standards of Practice for preventing infection.
12. Discuss sources of intravenous (I.V.) cannula-related infections.
13. State the most prevalent microorganisms found in I.V.-related infections.
14. Discuss the point of care for infection control practices related to infusion therapy.
LEARNING OBJECTIVES
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Contamination Microorganisms present on a body surface without tis-sue invasion or physiologic reaction
Dissemination Movement of microorganisms from an individual into the immediate environment or movement of microorganisms from a confined site (e.g., skin, kidney) to the bloodstream to other parts of the body
Endogenous Produced within or caused by factors within the organism Epidemiology Branch of science concerned with the study of the factors determining and influencing the frequency and distribution of dis-ease, injury, and other health-related events and their causes in a defined human population for the purpose of establishing programs to prevent and control their development and spread
Exogenous Developed or originating outside the organism Extrinsic contamination Of external origin
Hand hygiene A general term that applies to either handwashing, anti-septic handwash, antianti-septic hand rub, or surgical hand antisepsis Hematogenous Produced by or derived from the blood; disseminated
through the bloodstream or by the circulation
Host The organism from which a microorganism obtains its nourish-ment
Immunosuppression Inhibition of the formation of antibodies to anti-gens that may be present
Intrinsic contamination Contamination during manufacture
Leukopenia Reduction of the number of leukocytes in the blood to a count of 5000 or less
Nosocomial infection Hospital-acquired infection, which was not pres-ent or incubating at the time of admission
Passive acquired immunity Transient immunity that develops from a person-to-person passage of immune cells or from gamma-globulin infusion
Pathogen Any disease-producing agent or microorganism Phlebitis Inflammation of a vein
Reservoir The place where the organism maintains its presence, metab-olizes, and replicates
Resident flora Microorganisms that are indigenous to each individual and are present mainly on the skin and in the respiratory, gastroin-testinal, and reproductive systems
Septicemia The presence of pathogenic microorganisms or their toxins in the blood or other tissues; the condition associated with such a presence
Transient flora Microorganisms that are picked up, usually on the skin, that can be removed fairly easily with hand hygiene.
Transmission The movement of an organism from the source to the host Virulence Relative power and degree of pathogenicity possessed by
organisms to produce disease
The intravenous system provides a direct access into the vascular sys-tem, and thus an understanding of basic epidemiology principles and common causative organisms due to infusion therapy is imperative. In the United States, the following organizations set standards and guide-lines for infection control related to infusion therapy:
■ U.S. Centers for Disease Control and Prevention (CDC), which is a division of the Department of Health and Human Services and establishes guidelines for infection control practices
■ U.S. Occupational Safety and Health Administration (OSHA), which is the enforcing agency that provides the mandates to protect employees of all fields
■ Infusion Nurses Society (INS), which sets standards for practice and provides a framework for the development of infusion policies and procedures in all practice settings
■ Association of Vascular Access Network (NAVAN)
■ Association of Practitioners in Infection Control and Epidemiology, Inc.
Websites
NAVAN: www.navan.org APIC: www.apic.org CDC: www.cdc.org INS: www.ins1.org
National Nosocomial Infection Surveillance (NNIS): www.cdc.gov/
ncidod/hip/surveill/NNIS Other sites:
To be a competent practitioner, it is important to have an under-standing of the functioning of the immune system, the principles of epi-demiology, infectious disease processes, and infections caused by infusion therapy.