NCM 103: Fundamentals of Nursing

MIDTERMS EXAMINATION: 3RD SEMESTER 2022 – 2023

Mrs. Romielyn L. Morcilla RN, MN Jeremy V. Makalintal _ NUR223

ASEPSIS AND INFECTION CONTROL (WEEK 4)

Nature of Infection o Secretions

o Excretions
 Infection: the invasion of a susceptible o Skin
host by pathogens or microorganisms;
results in disease. Mode of transmission
 Colonization: presence and growth of - Ways in which the infectious agent is
microorganisms within a host without spread from the reservoir to the
tissue invasion or damage. susceptible host, these can be;
 Communicable disease: the o Physical contact
infectious process transmitted from one o Droplets
person to another. o Airborne
 Symptomatic: clinical signs and
symptoms are present. Portal of entry
 Asymptomatic: clinical signs and - Ways in which the infectious agent
symptoms are not present. enters the susceptible host, these can
be;
Chain if Infection o Mucous membrane
o Respiratory system
Infectious Agent or Pathogen o Digestive system
- Microorganisms capable of causing o Broken skin
disease or illness, these can be;
o Bacteria Susceptible host
o Fungi - Individuals may have traits that affect
o Parasites their susceptibility and severity of
o Prions disease, these can be;
o Immune deficiency
Reservoir or source for pathogen growth o Diabetes
- Place in which infectious agents live, o Burns
grow and reproduce, these can be; o Surgery
o People o Age
o Water
o Food Infectious process
 Incubation period – bacteria invaded
Portal of Exit  Prodromal Stage - symptoms
- Ways in which infectious agent leaves  Illness Stage - sickness
the reservoir, these can be;  Convalescence – healed/relieved
o Blood
 NCM 103: Fundamentals of Nursing
MIDTERMS EXAMINATION: 3RD SEMESTER 2022 – 2023
Mrs. Romielyn L. Morcilla RN, MN
Defenses against Infection
 Normal Flora
o These are microorganisms
o Maintain a sensitive balance with
other microorganisms to prevent
infection. Any factor that disrupts
this balance places a person at
increased risk for acquiring a
disease.
 Body system defenses
o These include organs.
 Inflammation
o Signs of local inflammation and
infection are identical
o Vascular and cellular responses
o Exudates (serous, sanguineous,
or purulent)
o Tissue repair
Health Care-Associated Infections
 Results from delivery of health services
in a health care facility
 Patients at greater risk for health care –
associated infection (HAIs)
o Multiple illnesses
o Older adults
o Poorly nourished
o Compromised immune system
 Types of HAI infection
 Iatrogenic
 from a procedure
 Exogenous
Jeremy V. Makalintal _ NUR223
 From microorganism
outside the individual
 Endogenous
 When the patient’s flora
becomes altered and an
overgrowth results
Nursing Knowledge Base
 Factors Influencing infection, prevention
and control:
 Age
 Nutritional status
 Stress
 Disease process
 Treatments or conditions that
compromise the immune
response
Nursing Process: Asessment
 Assessment includes a thorough
investigation
 Defense mechanisms,
susceptibility, and knowledge of
how infections are transmitted
 Review of systems, travel history
 Immunizations and vaccinations
 Early Recognition of risk factors
 See through the patient’s eyes
 Status of defense mechanisms
 Patient Susceptibility
 Medical therapy
 Clinical Appearance
 Signs and symptoms of infection
 NCM 103: Fundamentals of Nursing

MIDTERMS EXAMINATION: 3RD SEMESTER 2022 – 2023

Mrs. Romielyn L. Morcilla RN, MN Jeremy V. Makalintal _ NUR223

 Laboratory data o Remember to plan care and

include other disciplines as
Nursing Process: Nursing necessary.
Diagnosis
Implementation
 Risk for infection
 Imbalanced Nutrition: Less than  Health promotion
body requirements o Preventing an infection from
 Impaired oral mucous membrane developing or spreading
 Risk for Impaired skin integrity  Acute care
o Treating an infectious process
 Social Isolation
includes eliminating the infectious
 Impaired tissue integrity organisms and supporting the
 Readiness for enhanced patient’s defenses
immunization status  Asepsis
o Absence of pathogenic (disease-
 Nursing Process: Planning producing) microorganisms
o Medical asepsis
 Goals and outcomes o Standard precautions
o Hand hygiene
 Common goals of care applicable to o Alcohol-based hand rub
patients with infection often  Cleaning
include the following:
o The removal of all soil
o Preventing exposure to infectious
organisms o Use protective eyewear and
gloves
o Controlling or reducing the extent of
infection o Steps

o Maintaining resistance to infection  Rinse contaminated object

or article with cold running
o Verbalizing understanding of water to remove organic
infection prevention and control material.
techniques (e.g. hand hygiene)
 Wash the object with soap
and warm water.
 Setting priorities
o Establish priorities for each  Use a brush to remove dirt
diagnosis and for related goals of or material in grooves or
care. seams.
 Teamwork and collaboration
 NCM 103: Fundamentals of Nursing

MIDTERMS EXAMINATION: 3RD SEMESTER 2022 – 2023

Mrs. Romielyn L. Morcilla RN, MN Jeremy V. Makalintal _ NUR223

 Rinse the object in warm  Dirty linen

water.
 Maintain skin integrity
 Dry the object and prepare
it for disinfection or  Perineal care after toileting
sterilization if indicated
 Urinary catheters and drainage
 Clean and dry cleaning sets
equipment
 Wound cleaning
 Role of the infection control
professional
 Infection prevention and control Isolation and isolation
for hospital personnel precautions
 Patient education
 Isolation is the separation and
restriction of movement of ill persons
Disinfection and Sterilization with contagious diseases.
o Barrier precautions
o Disinfection: a process that eliminates
o Standard precautions
many or all microorganisms, with the
o Isolation precautions: airborne,
exception of bacterial spores, from
droplet, contact, and protective
inanimate objects
environment
 Disinfection of surfaces
 High-level disinfection, which is
required for some items such as Airborne Diseases
endoscopes 1. Tuberculosis
2. Rubeola virus (Measles
o Sterilization: the complete elimination 3. Varicella Virus (Chickenpox)
or destruction of all microorganisms, 4. SARS
including spores 5. Smallpox
6. Dissemination Varicella Zoster
Virus (VZV)
Infection Prevention and
Control – Patient safety Airborne Infection Isolation
o Patient Safety Precautions
 Perform hand hygiene
 Separate personal care items  Wear N95
 Keep door closed
 Handling exudate  Dietary may not enter
 Wound cleaning

 Cough etiquette
 NCM 103: Fundamentals of Nursing

MIDTERMS EXAMINATION: 3RD SEMESTER 2022 – 2023

Mrs. Romielyn L. Morcilla RN, MN Jeremy V. Makalintal _ NUR223

Psychological Implication of  Coveralls

Isolation  Surgical cap
 N95 mask
 Psychological implications  Scrub suit
 Goggles/face shield
 Double gloves
 Isolation environment
 Dedicated shoes
 Shoe covers
 Personal protective equipment
Medical Surgical
 Specimen collection Asepsis Asepsis
Goal Reduce Completely
 Bagging of trash or linen number of eliminate all
microorganism microorganisms
to prevent and spores
 Patient transport
spread
Equipment Clean via Sterile
Levels of PPE (Personal sanitation, (disposable
Protective Equipment) antisepsis or sterile
o Level 1 disinfection equipment or
 Surgical masks sterilized
reusable
o Level 2 - for areas with bathrooms equipement
where healthcare workers can bathe PPE Clean PPE Sterile PPE
after duty. They require the same Field Clean Sterile
amount of protection, as Level 3, but do Examples All client care Catheterization
not need face shields. activities, s, central line
medication, and chest tube
o Level 3 - for the triage and areas administration, insertion,
where patients under investigation tube feedings, surgical
(PUIs) are admitted.PPE protection enemas, procedures
consists of: wound
 Cap and goggles or face shield dressing
 N-95 mask changes
 Gloves
 Gown or coveralls Medical Asepsis practices to
be implemented
1. Wash hands frequently
 Level 4 - the COVID-19 wards and 2. Keep soiled linens/equipment
operating rooms require the most from touching the clothing
protection for personnel. This level of
PPE protection consists of the following:
 NCM 103: Fundamentals of Nursing
MIDTERMS EXAMINATION: 3RD SEMESTER 2022 – 2023
Mrs. Romielyn L. Morcilla RN, MN
3. Instruct the client to cover mouth
and nose when coughing and
sneezing
4. Avoid raising dust, do not shake
linens
5. Clean least contaminated areas
first then move to more
contaminated areas
6. Practice segregation of wastes
7. Sterilized objects suspected of
containing pathogens
8. Use practices of good persona
hygiene to help prevent the
spread of microorganisms
Surgical Asepsis
 Sterile technique prevents
contamination of an open wound, serves
to isolate the operative area from the
unsterile environment, and maintains a
sterile field for surgery
 Includes procedures used to eliminate
all microorganisms, including pathogens
and spores, from an object or area
 Situations surgical asepsis is used
 Patient preparation
 Sterile field: an area free of
microorganisms and prepared to receive
 Performing sterile procedures
 Donning and removing caps, masks, and
eyewear
 Opening sterile packages
o Opening a sterile item on a flat
surface
o Opening a sterile item while
holding it
 Preparing a sterile field
 Pouring sterile solutions
Jeremy V. Makalintal _ NUR223
 Surgical scrub
 Applying sterile gloves
Surgical Asepsis Principles
1. A sterile object remains sterile only
when touched by another sterile object
2. Only sterile objects may be place on a
sterile field
3. A sterile object or field out of the range
of vision or an object held below a
person’s waist is contaminated.
4. A sterile object or field becomes
contamination by prolonged exposure to
air.
5. When a sterile surface comes in contact
with a wet, contaminated surface, the
sterile object or field becomes
contaminated by capillary action
6. Fluid flows in the direction of gravity
7. The edges of a sterile field or container
are considered to be contaminated
Evaluation
o See through the patient’s eyes:
 Have the patient’s expectations
have been met?
o Patient outcomes
 Measure the success of the infection
control techniques.
 Compare the patient’s actual
response with expected outcomes.
 If goals are not achieved, determine
what steps must be taken.
o Exposure Issues
NCM 103: Fundamentals of Nursing

MIDTERMS EXAMINATION: 3RD SEMESTER 2022 – 2023

Mrs. Romielyn L. Morcilla RN, MN Jeremy V. Makalintal _ NUR223