UNIVERSITY OF LA SALETTE, INC.

COLLEGE OF NURSING, PUBLIC HEALTH & MIDWIFERY

SANTIAGO CITY

NCM 103 – FUNDAMENTALS OF NURSING LAB

LEARNING MODULE
Prepared by: MELISSA D. SARMIENTO, RN, RM, MSN

CONCEPT: NURSING AS A SCIENCE

Nature of infection
 Infection: the invasion of a susceptible host by pathogens or
microorganisms; results in disease.
 Colonization: presence and growth of microorganisms within a host
without tissue invasion or damage.
 Communicable disease: the infectious process transmitted from one
person to another.
 Symptomatic: clinical signs and symptoms are present.
 Asymptomatic: clinical signs and symptoms are not present.

Chain of Infection
 The chain of infection refers to those elements that must be present to cause an
infection from a microorganism

1. Infectious agent; microorganisms capable of causing infections are referred to as

an infectious agent or pathogen
 The potential for microorganisms or parasites to cause disease depends on:
1. the number of microorganisms present;
2. their virulence, or ability to produce disease;
3. their ability to enter and survive in a host;
4. and the susceptibility of the host
Immunocompromised - has an impaired immune system

2. Reservoir: the environment in which the microorganism lives to ensure survival;

 Common reservoirs are humans and animals (hosts), insects, food, water, and
organic matters on inanimate surfaces (fomites).
 To thrive organisms require a proper environment, including appropriate
food, oxygen, (aerobic and unaerobic), water, temperature, pH and light.
bacteriostatic - Cold temperatures that tend to prevent growth and reproduction of
bacteria
bactericidal - A temperature or chemical that destroys bacteria

3. Portal of exit: the means in which the pathogen escapes from the reservoir and can
cause disease; common escape routes are the gastrointestinal, respiratory and
the genitourinary tract.

4. Modes of transmission: the microorganism must have a means of transmission to

get from one location to another, called direct and indirect
  by practicing infection prevention and control techniques such as hand hygiene,
you interrupt the mode of transmission
 Contact
a. Direct contact: describes the way in which microorganisms are transferred from
person to person through biting, touching, kissing, or sexual intercourse
b. Indirect contact: can occur through fomites (inanimate objects or materials) or
through vectors (animal or insect, flying or crawling); the fomites or vectors act as
vehicle for transmission
 Droplet: An infected person coughs or sneezes, creating droplets that carry germs
short distances (within approximately 6 feet).
 Airborne: involves droplets or dust; droplet nuclei can remain in the air for long
periods and dust particles containing infectious agents can become airborne
infecting a susceptible host generally through the respiratory tract
 Vehicles: Contaminated items. For example, sharps injuries can lead to
infections; Water • Drugs, solutions • Blood • Food (improperly handled, stored, or
cooked; fresh or thawed meats)
 Vector: External mechanical transfer (flies); Internal transmission such as
parasitic conditions between vector and host

5. Portal of entry: the means of a pathogen entering a host: the means of entry can be
the same as one that is the portal of exit (gastrointestinal, respiratory,
genitourinary tract).
 Factors such as a depressed immune system that reduce body defenses
enhance the chances of pathogens entering the body.

6. Susceptible Host: describes a host (human or animal) not possessing enough

resistance against a particular pathogen to prevent disease or infection from
occurring when exposed to the pathogen; in humans this may occur if the
person’s resistance is low because of poor nutrition, lack of exercise of a
coexisting illness that weakens the host.

Hand hygiene is the most effective way to break the chain of infection (CDC,
2008; WHO, 2009).

THE INFECTIOUS PROCESS

Infection- an invasion of the body tissue by microorganisms and their proliferation
there.

THE INFECTIOUS PROCESS

 Localized
- experiences localized symptoms
 Systemic
- an infection that affects the entire body instead of just a single organ or
part and can become fatal if undetected and untreated

Signs of Localized Infection

 Localized swelling
 Localized redness
 Pain or tenderness with palpation or movement
 Palpable heat in the infected area
 Loss of function of the body part affected, depending on the site and extent
of involvement

Signs of Systemic Infection

 Fever
  Increased pulse and respiratory rate if the fever high
 Malaise and loss of energy
 Anorexia and, in some situations, nausea and vomiting
 Enlargement and tenderness of lymph nodes that drain the area of infection

Factors Influencing Microorganism’s Capability to Produce Infection

 Number of microorganisms present
 Virulence and potency of the microorganisms (pathogenicity)
 Ability to enter the body
 Susceptibility of the host
 Ability to live in the host’s body

Factors Increasing Susceptibility to Infection

1. Age
2. Heredity
3. Cultural practices
4. Nutrition
5. Stress
6. Rest, exercise and personal health habits
7. Inadequate defenses
The immune system functions throughout the body and depends on the
following:
 Intact skin and mucous membranes
 Adequate blood cell production and differentiation
 A functional lymphatic system and spleen
 An ability to differentiate foreign tissue and pathogens from
normal body tissue and flora; in autoimmune disease, the body
has a problem with recognizing its own tissue and cells; people
with autoimmune disease are at increased risk of infection related
to their immune system deficiencies.

8. Environmental
9. Immunization history
10. Medications and medical therapies

COURSE OF INFECTION BY STAGE

• When the patient acquires an infection, observe for signs and symptoms of
infection and take appropriate actions to prevent its spread. Infections follow a
progressive course.
The incubation period is the time interval between entrance of the pathogen and
appearance of first symptoms.
Prodromal stage is the interval from onset of nonspecific signs and symptoms to more
specific symptoms.
Illness stage is the interval when the patient manifests signs and symptoms specific to
the type of infection.
Convalescence is the interval when acute symptoms of infection disappear.
• If an infection becomes localized, as in a wound infection, use standard
precautions, appropriate personal protective equipment (PPE), and hand hygiene
to block the spread of infection to other parts of the body or other patients.
 • Supportive therapy includes providing adequate nutrition and rest to bolster the
body’s defenses against the infectious process. The course of care for the patient
often has additional effects on body systems affected by the infection.

NURSES RESPONSIBILITIES DURING THE COURSE OF INFECTION

(Infection Process)
Interventions to Reduce Risk for Infection
 Proper hand hygiene techniques
 Environmental controls
 Sterile technique when warranted
 Identification and management of clients at risk

 Proper administration of antibiotics

 Monitoring the response to drug therapy
 Practicing proper hand hygiene
 Practicing standard precautions
 Supportive therapy (adequate nutrition and rest)

Breaking the Chain of Infection

Etiologic agent
 Correctly cleaning, disinfecting or sterilizing articles before use
 Educating clients and support persons about appropriate methods to clean,
disinfect, and sterilize article
Reservoir (source)
 Changing dressings and bandages when soiled or wet
 Appropriate skin and oral hygiene
 Disposing of damp, soiled linens appropriately
 Disposing of feces and urine in appropriate receptacles
 Ensuring that all fluid containers are covered or capped
 Emptying suction and drainage bottles at end of each shift or before full or
according to agency policy
Portal of exit
 Avoiding talking, coughing, or sneezing over open wounds or sterile fields
 Covering the mouth and nose when coughing or sneezing

Method of transmission
 Proper hand hygiene
 Instructing clients and support persons to perform hand hygiene before
handling food, eating, after eliminating and after touching infectious material
 Wearing gloves when handling secretions and excretions
 Wearing gowns if there is danger of soiling clothing with body substances
 Placing discarded soiled materials in moisture-proof refuse bags
 Holding used bedpans steadily to prevent spillage
 Disposing of urine and feces in appropriate receptacles
 Initiating and implementing aseptic precautions for all clients
 Wearing masks and eye protection when in close contact with clients who
have infections transmitted by droplets from the respiratory tract
 Wearing masks and eye protection when sprays of body fluid are possible

Portal of entry
 Using sterile technique for invasive procedures, when exposing open
wounds or handling dressings
 Placing used disposable needles and syringes in puncture-resistant
containers for disposal
  Providing all clients with own personal care items

Susceptible host
 Maintaining the integrity of the client’s skin and mucous membranes
 Ensuring that the client receives a balanced diet
 Educating the public about the importance of immunizations

Asepsis
is the state of being free from disease-causing contaminants (such as bacteria, viruses,
fungi, and parasites) or, preventing contact with microorganisms. The
term asepsis often refers to those practices used to promote or induce asepsis in an
operative field in surgery or medicine to prevent infection.

Medical asepsis
1. Includes all practices intended to confine a specific microorganism to a
specific area
2. Limits the number, growth, and transmission of microorganisms
3. Objects referred to as clean or dirty (soiled, contaminated)

Surgical asepsis
1. Sterile technique
2. Practices that keep an area or object free of all microorganisms
3. Practices that destroy all microorganisms and spores
4. Used for all procedures involving sterile areas of the body