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SOURCE OF INFECTIONS 1.

ENDOGENOUS SOURCE An infection caused by an infection agent that is already present in the body, but has previously been unapparent or dormant Airbone infection. One that is contracted by inhalation of micro organisms or spores suspended in the air on water droplets or dust practice . Droplet infection Droplet infection due to inhalation of respiratory pathogens suspended on liqeuied particle exhaled by some one already infected (droplet nuclei) Tunnel infection Subcutaneous infection of an artificial passage into the body that has been kept patent Opportunistic Infection Infection by an organisum that does not ordinarily cause disease but become pathogenic under certain circumstances Eg : Impaired immune response 2. EXOGENOUS The exogenous sources of infection introduce organisms from any where out side to inside the body. Which is the case most of the time. In addition to being exogenous, most of the time infection are transmitted from person to person or from animal to man Human The common source of infection for human beings are human beings themselves. Depending on the duration of the carriage, carriers are classified as temporary and cheronic. The temporary carriers states lasts less than six month, whiled cheronic carrier may lasts forseveral yuears and sometimes even for the rest of ones life. Animal Many pathogens are able to infect both human beings and animals. Infectious diseases transmitted from animals to human beings are called zoonoses. Zoonotic diseases may be bacterial (Plague from eats) viral (rabies from dogs), protozeal toxoplasmosis from eats) helminthic chydalid disease from dogs) or fungal zoophilic deematophyter from cats and dogs. Soil and Water Some pathogens can survive in the soil for very long periods spores of tetanus bacilli many remain viable in the soil for several deeades and serve as the source of infection. Fungi (Histoplasma capsulate nomadic asteroids ) and also parasites such as roundworm and hookworm survive in the soil and cause human infection. Water may act as source of infection either due to contamination with [pathogenic micro organisms (cholera vibrio, infective hepatitis virus ) or due to the presence of aquatic vectors (Cyclops in guineas worm infection). Food

Contaminated food may act as a source of infection. The presence of pathogens in food may be due to external contamination (Food poisoning by staphylococcus) or due to pre existent infection in meat or other animal products (salmonellas) INFECTION PRECAUTIONS Patient Care Major goals in the care of patient with threatening, suspected or diagnosed infectious disease include the following. 1. Prevent the spread of infection 2. Provide physiological support to enhance the patients natural creative power and resources for warding off or recovering from an infection 3. Provide psychological support 4. Prepare the patient for self care of this is feasible. 5. Special precautions of prevention of spread of infection can very from strict solution of the patient and such measures are wearing .. mask, or gown to simply using care which handling infective material. 6. Hand washing before and after each contact as imperative. INFECTION CONTROL A client entering a healthcare setting is at risk for acquiring infections because of lowered resistance to infection, microorganisms and invasive procedures. The nurse comes in contact with a variety of microorganisms and thus must practice techniques to avoid spreading them to clients. The nurse is responsible for teaching clients about infection, mode of transmission, reasons for susceptibility and infection control. Infection Agent The pathogenic organisms include bacteria, viruses, fungi and protozoa and more prevalent agents that are capable of causing infection. Portal of Exist The exist from the reservoir is the point of escape for the organism. The organism cannot extend its influence unless it moves away from its original source. In human common escape routes are as follows: 1. Skin and mucus membrane, e.g. S. Aureus, cause yellowish drainage. P. aeruginde causes greenish drainage 2. Respiratory tract e.g. Mycobacterium tubercle causes tuberculosis 3. Gastro urinary tract. 4. GI tract 5. Reproductive tract, e.g. STDs, HIV 6. Blood-serum hepatitis. Portal of entry The portal of entry is the point at which organism enters the host. The entry route often is the same as the exist route. The urinary, respiratory, gastrointestinal, reproductive tract and the skin are common entry points. Susceptible Hose An organism or parasite potential to produce disease depends on a variety of factors which includes following.

Number of organisms or parasites . Virulence of organism or its ability to cause disease. Competence of a persons immune system Ability to enter and survive in the host Length and intimacy of the contact between a person and the microorganisms Susceptibility of the host. Course of Infection An understanding of the course of infection by stages in the development of an infection is necessary if the nurse is to intervene and disrupt the infection cycle. An infection progresses through the different phases which includes, incubation period, prodromal stage, full stage of illness, convalescent phase. Incubation Period Incubation period is the interval between the invasion of the body by the pathogen. Eg. Chickenpox 2-3 weeks, common cold 1-2 days, tetanus 2 to 21 days. Prodromal stage A person is most infectious during this stage. It is an internal from onset of nonspecific signs and symptoms (malaise, low grade fever, fatigue) to more specific symptoms. During this time, microorganisms grow and multiply and client is more capable of spreading disease to others. Full stage of Illness Full stage of illness is an interval when client manifests signs and symptoms specific type of infection. The types of infection determine the length of illness and the severity of manifestations. Convalescent Period Convalescent period represents recovery from the infection. It is an interval when acute symptoms of infection disappear and the person returns to healthy state-length of recovery depends on severity of infection and clients general state of health; recovery may take several days to months. Defenses against Infection The body has normal defenses against infection. Normal body flora that reside inside and outside of the body protect a person from several pathogens. Skin In skin intact multilayered surface is a bodys first line of defense against infection, that is, it provides barrier to microorganisms. The sebum contains fatty acid that kills some bacteria. Month Intact multilayered mucosa of mouth provides mechanical barriers to microorganisms. Saliva produces in the mouth, washers away particles containing microorganism and it contains microbial inhibitor, e.g. lysozyme, factors that alter defense are lacterations, trauma, extracted teeth, poor oral hygiene, dehydration. Respiratory Tract. The factors that may alter defence here are smoking high concentration of oxygen and carbon dioxide, decreased humidity, cold air, etc.

Urinary Tract The flushing action of urine flow washes away microorganism on lining of bladder and urethra. An infect multilayered epitheliums of the tract provide barrier to microorganism. Vagina The immune system is composed of separate cells and molecules resistant to disease. Certain responses of the immune system are non specific, whereas others are specific defenses against specific pathogens. If any of the bodys defense fails, an infection can quickly progress to a serious health problem. The factors which affecting immunological defense mechanism are as follow: Increasing age Stress Poor nutrition Inherited condition Type of disease process Environments Concepts of Asepsis The nurses efforts to minimize the onset and spread of infection are based on the principles of aseptic technique The two types of aseptic techniques, the nurses usually practice, are medical and surgical asepsis. Medical asepsis Medical asepsis or clean technique includes procedures used to reduce the number of microorganisms and prevent their spread. Changing a clients bed linen daily, hand washing Wash hands frequently but especially before handling foods, before eating, after using a handkerchief, after going to the toilet, before and after each client contact, and after removing gloves. Do not place solid bed linen or ay other items on the floor, which is grossly contaminated, it increases contamination of both surfaces. Move equipment away fro you when brushing, dusting or scrubbing articles. This helps prevent contaminated particles from settling on the hairs, face and uniform. Clean the least soiled areas first and then the more soiled ones. This helps prevent having the cleaner areas soiled by the dirtier areas. Pour liquids that are to be discarded, such as bath water, mouth rinse and the like directly into the drain so as to avoid splattering in the sink and on to you Sterilize items that are suspected of containing pathogen. After sterilization, they can be managed by clean technique. Use practices of personal grooming that help prevent spready microorganism, i.e. shampooing, nail cutting avoid wearing rings, etc. Follow guidelines conscientiously for isolation in barier technique as prescribed by agency. Surgical asepsis Surgical asepsis or sterile technique, includes procedures used to eliminated microorganisms from an area. i.e, care of surgical wounds, urinary catheter insertion, invasive procedures and surgery.

Only a sterile object can touch another sterile object, unsterile touching sterile means contamination has occurred. Hold sterile objects above the level of the waist. This will help ensure keeping the object within sight and prevent accidental contamination. Avoid talking, coughing, sneezing or reaching over a sterile field or object. This helps prevent contamination by droplets, from the nose and the mouth or by particles dropping from the workers arms. Never walk away from or turn your back on a sterile field. This prevents possible contamination while the field as out of the workers view. Use dry, sterile, forceps when necessary, forceps soaked in disinfectant are not considered sterile Consider the edge (outer one inch) of a sterile field to be contaminated Consider an object contaminated if you have any doubt as to its sterility. ROLE OF THE NURSE IN INFECTION CONTROL The roles and responsibilities of the nurses in infection control are as follows: Providing staff education on infection control Reviewing infection control policies and procedures. Reviewing client medical records and laboratory reports to recommend appropriate isolation procedures Screening client record for community acquired infection Consulting with employer health departments concerning recommendation to prevent and control the spread of infections among personnel such as tuberculosis testing Gathering statistics regarding the epidemiology of no monomial infections Notifying public health department of incidences of communicable diseases Conferring with all hospital departments to investigate unusual events or clusters of infection Educating clients and families Identifying infection control problems with equipment Checking microorganism sensitivity to antibiotics in sue and reminding medical staff or resistance. Teaching about Infection Control Clients should be taught to use basic principles of asepsis at home and in public facilities. Teaching about medical aspects and infection control is a challenging nursing responsibility. The following are examples of medical aseptic practices used in home Wash hands before preparing food and before eating Prepare food at temperature sufficiently high to ensure that they are safe to eat. Use care with cutting boards and utensils and wash hands, before and after handling raw meat. Keep food refrigerated, especially those containing mayonnaise Wash raw fruits and vegetables before serving them Use pasteurized milk

Wash hands after using the bathroom Use individual personal care items, such as wash cloths, towels, tooth brushes. Observe infection prevention in public facilities by following these guidelines: Wash hands after using any public bathroom Use paper towels or hot air dryers in restroom Use individually wrapped drinking straws Use tongs to lift food from common service trays in caterings food stores, and salad bars. The community reinforces medical aseptic practices in several ways which includes the following: Use of sterilized coombs and brushes in barber and beauty shops Examination of food handlers for evidence of disease Enforcement of frequent hand washing by food handlers.

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