Role of Nurse in Prevention of Communicable Disease

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Role of a nurse in infection control
In order for infection and disease to occur in an individual, a process involving 6 related components must occur. This process has been referred to as the chain of infection. The six steps or links in the chain are etiologic agent, reservoir, portal of exit, mode of transmission, portal of entry and susceptible host. To stop the spread of disease, one or more of these links must be broken. 1. Etiologic agent

a. Metazoan – multicellular animals many are parasites like hookworm b. Protozoa – are single-cell organism with a well-defined nucleus eg malaria falciparum c. Fungi - fungi are nonmotile, filamentous organism eg candidiasis d. Bacteria – are single-celled organisms that lack a nucleus e.g. mycobacterium tuberculosis e. Rickettsia – genus of bacteria usually in the cells of lice, ticks, fleas and mites f. Viruses – consisting of an RNA or DNA core and outer coat of protein. Reproduce and grow in living cells like HIV, measles, mumps g. Prions – infectious agent that do not have any genes but consist of protein with an aberrant structure replicates in animal or human tissue

2. Reservoirs
* Is the usual habitat in which the agent lives and multiplies. Depending upon the agent, the reservoir may be: i. Human - acute clinical cases / carriers
ii. Animal
iii. Environmental – plant, soil and water

3. Portal of exit
* Is the route by which the disease agent may escape from the human or animal reservoir. * Respiratory - airborne
* Genitourinary – sexually transmitted disease, leptospirosis * Alimentary – by bites (mouth)
* Skin – percutaneous penetration (mosquito bites, needles) * Transplacental – mother to fetus

4. Mode of transmission
* Is necessary to bridge the gap between the portal of exit from reservoir and the portal of entry into the host. * Direct – contact / droplet
* Indirect – animate (vectors), inanimate (air, food, water, milk, objects)

5. Portal of entry
* Usually the same as the portal of exit from the reservoirs Correspondence between Portal of Entry, mode of transmission and portal of exit Portal of entry | Mode of transmission | Portal of exit | Type of disease| Respiratory tract | Airborne droplets, fomites | Respiratory secretions | Measles, common cold| Alimentary tract| Water, food, flies, fomites| Faeces| Typhoid, polio, shigellosis| Skin, genital membranes | Direct contact, fomites, sexual intercourse| Lesion, exudates | Syphilis, gonorrhoea| Ocularmucous | Fomites, flies| Conjunctival exudates | Trachoma | Broken skin | Bloodsucking arthropod vector | Blood | malaria, yellow fever|

6. Susceptible host
Susceptibility is affected by:
* Genetic factors
* General resistance factors – like skin, gastric juice * Specific acquired immunity – active natural immunity / passive natural immunity

To stop the spread of infection is to break the links or chain of infection. Some of the basic strategies include:
* The practice and promotion of hand hygiene
* Performing hand hygiene consistently before each patient contact , after each patient contact, after contact with environmental surfaces and equipment/medical devices and before and after donning gloves. * Keeping fingernails one short to ensure hand hygiene products reach hand surfaces. * Develop the habit of routinely performing hand hygiene when performing patient-care tasks and procedures or handling medical devices and equipment. * Healthcare providers need to be empowered to hold one another accountable to ensure everyone is compliant with hand hygiene. * Consistent use of aseptic technique

* When performing tasks and procedures such as starting a peripheral i.v. connector before injection, potential for infection can be reduced by performing hand hygiene before...
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