Much like many of my other nursing related Info Barrel articles, this article is about safety and infection control. This topic is just one, of many topics, that fits nicely in alignment with a registered nurses implied role of creating and maintaining a safe and effective environment where care can be delivered most efficiently in accordance with agency or hospital policy. While the numerous intricate elements of ensuring adequate workplace safety are really too broad to detail in just one article alone, you can find related articles, that I have written, in the right hand side of this screen.
In order to understand what measures, or interventions, a registered nurse should take in ensuring infection control; one must first understand the underlying bodily processes that are involved in eliciting the signs and symptoms of an infection, in general. Whether you are covering this material in one of your nursing classes, or are studying specifically for the rigorous NCLEX examination, many nursing textbooks, and online courses like Kaplan, will begin by detailing the process of inflammation.
Inflammation is essentially the human body's way of responding to an infection. When an infection occurs, inflammation is a gradual process that results in numerous signs, and symptoms, that manifest themselves in a variety of ways. There are both localized and systemic signs of inflammation. In a patient who has local inflammation, a nurse will observe swelling, redness, heat, pain or tenderness, and possible drainage. While you may be able to visually observe all these signs, don't underestimate the value of using all of your other senses, and instruments, in order to gain a more clear, and accurate, clinical understanding of how extensive your patient's inflammation, or infection, may be.
If there is drainage involved in the observed localized inflammation, it may come in a variety of forms, ranging from bloody (sanguineous) to serous or puss-filled. These forms of drainage can be viewed on a continuum of occurrence based on how far along the healing process has progressed.
Along with the localized signs of inflammation that may manifest as a result of an infection, as mentioned above, one may also experience systemic signs of inflammation. Oftentimes, systemic and localized signs of inflammation will occur in conjunction with each other; however, they may occur alone. These systemic signs that may occur are fever, malaise and general weakness. Throughout your health assessment class in nursing school, you more than likely were expected to learn how to assess a patient's lymph nodes. This skill will come in handy because lymph node enlargement is actually a common occurrence in those who are experiencing systemic signs of inflammation as a result of infection. While it may be rare that you perform this skill, you may want to consider using it, especially if you observed any of the following localized signs of inflammation, as stated above.
Remember, also, that your laboratory values are done for a reason in order to improve patient care. Even if you aren't familiar with some of the more obscure tests that are conducted rather infrequently, most nursing students will be familiar with how a patient's white blood cell count will typically rise as a result of inflammation that occurs as a result of infection. The reason for this congregation of white blood cells is simple, and is done as one of our body's natural responses to infection. Ideally, your white blood cell count should be between 5,000-10,000 WBC's per cubic millimeter. An elevated erythrocyte sedimentation rate (ESR) (any number over 15-20 mm in an hour indicates inflammation, according to Kaplan) may also occur, in inflammation, in conjunction with a noted increasing in a patient's white blood cell count.
Whenever a substance that is foreign to your body invades it, and elicits an immune response, that is essentially an infection. While infections can take many forms, the two most noted are communicable diseases (or infections) and nosocomial infections. Both of these infection forms are very broad in nature and can take many forms, and, of course, manifest themselves in a variety of different ways. Communicable diseases are caused by organisms that are pathogenic in nature, that invade the body through direct contact. Unfortunately, this is not the only way that communicable diseases are caused. They can also be transmitted through droplets, contaminated articles or through carriers. For those diseases that are spread through droplets, one may be familiar with droplet precautions which build upon standard precautions, which are essentially applied to every patient universally.
A nursing student's introduction to nosocomial infections, more than likely, occurred early in their nursing school career. Nosocomial infections are essentially infections that are obtained while a patient is simply in the hospital. Even the cleanest, most pristine, environment may have bacteria that can invade one's skin, especially if that patient is in an immunocompromised state from a disease like AIDS. While nosocomial infections may be obtained in a variety of ways, this infection typically occurs as a result of Staphylococcus (Staph) Auereus. A preventative approach is immediately warranted and is typically applied consistently from each patient to the next with a registered nurse, or other healthcare professionals, taking the time to simply wash their hands. The importance of hand washing is oftentimes underestimated, or forgotten, under the increasing demands of intense working schedules and nurse to patient ratios. Even still, it is an absolutely important task that may go undone when registered nurses are in a rush to pass out medications or to provide further care to their assigned patients.
Finally, to expand upon the ever important topic of hand washing, registered nurses can also apply a variety of other interventions in order to address infection. Whether from a preventative approach, or to help promote resistance in the fight against a current infection, a registered nurses' understanding of other elements of health and wellness, like nutrition, can also help their patient. It is for this reason that adults and children are both highly suggested to have updated immunizations, as well. When these preventative practices are applied in combination with hand washing, research has consistently demonstrated that infections can be managed and controlled much better in the clinical setting.
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