Microbes Can Cause Different Kinds of Infections

Some disease-causing microbes can make you very sick quickly and then not bother you again. Some can last for a long time and continue to damage tissues. Others can last forever, but you won’t feel sick anymore, or you will feel sick only once in a while. Most infections caused by microbes fall into three major groups:

1. Acute infections

2. Chronic infections

3. Latent infections

What are microbes?

Microbes are tiny organisms—too tiny to see without a microscope, yet they are abundant on Earth. They live everywhere—in air, soil, rock, and water. Some live happily in searing heat, while others thrive in freezing cold. Some microbes need oxygen to live, but others do not. These microscopic organisms are found in plants and animals as well as in the human body.

Some microbes cause disease in humans, plants, and animals. Others are essential for a healthy life, and we could not exist without them. Indeed, the relationship between microbes and humans is delicate and complex.

Most microbes belong to one of four major groups: bacteria, viruses, fungi, or protozoa. A common word for microbes that cause disease is "germs." Some people refer to disease-causing microbes as "bugs." "I've got the flu bug," for example, is a phrase you may hear during the wintertime to describe an influenza virus infection.

Since the 19th century, we have known microbes cause infectious diseases. Near the end of the 20th century, researchers began to learn that microbes also contribute to many chronic diseases and conditions. Mounting scientific evidence strongly links microbes to some forms of cancer, coronary artery disease, diabetes, multiple sclerosis, and chronic lung diseases.

Antimicrobial Surfaces

Microorganisms are known to survive on inanimate ‘touch’ surfaces for extended periods of time. This can be especially troublesome in hospital environments where patients with immunodeficiencies are at enhanced risk for contracting nosocomial infections.

Touch surfaces commonly found in hospital rooms, such as bed rails, call buttons, touch plates, chairs, door handles, light switches, grab rails, intravenous poles, dispensers (alcohol gel, paper towel, soap), dressing trolleys, and counter and table tops are known to be contaminated with Staphylococcus, Methicillin-resistant Staphylococcus aureus(MRSA), one of the most virulent strains of antibiotic-resistant bacteria and Vancomycin-resistant Enterococcus (VRE). Objects in closest proximity to patients have the highest levels of staphylococcus, MRSA, and VRE. This is why touch surfaces in hospital rooms can serve as sources, or reservoirs, for the spread of bacteria from the hands of healthcare workers and visitors to patients.

Prevention of Nosocomial Infection

Hospitals have sanitation protocols regarding uniforms, equipment sterilization, washing, and other preventative measures. Thorough hand washing and/or use of alcohol rubs by all medical personnel before and after each patient contact is one of the most effective ways to combat nosocomial infections. More careful use of antimicrobial agents, such asantibiotics, is also considered vital.

Despite sanitation protocol, patients cannot be entirely isolated from infectious agents. Furthermore, patients are often prescribed antibiotics and other antimicrobial drugs to help treat illness; this may increase the selection pressure for the emergence of resistant strains.

• Sterilization

Sterilization goes further than just sanitizing. Sterilizing kills all microorganisms on equipment and surfaces through exposure to chemicals, ionizing radiation, dry heat, or steam under pressure.

• Isolation

Isolation precautions are designed to prevent transmission of microorganisms by common routes in hospitals. Because agent and host factors are more difficult to control, interruption of transfer of microorganisms is directed primarily at transmission

• Handwashing and gloving

Handwashing frequently is called the single most important measure to reduce the risks of transmitting skin microorganisms from one person to another or from one site to another on the same patient.

Nosocomial Infection

A nosocomial infection, also known as a hospital-acquired infection or HAI, is an infection whose development is favoured by a hospital environment, such as one acquired by a patient during a hospital visit or one developing among hospital staff. 

Such infections include fungal and bacterial infections and are aggravated by the reduced resistance of individual patients.In the United States, the Centers for Disease Control and Prevention estimate that roughly 1.7 million hospital-associated infections, from all types of microorganisms, including bacteria, combined, cause or contribute to 99,000 deaths each year.

In Europe, where hospital surveys have been conducted, the category of Gram-negative infections are estimated to account for two-thirds of the 25,000 deaths each year. Nosocomial infections can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Many types are difficult to attack with antibiotics, and antibiotic resistance is spreading to Gram-negative bacteria that can infect people outside the hospital. 

Nosocomial infections are commonly transmitted when hospital officials become complacent and personnel do not practice correct hygiene regularly. 

Also, increased use of outpatient treatment means that people who are hospitalized are more ill and have more weakened immune systems[clarification needed] than may have been true in the past. Moreover, some medical procedures bypass the body's natural protective barriers. Since medical staff move from patient to patient, the staff themselves serve as a means for spreading pathogens.

Putting on and taking off the Gloves

Putting on the Gloves

Non-sterile gloves are simpler to handle than non-sterile gloves. Non-sterile gloves simply require the medical professional to thoroughly wash her hands before putting on the gloves.

There's a more complicated procedure for putting on sterile gloves. The professional must, of course, was his hands. He must then handle the gloves carefully. The finger tips and palm of the glove must not come into contact with any non-sterile surfaces.

Taking off the Gloves

Non-sterile gloves can be piled off and thrown in the trash, while sterile gloves must be removed from the wrist, turned inside and carefully removed.

How to wash your hands

It's generally best to wash your hands with soap and water.

Follow these simple steps:

- Wet your hands with running water.Apply liquid, bar or powder soap.

- Lather well.

- Rub your hands vigorously for at least 20 seconds.

- Remember to scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails. 

- Rinse well.  

- Dry your hands with a clean or disposable towel or air dryer.     

- If possible, use your towel to turn off the faucet.

Keep in mind that antibacterial soap is no more effective at killing germs than is regular soap. Using antibacterial soap may even lead to the development of bacteria that are resistant to the product's antimicrobial agents — making it harder to kill these germs in the future.

Wash your hands

Handwashing is easy to do and it's one of the most effective ways to prevent the spread of many types of infection and illness in all settings—from your home and workplace to child care facilities and hospitals. Clean hands can stop germs from spreading from one person to another and throughout an entire community.

When should you wash your hands?

- Before, during, and after preparing food

- Before eating food

- Before and after caring for someone who is sick

- Before and after treating a cut or wound

- After using the toilet

- After changing diapers or cleaning up a child who has used the toilet

- After blowing your nose, coughing, or sneezing

- After touching an animal, animal feed, or animal waste

- After touching garbage

What is the right way to wash your hands?

Wet your hands with clean running water (warm or cold) and apply soap.

Rub your hands together to make a lather and scrub them well; be sure to scrub the backs of your hands, between your fingers, and under your nails.

Continue rubbing your hands for at least 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice.

Rinse your hands well under running water.

Dry your hands using a clean towel or air dry.

Washing hands with soap and water is the best way to reduce the number of germs on them. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs.

Glove Use (continuation)

   The Glove Pyramid – to aid decision making on when to wear (and not wear) gloves.

  Gloves must be worn according to STANDARD and CONTACT PRECAUTIONS. The pyramid details some clinical examples in which gloves are not indicated, and others in which examination or sterile gloves are indicated. Hand hygiene should be performed when appropriate regardless of indications for glove use.

Glove Use

Gloves should therefore be used during all patient-care activities that may involve exposure to blood and all other body fluid (including contact with mucous membrane and non-intact skin), during contact precautions and outbreak situations.

The efficacy of gloves in preventing contamination of health-care workers’ hands and helping to reduce transmission of pathogens in health care has been confirmed in several clinical studies.

Nevertheless, health-care workers should be informed that gloves do not provide complete protection against hand contamination.

Pathogens may gain access to the caregivers’ hands via small defects in gloves or by contamination of the hands during glove removal. Hand hygiene by rubbing or washing remains the basic to guarantee hand decontamination after glove removal

The impact of wearing gloves on adherence to hand hygiene policies has not been definitively established, since published studies have yielded contradictory results. However, the recommendation to wear gloves during an entire episode of care for a patient who requires contact precautions, without considering indications for their removal, such as an indication for hand hygiene, could actually lead to the transmission of germs.

it is important that health-care workers are able to differentiate between specific clinical situations when gloves should be worn and changed and those where their use is not required. Moreover, the health-care worker should be accurately informed on the moment for donning and removing gloves.

Indications for gloving and for glove removal:

	Indication
Gloves on	1) Before a sterile procedure 2) When anticipating contact with blood or another body fluid, regardless of the existence of sterile conditions and including contact with non-intact skin and mucous membrane 3) Contact with a patient (and his/her immediate surroundings) during contact precautions.
Gloves off	1) As soon as gloves are damaged (or non-integrity suspected) 2) When contact with blood, another body fluid, non-intact skin and mucous membrane has occurred and has ended 3) When contact with a single patient and his/her surroundings, or a contaminated body site on a patient has ended 4) When there is an indication for hand hygiene.

Nurses Rock

The skinny on Nurse’s Week and The Florence Nightingale Oath…

Where did it all start?

“The Florence Nightingale Oath” is a modified “Hippocratic Oath” and was composed in 1893 as a token of esteem for the founder of modern nursing.

“I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully.I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.”

 The proposals for National School Nurse Day begun in the early 50’s and officially as of 2003 it is celebrated on the Wednesday within National Nurses Week culminating on May 12th, Florence Nightingale’s birthday.

What hierarchy of needs model is most valid?

Abraham Maslow created the original five level Hierarchy of Needs model, and for many this remains entirely adequate for its purpose. The seven and eight level 'hierarchy of needs' models are later adaptations by others, based on Maslow's work. Arguably, the original five-level model includes the later additional sixth, seventh and eighth ('Cognitive', 'Aesthetic', and 'Transcendence') levels within the original 'Self-Actualization' level 5, since each one of the 'new' motivators concerns an area of self-development and self-fulfilment that is rooted in self-actualization 'growth', and is distinctly different to any of the previous 1-4 level 'deficiency' motivators. For many people, self-actualizing commonly involves each and every one of the newly added drivers. As such, the original five-level Hierarchy of Needs model remains a definitive classical representation of human motivation; and the later adaptations perhaps serve best to illustrate aspects of self-actualization.

Maslow's Hierarchy of Needs

Abraham Maslow developed the Hierarchy of Needs model in 1940-50s USA, and the Hierarchy of Needs theory remains valid today for understanding human motivation, management training, and personal development.
Indeed, Maslow's ideas surrounding the Hierarchy of Needs concerning the responsibility of employers to provide a workplace environment that encourages and enables employees to fulfil their own unique potential (self-actualization) are today more relevant than ever. Abraham Maslow's book Motivation and Personality, published in 1954 (second edition 1970) introduced the Hierarchy of Needs, and Maslow extended his ideas in other work, notably his later book Toward A Psychology Of Being, a significant and relevant commentary, which has been revised in recent times by Richard Lowry, who is in his own right a leading academic in the field of motivational psychology.

Each of us is motivated by needs. Our most basic needs are inborn, having evolved over tens of thousands of years. Abraham Maslow's Hierarchy of Needs helps to explain how these needs motivate us all.

Maslow's Hierarchy of Needs states that we must satisfy each need in turn, starting with the first, which deals with the most obvious needs for survival itself.

Only when the lower order needs of physical and emotional well-being are satisfied are we concerned with the higher order needs of influence and personal development.

Conversely, if the things that satisfy our lower order needs are swept away, we are no longer concerned about the maintenance of our higher order needs.

Maslow's original Hierarchy of Needs model was developed between 1943-1954, and first widely published in Motivation and Personality in 1954. At this time the Hierarchy of Needs model comprised five needs. This original version remains for most people the definitive Hierarchy of Needs.

 Maslow's hierarchy of needs

1. Biological and Physiological needs - air, food, drink, shelter, warmth, sex, sleep, etc.

2. Safety needs - protection from elements, security, order, law, limits, stability, etc.

3. Belongingness and Love needs - work group, family, affection, relationships, etc.

4. Esteem needs - self-esteem, achievement, mastery, independence, status, dominance, prestige, managerial responsibility, etc.

5. Cognitive needs - knowledge, meaning, etc.

6. Aesthetic needs - appreciation and search for beauty, balance, form, etc.

7. Self-Actualization needs - realising personal potential, self-fulfillment, seeking personal growth and peak experiences.

8. Transcendence needs - helping others to achieve self actualization

The Nursing Process

The common thread uniting different types of nurses who work in varied areas is the nursing process—the essential core of practice for the registered nurse to deliver holistic, patient-focused care.

·                Assessment
An RN uses a systematic, dynamic way to collect and analyze data about a client, the first step in delivering nursing care. Assessment includes not only physiological data, but also psychological, sociocultural, spiritual, economic, and life-style factors as well. For example, a nurse’s assessment of a hospitalized patient in pain includes not only the physical causes and manifestations of pain, but the patient’s response—an inability to get out of bed, refusal to eat, withdrawal from family members, anger directed at hospital staff, fear, or request for more pain mediation.

·                Diagnosis
The nursing diagnosis is the nurse’s clinical judgment about the client’s response to actual or potential health conditions or needs. The diagnosis reflects not only that the patient is in pain, but that the pain has caused other problems such as anxiety, poor nutrition, and conflict within the family, or has the potential to cause complications—for example, respiratory infection is a potential hazard to an immobilized patient. The diagnosis is the basis for the nurse’s care plan.

·                Outcomes / Planning

Based on the assessment and diagnosis, the nurse sets measurable and achievable short- and long-range goals for this patient that might include moving from bed to chair at least three times per day; maintaining adequate nutrition by eating smaller, more frequent meals; resolving conflict through counseling, or managing pain through adequate medication. Assessment data, diagnosis, and goals are written in the patient’s care plan so that nurses as well as other health professionals caring for the patient have access to it.

·                Implementation
Nursing care is implemented according to the care plan, so continuity of care for the patient during hospitalization and in preparation for discharge needs to be assured. Care is documented in the patient’s record.

·                Evaluation
Both the patient’s status and the effectiveness of the nursing care must be continuously evaluated, and the care plan modified as needed.

Internacional Nurses Day

International Nurses Day is celebrated around the world every May 12, the anniversary of Florence Nightingale's birth. The International Council of Nurses (ICN) has celebrated this day since 1965. In 1953 Dorothy Sutherland, an official with the U.S. Department of Health, Education and Welfare, had proposed that President Dwight D. Eisenhower proclaim a "Nurses Day," but he did not approve it.

In January 1974, the decision was made to celebrate the day on 12 May as it is the anniversary of the birth of Florence Nightingale, who is widely considered the founder of modern nursing. Each year, ICN prepares and distributes the International Nurses' Day Kit. The kit contains educational and public information materials, for use by nurses everywhere.

In 1999 the British public sector union UNISON voted to ask the ICN to transfer this day to another date, saying Nightingale did not represent modern nursing.

As of 1998, 8 May was designated as annual National Student Nurses Day. As of 2003, the Wednesday within National Nurses Week, between 6 and 12 May, is National School Nurse Day.
Every year ICN have a new theme for International Nurses Day, this are some of this themes since 2000:

- 2000: Always there for you
- 2001: Nurses, Always There for You: United Against Violenc
- 2002: Nurses, Always There for You: Caring for Familie
- 2003: Nurses: Fighting AIDS stigma, working for all
- 2004: Nurses: Working with the Poor; Against Poverty
- 2005: Nurses for Patients Safety: Targeting counterfeit medicines and substandard medication
- 2006: Safe staffing saves lives
- 2007: Positive practice environments: Quality workplaces = quality patient care
- 2008: Delivering Quality, Serving Communities: Nurses Leading Primary Health Care
- 2009: Delivering Quality, Serving Communities: Nurses Leading Care Innovations
- 2010: Delivering Quality, Serving Communities: Nurses Leading Chronic Care
- 2011: Closing The Gap: Increasing Access and Equity
- 2012: Closing The Gap: From Evidence to Action.

What is the importance of Florence Nightingale?

Florence Nightingale is considered the founder of modern nursing. The myth of the nurse as a guardian angel to the patient's bedside, starring Florence, will typically be a social construction of English romanticism, in full Victorian.

Let us remember, however, some of the problems that emerged to hospital nursing ashore in Britain until the mid-19th century, dominated by matrons and nurses, the sisters of charity:

• Sporadic work, disqualified, socially undervalued and underpaid;
• Crude application of medical care;
• The absence of specificity of functional and technical autonomy;
• Highly painful working conditions in hospitals and in worhouses;
• Difficulties in the recruitment of staff;
• Lack of training structures, etc.

In addition to technically disqualified, matrons and nurses had often behaved morally wrong. The registration books of most British hospitals of the era report of impressive frequency of cases of nurses who were dismissed by alcoholism, insolence, lack of discipline, absenteeism, theft or extortion practiced in patient person.

Nightingale attacked these problems by creating a system based on training, workout, dedication, in iron discipline and strong hierarchical stratification, according to a mixed model, conventual and military.

Who is Florence Nightingale?

Florence Nightingale (Florence, May 12, 1820 – August 13, 1910) was a British nurse who became famous for being a pioneer in treating the war-wounded, during the Crimean War. She is best known in history by nickname the "Lady of the Lamp", because use of this instrument to aid in lighting to assist the wounded during the night.
His contribution in nursing, being a pioneer in the use of the biomedical model, based on the medicine practiced by doctors.
He also contributed in the field of statistics, being a pioneer in the use of methods of visual representation of information, such as pie (usually known as pie chart type) initially created by William Playfair.

What is nursing?

“Nursing is a science and art. Based on a body of knowledge and practices covering the state's of health, disease and personal transactions mediated, professional, scientific, aesthetic, ethical and policy of caring for human beings”

Nursing is an art and a science care whose essence and specificity is careful to human beings, individually, in the family or in the community so integral and holistic, developing autonomously or in a team, protection, promotion activities, prevention and recovery of health.

The knowledge that underlies the nursing care must be built at the intersection of philosophy, that answers the big question an existential human science and technology, having the formal logic as a normative correction officer and ethics, epistemological approach effectively committed to human emancipation and evolution of societies.

Florence Nightingale outlined how nursing assistance's goal to keep the person under the best possible conditions, in order that the nature can act on it.

It is bounded nursing activities to caring and clarity that there is no cure, but don't exits cure without care.