Asepsis, Infection Control & Patient Safety - Concept Map
Infection Prevention & Patient Safety
Related concepts
Chain of Infection
Sub concepts
- Infectious Agent (bacteria, virus, fungi, parasite)
- Reservoir (human, animal, environment, equipment)
- Portal of Exit (respiratory, GI, GU, blood, skin)
- Mode of Transmission (contact, droplet, airborne, vehicle, vector)
- Portal of Entry (broken skin, mucous membranes, invasive lines)
- Susceptible Host (immunocompromised, very young/old, malnourished)
Relationship to central
Foundation for understanding how infections spread; breaking any link prevents disease transmission
Stages of Infection
Sub concepts
- Incubation (exposure to first symptoms)
- Prodromal (early, nonspecific symptoms; highly communicable)
- Acute Illness (specific signs/symptoms peak)
- Convalescence (recovery phase)
Relationship to central
Identifies when patients are most communicable and symptomatic; guides nursing assessment and isolation timing
Body Defenses Against Infection
Sub concepts
- Nonspecific (Innate) Immunity: skin, mucous membranes, normal flora, gastric acid, cilia, inflammatory response, phagocytosis
- Specific (Adaptive) Immunity: antibody-mediated (B cells), cell-mediated (T cells)
Relationship to central
Understanding immunity guides assessment of patient susceptibility and intervention timing
Medical vs Surgical Asepsis
Sub concepts
- Medical Asepsis (Clean Technique): reduces microorganism numbers, used for routine care, handwashing, clean gloves
- Surgical Asepsis (Sterile Technique): eliminates all microorganisms and spores, required for invasive procedures, surgery, catheterization
Relationship to central
Core nursing competencies; medical asepsis for routine care; surgical asepsis for invasive procedures
Principles of Surgical Asepsis
Sub concepts
- Sterile touches sterile only
- Sterile field created just before use; never left unattended
- 1-inch outer border is contaminated
- Anything below waist level or table edge is contaminated
- Moisture wicks microorganisms (strike-through contamination)
- Do not reach across or turn back on sterile field
- If in doubt, consider it contaminated
Relationship to central
Essential knowledge for maintaining sterile fields during invasive procedures; high NLE frequency
Equipment Reprocessing (Spaulding Classification)
Sub concepts
- Critical Items: sterilization required (steam autoclave, ethylene oxide, hydrogen peroxide plasma)
- Semi-Critical Items: high-level disinfection required
- Non-Critical Items: cleaning and low/intermediate-level disinfection
Relationship to central
Determines appropriate cleaning, disinfection, or sterilization methods based on infection risk
Hand Hygiene
Sub concepts
- WHO Five Moments: before patient contact, before aseptic procedure, after body-fluid exposure, after patient contact, after patient surroundings
- Alcohol-based hand rub: routine decontamination when hands not visibly soiled
- Soap and water: visibly soiled hands and for spore-forming organisms (C. difficile)
- Duration: at least 20 seconds; keep hands lower than elbows
Relationship to central
Single most effective infection-control measure; breaks chain of infection at transmission point
Personal Protective Equipment (PPE)
Sub concepts
- Donning Sequence: gown → mask/respirator → goggles/face shield → gloves
- Doffing Sequence: gloves → goggles/face shield → gown → mask/respirator
- Hand hygiene after removal
- Single-use gloves; change between patients and between dirty/clean tasks
Relationship to central
Protects patient, nurse, and healthcare workers from pathogen exposure
Standard Precautions
Sub concepts
- Treat all blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes as potentially infectious
- Hand hygiene
- PPE as needed
- Safe injection practices
- Respiratory hygiene and cough etiquette
Relationship to central
Universal infection-control practices applied to ALL patients regardless of diagnosis
Transmission-Based Precautions (Isolation Precautions)
Sub concepts
- Contact Precautions: MRSA, VRE, C. difficile, scabies; gown and gloves required; dedicated equipment; single room preferred
- Droplet Precautions: influenza, pertussis, mumps, N. meningitidis, rubella; surgical mask; private room or spatial separation
- Airborne Precautions (MTV): Measles, TB, Varicella; N95 respirator and negative-pressure (airborne infection isolation) room
- Protective (Reverse) Isolation: shields immunocompromised patients; positive-pressure room; no fresh flowers/standing water
Relationship to central
Used in addition to standard precautions; tailored to specific organism transmission routes
Healthcare-Associated Infection (HAI) Prevention Bundles
Sub concepts
- CAUTI Prevention: aseptic insertion, closed drainage system, keep bag below bladder level, remove catheter early
- CLABSI Prevention: hand hygiene, maximal sterile barriers, chlorhexidine skin prep, daily line necessity review
- VAP Prevention: head of bed 30-45 degrees, oral care, sedation/spontaneous breathing assessments
- SSI Prevention: perioperative antibiotics, glucose control, sterile technique, skin antisepsis
- Antimicrobial stewardship support
Relationship to central
Evidence-based interventions to prevent common hospital-acquired infections
Sterile Gloving and Gowning
Sub concepts
- Open (Closed Hand) Method: used for catheterization, dressing changes
- Closed Method: used in OR with sterile gown
- Handle glove cuff (inside) with bare hands; gloved hand touches only outside of second glove
- Keep gloved hands above waist and in view
- If glove tears or contaminated, change immediately
Relationship to central
Procedural competencies for maintaining surgical asepsis during invasive procedures
Patient Identification and Safety Verification
Sub concepts
- Verify with at least two identifiers (name and birthdate/hospital number)
- Never use room number alone
- Applies to all medications, procedures, and treatments
Relationship to central
Prevents medication errors, wrong-site procedures, and harmful events
Fall Prevention
Sub concepts
- Assess fall risk on admission (Morse Fall Scale or similar)
- Bed in lowest position with brakes locked
- Side rails per policy (four raised rails = restraint)
- Call light, personal items, water, glasses within reach
- Adequate lighting, dry non-slip floors, clear pathways, non-slip footwear
- Assist high-risk patients with ambulation and toileting
- Use fall-risk identifier (color-coded band)
- Manage orthostatic hypotension (rise slowly)
Relationship to central
Leading cause of injury, especially in elderly; requires comprehensive prevention strategy
Restraints
Sub concepts
- Require physician order (time-limited)
- Use least-restrictive type
- Never tie to side rails
- Use quick-release knot to movable bed part
- Frequent monitoring: skin integrity, circulation, toileting, range of motion
Relationship to central
Last-resort safety intervention with significant ethical and legal implications per RA 9173
Environmental and Waste Safety
Sub concepts
- Yellow bags: infectious waste
- Black bags: non-infectious waste
- Puncture-proof sharps containers for needles and sharps
- Never recap needles (or use one-handed scoop technique)
- Dispose at point of use
- Needlestick/sharps injury management: wash, report, post-exposure prophylaxis assessment
Relationship to central
Protects healthcare workers and environmental safety; aligns with DOH Health Care Waste Management guidelines
Surgical Safety and Communication
Sub concepts
- WHO Surgical Safety Checklist
- Site marking protocols
- SBAR structured handoff (Situation, Background, Assessment, Recommendation)
- High-alert medication double checks
Relationship to central
Prevents wrong-site surgery, wrong procedures, and communication failures
Concept connections
- Chain of InfectionHand HygieneHand hygiene breaks the chain at the transmission point, preventing pathogen movement from reservoir to next host
- Chain of InfectionTransmission-Based PrecautionsUnderstanding transmission routes (contact, droplet, airborne) determines which precautions are required
- Stages of InfectionTransmission-Based PrecautionsProdromal and acute stages require isolation implementation; timing of precautions based on stage progression
- Body Defenses Against InfectionSusceptible HostImmunocompromised patients have impaired body defenses; understanding defenses guides identification of at-risk populations
- Medical vs Surgical AsepsisPrinciples of Surgical AsepsisSurgical asepsis principles are the practical application of sterile technique rules
- Principles of Surgical AsepsisSterile Gloving and GowningSterile gloving and gowning are specific procedures that apply surgical asepsis principles
- Equipment ReprocessingMedical vs Surgical AsepsisSpaulding classification determines whether cleaning, disinfection, or sterilization is used based on equipment contact level
- Hand HygieneStandard PrecautionsHand hygiene is a core component of standard precautions applied to all patients
- PPE ManagementTransmission-Based PrecautionsDifferent precautions require different PPE combinations; donning and doffing sequences prevent self-contamination
- Standard PrecautionsTransmission-Based PrecautionsTransmission-based precautions are used in addition to, not instead of, standard precautions
- HAI Prevention BundlesChain of InfectionHAI prevention bundles work by breaking the chain of infection through targeted interventions at specific links
- Fall PreventionPatient SafetyFall prevention is a key patient safety intervention addressing a leading cause of hospital injury
- Patient IdentificationPatient SafetyProper identification is fundamental to preventing wrong-patient, wrong-medication, and wrong-procedure errors
- RestraintsPatient SafetyRestraint use is a safety measure of last resort that carries ethical and legal implications per RA 9173
- Environmental and Waste SafetyHand HygieneProper waste disposal and sharps management prevent occupational exposure injuries and need for hand hygiene after exposure
- Surgical Safety and CommunicationPatient SafetyWHO Surgical Safety Checklist and SBAR communication prevent wrong-site surgery and communication failures
- Medical vs Surgical AsepsisHAI Prevention BundlesHAI bundles apply asepsis principles; CAUTI uses aseptic insertion and closed systems; CLABSI uses sterile barriers
- Infectious AgentTransmission-Based PrecautionsType of infectious agent determines transmission route and therefore the appropriate isolation precautions
- Portal of EntryPPE ManagementUnderstanding portals of entry guides selection of appropriate PPE to block pathogen access
- Cleaning, Disinfection, and SterilizationMedical vs Surgical AsepsisSterilization achieves surgical asepsis; disinfection and cleaning achieve medical asepsis at different levels
Diagrams
Infection Prevention & Patient Safety - Complete Concept Hierarchy
Comprehensive mind map showing all major concepts and their relationships in infection prevention and patient safety. Displays the hierarchical organization of topics from the central theme down through specific practices and interventions.
Chain of Infection - Breaking the Transmission Cycle
Illustrates the six links of the chain of infection sequentially, showing how each link must be present for infection to occur. Demonstrates critical intervention points where hand hygiene, vaccination, disinfection, and barriers can break the chain.
PPE Donning and Doffing Sequence
Step-by-step flowchart showing correct donning sequence (gown-mask-goggles-gloves) and doffing sequence (gloves-goggles-gown-mask), with emphasis on removing most contaminated items first and hand hygiene after doffing.
Transmission-Based Precautions Decision Tree
Decision tree for selecting appropriate transmission-based precautions based on patient diagnosis and transmission route. Includes specific examples and required PPE/environmental controls for contact, droplet, airborne, and protective isolation.
Surgical Asepsis Principles - Sterile Field Maintenance
Flowchart demonstrating critical principles for maintaining sterile fields, including contamination risks (below waist level, turning back, reaching across, moisture, borders). Emphasizes decision points and when to discard and restart a contaminated field.
Fall Prevention Assessment and Intervention
Assessment and intervention flowchart for fall prevention using Morse Fall Scale risk stratification. Shows differentiated interventions based on risk level (low, moderate, high) and emphasizes reassessment with condition changes.
Healthcare-Associated Infection Prevention Bundles
Comprehensive view of evidence-based HAI prevention bundles for catheter-associated UTI (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI), with specific interventions for each.
Stages of Infection and Nursing Implications
State diagram showing the four stages of infection with nursing implications at each stage. Highlights the prodromal stage as the most communicable period when isolation should be implemented, and shows progression through recovery.
Cleaning, Disinfection, and Sterilization - Spaulding Classification
Spaulding classification system for equipment reprocessing showing three categories (critical, semi-critical, non-critical) with appropriate sterilization or disinfection methods. Emphasizes that cleaning must always precede disinfection or sterilization.