Patient Situations:  [1]    [2]
 
Patient Situation: 1
The Spread of Infection
 

An elderly patient, hospitalized with a gastrointestinal disorder, was on bed rest and required assistance for activities of daily living. The patient had frequent uncontrolled diarrhea stools and the nurse provided excellent care to maintain cleanliness and comfort. Following one episode of cleaning the patient and changing the bed linen, the nurse immediately went to a second patient to provide care. The nurse's hands were not washed before assisting the second patient.

Let's examine the chain of infection as it applies to this situation.


Escherichia coli

Large intestine
E. coli, bacteria in the large intestine of humans forms the greater part of the normal intestinal flora.


E. coli exited the body in feces.


The nurse removed the contaminated linen from the bed. The E. coli organism contaminated the hands of the nurse who then provided morning care to another patient.

The second patient receiving care had a Foley catheter. The nurse manipulated the tubing attached to the catheter. The E. coli organism on the nurse's hands contaminated the catheter tubing and ascended to the patient's meatus and then into the urinary bladder.
 
The second patient with a Foley catheter. This patient was elderly and had a chronic illness necessitating complete bed rest. The Foley catheter contaminated by the E. coli organism provided a direct route into the urinary bladder.
 
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PATIENT SITUATION 2