Diploma In
Nursing First
Year
IPC Microbiology Assignment
Kaitlyn Edwin
Student Number – 0002221808
Lecturer – Marna Rautenbach
DNIPC1B
11/15/2022
Contents
Introduction ............................................................................................................................................ 2
Topic 1: Health care associated infections ............................................................................................. 3
A. Intravenous lines ............................................................................................................................ 3
B. Nebulizer masks .............................................................................................................................. 4
Topic 4: Notifiable Diseases .................................................................................................................... 5
Conclusion ............................................................................................................................................... 8
Bibliography ............................................................................................................................................ 9
Appendices............................................................................................................................................ 11
1
Introduction
Microbiology, commonly known as the study of microorganisms or microbes, is the study of a wide
range of typically small, basic life forms, such as bacteria, viruses, and archaea. The structure,
categorization, and use of such organisms as well as methods for directing and manipulating their
behaviour are all topics covered in this study. Medical microbiology consists of identifying bacteria
for the diagnosis of communicable disorders and determining the likelihood that they will respond to
therapeutic measures. In this assignment it will be more revealed on how these agents of
microbiology contribute to healthcare associated infections (which is narrowed down to the nursing
practice of intravenous lines and nebulizers) and notifiable diseases such as Hepatitis B,
Tuberculosis, and COVID-19. With a greater understanding of these bacteria because of
microbiology, a healthcare worker can ensure the safety and well-being of a patient whose immune
response has weakened and who is constantly at risk of contracting any microorganism while under
the care of a nurse
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Topic 1: Health care associated infections
A. Intravenous lines
The patient's body can get certain substances through intravenous lines. Through an IV, the body
receives fluids such as blood, medicine, or other fluids. The most frequent location for IV insertion is
an arm vein, however other locations may also be used, dependent on the clinical condition of a
patient. The three types of intravenous lines are peripheral IV’s, midline catheters and central lines.
A medical ward inspection revealed that nurses keep inconsistent documents, particularly those
pertaining to the placement of intravenous lines. Intravenous insertions should be first documented
to encourage others to sustain continuous intravenous line maintenance, such as checking the site
for problems and removing any unnecessary lines or tubing as soon as appropriate. As a result of
inadequate checking of IV sites and no knowledge on whether the site was checked prior due to
poor documentation, this resulted in a few patients with peripheral IV’s experience IV infiltration
and IV extravasation. Fluid escapes from the vein into the nearby soft tissue, causing IV infiltrations
and extravasations. IV infiltration led to swelling, discomfort due to late detection and poor
maintenance, but luckily the patient did not have exertional compartment syndrome and potential
the amputation of the injured area. IV extravasation led to the tissue death (necrosis) of a patient’s
limb.
During a medical ward round, it was also noted that nursing professionals' poor hand hygiene is a
clear risk factor for intravenous line contamination therefore resulting in an infection. Before
inserting an IV line or putting on gloves, properly disinfecting hands will greatly decrease the risk of
health care associated infections. Therefore, all practitioners must follow the proper hand
decontamination procedure prior to and following any contact with insertion site. This includes
washing hands with anti-microbial soap and water or decontaminating hands with an alcohol-based
hand rub if your hands are contaminated with blood or other body fluids.
During the medical ward round, it was reported that a patient had obtained a central line-associated
blood stream infection (CLABSI). The central catheter was placed in the patient’s neck to administer
medication. The main reason was due to poor adherence of the rules on hand hygiene, not cleaning
the access port with the proper antiseptic agents just before each usage, not only using sterile tools
to access catheters, and changing dressings in a non-aseptic manner. These actions allowed for easy
access of micro-organisms from the central line into the patient’s bloodstream, but luckily the
infection was successfully treated with antibiotics.
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B. Nebulizer masks
A nebulizer turns liquid medication into tiny droplets that can be inhaled through a mouthpiece or
mask as an aerosol or mist. Many kinds of drugs can be administered using nebulizers. The
medications and moisture release lung secretions and reduce breathing issues including wheezing.
One of the main problems noted during the medical ward round was that nebulizer masks used on
patients were left lying around on unclean surfaces when they were not in current use by the
patient, this resulted in microorganisms attaching themselves to the masks and then entering
through the patients mouth when used again. Poor cleaning of the nebulizer masks resulted in a
slower recovery of the patient and an increased difficulty of breathing due to the number of
microorganisms that enter through this way.
It was also noted that when nurses administered nebulizer masks to patients, improper or no hand
hygiene was done therefore increasing the risk of transmission of microorganisms into the patient’s
respiratory tract. Additionally, no health education was given to the patients when handling the
nebulizer mask therefore resulting in increased infections through nebulizer masks.
During the medical ward round, it was reported that a patient who unknowingly had COVID-19 had
spread it to other patients in the ward mainly due to the accelerated spread because of the use of a
nebulizer mask. Nebulizer usage results in two things. The first is that they exhale more strongly than
usual and frequently take in large breaths. By itself, this increases the number of particles produced.
The second is that they inhale a tiny mist that is not entirely absorbed by the lung. Also, this is
exhaled. Additionally, when lung mucus is loosened by a nebulizer, it may also be exhaled. This
might come out as coughed-up particles. Therefore, regardless of the mechanism, the patient with
COVID-19 who used a nebulizer had the risk of unintentionally infecting others.
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Topic 4: Notifiable Diseases
Hepatitis B
Notifiable
Disease
Transmission
Symptoms
Diagnosis
Hepatitis B is spread
when blood, semen, or
another bodily fluid
that contains the virus
enters the body of a
person who is not
already infected or who
has not gotten the
vaccine. Examples of
how this could occur
include sexual contact,
sharing of needles,
syringes, or other drug
injection instruments,
or transmission from
mother to child during
childbirth.
Most people don't
exhibit any
symptoms when
they are first
infected. Some
people do, however,
experience acute
illness with
symptoms that last
for several weeks.
These signs and
symptoms include
nausea, vomiting,
severe tiredness,
darker urine, and
jaundice.
The following tests can be
used to identify hepatitis B or
its complications:
-Blood test. Acute or chronic
hepatitis B can be identified
by blood testing. You can also
find out if you are immune to
the illness with a basic blood
test.
-Liver
ultrasound. Transient
elastography, a specialist
ultrasound, can assess the
extent of liver injury.
-Liver biopsy. Your doctor
might take a small sample of
your liver for testing to
screen for liver disease (liver
biopsy). During this surgery,
your doctor places a tiny
needle into your liver and
removes a small bit of liver
tissue for lab testing.
Primary, Secondary &
Tertiary Treatment
Primary- The primary
objective of treatment for
those infected with
hepatitis B (HBV) is to
prevent disease
progression, especially to
cirrhosis, liver failure, and
hepatocellular carcinoma.
The immune system is
boosted by medications
from the interferon family,
which also help eradicate
the hepatitis B virus.
Pegylated interferon and
interferon alpha are two
examples.
Secondary- Antiviral drugs
reduce hepatitis B virus
reproduction, hence
reducing liver
inflammation and injury.
They are taken as a pill
once a day for at least a
year and frequently
longer. Tenofovir
disoproxil fumarate (TDF)
and entecavir (ETV) are
two examples.
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Tubercul osis
The main tuberculosis
carriers are airborne
droplet nuclei, which
have a size range of
one to five microns.
Infectious droplet
nuclei are formed
when persons with
pulmonary or laryngeal
TB disease cough,
sneeze, shout, or sing.
TB can spread from one
person to another
through the air.
Most persons who
have latent TB, or
the absence of
symptoms, are
infected with the
tuberculosis virus. A
fever, weight loss,
night sweats, and a
cough are usually
present symptoms
when they do occur
(which can
occasionally have a
bloody tint).
The two types of tests used
to discover TB bacterium in
the body are the TB skin test
(TST) and TB blood testing. It
cannot establish a person's
latent TB infection status
(LTBI) or the stage of their TB
disease. A chest x-ray and a
sputum sample are two
additional tests needed to
evaluate whether a person
has TB illness. During the
physical examination, your
doctor will use a stethoscope
to listen to your lungs and
will check your lymph nodes
for oedema. The most
common approach for
detecting tuberculosis is still
skin testing. A tiny amount of
tuberculin is injected just
beneath the skin on the
inside of your forearm. In the
following 48 to 72 hours, a
doctor will inspect your arm
to check for swelling where
the injection was
administered. Undoubtedly,
you have TB infection if you
have a hard, elevated red
bump. Latent or active TB can
be confirmed or ruled out by
blood testing. These
examinations assess your
body's immunological
response to the TB
bacterium. Your doctor could
request samples of your
sputum, or the mucus that
comes up when you cough, if
the results of your chest Xray reveal that you have
tuberculosis. TB drugresistant bacteria can also be
discovered using sputum
samples. This aids your
doctor in selecting the drugs
with the highest likelihood of
success.
Primary- You will be
prescribed at least a 6month course of a
combination of medicines
if you are found to have
active pulmonary TB,
which affects your lungs
and manifests as
symptoms. Isoniazid and
rifampicin are the
standard of care, and for
the first two months of the
six-month therapy period,
two other antibiotics
(pyrazinamide and
ethambutol) are also used.
Secondary- Streptomycin
(SM) used to be, and in
some cases still is, a firstline therapeutic option.
The increasing prevalence
of SM resistance in various
parts of the world has
reduced the general utility
of SM. Other drugs, such
capreomycin and
cyclosporine, are reserved
for special situations like
drug intolerance or
resistance.
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Covid-19
COVID-19 can be
obtained from those
who are infected with
the virus. Aerosols—
tiny droplets or
particles that are
emitted from the
mouth or nose when a
person with COVID-19
coughs or exhales—can
transmit the illness
from one person to
another. Anyone within
six feet of that
individual can breathe
it into their lungs.
These droplets fall on
numerous objects and
surfaces all around the
person.
The symptoms of
many COVID-19
patients are mild to
moderate, and they
usually go away on
their own. Some
people, however,
will develop serious
illnesses and need
medical care. The
most common
symptoms are fever,
coughing, fatigue,
and a loss of taste
and smell. Chest
pain, shortness of
breath, trouble
breathing, loss of
voice or movement,
confusion, and
disorientation are all
major warning signs.
You should seek
immediate medical
assistance if you
encounter serious
symptoms.
To test for the COVID-19
virus, a medical expert takes
a sample from the nose,
throat, or saliva. The samples
are then brought to a lab for
examination. You could send
the sputum from your cough
for examination. These can
only be obtained with a
prescription from a doctor. A
positive Nucleic Acid
Amplification Test (NAAT) or
antigen test is usually
indicative of a person
containing COVID-19, and
additional testing is not
usually required.
Primary- If you just have
minor symptoms, your
doctor can recommend
that you heal at home.
When you are ill, it is
recommended that you
stay as far away from
family members and pets
as you can, protect them
by wearing a mask, and
use a different bathroom
and bedroom.
Additionally, regulate your
home's airflow by opening
windows and, when
needed, using air purifiers.
Secondary- Sotrovimab
and Bebtelovimab are
effective treatments for
COVID-19 omicron variant.
These treatments are
given to people with mild
to moderate COVID-19
who are at an increased
risk of becoming seriously
unwell as a result of the
condition. The course of
treatment includes a single
intravenous infusion. For
the greatest outcomes,
these medications must be
used as soon as COVID-19
symptoms emerge and
before reaching
hospitalization.
Tertiary- Supportive
therapy helps to reduce
symptoms and may
include ibuprofen or
acetaminophen painkillers,
cough medicine, rest, and
fluid consumption.
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Conclusion
It is evident throughout this assignment that micro-organisms are widely spread throughout
healthcare settings as well as from person to person. This results in a variety of diseases or viruses
being spread and therefore causing further illness or possibly death if left untreated. It is important
for nurses to be mindful of the harmful effects of micro-organisms that cause harm to patients
health and also important for nurses to be cautious when providing care to a patient, ensuring they
are not contaminating or creating an easy pathway for bacteria to enter and reach the patient. This
can be seen by the actions done when administering I.V lines and nebulizers, failure to administer
these devices aseptically or ensure no contamination of them results in a variety of healthcare
associated infections. It is also evident that notifiable diseases described in this assignment are
caused by harmful micro-organisms and can occur in healthcare settings as well. If left untreated this
may result in worsened signs and symptoms, and possible death. As nurses, we always need to
ensure the safety of our patients and in doing so we also ensure the safety of ourselves and other
people that are involved. Microbiology also helps us as nurses identify possible treatments for when
an individual has become infected due to harmful micro-organisms. These treatments are evident
throughout the assignment, for both medical devices and notifiable diseases.
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Appendices
Kaitlyn Edwin
0002221808
Kaitlynedwin27@gmail.com
Diploma in Nursing
GNE Netcare Campus
Netcare Pretoria East Hospital
Sr. Marna Rautenbach
IPC Assignment
12 November 2022
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