Infections and infectious diseases

[Pages:282]Infections and infectious diseases

A manual for nurses and midwives in the WHO European Region

World Health Organization Regional Office for Europe

International Federation of Red Cross and Red Crescent Societies

ABSTRACT

There is an urgent need to re-establish basic infection control measures, which have been overlooked or played a less important role in controlling the spread of infections since the introduction of antibiotics in the 1940s. This manual has been written with the aim of developing the knowledge, skills and attitudes of nurses and midwives regarding infections and infectious diseases and their prevention and control. It is intended to be used as an interactive learning package for nurses and midwives in the WHO European region, specifically in eastern Europe. There are seven modules. Each module is in two parts: theory and practice. A workbook is provided separately, with opportunities for self-assessment through learning activities. A completed workbook is also available for each module to give further guidance to readers.

Keywords

INFECTION CONTROL INFECTIOUS DISEASES PREVENTION TREATMENT NURSING CARE

? World Health Organization 2001 All rights in this document are reserved by the WHO Regional Office for Europe. The document may nevertheless be freely reviewed, abstracted, reproduced or translated into any other language (but not for sale or for use in conjunction with commercial purposes) provided that full acknowledgement is given to the source. For the use of the WHO emblem, permission must be sought from the WHO Regional Office. Any translation should include the words: The translator of this document is responsible for the accuracy of the translation. The Regional Office would appreciate receiving three copies of any translation. Any views expressed by named authors are solely the responsibility of those authors.

Foreword

Infections and infectious diseases are a great burden on many societies, including the countries in the WHO European region. To reduce that burden an integrated approach is required, combining health promotion, disease prevention and patient treatment. The prerequisite for success in this fight is the participation of all health care professionals. Nurses and midwives, as major frontline providers of care, are in a position to contribute significantly to reducing the burden.

Infections and infectious diseases: A manual for nurses and midwives in the WHO European region has been written with the aim of developing the knowledge, skills and attitudes of nurses and midwives regarding infections and infectious diseases and their prevention and control. It is intended for use as an interactive learning package for nurses and midwives in the WHO European region, specifically in the more eastern part of the region. Mastery of this material will enable nurses and midwives to respond to threats to the community, to teach their patients and members of the community effective ways of preventing infections and infectious diseases, to provide high quality and effective care to people with infectious diseases and to use appropriate measures to ensure safe practice.

The manual comprises seven modules. Each module is in two parts: theory and practice, with opportunities for self-assessment through learning activities and a workbook. The manual should be used as a package to ensure that, after training, nurses and midwives have a broad and up-to-date knowledge of infections and infectious diseases. Each section of the manual can also be used independently to develop knowledge in a specific area, and the manual as a whole can be used as a reference book in health care settings.

The manual is a joint initiative between the Red Cross and the WHO Regional Office for Europe. It has been based on Communicable disease. Nursing course manual. Prepared for distance education by the National Nursing Centre of China, 1992. Over the last two years, the Scottish Centre for Infection and Environmental Health has adapted the Chinese manual to make it relevant to nurses and midwives in Europe. The WHO Regional Office for Europe and the Red Cross wish to thank the staff at the Scottish Centre for their work, as well as the many other people who have contributed to making the manual a reality, including the WHO collaborating centres for nursing and midwifery in the European Region and Barbara Stilwell, Scientist at WHO headquarters.

Terhi Heinasmaki International Federation of Red Cross and Red Crescent Societies

Ainna Fawcett-Henesy WHO Regional Office for Europe

Introduction How to use this manual This manual on infections and infectious diseases is intended for use as an interactive learning package, relevant for nurses and midwives within the European region, and specifically within Eastern Europe. It is intended that each module should consist of theory and also require practice for completion.

Aim To develop existing knowledge skills and attitudes of nurses and midwives on infections and infectious diseases and their prevention and control, within the European region.

Objectives On completion of this manual you should have an understanding of: 1. the main concepts of prevention and control of infection; 2. important infections and infectious diseases in the European region, including: ? definition; ? modes of transmission; ? epidemiological summary; ? manifestations; ? complications; ? risk factors / age groups affected; ? prognosis; ? diagnosis; ? methods of treatment; ? prevention of spread; ? screening; ? contact tracing; ? nursing care; ? rehabilitation; ? prevention strategies; and ? general information on less common infections

and infectious diseases; and

3. practical measures that can be taken and implemented into your own practice to prevent the spread of infection.

Format There are seven modules: Module 1: The prevention and control of infection Module 2: The Expanded Programme of Immunization (EPI) Module 3: Infections spread by food and water Module 4: Infections spread by animals and insects and less common infectious diseases Module 5: Diseases spread by person-to-person contact Module 6: Tuberculosis Module 7: Infections spread by sexual contact and blood and body fluids; Part I: Infections spread by sexual contact and Part II: Infections spread by blood and body fluids.

Layout of each module Each module follows the same format and layout. 1. A front title page. 2. An index that indicates which topics are covered and where you can find them. 3. A glossary of terms that explains what terms mean; you should refer to this throughout each module. Some words or terms may be found in more than one module. 4. A brief overall introduction to the module. 5. Stated learning outcomes, indicating what you should achieve on satisfactory completion at the end of each module. 6. Key words, that is, words or terms of particular relevance to an individual module. 7. The main body of the text, containing theory and factual content; the same paragraph headings are used throughout the manual where appropriate. 8. Learning activities, to be carried out when indicated in the text; a workbook is provided

separately for this. 9. Revision points: these indicate that you should stop and note some points or answer a question. 10. The summary of key points is a reiteration of the most important messages to absorb and remember from each module. 11. Bibliography: although numerous sources of information have been used in the production of each module, the authors have tried to use WHO sources whenever possible; only the main sources used for each module are included in the bibliography. 12. Appendices, which are useful sources of further information.

Theory versus practical learning composition The manual content contains most of the theory required to provide a firm basis of knowledge on infections and infectious disease. The purpose of the revision points is to test your knowledge on material already covered in the manual text. Try to respond to the revision points without referring to the text in the first instance, then compare your response to the information in the manual.

The learning activities are intended to be more practical and are related to nursing or midwifery practice incorporating wider aspects relevant to the module content. For example, you may be asked to visit a laboratory, carry out an audit in your place of work or produce a leaflet to give to patients. The learning activities are designed to further develop your knowledge and are also practical and useful. Depending on your area of practice, some learning activities will be more useful than others.

Assessment of learning activities It is indicated within the text of each module when you should carry out a particular learning activity. A workbook containing instructions for the

learning activities is provided separately. The workbook is designed to assist you to complete the activities, and there will be instructions. If there is a blank space under an activity, this should be used for notes. On completion of the each module, you can compare your findings with information in the completed workbook. This document is designed to help you find out if you are on the right track with the learning activities. It is recommended that in order to get the most benefit from the manual, you should not refer to this until you have completed all the learning activities for each module.

Further information The manual is designed to be self-contained. The number of other sources of information in the bibliography of each module has been kept to a minimum; those which have been cited are particularly useful. The information within this manual is only as up-to-date as the date of publication; to obtain the most up-to-date information available, visit the websites mentioned in the bibliography.

Assessment of revision points You can test this yourself by comparing your response to the information in the manual text.

Table of contents

Module 1: The prevention and control of infection

1

Module 2: The Expanded Programme of Immunization (EPI)

38

Module 3: Infections spread by food and water

53

Module 4: Infections spread by animals and insects and less common infectious diseases

92

Module 5: Diseases spread by person-to-person contact

125

Module 6: Tuberculosis

155

Module 7: Infections spread by sexual contact and blood and body fluids

Part I: Infections spread by sexual contact

189

Part II: Infections spread by blood and body fluids

231

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