Preventing septic shock. Infection control in the intensive care unit

Preventing nosocomial infection in the critically ill patient is a challenge for the critical care nurse. The prevention of nosocomial infection may be impossible in the critically ill patient as long as invasive therapeutic interventions are key to patient care. Therefore, nursing practice must be guided by a clear understanding of the patient's host defense mechanisms and how they are jeopardized by the underlying medical condition and therapeutic interventions. Classic recommendations of infection control practices, such as hand washing and meticulous aseptic technique, plus an awareness of the many ways that microorganisms can contaminate and inoculate the patient are essential for preventative nursing care. The most effective infection control measures may be continual patient assessment, observing for subtle changes that indicate an infection is incubating. It is the early distinction of infection as the underlying mechanism for fever, inflammatory response, and clinical deterioration that can best facilitate an expedient and appropriate course of therapy and minimize the consequences of disease.