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Microbiology > 05- Infection prevention and control > Flashcards

05- Infection prevention and control Flashcards

1
Q

chain of infection

A

factors that lead to the transmission or spread of disease

  • need a source
  • transmission
  • susceptible host
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2
Q

Sources

A 
Patient
Visitor
Staff
Environment
Equipment
Other sources such as food or contamination at the manufacturer.
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3
Q

Transmission

A 
Contact - skin to skin
Indirect Contact - skin to inanimate object
Droplet
Airborne
Blood and Body fluids
Vector (mosquito)
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4
Q

contact transmission

A

skin to skin

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5
Q

Indirect transmission

A

skin to inanimate object

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6
Q

Airborne

A

molecules suspended in the air

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7
Q

Blood borne pathogens

A

Disease-causing organisms transferred through contact with blood or other body fluids

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8
Q

vector transmission

A

transmission of an infectious agent by an insect, arthropod, or animal

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9
Q

Susceptible Hosts

A 
Age (very young and very old)
Immunosuppression
No immunity
Chronic underlying conditions (diabetes)
Emergency procedures
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10
Q

Routine Practices

A

Published in 1999 by Health Canada (now PHAC).
Recommends practices for the routine care of all patients in various settings and incorporates previous precautions against bloodborne pathogens.
Similar to Standard Precautions, published by the CDC in 1996.

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11
Q

Routine practice interventions

A

think about what intervention we are doing rather then what the patient has (gloves for needles, etc).

Determined by the interaction with the patient not by the patient’s diagnosis.

Anticipate the risk of exposure to blood and other body fluids

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12
Q

all body substances……………

A

(Blood, body fluids, secretions, excretions, drainage) of ALL patients are considered potentially infective.

Practice determined by risk of encountering body substance NOT by diagnosis

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13
Q

Additional Precautions for

A

Droplet and airborne
Bacteria that are resistant to multiple antibiotics
Organisms/infections of significance

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14
Q

Goal of infection control

A

Break the chain of infection

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15
Q

Best way to break the chain of infection

A

hand washing

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16
Q

Hand hygiene

A

Good hand hygiene can terminate outbreaks in health care facilities, reduce transmission of antimicrobial resistant organisms and reduce overall infection rates.

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17
Q

Best hand hygiene method

A

Hand washing with soap and running water remains most sensible strategy in non health care settings

Hand rubs with alcohol-based products significantly reduce the microorganisms, fast acting, and cause less skin irritation- works well

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18
Q

4 moments for hand hygiene

A
  1. before entering a patients room
  2. before procedure
  3. after body fluid exposure
  4. after contact with patient or patient environment
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19
Q

Gloves

A

Should be used as an additional measure not as a substitute for hand hygiene.

To be used when in direct contact with any body fluids or moist substances/exudate from wounds.
The use of gloves does not eliminate the need for hand hygiene.
The use of hand hygiene does not eliminate the use of gloves.
Gloves reduce hand contamination by 70% to 80%, prevent cross contamination and protect patients and health care personnel from infections

Hand hygiene before donning gloves and
after glove removal

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20
Q

Mask, eye protection, face shield

A

worn to protect mucous membranes during procedures and activities likely to cause splashes of body fluids

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21
Q

Gowns

A

Where gowns when clothing likely to be soiled.
Protect clothing during procedures and patient care activities likely to generate splashes or sprays of blood, body fluids, secretions or excretions.

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22
Q

Accommodation

A

single room not required unless patient visibly soils environment.

23
Q

Patient Care Equipment

A

All reusable equipment to be cleaned between patients. Safe disposal of sharps.

24
Q

Environmental Control

A

establish routine care, cleaning of surfaces and furniture, using hospital approved disinfectant. “High touch” items and horizontal surfaces daily.

25
Factors for Risk of Infection
The pathogen involved The type of exposure The amount of blood involved The amount of virus in the blood
26
Hepatitis B, Hepatitis C, HIV
not transmitted by feces, nasal secretions, sputum, tears, urine, and vomit... unless they are visibly contaminated by blood.
27
Hepatitis B (HBV)
Risk = 6%-30% | If vaccinated and developed immunity, then virtually no risk
28
Hepatitis C (HCV)
Risk = 1.8 % (after cut or needle stick) | Risk unknown following a blood splash
29
Human Immunodeficiency Virus (HIV)
Risk = 0.3% after needle stick or cut Risk = 0.1% after splashes to nose, mouth, eye Risk< 0.1% after exposure to skin
30
Safe Handling of Sharps
Place intact needle/syringe units and sharps in designated puncture resistant disposal container. Use needle safety devices DO NOT RECAP NEEDLES
31
Blood Borne Pathogens prevention
Risk Prevention: Hepatitis B vaccine, maintain intact skin, maintain good health
32
Blood borne pathogens risk elimination
Disinfection, safe containment of blood
33
Blood Borne Pathogens Risk Reduction
Personal Protective Equipment (PPE)
34
The microbe
``` Ability to survive in environment Low infective dose Virulence and pathogenicity Can exist in a carrier state Means of transmission ```
35
The source patient
Symptoms of diarrhea Requires hands on care Poor hygiene Copious respiratory secretions
36
Patient Care Environment
The housekeeping is poor Equipment is shared between patients Multiple bed rooms Patient/nurse ratio
37
The new susceptible host
``` Portals of entry (catheters, intact skin) Immune status Underlying medical condition Antibiotic therapy High acuity and ++hands-on-care ```
38
Additional precautions based on......
transmission and required when Routine Practices insufficient. Droplet and Airborne spread is highly transmissible Epidemiologically significant transmission by direct/indirect contact.
39
Airborne Transmission
Specific Diseases or clinical symptoms Examples: Pulmonary /laryngeal TB Measles Rash with measles presentation
40
Airborne Precautionary Measures
``` Single room, door closed at all times Negative pressure 6- 9 air changes per hour new construction 12 air changes Direct exhaust (air from room is not recirculated) ```
41
Airborne Precautionary Measures; PPE
Respirators that filter submicron particles and fit around contours of face to avoid air leaks.
42
Airborne Precautionary Measures; patient transport
Patient should leave room for essential procedures only. Patient to wear surgical mask
43
droplet transmission
``` Specific Diseases or Clinical symptoms Bronchiolitis, colds Bacterial Meningitis Diphtheria Pertussis Respiratory Syncytial Virus Adenovirus Influenza ``` *Many droplet spread viruses contaminate the Pt. environment (indirect contact transmission)
44
Droplet precautions Accommodation:
Single room preferred, if not able, spatial separation of > 4 metres. May cohort patients with same diagnosis. In nurseries, must keep 1-2 metres between bassinettes. Door may be kept open.
45
Droplet precautions PPE
Surgical/procedure mask Eye protection (glasses, goggles, face shield) Gowns - as per routine practices, when droplets, splatters to clothing anticipated. Gloves - when handling respiratory secretions.
46
droplet precautions patient transport
Patient to leave room only for essential services. | Patient to wear surgical/procedure mask whenever leaving room.
47
Contact Transmission
``` Enteric organisms (e.g. Clostridium difficile) Antibiotic resistant organisms such as MRSA (methicillin resistant staphylococcus aureus, VRE (vancomycin resistant enterococcus). ```
48
Contact Precautions
Gown and gloves for patient care and when handling patient's personal items and equipment. Single room preferred. Door can remain open. Assess patient, organism, roommate when considering shared accommodation. Special attention to cleaning of environment
49
Contact precaution patient transport
may leave room for necessary procedures. Patient should be transported with a clean gown/sheet and perform hand hygiene upon leaving room.
50
Healthy Workplace
Do not come to the hospital if you have an acute illness that is probably of infectious etiology Respiratory infections coughs, colds, the flu (cough and colds , 1st 2-3 days or until feeling improvement in symptoms) Gastrointestinal infections, vomiting, diarrhea Conjunctivitis Skin rashes or lesions Keep immunization up to date Protect Vulnerable patients Be considerate to your colleagues
51
Isolation carts
do not put supplies in an isolation cart
52
Patient and Family Teaching
Patients to have their infection and the precautionary measures explained to them. The means of transmission, the risks and the prevention strategies for family and caregivers should be explained. Educational material should be clear, and in "layman's terms".
53
Decisions for Precautions
Acute Care - more acuity - more open/broken skin - surgical incisions - catheters, IV's, tubes Long Term Care - some underlying conditions - decubitus ulcers - peg tubes - partial to total care Lodging Homes / Senior Residences - self Care - intact skin - able to follow directions

Microbiology (7 decks)

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