(10) NOSOCOMIAL INFECTIONS

Question 1

• Hospital-acquired infections
• The offending organism was obtained in the hospital environment during period of confinement of the patient

Answer 1

Nosocomial Infections

Question 2

COMMON NOSOCOMIAL INFECTIONS:

1. CAUTI - ________
2. CLABSI - ________
3. VAP - _______
4. SSI - _______

Answer 2

(1) Catheter Associated Urinary Infection
(2) Center Line Associated Bloodstream Infection
(3) Ventilator Associated Pneumonia
(4) Surgical Site Infection

Question 3

PATIENTS MOST-LIKELY TO DEVELOP NOSOCOMIAL INFECTIONS:
1. _____ - weakened immune system
2. _____ - second most common cause of maternal immortality
3. _____ - immature development
4. _____ - break in skin barrier
5. _____ - due to development bedsores and higher risk of infection

Answer 3

(1) Elderly Patients
(2) Women in Labor and Delivery
(3) Premature Infants and Newborns
(4) Surgical and Burn Patients
(5) Paralyzed Patients and undergoing Renal Dialysis or Catherization

Question 4

CONTRIBUTING FACTORS
1. _______ Pathogens
2. Failure of HCP to follow _______
3. _______ Patients

Answer 4

(1) Drug-resistant
(2) infection control guidelines
(3) Immunocompromised

Question 5

OTHER FACTORS
1. The _____ of antimicrobial agents
2. A ______ about antimicrobial agents
3. ______ types of surgeries
4. ______ of hospitals and other healthcare facilities
5. Increased use of ______ healthcare workers
6. Increased use of ______
7. Overuse and improper use of ______

Answer 5

(1) indiscriminate use [drug resistant and MDR pathogens]

(2) false sense of security [neglect of aseptic techniques]

(3) Lengthy and more complicated surgeries

(4) Overcrowding [as well as shortage of staff]

(5) less-highly trained [downgrade in quality]

(6) anti-inflammatory and immunosuppresant agents [suppresses the immune system]

(7) indwelling medical devices [devices left inside the body]

Question 6

Reservoir of nosocomical infections

Answer 6

Hospital Environment

Question 7

MICROORGANISMS IN THE HOSPITAL ENVIRONMENT
1. _____ - wound infections, UTI, bacteremia, and meningitis

2. _____ - UTI, pelvic infection, meningitis, and bacteremia pneumonia
3. _____ - UTI
4. _____ - difficult to treat; malignant external otitis, meningitis, pneumonia, and septiscemia
5. _____ - nearly half of nosocomial diarrhea
6. _____ - UTI and sepsis
7. _____ - cause UTI and SSI

Answer 7

(1) Enterococcus
(2) Escherichia coli
(3) Staphylococcus aureus
(4) Psedomonas aeruginosa
(5) Clostridium difficile
(6) Candida albicans
(7) Other gram-negative bacteria

Question 8

CRITICAL AREAS COMMON IN INFECTION
1. _______
2. _______
3. _______
4. _______
5. _______

Answer 8

(1) ER
(2) OR
(3) DR
(4) NURSERY
(5) ICU

Question 9

THE COMPROMISED HOST
1. ________ - if intact, provides formidable and physical barrier; first line of defense

2. ________ - if functional, T-Cells (T-lymphocytes) provide resistance to diseases

Answer 9

(1) Broken skin or mucous membranes
(2) Suppressed immune system

Question 10

CHAIN OF TRANSMISSION
1. ______ - hospital staff to patient to another patient

2. ______ - through fomites (catheter, needles, & surgical dressing) and ventilation systems (respiratory aids)

Answer 10

(1) Direct Contact Transmission
(2) Indirect Contact Transmission

Question 11

CONTROL OF NOSOCOMIAL INFECTIONS
1. _____ - single most important means to prevent spread on infection

2. _____ - used from patient to patient and must be cleaned (tubs, respirator, & humidifier
3. _____ - items that can’t be used again

Answer 11

(1) Handwashing
(2) Disinfection of Materials
(3) Single-use / Disposable / Sterilized Equipment

Question 12

• “Clean”
• Exclude pathogens

Answer 12

Medical Asepsis

Question 13

• “Sterile”
• Exclude all microorganisms
• OR, labor and delivery rooms, certain areas of hospital laboratory, patient’s bedside during invasive procedures

Answer 13

Surgical Asepsis

Question 14

AIRBORN PRECAUTIONS
• Place the client on a private room that has (1) _______.

• If a negative pressure room is unavailable, then (2) _______.

• Wear a (3) _______.

• (4) _______ should not enter the room.

• (5) _______ of client outside the room to essential purposes. Place ______ on the client during transport.

Answer 14

(1) negative pressure [air stays in a room]
(2) cohort [placing patients w/ same microorganism in one room]
(3) respiratory device
(4) Susceptible people
(5) Limit movement; surgical mask

Question 15

DROPLET PRECAUTIONS
• Wear a mask if working within _____ of the client.

Answer 15

(1) 3 feet

Question 16

CONTACT PRECAUTIONS
• Wear (1) _____ as described in standard precautions.

• Wear a (2) _____ when entering a room if contact with patient’s items or wound drainage is inevitable

• Dedicate the use of ______ to a single client with the same infecting microorganisms.

Answer 16

(1) gloves
(2) gown
(3) noncritical client care equipment

Question 17

• Measures designed to prevent spread of infection or potentially infectious microorganism to health personnel, clients, visitors
• Placed in isolation to protect other people (negative pressure)

Answer 17

Source Isolation

Question 18

• Protective isolation, neutropenic isolation
• To protect patient from infection
• When patient is placed in isolation to protect the patient themselves (positive pressure)
• Patient is in a total protected environment (TPE)

Answer 18

Reverse Isolation

Question 19

• Filter that removes 99.97% of particles in the air
• Vacuum / air purifier

Answer 19

High-Efficiency Particulate Air Filter