Barrier Nursing (+CR)

Question 1

What is an Nosocomial Infection?
And how else is it reffered to as?

Answer 1

An infection, caused by a pathogenic organism, that is aquired during patient hospitalization
+
Also called Hospitalized Acquired Infection (HAI)

Question 2

What is a Zoonosis?
&
Who are the susceptible hosts?

Answer 2

A disease caused by a pathogenic organism, that can be transmissible to humans
+
Humans (primarly/in reference to)
But also includes animals

Question 3

What is disinfection?

Answer 3

The process used to reduce the number of pathogenic organisms in the environment
+
To a level considered ‘safe’
Usually, using a disinfectant (A chemical solution that inactivates pathogenic organisms)

Question 4

What is Sterilization?

Answer 4

The process used to destroy all
living tissues, microbial life/micro-organisms with the potential to cause disease.

Question 5

What form of care is given to Immunocompromised, long-term hospitlisation & neonate patients?

Answer 5

Reverse
Barrier Nursing

Question 6

A-side of Immunocompromised, long-term hospitlisation & neonates - who else are vulnerable susceptible hosts?

What about an example of susceptible humans?

Answer 6

Patients undergoing chemotherapy, un-vaccinated or with open wounds

+
Pregnant woman

Question 7

What is the tier system called, that is used as a guide to housing patients with Infectious diseases?

And how many tiers are there?

Answer 7

Tier System
(O’Dwyer 2012)
+
4

Question 8

What type of cases are applicable for Tier 1?
+
Where should they be housed?

Answer 8

Patients with:
* Poor Immune status
* High risk of Infection
* Critically ill
* Immunocompromised
* Long-term hospitalised
* Un-vaccinated
* Neonates

Housed in main hospitlisation ward or Intensive care

Question 9

What type of cases are applicable for Tier 2?
+
Where should they be housed?
+
When do you attend them?

Answer 9

Patients with:
* No history of infectious disease
* Elective surgery
* Work up for Non-infectious disease
+
House in main hospitilsation ward
+
Attend after tier 1 patients

Question 10

What type of cases are applicable for Tier 3?
+
Where should they be housed?

Answer 10

Patients with:
* Infectious diseases
* Mildly contagious
* Multi-drug Resistant Bacterial Infections (Excluding MRSA)
* Open draining wounds
* Long term antibiotics therapy
* FIV (Feline Immunodeficiency Virus)
* FIP (Feline Infectious Peritonitis)
* FeLV (Feline Leukemia Virus)
* Ringworm
* Campylobacter
* Giardia
* Pyoderma

Housed in general hospilisation ward, BUT with barrier nursing!

Question 11

What type of cases are applicable for Tier 4?
+
Where should they be housed?

Answer 11

Patients with:
* Highly contagious diseases like:

• Parvo Virus
  (Canine Infectious Enteritis)
• Distemper
  (Canine Adenovirus)
• Corona Virus
  (Feline Infectious Adenovirus)
• Kennel Cough
  (Canine Infectious Respiratory Disease)
• Cat Flu
  (Feline Herpes Virus)
• Canine Adenovirus
  (Infectious Canine Hepatitis)
• Bacterial Enteritis
  (Such as Salmonella spp)

MUST be housed in Isolation unit

If suspect - never invite into practice, access from outside practice
+
Keep there till discharge

Question 12

Senario..

A client calls into practice, saying their dog has a persitant cough, unproductive retching + lethargy.

The dog is not vaccinated for KC + has been with a dog walker all day.

What is the suspected disease?

Answer 12

Kennel Cough

(Canine Infectious Respiratory Disease)

Question 13

What tier does KC require?

Answer 13

4

Question 14

What 3 factors must you consider when are barrier nursing an infectious patient?

Answer 14

1. What tier of barrier nursing is required
2. What precautions should be implemented - Including isolation + chemical protocols
3. Where the patient should be hospitalised - including environment that would be most benefical for the patient

Question 15

If an unknown infectious/contagious patient has arrived and been in practice + around reception

Who do you need to inform?

Answer 15

All the clients in that day

Question 16

(Following the previous scenario)

How must you inform clients?

Answer 16

You must ring them, to inform them immediately

Question 17

(Following the previous scenario)

What must you be aware of when calling these clients ?
&
What must you ask them to do with their pet?

Answer 17

• Be aware + prepared that clients can be:
• Offended
• Upset
• Angry
• A chance you may lose some customers
• Ask them to isolate their pet for a minimum of 24 hrs + not travel

Question 18

(Following the previous scenario)

What are the minimal amounts of cleaning that should be done, following this?

Answer 18

Immediately:
* Mop + clean all floors
* Wipe down all equipment
* Use the high ratio of disinfectant to water solutions (as stated by manafacture’s guidelines)

• Use an aersol treatment (Angiene bomb) and leave for 12 hours

Question 19

What is the importance of adequate telephone triage?

Answer 19

Protecting:
* Hospitilised patients
* Patients in waiting area + consult rooms
* Personnel
* Owners

Question 20

Why is it importance to know the vaccination status of patients?

Answer 20

• For their protection - to identify how protected they are
• To protect other patients + personnel
• Helps within clinical diagnosis for VSs
• To establish a travel history - as maany infectious or parasitic diseases come from abroad

Question 21

(Depending on the disease involved)

Name the 13 ways in which infectious organisms can be excreted?

Answer 21

1. Faeces
2. Urine
3. V+
4. D+
5. Nasal discharge
6. Ocular discharge
7. Salvia
8. Gential discharge
9. Body fluids
10. Fluids from wounds/lesions
11. Blood
12. Milk
13. Deceased animals

Question 22

What system should you try and implicate, when it comes to keeping kennel items kept with their specific kennels, in Isolation?

Answer 22

Using a number system

Question 23

What is the main, specific piece of PPE should always been worn in Isolation?

Answer 23

Full body disposable gown

Question 24

What is a fomite?

Answer 24

An inanimate object, which disease-producing agents can be carried on

Question 25

Again, what is a Nosocomial infection?

Answer 25

An infection aquired during a patient’s hospitalization or from a hospital visit

Question 26

What is meant by barrier nursing?

Answer 26

A form of nursing care which is provided to patients with infectious diseases

Question 27

Define an ‘Infectious disease’

Answer 27

A disease caused by pathogenic organisms, which under certain circumstances can be easily transmissible between animals/persons

Question 28

What should be set in place to limit cross-contamination between patients and personnel in the VP?

Answer 28

Protocols

Question 29

What is another term used to describe ‘seperating’ other hospitlised patients in an isolation?

Answer 29

Segregation

Question 30

What are the 6 main types of patients should you reverse barrier nurse?

Answer 30

1. Patients undergoing Chemotherapy
2. Immunocomprimised
3. Un-vaccinated
4. Patients with compromised wounds
5. Those at a high risk of easily attaining an infection
6. Long-term hospitalized patients

Question 31

What 5 types of PPE should you use for nursing patients with Lepto?

Answer 31

Disposable:
1. Foot covers
1. Face visor
2. Face mask
1. Gloves
1. Full body gown

Question 32

When barrier nursing patients, what 5 routes of pathogenic transmission should you be aware of?

Answer 32

1. Direct contact (Contact w/infected animal to new host)
2. Indirect contact
3. Aersol transmission
4. Contaminated food + water
5. Via a carrier animal