Basic Didactic Flashcards
What are the 3 National Patient Safety Goals?
- Identify patients correctly (using 2 ways i.e. name & DOB)
- Improve staff communication
- Prevent infection
What are the 3 regulating agencies for safety
- OSHA
- CDC
- NFPA
What does OSHA stand for?
Occupational Safety and Health Administration
What are the OSHA standards required of all healthcare facilities?
- hand hygiene
- hazardous waste disposal
- engineering controls (safety devices)
- annual employee safety training
- blood borne pathogens training
What does the CDC stand for?
The Centers for Disease Control and Prevention
What does the CDC do?
It is a federal agency responsible for identifying, monitoring, and reporting diseases capable of becoming epidemic
What does CLSI stand for?
Clinical and Laboratory Standards Institute
What does CLSI do?
promotes the development and use of guidelines and standards within the healthcare industry
formerly known as NCCLS
Define CLIA88 (or CLIA)
Clinical Laboratory Improvement Amendments
federal law that regulates clinical laboratory testing
What does NFPA stand for?
National Fire Protection Agency
Define MSDS (or SDS)
Material Safety Data Sheet
What is the purpose of a MSDS (or SDS)?
mandated by OSHA
has information on how to safely handle each chemical (how to contain and clean a spill)
Define HazCom (“right to know law”)
labeling must have warning statements, precautions and first aid measures
Identify the 4 colors of an NFPA rating/label diamond.
Red
Blue Yellow
White
Red: Fire hazard
Yellow: Reactivity (instability/risk of explosion)
White: Specific Hazard
Blue: Health hazard
Define medical asepsis
sterilization of equipment/surfaces
NOT PEOPLE
What is the scientific name for Bleach?
Sodium hypochlorite
What is the ratio for diluting bleach for disinfectant?
1:9
10% bleach 90% water
How long can you keep a disinfecting bleach solution?
only 24 hours, must make fresh
Should you wear PPE for a biohazard clean up? What is the minimum PPE you can use?
Yes
gloves
What is the most important step when cleaning up a spill?
Focus on absorbing the spill and keeping it from spreading
What are the 2 guidelines on Standard precautions?
- treat all patients as potentially infectious
- treat all blood/body fluids, and unattached non-intact tissue as potentially infectious
What is the minimum PPE when considering Standard precautions? And an important step when dealing with patient contact?
Gloves and handwashing
Define the purpose of an Infection Control Plan
to prevent spread of infection within healthcare facilities
When should you use Standard precautions?
At ALL times with ALL patients whenever body fluid contact is anticipated
How many times should you wash your hands when dealing with a patient? When should you wash hands?
Twice, before & after each patient contact
What is an engineering control?
A device or system designed to promote safety
What is a good rule to best use the needle safety device?
activate immediately upon removal from venipuncture site/person
Describe the proper use of a sharps container
All sharps must be discarded into a sharps container
Must only be filled 3/4s worth, locked and placed in biohazard box
never reused, not placed in bag, never shake container
Describe the qualities of a good sharps container
It is puncture resistant, tamper proof, & spill proof
What should you do as soon as a needle leaves a patient?
- Lock needle
- Discard into sharps
What is a syringe transfer device?
An engineering control to allow safe transfer of blood from syringe to test tube
How to use a syringe transfer device?
- syringe needle locked, removed & discarded into sharps
- transfer device is attached to the syringe (to allow transfer to tube)
- after use, syringe with transfer device is discarded into sharps
What is the purpose of PPE?
it protects against possible exposure
List examples of PPE
mask, gloves, goggles, face shield, gown
What is special about a N95 Face mask/respirator?
designed for seal around nose & mouth
must be personally fit tested (the right size)
Order for don/doffing PPE
ON : gown, mask, gloves
OFF : gloves, gown, (wash hands) mask
What are 2 things you should remember about using gloves?
minimum required PPE under standard precautions
ask patient about potential anaphylaxis/latex allergy
What is another word for HAI, Hospital Associated Infection?
Nosocomial Infection
List 3 examples of a nosocomial/HAI pathogen
MRSA, C. diff., UTI
What is the most common HAI
UTI
What does HAI stand for?
Hospital Associated Infection
List the 6 links in the chain of infection
- infectious agent
- reservoir/source
- exit pathway (portal of exit)
- means of transmission
- entry pathway (portal of entry)
- susceptible host
What is the purpose to break the chain of infection?
to prevent further spread of infection
According to the CDC, what is the most important method to prevent the spread of infections?
hand washing before & after each patient
What is the proper technique for handwashing? (NCCT Exam)
wash hands in a downward motion for at least 15 seconds
(current: 20 seconds)
What minimum PPE is required for Droplet Precautions?
face mask
What are example pathogens for Droplet Precautions?
Flu, RSV, SARS, meningitis, pertussis
What is the minimum PPE for Airborne precautions?
N95 mask/respirator
What are example pathogens for Airborne Precautions?
TB (tuberculosis), measles, chickenpox (varicella), mumps, adenovirus (cold)
What is the minimum PPE for Contact Precautions?
gown & gloves
What are example pathogens for Contact precautions?
C. diff., rotavirus, Herpes simplex, scabies, antibiotic resistant infections
How many body systems are there?
9
What is the function of the Cardiovascular system?
transportation
What type of system is the vascular system?
It is a closed system
What direction does blood flow in the arteries?
Blood flows AWAY from the heart
What type of blood is in the arteries?
oxygenated blood
What are the smallest arteries called?
arterioles
List the qualities unique to an artery
thick walls, high pressure, and a pulse
What direction does blood flow in the veins?
blood flows back to the heart
What are the smallest veins called?
venules
What type of blood is carried in the veins?
deoxygenated blood
List the qualities of veins
thin walls (CAN COLLAPSE), has valves to prevent backflow
What are the smallest blood vessels?
capillaries
How small are capillaries?
microscopic (blood cells go single file)
What type of blood is found in a capillary?
a mixture of arterial & venous blood
What is special about the form of a capillary?
Has a thin wall that allows gas exchange
What does ACF stand for?
antecubital fossa
Where does routine blood draw (venipuncture) occur?
ACF, antecubital fossa
Why is the ACF the best choice for venipuncture?
veins are located close to skin surface, veins are “anchored” by connective tissue
What are the 3 major veins in the ACF?
Median cubital vein, Cephalic vein, Basilic vein
What are the special qualities of the median cubital vein?
first vein of choice, safest vein to puncture
What is a key quality for a cephalic vein?
second choice, prone to rolling
What is the position of the cephalic vein when looking from above?
outer to thumb side
What is a key quality of the basilic vein?
third choice, least safe to puncture
(above brachial artery, & next to median nerve)
What is the location of the basilic vein when viewing from above? (palm up)
inner pinky side
Where are capillary punctures performed on adults & older children?
finger sticks
Where are capillary punctures performed on infants 6 months of age? (or less)
heel stick
What makes up blood composition?
Plasma & formed elements
What is plasma?
liquid portion of blood, contains fibrinogen
What percentage of blood is plasma?
55%
What are formed elements?
solid portion of blood: RBCs, WBCs, platelets
What percentage of blood is formed elements?
45%
What is the scientific name for RBCs?
erythrocytes
What is the lifespan of RBCs?
120 days
What helps RBCs transport Oxygen in the body tissues?
Hemoglobin (Hgb)
What is the scientific name of WBCs?
leukocytes
What is the purpose of leukocytes?
protects the body against infectious disease & foreign invaders
How many types of WBCs are there?
5
List the 5 types of WBCs
- Lymphocyte
- monocyte
- neutrophil
- basophil
- eosinophil
What is the scientific name for platelets?
thrombocytes
What is the lifespan of thrombocytes?
10 days
What is the importance of platelets?
essential to coagulation
stops bleeding of injured blood vessels
Describe clotting
where blood turns from fluid into solid
What are the medical terms of clotting?
hemostasis, coagulation, thrombosis
What are the 2 definitions of hemostasis
- natural state of blood vessels
- process of body which stops leakage of blood
What are the 4 stages of hemostasis (in order)?
- vasoconstriction
- platelet plug formation
- fibrin clot formation
- fibrinolysis
Describe vasoconstriction (what step is this in thrombosis)
First step
when blood vessel damages, vessel constricts to lessen amount of blood leakage
Describe platelet plug formation (what step is this in coagulation)
Second step
platelets form literal plug around site of leakage
If the damage to a blood vessel is small/minor, platelet plug formation…
is enough to stop bleeding
Describe fibrin clot formation (what step in hemostasis) IMPORTANT STEP
Third step
fibrinogen turns into fibrin
causes all blood cells to be trapped in a solid blood clot —> stops bleeding
Describe fibrinolysis (what step in hemostasis)
Fourth step
clot is no longer needed —> broken down
dissolves blood clot
plasminogen turns to plasmin that breaks down fibrin into small fragments
What is the most important step in thrombosis?
fibrin clot formation, third step
What is a key quality of clotted blood?
no longer contains any fibrinogen
What are the 2 parts of clotted blood
serum & blood clot