Ch 2 - medical asepsis and OSHA standard Flashcards
list six growth requirements needed by microorganisms to survive
optimum temperature - mos prefer 98.6 F
pH - most prefer neutral
nutrition - autotrophs (uses inorganic) or heterotrophs (uses organic)
darkness
moisture - need moisture for cell metabolism and carry away wastes
oxygen - aerobes or anaerobes
definition of medical asepsis
practices that are employed to inhibit the growth and hinder the transmission of pathogenic microorganisms to prevent the spread of infection meaning
that an object or area is clean and free from disease-producing microbes
examples of nonintact skin
abrasions, cuts, hangnails, paper cuts, burns etc
what are 4 factors that contribute to low resistance and increased susceptibility to being infected by pathogen in a host?
poor health, poor hygiene, poor nutrition, and stress
what are means of entry/exit for infection process cycle
mouth, nose, throat, ears, eyes, intestinal tract, reproductive tract, open wounds, breaks in skin, mucous membranes
when should you wash hands with soap rather than use alcohol
visibly soiled with dirt or body fluids
before eating
after using the restroom
why should you not top off the soap dispenser?
topping off soap to a partially empty dispenser can lead to bacterial contamination of the soap. get a new one
how many percent does wearing gloves reduce contamination
70-80%
when should you use sterile gloves?
dressing change or assisting provider with minor office surgery
what are types of nonlatex gloves?
nitrile, vinyl, polychloroprene
Symptoms of allergic reaction to latex?
redness of skin, urticaria, runny nose, asthma symptoms - sob, coughing and wheezing
how much soap should you use to wash your hands?
1 teaspoon or the size of a nickel
how much gel/lotion type alcohol based rub should you use?
1 ml or the size of a dime for gel or lotion
what is the purpose of OSHA
to assist employers in providing a safe and healthy working environment for their employees
why did OSHA develop a set of regulations called the Bloodborne Pathogens Standard?
these regulations are designed to reduce the risk of employees of exposure to infectious diseases
definition of occupational exposure
reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other OPIM that may result from the performance of an employee’s duties
example of serosanguineous fluid
liquid part of blood eg. exudates from wound
definition of exposure incident
specific eyes, nose, mouth, or other mucous membrane, nonintact skin, or parenteral contact with blood or OPIM that results from an employee’s duties
what is an example of a medication derived from blood
immune globulins
what are the components of the OSHA bloodborne pathogens standard?
exposure control plan
labeling requirements
communication of hazards to employees
record keeping
what are the three parts of the exposure control plan?
exposure determination
the method of compliance
postexposure evaluation and follow-up procedures
what must an exposure determination include?
- a list of all job classifications in which all employees are likely to have occupational exposure
- a list of job classifications in which only some employees have occupational exposure; must include a list of tasks in which occupational exposure may occur
what must the method of compliance include?
document of the specific health and safety control measures that are taken in the medical office to eliminate or minimize the risk of occupational exposure
what must the postexposure evaluation and follow-up procedures specify?
method of documenting investigating an exposure incident postexposure evaluation medical treatment follow-up that would be made available to the employee
what information do you need for an exposure incident documentation?
route of exposure and conditions and circumstances of the exposure incident including engineering controls, work practice controls, PPE being used at the time of incident
identify and document the source individual
what is a source individual?
any person, living or dead, whose blood or OPIM may be a source of occupational exposure to the health care worker
what is the overview/outline of an postexposure evaluation and follow-up procedure?
- perform initial first aid
- document exposure details and source individual
- obtain consent from source individual to test their blood for HBV, HBC, HIV
- provide exposed employee with results
- obtain consent to test employee’s blood
- provide exposed employee with postexposure prophylaxis as recommended by US public health service
how often should employers present their ECP to their employees?
Employers must present their ECP training at the time of task assignment and at least annually thereafter.
what do employers need to include in their records of ECP training? and how long does these records need to be maintained?
- employers must maintain records of the training sessions, which includes the presentation dates, content, names and qualifications of trainers, and names/job titles of employees who attended.
- records must be maintained for 3 years
what does the OSHA medical record need to include? and kept for how long?
employers must include: employee's name SSN hepB vaccination status with dates results of any postexposure examinations medical testing f/u procedures written evaluation of exposure incident must maintain these records for duration of employment plus 30 years
requirements for sharps injury log?
employers with more than 10 employees at risk
type and brand of device involved in the injury
location of incident
explanation of how incident occurred
definition of engineering controls
all measures and devices that isolate or remove the bloodborne pathogens hazard from the workplace
definition of work practice controls
reduce the likelihood of exposure by altering the manner in which the technique is performed
general categories of regulated medical waste
any liquid or semiliquid blood or OPIM
contaminated sharps or other materials
contaminated pathologic and microbiologic wastes
examples of waste that goes in the regulated waste container?
disposable drapes, pt gowns, table paper, sterile or clean gloves, a tinge of blood, thermometer probe covers, tongue depressors, tissue with respiratory secretions, ear speculums empty urine containers urine testing strips disposable diapers feminine hygiene products
examples of waste that goes into the biohazard bag?
anything saturated with blood/OPIM
vaginal speculums and collection devices
tissue or fluid removed during minor office surgery
microbiologic waste such as specimen cultures and collection devices
discarded live and attenuated vaccines
how should a biohazard box be labeled?
a warning label that appears on two opposite sides of the box
what needs to be included on the biohazard waste form?
type and quantity of waste (weighed in pounds)
where it is being sent
signature from rep of medical waste service
signature from rep of medical office
common symptoms of all hepatitis?
fatigue, nausea, loss of appetite, abdominal pain, and jaundice
how does hepatitis b survive outside the body?
in a dried state for at least 1 week and can still cause infection. dried blood or body fluids on countertops, equipment and instruments
when was the hepatitis c blood test developed?
July 1992
why do we not have hepatitis c vaccines?
it is difficult to develop due to the virus mutating so frequently
how effective are antiviral drugs for hepatitis c?
40%
what happens if individuals are infected with acute hepatitis c?
may develop chronic hep c
after 10-20 years develop cirrhosis or liver cancer
may die from liver failure
CDC definition of AIDS
HIV positive status and a CD4+ Tcell count below 200 cells/uL
(normal count is 500-1500cells/uL)
how much foam type alcohol based rub should you use?
3 grams for foam or the size of a walnut
susceptible host
likely to get infection….
recap a needle from medication
is okay
which of the following is a violation of the OSHA standard?
eating in the office laboratory
what is the name given to a person who cannot fight off a pathogen that has entered his or her body?
susceptible host
list 5 common types of microorganisms
bacteria, viruses, protozoa, fungi, animal parasites
define reservoir host
one that becomes infected by the pathogen and also serves as a source of transfer of the pathogen
the host provides to grow and multiply
eg. people and animals
define susceptible host
one who is capable of being infected by the pathogen
the resistance or that contribute to low resistance and increased susceptibility include poor health, poor, hygiene, poor nutrition, stress
define means of transmission the in the infection process cycle
from one person to another includes direct contact with an infected person or discharge.
Indirect transfer includes the transfer of microorganisms by droplets of moisture expelled from the upper respiratory tract known as droplet infection, when a person coughs, sneezes; contaminated hands and equipment; contaminated food and water; and insects that carry pathogens
list 7 protective mechanisms of the body
skin barrier
mucous membranes lines the nose, throat, GI tract, genital tract
mucus and cilia in the nose and respiratory tract, mucus traps the smaller microbes and cilia beat toward outside to remove from body
coughing and sweating
tears and sweat
urine and vaginal secretions are acidic
stomach acids
when to apply an alcohol based hand rub
before direct patient contact
after contact with patient’s skin
before or after gloves
after contact with body fluids obviously
when moving from a contaminated body site to a clean body site during patient care
after contact with inanimate objects when providing health care to a patient
stupid soap dispenser
do not add soap to a partially empty liquid soap dispenser. topping off can lead to bacteria contamination of soap
correct procedure is either dispose of an empty dispenser or to rinse an empty dispenser thoroughly and then refill it
define resident flora
normal flora resides in dermis
harmless nonpathogenic
difficult to remove
define transient flora
picked up from external source
resides in epidermis
pathogenic
easy to remove with proper had hygiene
CDC recommends hand washing for how long
at least 15 seconds
birthday song x2
define antiseptic
an agent that functions to kill or inhibit growth of microbes
antimicrobial soaps deposits an antibacterial film on skin that discourages bacterial growth
how much alcohol is in hand sanitizers
60-90% alcohol
ethanol or isopropanol
trim fingernails
1/4”
define contaminated
presence or reasonably anticipated presence of blood or OPIM on an item or surface
define decontaminated
the use of physical or chemical means to remove, inactivate, or destroy pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling use or disposal
define postexposure prophylaxis and use Hepatitis B as example
treatment administered to individual after exposure to an infectious disease to prevent the disease
24hours - 7 days
Hep B exposure:
passive immunizing agent provides temporary immunity to Hep B. giving the active agent a chance to take effect.
hepatitis B immune globulin HBIG contains antibodies that provide immunity to hepatitis B for 1 to 3 months
active immunizing agent in hep B vaccine produced from altered yeast cells named Recombivax HB and Energix-B is given IM in a series of three doses at 0, 1mth, 6 mth
opportunistic infection
an infection that results from a defective immune system that cannot defend itself from pathogens normally found in the environment
HIV screening
enzyme immunoassay and enzyme linked immunosorbent assay
