Chapter 12

Question 1

healthcare epidemiology

Answer 1

• study of occurrence, determinants, and distribution of heath and disease in healthcare
• primary focus on infection control an prevention of HAI
• includes activities to study and improve pt care outcomes

Question 2

2 categories of infectious diseases

Answer 2

1) HAI - acquired in healthcare facility or erupts within 14 days of discharge
2) community acquired infections - acquired outside healthcare

Question 3

frequency of HAIs

Answer 3

5% of pts acquire HAIs

Question 4

most common gram + cocci HAI

Answer 4

• staphylococcus aureus
• coagulase-negative staphylococci
• enterococcus spp

Question 5

most common gram - bacilli HAI

Answer 5

• escherichia coli
• pseudomonas aeruginosa
• enterobacter spp
• klebsiella spp

Question 6

% of HAI involving drug resistant bacteria

Answer 6

70%

Question 7

4 most common types of HAIs

Answer 7

• UTI
• surgical site infection
• lower respiratory tract infections (pneumonia)
• bloodstream infections (specticemia)
• other: C difficile

Question 8

pts most likely to develop HAIs (8)

Answer 8

• elderly
• labour & delivery
• infants & newborns
• surgical and burn
• diabetic, cancer, transplant pts
• steroid treatment, anticancer drugs, antilymphocyte serum, and radiation
• immunosuppressed
• paralyzed or undergoing renal dialysis or catheterization

Question 9

3 major factors of HAIs

Answer 9

• increasing number of drug resistant pathogens
• failure of HCP to follow infection control
• increase of immunosuppressed pts

Question 10

additional HAI factors (7)

Answer 10

• overcrowding and employee shortage
• indiscriminate use of antimicrobial agents
• false security about antimicrobial agents
• lengthy and more complicated surgeries
• increase use of less trained HCP
• increased use of anti-inflammatory and immunosuppressants
• over and improper use of indwelling devices

Question 11

ways to reduce HAIs (7)

Answer 11

• compliance with infection control guidelines
• hanwashing
• disinfection/sterilization
• air filtration
• UV lights
• isolation
• PPE

Question 12

infection control

Answer 12

• measures taken to prevent infections from occurring in healthcare

Question 13

2 types of asepsis

Answer 13

1) medical

2) surgical

Question 14

medical asepsis

Answer 14

• clean technique
• measure to prevent direct transfer of pathogens person to person and indirect transfer of pathogens through air or fomites
• exclude all pathogens

Question 15

surgical asepsis

Answer 15

• sterile technique
• used in ORs, labour and delivery, and during invasive procedures
• exclude all microbes

Question 16

standard precautions

Answer 16

• applied to all pts in all healthcare settings
• provide infection control guidelines
• primary strategy for prevention of HAI transmission between HCP and pt

Question 17

transmission based precautions

Answer 17

• used for pts who are known or suspected to be infected with highly transmissible or epidemiologically important pathogens
• additional safety precautions are required to interrupt transmission

Question 18

3 types of transmission based precautions

Answer 18

1) contact precaution
2) droplet precaution
3) airborne precaution

Question 19

2 types of contact precaution

Answer 19

1) direct contact (body surface to body surface)
2) indirect contact (through contaminated objects)
- most important and frequent mode of HAI transmission

Question 20

contact precaution pathogens

Answer 20

• ebola
• chickenpox
• smallpox
• wounds or burns

Question 21

droplet precaution

Answer 21

• droplets produced by sneezing, coughing, talking

- used for particles larger than 5um

Question 22

droplet precaution pathogens

Answer 22

• influenza
• meningitis
• mumps
• whooping cough

Question 23

airborne precaution

Answer 23

• small particles of evaporated droplets that remain suspended in air
• used for particles smaller than 5um

Question 24

airborne precaution pathogens

Answer 24

• SARS
• measles
• monkeypox
• pulmonary or laryngeal TB

Question 25

airborne infection isolation room

Answer 25

• placement for those infected with airborne precaution
• under negative pressure
• air exits through HEPA filter vents and enters through room door

Question 26

protective environments

Answer 26

• for patients who are especially vulnerable to infection
• severe burns, leukaemia, transplant, immunosuppressed, radiation, leukopenia, infants
• room is under positive pressure
• air enters through HEPA filter vent and exits through room door

Question 27

handling food and eating utensils (8)

Answer 27

• high quality fresh food
• proper storage and refrigeration
• proper washing, preparing and cooking
• proper disposal of uneaten food
• covering hair and wearing clean clothes/aprons
• hand washing and nail cleaning
• keep surfaces and cutting boards clean
• wash cooking and eating utensils with water temperature >80C

Question 28

handling fomites

Answer 28

• disposable equipment
• disinfection or sterilization soon after use
• individual equipment for each pt
• disposable thermometers or thermometer covers

Question 29

medical waste disposal

Answer 29

• general regulations follow OSHA standards for medical waste disposal

Question 30

disposal of sharps

Answer 30

• handle and dispose properly

- dispose in sharps container designed for puncture resistance

Question 31

infection control committee (ICC)

Answer 31

• representatives from hospital departments
• chairperson usually epidemiologist, infection control nurse, or microbiologist
• controls hospitals infection control programs

Question 32

clinical microbiology laboratory (CML)

Answer 32

personnel participates in infection control by:

• monitors types and # of hospital pt pathogens
• notifies appropriate infection control person should an unusual pathogen or number of pathogens be detected
• processes samples collected from wards