Chpt 19- Disease Transmission and Infection Prevention Flashcards
1
Q
Define Acquired Immunity
A
Immunity that is developed during a persons life time
2
Q
Define Acute Infection
A
Infection of short duration that is often severe
3
Q
Define Anaphylaxis
A
Extreme hypersensitivity to a substance that can lead to shock and life threatening respiratory collapse
4
Q
define artificially acquired immunity
A
immunity that results from a vaccination
5
Q
Define blood borne disease
A
disease that is caused by microorganisms such as viruses or bacteria that are carried in blood
6
Q
define blood borne pathogens
A
disease causing organisms transferred through contact with blood and other body fluids
7
Q
define chain of infection
A
conditions that all must be present for infection to occur
8
Q
define chronic infection
A
an infection for a long period of time
9
Q
define communicable disease
A
condition caused by an infection that can spread from person to person or through contact with body fluids
10
Q
define contaminated waste
A
items such as gloves and patient napkins that may contain potentially infectious body fluids of patients
11
Q
define direct contact
A
touching or contact with a patients blood or saliva
12
Q
define droplet infection
A
infection that occurs through mucosal surfaces of the eyes, mouth and nose.
13
Q
define epidemilogic studies
A
studies of the patterns and causes of diseases
14
Q
define hazardous waste
A
waste that poses a danger to humans or to the environment
15
Q
define immunity
A
ability of the body to resist disease
16
Q
define indirect contact
A
touching or contact with contaminated surface or instrument
17
Q
define infection control
A
policies and practices designed to prevent the spread of infectious agents
18
Q
define infection preventioin
A
ultimate goal of all infection control procedures and policies
19
Q
define infectious disease
A
disease that is communicable
20
Q
define infectious waste
A
waste that is capable of transmitting and infectious disease
21
Q
Define inherited immunity
A
immunity that is present at birth
22
Q
define latent
A
persistent infection that has recurrent symptoms that “come and go”
23
Q
define naturally acquired immunity
A
immunity that occurs when a person has contracted and is recovering from a disease
24
Q
define occupational exposure
A
any reasonably anticipated skin, eye or mucous membrane contact or percutaneous injury involving blood or any other potentially infectious material
25
define OSHA blood borne pathogens standard (BBP)
guidelines designed to protect employees against occupational exposure to blood borne pathogens
26
define pathogen
disease causing organism
27
define percutaneous
through the skin, such as with a needle stick, cut or human bite
28
define permucosal
contact with mucous membranes, such as eyes or mouth
29
define person protective equipment (PPE)
items such as protective clothing, masks, gloves and eyewear used to protect employees
30
define sharps
pointed or cutting instruments including needles, scalpel blades, orthodontic wire, and endodontic instruments
31
define standard precautions
standard of care designed to protect heath-care providers from pathogens that can be spread by blood or other body fluids via excretion or secretion
32
define universal precautions
guidelines based on treating all human blood and bodily fluids as potentially infectious
33
define virulence
strength of pathogens ability to cause disease
34
what is another name for virulence
pathogenicity
35
What are the 6 links for the chain of infection?
1. an infectious agent
2. a reservoir
3. a portal of exit
4. a mode of transmission
5. a portal of entry
6. a susceptible host
Ronald Plays Terrible Pattycake Sometimes
36
How do infection control strategies help with the chain of infection
they are intended to break one or more links in the imaginary chain. once a link is broken you break the infection process
37
True or false: A pathogen must be present in sufficient numbers to cause infection
True.
38
How does virulence affect disease
if the organism is not very virulent it may be incapable of causing disease
if the organism is very virulent it can cause serious disease
39
Can the body change the virulence of microorganisms?
No the body body cannot, it it left to the bodies defence and to immunizations .
40
What is a reservoir in the chain of infection
a place where microorganisms normally live and reproduce
ex. humans, animals, water and contaminated surfaces
41
what is bioburden?
organic materials such as blood and saliva
42
what are two pieces of equipment that minimize the number of microorganisms in the aerosol?
1. a dental dam
2. a HVE (high volume evacuation)
43
what can we as dental professionals do to minimize reservoirs for micro organisms?
maintain proper hand hygiene and through cleaning and disinfection of contaminated surfaces
44
what is portal of entry in regards of the chain of infection
means of entering the body
45
where is air borne pathogens portal of entry?
the mouth adn the nose
46
where is blood borne pathogens portal of entry?
a direct access to the blood supply (break in the skin) or through mucous membranes of nose and mouth
47
what is a susceptible host in the chain of infection?
a person who is unable to resist infection by a particular pathogen. ex. someone who has a weak immune system or in poor health is more likely to be infected
48
Explain acute infection ( what are symptoms like, how long does it last and an example)
symptoms are often severe and usually appear soon after the initial infection occurs.
they are of short duration
examples would be the common cold
49
Explain chronic infection ( how long does it last and an example)
microorganisms is present for a long period of time ( even whole life) the person may be asymptomatic but still may be a carrier of the disease
example would be hepatitis c virus
50
what is a latent infection ( how are symptoms, what occurs and an example)
persistent infection which symptoms come and go
ex. coldsore
the virus enters the body and causes the original lesion, it then lies dormant within a nerve cell, until certain conditions cause the virus to leave the nerve cell and seek the surface again. Once the virus reaches the surface it becomes detectable
51
what is an opportunistic infection? ( what is it, who does it effect most)
caused by normally nonpathogenic organisms it occurs in individuals who resistance is compromised
example: someone who is recovering from the flu may develop another virus
common in autoimmune disease, diabetic and elderly patients
52
what is direct transmission of a disease? and two ways it spreads
occurs through person to person contact
- droplets spread through sneezing or coughing
- also through unprotected contact with an infectious lesion or body fluids (blood, saliva, semen, vaginal fluids)
ex. hepatitis, HIV and Tv are all spread through direct contact
53
Explain indirect transmission of disease (define and example)
occurs when microorganisms first are transmitted to an object or surface and then are transferred to another person who touches those objects or surfaces
ex. a dental chart is touched with contaminated hands and then is passed to the receptionist with bare hands she is now at risk
54
what is airborne transmission? (what is it and how is it spread)
spread of disease through droplets of moisture that contain bacteria or viruses
this is how most contagious respiratory diseases are caused. also may be caused by coughs or sneezes
55
what is another name for airborne transmission of disease?
droplet infection
56
what do aerosols sprays and splatter generate during dental treatment?
blood, saliva and nasopharyngeal secretions
57
what is the difference between aerosols, sprays and splatter?
the size of the particles
58
what has the finest mist? aerosol, spray or splatter?
aerosol
59
Are aerosols typically visible to the human eye?
not always no
60
true or false: aerosol can remain airborne for extended periods of time?
true
61
What dental tools create aerosols? (2)
High-speed hand pieces and ultrasonic scalers
62
Fun fact: Inhaling the bacteria in the aerosol w out a face mask is comparable to what?
having someone sneeze in your face twice a minute at a distance of one foot away
63
true or false: aerosols can transmit respiratory infections?
true
64
true or false: aerosols can transmit HBV or HIV
false. despite the face they are inhaled
65
Define spatter
consists of larger droplet particles that are contaminates by blood, saliva and other debris
66
how are sprays and spatter created? (3)
the use of hand pieces, ultrasonic scaler and the air water syringe
67
which travels farther aerosol mist or sprays or spatter droplets?
spray and spatter droplets travel farther
68
What is intact skin and how does it aid in infection control?
intact skin is not broken in any way and acts as a natural protective barrier
69
what is non-intact skin and how does it affect the risk of infection?
skin in which a cut, scrape or needle stick injury has occurred
it provides a means of entrance for pathogens to enter the body
70
What is parenteral transmission of diseases? (what is it? how is it caused?)`
means through the skin, as with cuts or punctures
disease causing organisms transferred through contact with blood or other body fluids
this is caused by needle stick injures, human bites, cuts or any break in the skin
71
Explain Blood-Borne Transmissions (what are they? what contacts are they delivered with?)
carried in the blood and body fluids of infected individuals and can be transmitted to others
they can be transmitted through direct and indirect contact
72
what is the most common concern for dental professionals in regards to blood borne transmissions?
saliva
73
true or false: you can always see blood in saliva if it is present?
false: blood may not always be visible in saliva but can still be present
74
how can blood borne diseases be commonly spread in the dental clinic and whats a prime example outside of the dental clinic?
improper sterilized instruments can transfer all blood borne disease
individuals who share needles while using drugs and unprotected sex
75
3 major blood borne disease in dentistry
HCV- Hepatitis C
HBV- Hepatitis B
HIV- Human immunodeficiency virus
76
What is food and water transmission? ( how is it caused and examples of how and diseases it may cause)
contaminated food or water
food- uncooked or un unfrigerated food
water- contaminated with decal matter for ex
medical ex. tuberculosis, botulism and staphylococcal
77
Explain Fecal- Oral Transmission (what is it and what types of contact can cause it)
many pathogens are present in fecal mater if proper sanitation (hand-washing) procedures are not used after the toilet the pathogens can be transmitted directly or indirectly.
78
Explain Naturally Acquired Immunity (what is it and how is it done?)
it occurs when a person has previously contracted a disease and recovered, when the body was fighting the invading pathogens it formed antibodies that provide future resistance against that particular pathogen
79
what type of immunity is naturally acquired immunity?
active immunity- because the body of the host is actively involved in the process
80
Explain Passive immunity (what is it ? and what makes it passive?)
It is a naturally acquired immunity that occurs during pregnancy and while breastfeeding, the baby receives antibodies from the mother's placenta and breast milk
its called passive immunity because the antibodies are acquired from an outside source
81
Explain artificially acquired immunity (what is it and how does it work?)
when the human body has not been exposed to a disease it has not developed antibodies and is defenceless, these antibodies are introduced into the body by immunizations or vaccines
82
how do vaccines work in artificially acquired immunity?
it contains the weakend disease causing organism and is injected into the body. the harmful characteristics of the disease are eliminated from the vaccine to make them less likely to cause disease. the body then forms antibodies in response to the vaccine
83
3 mains ways disease transmits to the dental office
1. direct contact- patients blood or saliva touching open skin
2. droplet infection- inhaling contaminated aerosol
3. indirect contact- dental team member touches a contaminated surface or a contaminated surface comes in contact w broken skin
84
tip 5 infection control measures that help prevent disease transmission from patient to dental member
1. gloves
2. masks
3. rubber damns
4. hand-washing
5. patient mouth rinses
85
common ways team to patient spread of disease happens
1. if the dental team member has a cut while in the patients mouth
2. if the dental team member has a cold and droplets get on to patient
86
how does patient to patient disease transmission occur?
contamination from instruments used on one patient would need to be transferred to another patient
87
how to avoid patient to patient disease transmission (5 things)
1. instrument sterilization
2. surface barriers
3. hand-washing
4. glove
5. use of sterile instruments
88
how does dental office to community disease transmission occur?
if a contaminated object/ thing leave the dental office
this can be:
- contaminated impression
- equipment being sent out for repair
or - if members of the dental office transport microorganisms out of the office by their hair or clothing
89
How does Community to Dental Office to Patient disease transmission occur?
microorganisms enter the dental office through municipal water that supplies the dental unit water borne organisms colonize inside of dental unit waterlines and form BIOFILM. as water flows through the hand piece, air water syringe and ultrasonic scaler the patient can swallow contaminated water
90
Explain the CDC ( is it a regulatory agency and what is their role?)
CDC is NOT a regulatory agency
its role is to issue specific recommendations that are based on sound scientific evidence
91
Explain OSHA (is it a regulatory agency? what is their role?)
It IS a regulatory agency, its role is to issue specific standards that must be used to protect employees
92
Who do the guidelines of CDC apply to?
All paid and unpaid dental health professionals who might be exposed to blood and bodily fluid
93
CDS Rankings: Category IA
strongly recommended for implementation and strongly supported by well designed experimental, clinical or epidemiologic studies
94
CDS Rankings: Category IB
strongly recommended for implementation and supported by experimental, clinic, or epidemiologic studies and strong theoretical rationale
95
CDS Rankings: Category IC
Requires from implementation, as mandated by federal or state regulation
96
CDS Rankings: Category II
Suggested for implementation and supported by suggestive clinical or epidemilogic studies or a theoretical rationale
97
CDS Rankings: Unresolved issue
no recommendation- practices for which insufficient evidence or no consensus regarding efficacy exists
98
What does OPIM stand for?
other potentially infectious material
99
What is the most important infection control law in dentistry ?
OSHAS Blood Borne Pathogens Standard
100
What is the purpose of OSHA's BBP standard?
its designed to protect employees against occupational exposure to blood borne disease causing organisms, it requires employers to protect their employees
101
What is an exposure control plan?
Every dental office must have a written exposure control plan, that clearly describes how the office complies with the BBP Standard.
must be reviewed and updated annually and and each employee must have access to have a copy
102
Explain Universal Precautions? why is it used?
OSHA BBP- they're used based on the concept that all human blood and bodily fluids are to be treated as if known to be infected with a blood-borne disease (HCV OR HIV)
It is impossible to identify those who are infectious so universal precautions are used for all healthcare personnel
103
Categories of Occupational Exposure Determination: Category I
Routinely exposed to blood, saliva or both
example: dentist, DA, DH
104
Categories of Occupational Exposure Determination: Category II
May on occasion be exposed to blood, saliva or both
ex. receptionist or office manager who may occasionally clean a treatment room
105
Categories of Occupational Exposure Determination: Category III
Never exposed to blood, saliva or both
ex. financial manager, insurance clerk
106
Post exposure Management: what happens when an accident does happen?
the BBP standard requires the employer to have a written plan this plan explains exactly what steps the employee must follow after the exposure incident occurs and the type of medical followup that will be provided to the employee at no charge
107
true or false: the dentist must provide training in infection control procedures and safety issues to all personnel who may come in contact with blood, saliva or contaminated instruments
true
108
How do we manage contaminated sharps?
contaminated needles and other disposable sharps but must place into a sharps container, it must be located as close as possible to the place of immediate disposal
109
true or false: you should always bend or break needles before disposal
false, never cut bend or break the needles before disposable
110
what the safest way to re cap needle sticks?
the single- handed scoop technique
111
When do you perform proper hand washing in regards to wearing gloves?
before you put gloves on and after you remove gloves
112
which is better liquid or bar soap in regards to hand washing?
liquid soap should always be used as bar soap harbours bacteria
113
what is more effective hand washing or hand rubs
hand rubs are more effective
114
what are alchohol based hand rubs
water antiseptic agents, ethier gel, foams or rinses that do not require water. They are very effective
115
True or False: When looking at alcohol based hand rubs high concentration of alcohol is more effective
false: higher concentrations are less effective
116
When is it not acceptable to just use a alcohol based rub?
When you have visible soiled or contaminated. you must first use proper hand washing hygiene.
117
True or false: according to OSHA's BBP Standard requires the employer to provide employees with proper PPE with out charge to the employee
True
118
Why are patients supplied with eye wear as well?
may be subject to 1. hand piece spatter 2. spilled or splashed dental materials 3. air-borne bits of acrylic or tooth fragment
119
who regulates gloves?
The FDA
120
What do you do if your glove puntures?
Remove the gloves, perform hand hygiene and re glove
121
are examination gloves sterile?
they are considered non sterile and simply act as a barrier
122
what are over-gloves?
also known as food handlers gloves made of lightweight inexpensive clear plastic, they may be worn over contaminated treatment gloves to prevent contamination of clean item during treatment
123
whats the term used for wearing over gloves over contaminated treatment gloves?
over gloving
124
what are sterile surgical gloves? when are they used?
supplied in pre packaged units to maintain sterility before use, worn for invasive procedure involving the cutting of bone or significant amounts of blood or saliva
125
what are utility gloves? what are they used for? disposable or reusable?
are not used in direct patient care they are worn when the treatment room is cleaned and disinfected between patients or while contaminated instruments are being cleaned or handles also for surface cleaning and disinfecting.
Utility gloves must be sterilized
126
how do you limit cross contamination while gloved
make sure you have everything ready before the treatment starts this minimized opening the drawers and cabinets
keep a pair of clean forceps to open and grab items with, this will keep bacteria out of cupboards
127
how do you limit cross contamination while opening containers during treatment? how do you remove the item from inside the container?
open the container with over gloves, a paper towel or sterile gauze, use sterile cotton pliers to to remove items from the container. if other parts of the container are touched it must be sterlized
128
what is irritant dermatitis? ( causes)
its a non immunologic process that does not involve the body's immune system it is caused by contact with a substance that produces a chemical irritation to the skin.
causes: frequent hand washing, not getting all the soap odd excessive sweating while wearing gloves
129
Type IV Allergic Reaction (where does it affect and how long until it shows)
most common type of latex allergy and is a delayed reaction that involves the immune system, it shows as a red itchy rash reactions are limited to the area of contact and do not spread across entire body. it may take 48-72 hours for symptoms to set in
130
Type I Allergic reaction (what is it and what occurs)
its the most serious type of latex reaction and can result in death, can take as little as 2 minutes to show
symptoms- coughing, sneezing, shortness of breath and respiratory distress
131
what is anaphylaxis in terms of type 1 latex allergy reaction? what happens
most serve form of allergic reaction, death results from closure of the airways
132
what is the treatment of a latex allergy
there is no specific cure but option for prevention an treatment of symptoms
133
why should saliva be considered potentially infectious waste?
because blood may not always be visible
134
what is general waste?
all non hazardous and non regulated waste
example paper towels, paper mixing pads
135
what is contaminated waste (examples)
waste that has been in contact with blood or other body fluids
examples- barriers and patient napkins
136
what is hazardous waste (examples)
poses a risk to humans and to the environment
examples- amalgam and lead foil from x rays
137
what is infectious waste (disposal and examples)
contaminated waste that is able to transmit infectious diseases. must be disposed of diffrently
examples blood or saliva soaked items, pathologic waste (soft tissue and extracted teeth), sharps
138
what are extracted teeth classified as in terms of disposing of them
they are classified as medical waste
139
what do you do with extracted teeth that contain amlgam?
do not include in medical waste bin as amalgam as it contains mercury and medical wastes are incinerated
140
how does back flow occur in saliva ejectors? why is this a concern?
it occurs when the pressure in the patients mouth is less than that in the evacuator. this back flow can create a source of cross-contamination
141
what are pre-procedural mouth rinses and why are they used?
its an anti-microbial rinse that patients do before the procedure, it reduces the amount of micro-organisms released in the form of aerosol and spatter
it also cleans the patients mouth before an invasive procedure to prevent the micro organisms from reading the patients blood stream
142
What is M. Tuberculosis? ( how is it spread and how)
a bacterium that is spread by airborne infective particles (when the patient sneezes, coughs or even talks) they can remain airborne for several hours. infection occurs when the host inhales the bacteria
143
What is latent TB Infection? (what is it, how does it present)
tb bacteria can remain alive in the lungs for years. a person with latent tb will have a reactive tb test but show no symptoms and are not infectious. Active symptoms can show later in life
144
What is Creutzfeldt- Jakob Disease? (what is it and what does the outcome look like?)
its a progressive, fatal degenerative neurologic disorder, that is thought to be caused by prion infection . there is a incubation between time between infection and signs of disease of years but once diagnosed its usually fatal within a year
145
infection control concerns with laser and electrosurgery plumes or surgical smoke
may expose aerosol infectious materials CDS has no input on the issue as of right now
