Clinical Competency Exam Flashcards
What is the chain of infection
susceptible host → pathogen → source → mode → entry →
What are four modes of transmission
1. Direct contact with blood or body fluids
- Indirect contact with a contaminated instrument or surface
- Contact of mucosa of the eyes, nose, or mouth with droplets or spatter
- Inhalation of airborne microorganisms
What are the top 5 most common infection control violations seen in our clinics
1. MISSING BARRIERS IN CLINIC CUBICLES
- IMPROPER PPE – masks , protective eyewear (provider and patient)
- Leaving Instruments Uncovered when away from the cubicle (use clean patient napkin)
- Not wearing gloves and gowns to return dirty equipment and/or instruments
- Not wearing gowns and gloves when cleaning operatories
What are four additional infection control violations seen in our clinics
- Wearing masks and gloves to the clean side dispensing windows
- Wearing gloves when getting supplies from the clinic side rooms
- Wearing gowns in patient lobbies and between floors
- Not removing gloves before handling patient charts
What are two methods in which there can be blood and body fluid exposure
- Cuts or puncture with contaminated needles or sharps “Needle-Stick”
- Blood, body fluid splashes to eyes, nose, mouth, broken skin
What is the MOST COMMON blood and body fluid exposure
puncture with contaminated burs on handpieces
How can you prevent the most common blood and body fluid exposure
(puncture via bur on handpiece)
→ remove burs from handpicks immediately after use and turn bur inward toward the bracket table
What are four guidelines to follow when handling the anesthetic syringes/needles
- Use needle “guard”
- One-handed scoop technique to recap-NEVER two-handed
- Do not bend or break contaminated needles after use
- Never re-cap for another person
Always consider gloves to be what
contaminated
Never wear gloves during which three actions
handling patient charts
obtaining supplies from side rooms
obtaining cassettes from clean side of dispensary
Always wear gloves during which three actions
disinfecting cubicle
during patient treatment
returning contaminated instruments
What are three characteristics of blood borne pathogens such as HBV, HCV, and HIV
- Are transmissible in health care settings
- Can produce chronic infection
- Are often carried by persons unaware of their infection
True or False
Standard Precautions apply only for patients with an infectious disease
False; they apply to all patients!
Standard precautions integrates and expands universal precautions to include organisms spread by blood and also which three things
body fluids, secretions, and except sweat, whether or not they contain blood
non-intact (broken) skin
mucous membranes
What are the 6 elements of standard precautions
- Handwashing
- Use of gloves, masks, eye protection, and gowns
- Patient care equipment
- Environmental surfaces
- Injury prevention
- Immunizations
This is a major component of Standard Precautions
PPE
What does PPE protect
the skin and mucous membranes from exposure to infectious materials in spray or spatter
When should PPE be removed
when leaving the treatment areas
Why is hand hygiene important (3 things)
hands are the most common mode of pathogen transmission
reduce the spread of antimicrobial resistance
prevent health-care associated infections
What are four methods of proper hand hygiene
hand washing
antiseptic hand washing
alcohol-based handrub
surgical anti-sepsis
When are three time when hands need to be cleaned
visibly dirty
after touching contaminated objects with bare hands
before and after patient treatment (before glove placement and after glove removal)
Rank these in order of good, better, and best;
antimicrobial soap
plain soap
alcohol-based handrub
plain soap < antimicrobial soap < alcohol based hand-rub
What are the critical instruments to sterilize and disinfect
those that penetrate mucous membranes or contact bone, the bloodstream, or other normally sterile tissues (of the mouth)
surgical instruments, scalpels, periodontal scalers, surgical dental burs
How should you properly sterilize/disinfect critical instruments
heat sterilize between use or use sterile single-use, disposable devices
What are the semi-critical instruments
Those that contact mucous membranes but do not penetrate soft tissue
mouth mirrors, amalgam condensers, mental handpieces
How should you properly sterilize/disinfect semi-critical instruments
heat sterilize or high-level disinfect
What are the non-critical instruments and devices
those that contact intact skin
X-ray heads, face bows, pulse oximeter, BP cuff
How should you properly sterilize/disinfect non-critical instruments
clean and disinfect using a low to intermediate level disinfectant
What are three characteristics of single-use (disposable) devices
intended for use on one patient during a single procedure
usually not heat-tolerant
cannot be reliably cleaned
syringes, prophylaxis cups, plastic orthodontic brackets, matrix bands, wedges, polishing discs/points
What are the two categories of environmental surfaces
clinical contact surfaces
housekeeping surfaces
This environmental surface has a high potential for direct contamination from spray or spatter or by contact with DHCPs gloved hand
clinical contact surface
This environmental surface does not come into contact with patients or devices; limited risk of disease transmission
housekeeping surfaces
What are 4 general cleaning recommendations
- Use barrier precautions (e.g., heavy-duty utility gloves, masks, protective eyewear) when cleaning and disinfecting environmental surfaces
- Physical removal of microorganisms by cleaning is as important as the disinfection process
- Follow manufacturer’s instructions for proper use of EPA- registered hospital disinfectants
- Do not use sterilant/high-level disinfectants on environmental surfaces
What is the proper protocol for flushing the air/water lines for the high speed and air/water syringe
Flush lines 2-3 minutes at beginning of day
20-30 seconds, BEFORE & AFTER patient treatment
After attaching handpieces, insert bur & run High Speed for 20-30 seconds before treatment
What is the proper protocol for flushing the evacuation lines; saliva ejector and HVE
Remove the disposable tips and run several cups of warm water through lines after patient treatment
What are the four types of waste
General waste
Contaminated waste Hazardous waste
Infectious waste
What are the 5 regulatory/advisory agencies
- OSHA (Occupational Safety & Health Administration)
- EPA (Environmental Protection Agency)
- OSDB (Ohio State Dental Board)
- FDA (Food and Drug Administration)
- CDC (Centers for Disease Control and Prevention)
What are the four steps in returning used instruments to dispensary
- Wear Gloves and Gown
- Wrap cassettes in blue sterilization paper
- Be sure instruments are in proper order
- Be sure all debris/blood is cleaned off
instruments with Caviwipe –be careful NOT to puncture gloves
