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Ash's Certification Study > Employee Occupational Health > Flashcards

Employee Occupational Health Flashcards

1
Q

Why OHP is important?

A
  • Promotes awareness of occ health hazards to hcp
  • regs look for safe hc env
  • promotes safe env to give and receive care
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2
Q

Elements of an OHP

A

1) Educate HCP
2) Partner with IP in monitoring and investigating potentially harmful infectious disease expsures and outbreaks
3) Care and follow-up for work related illnesses, exposures, and injuries
4) ID work related exposure risks and institute preventative measures
5) contain costs by preventing infectious diseases that result in absenteeism and disability

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3
Q

First step to post exposure intervention

A

Verify the dx of the index case

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4
Q

What is the next question once dx is confirmed?

A

Is the patient infectious?

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5
Q

If the patient was infectious- what is the next question to address?

A

Was barrier technique absent or was there a breach in technique that would have lead to expsure?

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6
Q

If there was a breach in technique or barrier technique was absent, what is the next question?

A

Who was exposed?

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7
Q

For people that were exposed, what is the next question?

A

Is the individual susceptible?

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8
Q

What to ask if the individual who was exposed is susceptible?

A

Does the disease have potential for further spread?

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9
Q

If the exposed person is susceptible, but there is no potential for further spread, what next?

A

Monitor the employee for clinical symotoms

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10
Q

If the exposed HCP is susceptible, and there is potential for futher spread, what next?

A

Ask if there are therapeutic measures for treatment?

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11
Q

If there are therapeutic measures for the exposed, susceptible employee, what next?

A

Implement intervention measures

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12
Q

If there are no therapeutic measures for the exposed, susceptible employee, what next?

A

Monitor employee for clinical symptoms and follow policy for restriction

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13
Q

Source of TB exposure for healthcare personnel

A

laryngeal and pulmonary Tb

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14
Q

When to educate HCP about TB?

A

Upon hire
annually
as needed

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15
Q

What should TB education include?

A
  • how it spreads
  • signs and symptoms
  • preventative measures (including fit testing for N95s)
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16
Q

What specific recommendations and guidance does the CDC provide to help control the spread of TB in HC facilities?

A
  • fit-testing
  • dx and treatment for latent TB
  • Facility respiratory protection programs
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17
Q

First step to the TB control plan

A
  • Assess an institutions TB risk by performing a TB risk assessment
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18
Q

What does the TB risk assessment include?

A
  • prevalence of recognized and unrecognized TB patients in the facility and the surrounding community
  • patterns of TST conversions or positive blood assay for M. tuberculosis in employees (bamt)
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19
Q

What are the risk classifications for TB?

A
  • low risk
  • Medium risk
  • potential ongoing transmission
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20
Q

How often does a facility need to complete a TB risk assessment?

A

Annually

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21
Q

When does the CDC recommend testing for TB?

A
  • upon hire
  • if there is a suspected exposure
  • if there is ongoing transmission in the facility
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22
Q

Bacillii multiplication in latent and active TB

A

Active: active and multipliyng
Latent: inactive and contained

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23
Q

TST and IGRA test results for latent and active TB

A

Active: Positive
Latent: positive

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24
Q

Chest xray results for latent and active TB

A

Active: abnormal
Latent: normal

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25
Q

Sputum smears and culture for latent and active TB

A

Active: positive
Latent: negative

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26
Q

Symptoms of active and latent TB

A

Active: symptomatic
Latent: asymptomatic

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27
Q

Infectiousness of active and latent TB

A

Active: Infectious
Latent: Not infectious

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28
Q

Does latent TB require treatment?

A

Yes

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29
Q

Does active TB require treatment?

A

Yes

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30
Q

How long after initial infection with TB does the immune system limit additional multiplication of the bacteria

A

2-12 weeks

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31
Q

Why treat latent TB

A

Prevents TB from turning into active disease

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32
Q

Who should be included in the TB screening program?

A

All part-time, temporary, contract, and full-time HCP and LIP
Students and volunteers may need to be considered for the program as well

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33
Q

What does the TB screening include for HCP?

A
  • individual risk assessment
  • Symptom evaluation
  • Testing
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34
Q

What are the two types of TB test?

A
  • PPD (purified protein derivative)-based tuberculin skin test (TST)
  • interferon-gamma release assay (IGRA)
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35
Q

What are the brands of IGRA?

A
  1. QauntiFERON-TB Gold in-tube test (QFT-GIT)
  2. T-Spot TB test
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36
Q

What is the benefit of IGRA testing?

A

Single visit to conduct the test and results are within 24 hours

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37
Q

TST process description

A

-0.1 ml of tb PPD into forearm
- read between 48-72 hours later
- place again if not read at 72 hours

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38
Q

How many TSTs are needed if it’s a new hire with no documented negative TST tests in the past 12 months?

A

two

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39
Q

What is the gold standard for TB testing?

A

IGRA

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40
Q

Rational behind IGRA

A

Persons infected with M. TB will release interferon gamma (IFN-g) when mixed with antigens derived from M. TB

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41
Q

Reasons BCG not administered in U.S.

A
  • low prevalence of M. tuberculosis
  • variable effectiveness against adult pulmonary TB
  • potential interference with TST
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42
Q

Preferred test for BCG vaccinated people

A

IGRA

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43
Q

What happens if an HCP screens positive for TB?

A

-Chest xray

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44
Q

What happens if a person is IGRA positive and chest xray negative?

A

provide info on symptoms that are suggestive of TB and instruct them to report

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45
Q

What happens if a person is IGRA positive and xray is abnormal?

A
  • take exposure history to determine if the infection is occupational or community associated
  • refer to hcp for therapy
  • follow regs for follow up CXR
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46
Q

Do chest xrays need to be repeated for latent TB cases?

A

Only if they become symptomatic

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47
Q

If TB conversion identified, who to refer HCP to

A

Provider for consideration of preventative therapy

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48
Q

What to do if there is a potential TB exposure..

A

Was the exposure unprotected? (N95 or higher not worn)

If yes- administer TST at time of exposure and again in 12 weeks

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49
Q

Will an employee with latent TB require CXR after exposure?

A

Not unless they have symptoms

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50
Q

What are the symptoms of TB?

A

Bloody cough that is long-term
fever
chest pain
chills
weight loss
fatigue
night sweats

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51
Q

When should employees with TB be excluded from work?

A

They have laryngeal or pulmonary TB

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52
Q

When can excluded staff with active TB return to work?

A

1) they are responding to anti-TB treatment
2) 3 consecutive sputum tests collected 8-24 hours apart are all negative
3) documented clearance to be non-infectious by a physician knowledgeable about managing TB

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53
Q

Requirement from OSHA that requires employers to provide a program for HCP working in an environment that could require a respirator

A

Respiratory Protection Program

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54
Q

Who oversees the respiratory protection program at the hc facility?

A

a program administrator who is qualified by appropriate training or experience and conduct required evaluations of program’s effectiveness

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55
Q

How often must the employer provide training to staff about the respiratory protection program?

A
  • upon hire
  • annually
  • as needed
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56
Q

What must the respiratory protection program training include?

A
  • how to select the correct respirator
  • when respirator needed
  • how to maintain and use the respirator
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57
Q

Parts of the respiratory protection program

A

1) written program
2) respirator medical evaluation
3) trainnig
4) fit testing
5) recordkeeping

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58
Q

Logistics of the respiratory program

A
  • procedures for selecting respirators
  • staff medical evaluations
  • fit testing procedures
  • procedures for proper use, storing, and discarding of respirators
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59
Q

Education - respiratory program components

A
  • respiratory hazards during routine and emergent situations
  • proper use of respirators- donning and doffing and fit checks
  • limitations of respirators
  • maintenance and care of equipment
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60
Q

When should fit-testing happen?

A
  • prior to use
  • annually
    -as needed
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61
Q

What are the two types of fit testing?

A

Qualitative fit test (QLFT)
Quantitative fit test (QNFT)

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62
Q

This fit test uses smell or taste and results in pass or fail

A

qualitative fit test

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63
Q

This fit test uses a machine to measure the actual amount of leakage into the mask

A

Quantitative fit test (QNFT)

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64
Q

Do PAPRs require fit testing?

A

No

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65
Q

Example of “as needed” for fit testing

A
  • facial/ physical changes such as extreme weight loss or gain
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66
Q

How often do HCP need to perform a seal check for their respirator?

A

with each use

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67
Q

Name for chicken pox

A

Varicella zoster virus

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68
Q

Name for shingles

A

Herpes zoster virus

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69
Q

How is chickenpox spread?

A
  • Person to person by direct contact
  • inhalation of aerosols from skin lesions (chickenpox or shingles)
  • infected respiratory secretions?
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70
Q

Contagious window for chickenpox

A

1-2 days before rash

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71
Q

How long do people with chickenpox remain contagious?

A

until all lesions are dry and crusted over

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72
Q

Incubation periods for chickenpox

A

14-16 days (range 10-21 days)

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73
Q

How chickenpox lesions present in vaccinated people and when they are contagious

A
  • lesions do not crust over
  • contagious until there are no new lesions that have appeared for 24 hours
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74
Q

What age group is a prodrome of fever and malaise 1-2 days before chickenpox common in: kids or adults?

A

Adults

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75
Q

What is the R0 of chickenpox?

A

8-12

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76
Q

evidence of varicella immunity in adults

A
  • history of clinical dx and lab evidence of immunity (titer)
  • documentation of age-appropriate vaccination
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77
Q

Recommendation for varicella vaccination who do not have evidence of immunity

A

Vaccinate

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78
Q

First step after varicella exposure

A

Verify dx in index case

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79
Q

Second step after varicella exposure once dx confirmed

A

test immunity of HCP who are exposed, immediately after exposure to check for antibodies

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80
Q

What to do if the HCP exposed to varicella does not have immunity

A

exclude from work from day 10 - day 21 postexposure

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81
Q

If chickenpox symptoms develop in an exposed person- how long to exclude?

A

until all lesions are dry and crusted over

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82
Q

What can be used in HCP exposed to chickenpox that are immunocompromised or pregnant

A

VZIG

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83
Q

How does VZIG impact exclusion?

A

Exclude from day 10- day 28

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84
Q

How are N. meningitidis transmitted?

A

respiratory droplets

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85
Q

Where do N. meningitidis attach to and multiply?

A

Nasopharynx and oropharnyx

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86
Q

What menningococcal disease patients can transmit meningitis?

A
  • meningococcemia
  • meningococcal meningitis
  • lower resp tract infection with N. meningitidis through handling lab specimens
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87
Q

First line of defense for staff against meningococcal disease

A

Vaccinate high-risk HCP, including lab personnel who handle N. meningitidis

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88
Q

How often to offer lab staff boosters for meningococcal disease?

A

Every 5 years

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89
Q

What does unprotected contact to N. Meningitidis entail?

A

NO MASK and
mouth to mouth
endotracheal intubation
endotracheal tube management
close examination of oropharynx

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90
Q

PEP for meningococcal disease exposure

A
  • rifampin every 12 hours for 2 days
  • single dose cipro
  • single dose ceftriaxone
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91
Q

What two meningicoccal PEP drugs are NOT recommended for pregnant women?

A

Cipro
Rifampin

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92
Q

Documentation of immunity for rubella

A
  • one dose of live rubella vaccine
  • lab evidence of immunity
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93
Q

Documentation of immunity for measles

A
  • documentation of 2-step MMR
  • lab evidence of immunity
  • lab confirmation of disease if born before 1957
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94
Q

documentation of mumps immunity

A
  • documentation of 2-step MMR
  • lab evidence of immunity
  • lab confirmation of disease if birth before 1957
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95
Q

What are the immunization recommendations for HCP born before 1957 who do not have lab evidence of immunity?

A

dose of MMR

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96
Q

Who should NOT receive the MMR vaccine?

A

Pregnant women or women who plan to become pregnant in the next 28 days

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97
Q

who should receive the MMR vaccine?

A

Anyone without evidence of immunity and not pregnant

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98
Q

Incubation period for measles

A

11-12 days

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99
Q

Prodrome for measles

A

2-4 days

100
Q

Exposure to rash onset measles

A

average 14 days (range 7-21 days)

101
Q

infectious period measles

A

4 days before and 4 days after rash onset

102
Q

How measles is transmitted

A

Respiratory droplets
airborne in closed areas for up to 2 hours

103
Q

What tissue does measles replication occur in?

A

Variety of tissues, including the immune system and nervous system

104
Q

What is the primary site of infection for measles?

A

Alveolar macrophages or dendritic cells

105
Q

Mumps incubation period

A

16-18 days (range 12-25 days)

106
Q

Transmission of mumps

A

Respiratory droplets

107
Q

Replication of mumps

A

Nasopharynx and regional lymph nodes

108
Q

Rubella incubation periods

A

14 days (range 12-23 days)

109
Q

Transmission of rubella

A

respiratory droplets

110
Q

Where rubella replicates

A

Nasopharynx
Regional lymph nodes

111
Q

Exclusion for measles

A

Day 5- Day 21

112
Q

Exclusion for mumps

A

Day 9- day 26

113
Q

Exclusion for rubella

A

day 7- day 21

114
Q

PEP for measles

A

administer vaccine to susceptible HCP within 72 hours of exposure

115
Q

Transmission of pertussis

A

Droplet

116
Q

Incubation period of pertussis

A

5-10 days

117
Q

Vaccine recommendations for adults for pertussis

A

Adults should receive Tdap initially, then a Td or Tdap booster every 10 years

118
Q

Who is at the greatest risk for serious illness and death from pertussis?

A

Infants less than 1 year old

119
Q

What are the 3 stages of pertusssis?

A

Catarrhal stage
Paroxysmal stage
Convalescence stage

120
Q

Describe the catarrhal stage of pertussis

A

lasts 1-2 weeks
Insidious onset, similar to common cold

121
Q

Describe the paroxysmal stage of pertussis

A

lasts 1-6 weeks
More severe cough and may experience paroxysms

122
Q

Describe the convaleescensce stage of pertussis

A

Lasts weeks to months
gradual recovery

123
Q

Communicable period of pertussis

A

Onset - 3 weeks after start of paroxysmal cough

124
Q

PEP for pertussis exposure

A

Erythromycin
azithromycin
clarithromycin

125
Q

Alternative PEP pertussis exposure

A

Trimethoprim-sulfamethoxazole (TMP-SXT)

126
Q

Should exposed personnel to pertussis be excluded?

A

no, not unless they develop symptoms

127
Q

When to exclude exposed HCP to pertussis and how long

A

if symptoms develop, for 21 days from onset of cough OR until 5 days after appropriate therapy

128
Q

Does immunity status matter for Pertussis PEP?

A

No

129
Q

Contagious window for flu

A

1 day before symptom onset- 7 days after (can be longer for immunocompromised)

130
Q

Transmission of flu

A

respiratory droplets

131
Q

Incubation period for flu

A

2 days

132
Q

Exclusion of employee with flu

A

Stay home until at least 24 hours after their fever is gone without the use of fever reducing meds

133
Q

PEP for flu?

A

Not usually recommended but antivirals may be given during outbreak sitations

134
Q

What factors impact the burden of flu?

A
  • Virus circulating
  • Vaccine effectiveness
  • Vaccine compliance
135
Q

best way to prevent flu

A

get flu vaccine each year

136
Q

High-risk groups for complications for influenza

A
  • Seniors
  • Infants
  • Young children
  • Persons with chronic medical conditions
  • Pregnant women
137
Q

Joint commission requirements for annual influenza vaccination program

A

1) provide education at least annually
2) provide vax free of charge
3) make vax accessible to staff
4) goal to improve flu vax rates in IP plan
5) written description of how flu vax rates were determined for faciltiy

138
Q

How long it takes flu antibodies to develop

A

2 weeks

139
Q

What are the BBPs?

A

Hep B, Hep C, HIV

140
Q

What does probability of infection with a BBP depend on?

A
  • route of exposure
  • Concentration of infectious virions in the implicated body fluid
  • volume of infective material transferred
  • for Hep B- susceptibilty
141
Q

Types of exposure to BBP

A
  • percutaneous injury
  • contact of mucous membrane or nonintact skin with blood or body fluids that are potentially infectious
142
Q

What is the risk of BBP to HCP from:
CSF
Synovial fluid
Pleural fluid
Peritoneal fluid
Pericardial fluid
Breast milk
Amniotic fluid

A

not assessed

143
Q

Precautions to use to prevent BBP exposure

A

Standard precautions

144
Q

How to prevent percutaneous injuries

A

-Implement safe work practices
-Ensure staff educated to handle/ dispose of sharps
-Ensure staff know how to report exposures

145
Q

Exposure prevention: vaccination

A

Vaccinate staff against Hep B

146
Q

Is HBV stable in the environment?

A

Yes, resistant to drying, simple detergents, and alcohol

147
Q

How long can HBV remain viable in the environment?

A

7 days or longer at room temp

148
Q

Does visible blood need to be present for infectious levels of HBV DNA?

A

Np

149
Q

Transmission of HBV

A

Percutaneous/ mucousal exposure
Equip that is not properly disinfected

150
Q

Risk of HBV infection from a needlestick injury if HBeAg positive?

A

37-62%

151
Q

Risk of HBV infection from needlestick injury if HBeAg negative?

A

23-37%

152
Q

What is the presence of HBeAg indicative of?

A

High infectivity

153
Q

What does anti-HBe correlate with?

A

The loss of replicating virus and lower levels of virus

154
Q

HBV incubation periods

A

90 days for jaundice

155
Q

Ratios of adults that are symptomatic/ asymptomatic with acute HBV infection

A

Asymptomatic (2/3) or symptomatic (1/3)

156
Q

Symptoms HBV

A

Jaundice
Dark urine
Scleral icterus
10x normal ALT and AST

157
Q

Time from exposure to onset of elevated liver function tests for HBV

A

60 days

158
Q

How long does it take HBsAg to show up in newly infected persons?

A

6-60 days, mean 30 after exposure

159
Q

When does anti-HBC appear?

A

At onset of symptoms of elevated liver tests

160
Q

When does anti-HBs develop?

A

After HBV recovery, within 3-4 months

161
Q

Which test demonstrates immunity for Hep B

A

Anti-HBS (only see with recovery and vax)

162
Q

Persistence of HBsAg for 6 months after dx of acute HBV

A

progression to chronic HBV

163
Q

HBsAg- negative
anti-HBc- negative
anti-HBs- negative

A

suceptible

164
Q

HBsAg- negative
anti-HBc- positive
anti-HBs- positive

A

Immune due to natural infection

165
Q

HBsAg- negative
anti-HBc- negative
anti-HBs- positive

A

Immune due to Hep B vax

166
Q

HBsAg- Positive
anti-HBc- positive
IgM anti-HBc- positive
anti-HBs- negative

A

Acute infection

167
Q

HBsAg- positive
anti-HBc- positive
IgM anti-HBc- negative
anti-HBs- negative

A

chronic infection

168
Q

HBsAg- negative
anti-HBc- positive
anti-HBs- negative

A

Unclear (resolved, false positive, low level, resolving acute)

169
Q

What is the PEP for HBV exposure?

A

Hep B vax

170
Q

OSHA BBP standard requires hc facilities to provide this vaccine for free to anyone who does not have previous immunity and is at risk of exposure

A

Hep B

171
Q

what type of vax is Hep B?

A

recombinant DNA
3 shots

172
Q

when should HCP be tested for anti-HBS after completing the series? if no response?

A

1-2 months
repeat the series

173
Q

What to do after HBV exposure

A
  • Unvax worker - initiate 3 vax series
  • When HBIG indicated, administer within 24 hours
174
Q

% of HBV vax recipients that develop a protective antibody response

A

90%

175
Q

Adults that develop a protective antibody response from the HBV vaccine are protected from…

A

Clinical disease and chronic infection

176
Q

Are boosters needed for HBV?

A

No

177
Q

Most common chronic bloodborne infection in the U.S.

A

Hep C

178
Q

Incubation period for acute HCV infection

A

2-24 weeks (averages 6-7 weeks)

179
Q

How is HCV transmitted?

A

exposure to infected blood

180
Q

What increases HCP risk of HCV exposure?

A

Injuries resulting in deep punctures or wounds with bleeding
Procedures involving a needle in a patient’s artery or vein

181
Q

How often (%) does chronic HCV develop?

A

75-85% of cases

182
Q

How often does cirrhosis develop in HCV positive patients?

A

10-20%

183
Q

Time period for liver effects from HCV

A

20-30 years

184
Q

Recommendation for HCV treatment

A

Evaluate presence and severity of chronic liver disease

185
Q

What does successful HCV treatment do?

A

Eliminates viremia
Reduces potential for transmission
Prevents further liver disease

186
Q

How often is screening for HCV recommended?

A

At least once for adolescents and adults aged 18-79

187
Q

Recommendation to prevent HCV infections

A

Screening and testing blood donors
viral inactivation of plasma
Risk reduction counseling
Screening people at risk for HCV
Standard precautions
Safe work practices

188
Q

Is there PEP for HCV?

A

No

189
Q

Recommendations for postexposure management to HCV

A

Early detection and more frequent testing
- refer to specialist for medical management

190
Q

When to begin testing for HCV if blood/ bodily fluid exposure occurs

A

ASAP (within 48 hours)

191
Q

Why test ASAP after blood/ body fluid exposure occurs?

A
  • Helps with stress and anxiety about the exposure plus reduces loss to follow up
  • Antiviral therapy my be most effective early in HCV infection
192
Q

Transmission of HIV

A

Exchange of body fluids

193
Q

What is the risk for HIV after percutaneous or mucosal exposure

A

0.3% after percutaneous injury
0.09% after mucosal exposure

194
Q

Incubation period HIV

A

weeks to months

195
Q

Symptoms of initial HIV infection

A

Flu-like febrile illness

196
Q

Does the EIA Antibody screening for HIV always have a positive result when there are early symptoms?

A

No

197
Q

What tests are appropriate for early HIV infection?

A

viral antigen (P24) and nucleic acid amplification testing

198
Q

What happens to CD4 counts in HIV patients?

A

Decrease over time (years)

199
Q

When is the HIV patient at risk for serious opportunistic infections?

A

when CD4 count drops below 200 cells/ mm3

200
Q

How many classes of anti-retroviral agents are available to treat symptoms related to HIV infection or CD4 cell counts <350 cells/ mm3?

A

6

201
Q

What testing needs to happen prior to initiating anti-retroviral therapy?

A
  • HIV drug resistant testing
  • screen for HLA-B*5701 before an abacavir- containing regimen (gene that predisposes to allergic reaction)
202
Q

Precautions to prevent HIV exposure

A

Standard

203
Q

When should HIV anti-retroviral treatment be started, regardless of CD4 count?

A

Pregnant women
Patients with HIV associated nephropathy
Patients coinfected with HBV when treatment indicated

204
Q

HIV Postexposure testing

A

Baseline and follow up testing for 6 months after exposure (ie immediately, 6 weeks, 3 months, and 6 months), if positive start anti-retroviral meds

205
Q

After HIV exposure - steps

A
  • Counsel
  • HIV testing
  • Determine source’s HIV status (viral load)
  • Select PEP regimen based on risk of infection by exposure
206
Q

What devices are most frequently associated with bbp exposures?

A

Blood-filled, hollow bore needles

207
Q

Recommendations for preventing needlestick injuries

A
  • use safety devices
  • avoid injecting blood into vacuum tubes using conventional syringes
  • Retract finger/ heel prick lancets
208
Q

example needless access equipment

A

Blunt cannula
valve systems

209
Q

preventing injuries from scalpels

A

1) alternate cutting methods when appropriate
2) scalpels with safety features (retracting blade or shield)
3) Hands free pass of instruments

210
Q

Engineering controls for IV catheters

A

1) Protective shield for the stylet before or during it’s withdrawal from the catheter
2) implement safety IV catheters
3) Gloves worn during IV insertion procedure
4) puncture-resistant sharps disposal container

211
Q

Two types of scabies

A

Conventional and Norwegian (crusted)

212
Q

Transmission of scabies

A

prolonged skin-to-skin contact and unprotected contact with bedding/ linens from infected patients

213
Q

Precautions for scabies

A

contact precautions

214
Q

How to respond to exposed personnel to scabies

A

Evaluate for signs and symptoms of mite infestation

215
Q

If HCP has confirmed or suspected scabies

A

exclude from duty until appropriate treatment is given and is effective

216
Q

What are the different types of lice?

A

Human head louse
Human body louse
Pubic louse

217
Q

Risk of HCP transmission of head and body lice? Pubic lice?

A

Unlikely, very unlikely

218
Q

what is pediculosis

A

Infestation with lice

219
Q

Should exposed personnel get pediculosis treatment?

A

Only if they have evidence of infestation

220
Q

Should routine prophylactic scabicides or pediculicides be given?

A

No, not unless transmission has occurred

221
Q

Should employees with pediculosis be excluded?

A

Yes- exclude from duty until they receive appropriate initial treatment and it is found to be effective

222
Q

What to do: employee has oral HSV

A

review and case by case basis- is there any transmission potential to high-risk patients?

223
Q

What to do if employee has herpetic whitlow

A

1) Exclude from patient care until lesions health

224
Q

What causes herpetic whitlow?

A

Touching an HSV sore or cold sore of an infected person

225
Q

How does herpetic whitlow present?

A

Mostly on fingers and is painful

226
Q

What to do if employee has herpes zoster virus (shingles)

A

Consider excluding personnel until lesions are dry with scab, but person with shingles should not provide care to susceptible patients with high risk for severe varicella

227
Q

What to do if employee has CMV

A

No need for reassignment or exclusion

228
Q

What to do if pregnant employee exposed to Parvovirus B19 (Fifth disease)

A

Pregnant personnel should contact their provider ASAP

229
Q

which human herpes virus is CMV?

A

HHV 5

230
Q

How is CMV transmitted?

A

Direct contact with infectious body fluids

231
Q

Precautions for CMV

A

Standard

232
Q

Concern for CMV

A

Pregnant women

233
Q

How is parvovirus transmitted?

A

Contact with infected persons, fomites, or large droplets

234
Q

What is the concern about pregnant women exposed to Parvovirus?

A

If acquired during the first half of pregnancy, risk of fetal death increased

235
Q

What to do if employee has RSV

A

Exclude from caring for high-risk patients

236
Q

Transmission of RSV

A

large droplets during close contact

237
Q

What to do if HCP has acute respiratory illness?

A

Exclude from caring for high-risk patients

238
Q

What to do if HCP exposed to MDRO

A

no recommendations for exclusion, except if there is an epi-link transmission BUT need to determine based on endemic organisms and policy

239
Q

Prevention of MDRO: how often to educate

A
  • on hire
  • annually
  • as needed
240
Q

What to do: staff has a draining skin lesion

A

Exclude from patient care activities and food handling

241
Q

What healthcare exposures are associated with adverse outcomes for pregnant healthcare personnel and/or their fetus

A

CMV
Parvovirus B19
Herpes simplex virus
Syphilis

242
Q

What diseases should HCP be immunized for PRIOR to conception

A

measles, mumps, rubella
Ruboela
Hep B
Varicella

243
Q

What precautions will protect pregnant women against most exposures

A

Standard Precautions

244
Q

Who does non-employed HCPs include?

A
  • volunteers
    -contract workers
  • other individuals not employed directly by the facility
245
Q

Non-employed HCP should:

A
  • understand the principles of transmission and prevention of disease within the framework of their duties
  • adhere to requests for prescreening health records including immunizations and TB screening

Ash's Certification Study (22 decks)

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