Hazards, Precautions, Etc. Flashcards
How many hospitalized patients in the US acquire 1 or more healthcare associated infections?
5-10% or 2 million people a year
What does HAI stand for?
healthcare-associated infections
What are the 4 most prevalent infections?
Urinary tract infections (catheter associated 35%)
Surgical site infections (20%, but 1/3 of the costs)
Bloodstream infections (15%)
Pneumonia (15% and usually ventilator-associated. accounts for 25% of mortality)
What organization makes the rules for ensuring workers have safe working environment?
National Institute for Occupational Safety and Health (NIOSH)
What organization enforces the rules and standards set forth?
Occupational Safety and Health Administration (OSHA)
What is methylmethacrylate?
Glue used in ortho rooms that can cause respiratory and genitourinary problems
What anesthetic vapor was known to cause/increase likelihood of Hepatitis and therefore is no longer used?
Halothane
What patient population is automatically treated as having a latex allergy?
Spina bifida (congenital birth defect)
What does PPE stand for?
Proper precautions equipment
You should stand at least _____ ft away from radiation to be safe for a 1 time zap IE. chest x-ray in PACU
6
Name the 4 risks associated with lasers?
Thermal burns
Eye injury
Electrical hazard
Fire/Explosions
What should healthcare personnel always wear in room with lasers?
Proper eye protection and high-efficiency laser mask
What percent of error in anesthesia management is attributed to fatigue?
64% by far the highest
For transmission of infection to occur, what must be present/required
Source Stabile pathogen Adequate numbers Infectivity of agent Appropriate vector Portal of entry
What respiratory infections can be transmitted by aerosolization (coughing sneezing airborne)
Influenza
Measles
TB
What respiratory infections can be transmitted by self inoculation (direct)
Rhinovirus
Respiratory syncital virus (RSV)
This disease leads to 36 K deaths a year, is very easily transmitted, and pt should be isolated bc disease is shed for 5 days
INFLUENZA
T OR F: If a patient has measles, mumps, or rubella, they can still have surgery?
FALSE–no surgery for these patients
All about rubeola:
aka measles
Transmitted aerosol
Carries fever and 3 c’s: cough, coryza,and conjunctivitis
All about rubella:
aka german measles
most adults immune
Can cause birth defects and miscarriages in 1st trimester
All about mumps:
transmitted by airborne droplets
swelling of salivary and parotid glands
most often seen in children 5-9 YO
All about respiratory syncytial virus (RSV):
most severe cause of lower respiratory disease in children
transmitted by self-inoculation–Infected children can shed virus for 7 days
viable on skin for 6 hours
can have recurrent asthma for 6 months
What is the common cold called?
Rhinovirus
What are the 3 types of Herpes virus?
Varicella-zoster (VZV)
HSV 1 & 2
Cytomegalovirus (CMV)
All about VZV:
aka chicken pox and shingles
transmitted to immuno-compromised patients
communicability 1-2 days before pt will show symptoms and lasts 5-6 days
All about herpes simplex type 1:
severe oral lesions and pt has fever
transmitted by self-inoculation
can lead to encephalitis
All about cytomegalovirus (CMV):
usually in childhood
transmitted by direct contact
can spread to fetus during pregnancy
Which is the “bad guy” of hepatitis?
Hep C
transmitted by blood/body fluids
All about Hepatitis B:
seroconversion up to 30%
can develop cirrhosis and ESLD
HBV primary prevention strategy
All about hep C:
leading cause of chronic liver disease
seroconversion 1.8%
What is seroconversion?
Exposure to a disease that will turn into an active disease in the exposed
All about Human immunodeficiency virus (HIV):
seroconversion 0.3%
increased risk with blood, deep injury, needle sticks
is terminal illness, death within 2 months
All about Tuberculosis (TB)
transmitted through airborne particles Protection: N95 mask detected with skin PPD test Elective surgeries should be postponed until pt no longer infectious non-elective performed at end of day
Is urine considered to be sterile?
YES
Fluids that can be considered infectious?
Blood, bloody fluids
CSF fluid
Amniotic/pleural/pericardial fluids
Peritoneal/ synovial fluids
What is the single most important action in prevention of the spread of infection?
Hand washing
What is the recommended minimal amount of time to scrub hands?
15 seconds
If spraying or splashing of fluids is anticipated during surgery, what should be worn?
Mask, eye protection, gowns
What goes in the blue contamination bags?
soiled linens
Needles or other sharps go in what bin?
RED
The reusable gowns go in which container?
green
For all airborne precautions, you should wear what PPD(device)/PPE(equipment)?
N-95 mask
Do not have contact with mumps,measles, or rubella unless immune
What procedure is done to a person who tested positive on a PPD?
Chest x-ray (CXR)
T OR F: All patients are treated as if they have a communicable blood and/or body fluid infection?
TRUE
Define cleaning
removal of foreign material
Define antiseptic
chemical germicide for use on living tissue
iodine, chlorohexadine
Define disinfectant
chemical germicide for use on non-living items
bleach
Define sterile:
completely free of all microorganisms
Define sterilization
process that results in probability of microorganism survival on an item is <1:1000000
What are the disinfection levels?
High level- kills fungi, viruses, and vegetative bacteria (no endospores)
Intermediate-level: kills fungi, large viruses, and bacteria (no endospores)
low-level : kills fungi, some viruses and bacteria (exception TB endospores)
T or F: Any item which comes in contact with mucous membranes but does not penetrate body surface must be washed and cleaned with high-level disinfectant
TRUE
laryngoscopes, bronchoscopes
Define simple cleaning:
soap and water
Define antiseptic cleaning:
substance that has antimicrobial activity and that can be applied to living tissue
Define steam sterilization:
autoclaving: kills everything b/c of pressure and temperature
15 min @ 121C
10 min @ 126C
3.5 min @ 134*C
confirmed by indicator strip on inside of tray
What is the most widely used of the chlorine disinfectants and used on tables, floors, and equipment?
Chlorine (hypochlorite)
What food allergies are also associated with latex allergy?
avocado, kiwi, banana, chestnuts, stone fruit
What past medical history can be associated with latex allergy?
hay fever
rhinitis
asthma
eczema
When do you want to schedule surgeries for patients who have latex allergy?
First cases of the day
Betadine allergy patients can also be allergic to?
Shellfish
Which vein carries the lowest risk of catheter related infections?
subclavian
Describe the best prevention for IV catheter related infections:
Single lumen
full body wraps when placing catheter
transparent, semi-permeable dressings
