Health care associated infections Flashcards
What is a nosocomial infection?
Infection acquired during an acute care hospitalization
When are nosocomial infections usually identified?
> 48-72 hours following admission
*Excludes infection incubating at admission
What is colonization?
-Presence or carriage of microorganisms on a body surface without causing disease
Example: MRSA nasal carriage
What is infection?
-Invasion of body tissues by microorganisms resulting in disease (clinical signs and symptoms)
Example: MRSA blood stream infection
What are the categories of organisms that cause HAIs in healthcare settings?
- Exogenous vs. Endogenous
- Pathogenic vs. Commensal
- Multidrug resistant organisms (MDRO)
What are two types of MDROs?
- Selection for due to antibiotic exposure
2. ‘Shared’ via cross-transmission
What are the top 4 HAI causing organisms is U.S. acute care hospitals?
- C. Diff
- S. Aureus
- Klebsiella spp.
- E. Coli
What are the links in the chain of infection for HAIs?
- Organism
- Reservoir
- Portal of Exit
- Transmission
- Portal of Entry
- Vulnerable hosts
What are the two links in the chain of infection that the healthcare workers can control?
- Transmission
2. Portal of entry
What puts hospitalized patients at risk for HAIs?
-Exposure to exogenous organisms from health care workers or contaminated shared equipment
According to the WHO, what are the 5 moments that indicate you should wash your hands?
- Before touching a patient
- Before clean/aseptic procedure
- After body fluid exposure
- After touching patient
- After touching patient surroundings
What are the standard body substance precautions?
- Hand hygiene with all patients
2. Wear appropriate PPE for the nature of interaction and anticipated body fluid exposure
What pathogens can be transmitted by direct/indirect contact?
- MRSA
- VRE
- CRE
- C. Diff
- Norovirus, RSV, etc.
What pathogens can be transmitted via droplets/splashes?
- Neisseria meningitidis
- Pertussis
- H. Flu
- Influenza
- RSV
- Other respiratory viruses
What are some airborne pathogens/diseases that can cause HAIs?
- TB
- Chicken pox
- Measles
- Influenza?
- SARS? (novel coronavirus)
What interventions give endogenous organisms the opportunity to invade?
- Surgery
- Invasive devices
- Urinary catheter
- Vascular catheter
- Ventilators
What are 3 important ways to prevent HAIs in a dental setting?
- Reduce Bloodborne pathogen exposures
- Sterilization and disinfection
- Dental unit water quality
Give 3 examples of blood borne viruses that can be transmitted in a healthcare setting
- Hep B virus
- Hep C virus
- HIV
T/F Bloodborne viruses can produce chronic infection and are often carried by persons unaware of their infection
True
What are two things associated with risk of blood borne exposure?
- Includes bodily fluids that can be contaminated with blood (like saliva)
- Type of exposure is important (needlestick vs. contact with intact skin)
What is the prevalence of HCV infection among dentists?
Similar to general population (about 1-2%)
What are the various ways that BBP exposures can occur?
- Manipulate needle during or after use
- Recap needle
- Use sharp to transfer specimen into container
- Needle not disposed in puncture-resistant sharps container
- Work quickly
- Bump into a needle/sharp or other worker while either holding a sharp
- Splash to eyes/nose/mouth without face protection
What are the 3 levels of classification for instruments and equipment?
- Critical
- Semi-critical
- Non-Critical
Which BBP would you have a 30% chance of getting via needle stick?
HBV
*10% of those develop into chronic infection
Which BBP would give you a 3% chance of getting it via needle stick?
HCV
*85% of those become chronic infection
Which BBP would you have a 0.3% chance of getting via needle stick?
HIV
*100% of these develop into chronic infections
For which BBP is there an effective vaccine and effective post exposure treatment?
HBV
For which BBP infection is there no vaccine and no good post exposure treatment?
HCV
*Still treat if become infected
For which BBP is there no vaccine but there is effective post exposure treatment?
HIV
*You should get the post exposure treatment asap
What defines the critical classification of instsruments?
Penetrate mucous membranes or contact bone, blood, or normally sterile tissues
What are examples of critical instruments?
- Surgical instruments
- Scalpel blades
- Dental burs
What should you do with critical instruments to keep them safe?
Heat sterilize between use or use sterile single-use, disposable devices
What defines a Semi-critical instrument?
Contact mucous membranes but do not penetrate soft tissue
What are some examples of semi-critical instruments?
- Dental mouth mirrors
- Amalgam condensers
- Dental hand pieces
How should semi-critical instruments be treated to keep their usage safe?
Heat sterilize or high-level disinfect
What defines a non-critical instrument?
Contact intact skin
Give some examples of Non-critical instruments
- X-ray heads
2. Blood pressure cuff
How should non-critical instruments be treated to keep their usage safe?
Clean and disinfect using a low to intermediate level disinfectant
The processing area for instruments should be divided into what 4 areas?
- Receiving, cleaning, and decontamination
- Preparation and packaging
- Sterilization
- Storage
What are the 3 options for automated cleaning of instruments?
- Ultrasonic cleaner
- Instrument washer
- Washer-disinfector
What should you do to manually clean instruments?
- Soak until ready to clean
2. Wear heavy-duty gloves, mask, eyewear, protective clothing
Which type of instruments should be wrapped or placed in containers before heat sterilization?
Critical and semi-critical
What are the 3 types of indicators for sterilization monitoring?
- Mechanical
- Chemical
- Biological
Which indicator for sterilization measures time, temperature, and pressure?
Mechanical
Which type of indicator for sterilization presents a change in color when physical parameter is reached?
Chemical
Which indicator for sterilization uses biological spores to assess sterilization directly?
Biological (spore tests)
