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Infection Control > Inection controll > Flashcards

Inection controll Flashcards

1
Q

What are the main methods of sterilisation in practice?

A

Ethylene oxide
Autoclave
Cold sterilisation

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2
Q

Define sterilisation.

A

Sterilisation
Killing ALL micro-organisms and their spores
Required for surgery, laboratory and hospital situations

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3
Q

De3fine disinfection

A

Disinfection:
Eliminating or reducing harmful micro-organisms from inanimate objects and surfaces
High level disinfection will kill most vegetative micro-organisms
Will not kill more resistant bacterial spores

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4
Q

What does BBE stand for? List the rule of BBE?

A

Bare below the elbow

No wrist or finger jewellery
No nail polish or extensions
No long sleeves
Short well trimmed nails

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5
Q

What is this?What cycle would you run a drill on

A

Autoclave 120

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6
Q

What are the sterile gloving techniques?

A

Open
Closed
Plunge

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7
Q

What part of a gown makes up the sterile field?

A

The arms
Neck to waist
Nothing below the waist, the back is the most unsterile part of the gown

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8
Q

List 4 packing materials?

A

Fabric
Stainless steel drum
Peel and seal packaging
Cloth

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9
Q

What are the advantages/disadvantages of this packing option?

A

Re-useable and relatively cheapCan become damp and rip

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10
Q

How do you empty and refill an autoclave? What fluid is used?

A

-Distilled water is used
1.Once the cycle is finished the autoclave should be emptied and all packaging should be checked to ensure sterile and dry.
When filling the autoclave:
Ensure adequate space between items when loading
Allowing steam to circulate freely
Ensure no blocking of inlet and exhaust valves
Before packing for sterilisation, instruments must be free of grease and organic matter
Allowing for effective penetration of steam

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11
Q

What is the role of flagella?

A

Aids in locomotion of the cell

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12
Q

How does an ultrasonic cleaner work and when should it be used?

A

Used to effectively deep clean instruments and equipment
Industrial machines also have jets attached to allow for cleaning of equipment such as scopes
Uses sound waves
Cavitation
Sterile water and enzyme cleaner should be added
All instruments should be open when placed in the cleaner

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13
Q

What instruments benefit most from ultrasonic cleaner? How should they be placed in the machine?

A

Instruments with hinges and jaws
They must be open in the machine

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14
Q

What items are cold sterilised?

A

Endoscopes
ET tubes
Plastics if ethylene oxide unavailable

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15
Q

What is the appropriate way to pass someone in an OR

A

Back to back

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16
Q

Name the shapes of these bacteria

A

rod
spherical
spiral

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17
Q

how do bacteria replicate

A

binary fission

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18
Q

how do virus replicate

A

replictiopn

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19
Q

howdo fungus replicate

A

Asexual and sexual via spores

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20
Q

how do protazoa replicate

A

Protozoa- Asexual binary fission

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21
Q

When do we need to wear gloves?

A

Wear gloves for aseptic technique
Barrier nursing

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22
Q

When do we need to wear sterile gloves?

A

Sterile gloves- all surgical procedures, sterile procedures such as central lines and urinary catheters

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23
Q

You are asked to scrub in to assist in an exploratory laparotomy. What gloving method would you use?

A

Closed gloving as in a body cavity

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24
Q

What are the 3 main types of surgery?

A

Emergency
Necessary or Urgent
Elective

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25
Q

In what order do you drape a patient using the four drape method

A

Sterile side, assistant side, cranial, caudal

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26
Q

Why do we clip patients for surgery? List at least 4 reasons

A

Reduce SSI
Clear the field to ensure visualisation
Reduce bacterial load and fomite contamination
Provides good margins for surgery
Ensures the surgical area can be disinfected appropriately

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27
Q

What surgical procedures/clinical conditions call for clipping to be carried out prior to induction?

A

Unstable patients/critical emergencies
Pregnant patients requiring a c-section
Should be done no more than 1hr prior to anaesthesia

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28
Q

List the rules of clipping. Minimum of 4.

A

Clip in the direction of the fur
Ensure clippers are clean and well lubricated
Monitor clippers for heat
Clip in the opposite direction of the fur to remove the finer hair
Check the clippers for damage
Use appropriate blade size
Clean between each patient

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29
Q

What are the risks of clipping an area in advance of the surgical procedure

A

Increased risk of bacterial colonisation and SSI

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30
Q

Provide examples of reservoirs

A

Environment
Animals
Humans

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31
Q

List five reasons a patient may be a more susceptible host.

A

Underlying medical conditions
Immunocompromised/Immunosupressed
Undergoing chemo or radiotherapy tx
Juveniles/paediatric
Geriatric
Unvaccinated
Pregnant patients

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32
Q

list some cleaning taskis to be preformed between surgeries

A
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33
Q

list some cleaning taskis to be preformed daily

A

-Thorough cleaning should be left until the end of the day when all surgical procedures are finished
This allows all airborne particles disturbed in the cleaning process time to settle before the next procedure

-REMEMBER the OR should always be ready for either the next day or for emergencies

-Empty the theatre of waste and surgical equipment

-Move objects to ensure thorough cleaning when sweeping and mopping

-Thoroughly clean all surfaces
End of the day cleaning should include scrub area, surgical storage area, prep room

-Restock equipment and anaesthesia drugs

-Empty and clean all bins and vacuum cleaners

-Wash all theatre drapes and theatre shoes

-Replenish theatre PPE

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34
Q

list some cleaning taskis to be preformed weekly

A

-Empty the OR of all moveable equipment

-All the equipment in the OR should be thorough cleaned and returned to theatre

-Work methodically- ceiling to floor
All fixed structures should be cleaned including walls, floors, drains

-Cupboards/theatre storage should be emptied, cleaned and re-stocked

-Theatres should always be ready to use in case of an emergency

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35
Q

Direct contact
Indirect contact
Mechanical
Biological
What are the following examples of?

A

Transmission of disease

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36
Q

define commensal

A

lives in or on the host, but cause no harm nor derive any benefit

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37
Q

define colonistaion

A

presence of micro-organisms in amounts that are not harmful, may be a carrier

38
Q

define symbolic

A

aka mutualistic – benefits both itself and micro-organism with its presence

39
Q

List a minimum of 5 considerations for parasite control plans

A

Breed or genetic/breed disposition factors
Parasite risks for the individual ie indoor
Live with other animals especially felines
Type of medication ie ability to administer
Frequency required
Parasites needing to be covered ie travelling

40
Q

What are pathogenic organisms?

A

Individual living organisms that cause disease

41
Q

define heterotrophic

A

Obtain molecules from environment

42
Q

define Autotrophic

A

Synthesise there own food

43
Q

define saprophytic

A

Feed on dead organic matter

44
Q

define Parasitic

A

Live on a host, obtain nutrients from the host, majority depend on host for survival

45
Q

identify

A

Bacteria

46
Q

identify

A

fungi

47
Q

identify

A

protozoa

48
Q

identify

A

virus

49
Q

What makes pathogens effective?List at least 4 things

A

Simple life cycles
Reproduce/replicate rapidly
Small
Mutate
Easily enter host
Increase rapidly in numbers
Respond to changes in host immune system to overcome defences host may have

50
Q

Histoplasmosis is an example of what micro-organism?

A

fungus

51
Q

What is the difference between endo and exotoxins?

A

Exotoxin:
Found inside living cells
Manufactured by living organisms
Released in to the surrounding tissue and cells whilst organism still active
Leads to toxic shock due to waste bacteria producers
Proteins produced by gram +ve

Endotoxin:
Released upon death of an organisms
Gram –ve
Heat stable
Poor antigens
Less toxic

52
Q

How is bacteria tested to establish what treatment is effective?

A

Bacterial cultures
Gram –ve/+ve staining

53
Q

Not membrane bound
Asexual, reproduce by binary fission
Example; Streptococcus
—identify

A

Bacteria

54
Q

How is fungi spread?

A

Direct skin contact
Indirect from contaminated soil or environment

55
Q

What is one health?

A

One Health is an approach calling for the collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals and our environment

56
Q

Provide examples of infection control measures that are implemented in practice.

A
57
Q

Explain antimicrobial resistance

A

Ability of a microbe to resist effects of medication that would previously have been used to treat it
Occurs when bacteria, viruses, fungi and parasites change over time
No longer respond to medicines, makes infections harder to treat

58
Q

How does antibiotic resistance occur?

A
59
Q

Example of nosocomial infections

A

MRSA or MRSP (pseudointermedius)
High profile
Isolated in range of species
Unclear whether spread is human to animal or vice versa

60
Q

What does iatrogenic mean?

A

Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence.

61
Q

What is the difference between exogenous and endogenous?

A

Endogenous:
Normal bacterial flora
Enters sterile area of body
ie GI tract bacteria causes a UTI

Exogenous:
Caused by organisms not normally found in body
Organisms gained entrance from environment

62
Q

identify

A

Ctenocephalides felis(Feline flea)

63
Q

identify

A

Linognathus Setosus(Sucking louse of canines)

64
Q

identify

A

Sarcoptes Scabiei/ Sarcoptic Mange

65
Q

identify

A

Notoedres Cati (Feline mange)

66
Q

identify

A

Otedectes Cynotis (Ear mite)

67
Q

identify

A

Cheyletiella spp (Walking dandruff)

68
Q

Explain the transmission of Rabies, making reference to the ‘Chain of Infection’

A

Infectious agent–Rabies virus

Reservoir–Dogs, foxes or other mammals

Portal of Exit–Via saliva

Mode of Transmission–Direct contact

Portal of Entry–Via bites, open wounds, mucous membranes

Susceptible host–Dog, other mammals, human. Effect – neurological signs, behavioural change, convulsions, coma, death

69
Q

Explain the transmission of toxoplasmosis , making reference to the ‘Chain of Infection’

A

Infectious agent- Toxoplasma Gondii

Reservoir–Cat

Portal of Exit–Oocysts in faeces

Mode of Transmission–Infection via intermediate hosts

Portal of Entry–Ingestion

Susceptible host–Humans

70
Q

Describe the isolation and barrier nursing procedures that should be used to prevent the spread of Toxoplasmosis.(5)

A
  • one named nurse, or contact with patient after other patients
  • wear appropriate PPE, gloves, apron, disposable cover shoes
  • contaminated PPE, consumables, newspapers etc in separate clinical waste
  • appropriate hand washing with soap/antiseptic and water
  • personal hygiene – don’t touch face/mouth with hands
  • use footbath with appropriate disinfectant (most are effective)
  • soak contaminated vetbeds in disinfectant prior to boil wash
  • use bowl, utensils, cleaning equipment etc only in isolation
  • clearly identify isolated area and communicate to other staff
71
Q

Describe the process for decontaminating with disinfectant the kennel that has housed a cat with toxoplasmosis. (5)

A
  • Prepare all equipment and PPE (particularly gloves)
  • Place animal in secure area
  • Remove vet beds and newspapers – soiled bed, disinfected and washed, soiled newspapers to clinical waste
  • Remove gross soiling and organic material
  • Clean all parts of kennel with detergent/disinfectant
  • Rinse with clean water
  • Disinfect all kennel at correct dilution rate
  • Leave for appropriate contact time
  • Rinse/dry
  • Remove PPE and dispose
  • Wash hands
72
Q

What tests can be carried out to ensure the patient receives he most effective antibiotic for the infection?

A

Bloods, culture and sensitivity

73
Q
  1. What does MRSA stand for?
A

Meticillin-resistant Staphylococcus aureus

74
Q

What is antimicrobial resistance?

A

Ability of microbe to resist effects of medication –antibiotics that would have previously been used to treat a condition. The number of resistant bacteria have increased, partly due to misuse of antibiotics in the 1970’s.

75
Q

What can be put into place in a veterinary practice to control the use of antibiotics?

A

Agreed prescribing policy which will reduce the antibiotic use in practice.

76
Q

Give two examples of antibiotic formulations that can be prescribed to patients?

A

creams or ointments, injections, or tablets

77
Q

What are the risk if an owner stops a patients course of antibiotics before they have completed the full course?

A

This is because low levels of bacteria may still be present which would be capable of multiplying again if the course is stopped early.

78
Q

What is a HA-MRSA?

A

Health care associate MRSA- acquired in hospital or care facilities.

79
Q

in patients with a HA-MRSA what areas of the body are likely to be affected?

A

Surgical sites, areas of implants.

80
Q

how is HA-MRSA contracted?

A

Skin-to-skin contact with someone/animal who has a staph infection.

Contact with surfaces that have staph on them.

Compromised immune systems.

Contaminated equipment.

Poor hand hygiene (healthcare workers not washing their hands or using alcohol-based hands sanitizer between patients).

81
Q

As a student Veterinary nurse what measures can you carry out to minimise the risk of HA-MRSA?

A

Practicing good hand hygiene by washing your hands often or using alcohol-based sanitizer.

Educating staff and owners.

Careful use of antimicrobial agents.

Patient surveillance and post-op follow-up.

82
Q

What are 10 important reminders when cleaning

A

1) Never mix cleaning solutions. Some mixtures, especially those containing bleach, can be dangerous.
2) Contact time is important. It all depends on the product you use.

3) Never eyeball dilutions. Instead, follow the manufacturer’s specific ratios.

4) Never walk into an OR without a cap and mask.

5) Don’t ever think “cleaning is not in my job description.”

6) Never use a disinfectant without knowing how.

7) Never ask the least trained, lowest paid person to clean your OR.

8) Never use the same cleaning equipment in the OR, isolation, the kennel, and the treatment room. Have a dedicated set for each space.

9) Always wear gloves and follow appropriate safety measures, and not only because the Occupational Safety and Health Administration (OSHA) demands it. Cleaning products can be toxic and caustic. Protect yourself and your team.

10) Update and follow information in your safety data sheets (SDS) binder. It’s the law

83
Q
  1. Explain the transmission of Leptospirosis. (6 Marks)
    You must refer to the ‘Chain of Infection’ in your answer. Your answer must include the following.
    * Aetiology (1 mark)
    * Mode of transmission (4 Marks)
    * Effect on the host (1 Mark)
    Use paper if you want
A

Infective agent – Leptospira Icterohaemorrhagiae and Leptospira Canicola. (1)

Reservoir – Cattle, Pigs, Horses, Dogs, Rodents and Wild animals.

Portal of Exit – Urine

Mode of Transmission – Contact
with urine from an infected animal. Contact with contaminated food, water, soil from an infected animal.

Portal of Entry – Ingestion or across mucous membranes or skin if broken, cut or scratched.

Susceptible Host – Dogs or Humans.

Effects on host – Hepatitis or renal failure. (1)

84
Q
  1. Describe THREE characteristics of the following pathogenic microorganism to include the name of ONE associated disease. (4 marks)
    * Protozoa
A

Unicellular organism

Microscopic, although larger than bacteria

Complex Structure

Can be pathogenic

Complex lifecycle

Some form cysts to assist transmission

Many are aquatic

(3 marks awarded for any of the above)

Disease: Dermatophytosis (1 mark)

85
Q

Explain how the veterinary nurse can reduce the potential risk of contacting a nosocomial infection whilst carrying out nursing interventions in relation to the IV cannula. (4 Marks)

A

Wash hands following WHO hand wash.

When handling the cannula, wear gloves.

Check the cannula site regularly for any signs of infection such as inflammation or phlebitis.

Change cannula dressing regularly.

86
Q

B) Explain the main cause of nosocomial infections. (1 mark)

A

Lack of hand hygiene as we carry MRSA on our skin.

87
Q

C) Name the two most common ‘superbugs’ we may come across in practice (2 marks)

A

Methicillin resistant staphylococcus aureus
Methicillin resistant staphylococcus pseudointermedius

88
Q
  1. Describe the process for carrying out the World Health Organisation (WHO) method for hand hygiene using antiseptic gel, including the total time for the procedure. (9 Marks)
A
  • Apply a handful (2-3mls) of antiseptic gel
  • Rub hands palm to palm
  • Right palm over left dorsum with fingers interlaced and vice versa
  • Palm to palm with fingers interlaced.
  • Backs of fingers to opposing palms with fingers interlocked.
  • Rotational thumb rubbing of left thumb in right palm and vice versa.
  • Rotational rubbing of fingertips of right hand in left palm and vice versa.
  • Total time = 20-30 seconds.
89
Q

State TWO properties required for sterilisation and packaging for equipment. (2 marks)

A

Must not damage equipment
Porous
Robust – withstand handling and sterilisation
Prevent microorganism penetrating the outer layer
Cost effective
Eco-friendly

90
Q

B) Explain the cleaning protocols for instruments. (12 marks)

A

1.Wear appropriate PPE – Plastic apron and gloves.

2.Soak instrument in cold water (NOT hot – coagulates blood traces) and chose instrument cleaner. (make sure handles are open to allow solution to move freely around the blades and hinge.

3.Rinse with cool running water and hand brush (distilled water preferably)

4.Check instruments for any damage.

5.Dry the instrument *manually or air dry.

6.Lubricate the hinge joint.

7.Apply protective cover to sharp end (rubber tip/swab)

8.Insert instrument into packaging (the correct way around with hinge open).

9.Insert appropriate indicator.

10.Remove excess air from the packaging
11. Secure the package – airtight seal
.
12.Label using permanent marker – instrument name, operator initial and date of packaging/reserialisation date.

13.Set on appropriate cycle 134*c.

Infection Control (2 decks)

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