Infection Flashcards
1
Q
These are infections that patients acquire during the course of medical treatment. I
A
Health care-associated infections (HAIs)
2
Q
Approximately how many percent of all patients admitted to a hospital develop an HAI, and how many percent of HAIs are pneumonias.
A
5%, 15%
3
Q
Infection control procedures aim to
A
eliminate the sources of infectious agents, create barriers to their transmission, and monitor and evaluate the effectiveness of control.
4
Q
People may also serve as their own source of infection, via_______ This latter process is called_______
A
endogenous flora, autogenous infection
5
Q
What are the susceptible host factor that can enhance susceptibility
A
poorly controlled diabetes mellitus, extremes of age, and underlying acquired (HIV infection) or iatrogenic (through chemotherapy or anti-tumor necrosis factor inhibitors) immunodeficiency
6
Q
These are infections that are acquired in the hospital.
A
Hospital-acquired or nosocomial infections
7
Q
Three elements must be present for transmission of infection within a health care setting:
A
a source (or reservoir) of pathogens, (2) a susceptible host, and (3) a route of transmission for the pathogen
8
Q
Patients with an artificial tracheal airway are at high risk for_________ for several reasons
A
nosocomial pneumonia
9
Q
The three major routes for transmission of human sources of pathogens in the health care environment are
A
contact (direct and indirect), respiratory droplets, and airborne droplet nuclei (respirable particles <5 µm).
9
Q
The three major routes for transmission of human sources of pathogens in the health care environment are
A
contact (direct and indirect), respiratory droplets, and airborne droplet nuclei (respirable particles <5 µm).
10
Q
It is the most common route of transmission
A
Contact transmission
11
Q
Two types of contact transmission
A
Direct and indirect
12
Q
It occurs when a pathogen is transferred directly from one person to another
A
Direct contact
13
Q
It is the most frequent mode of transmission in the health care environment and involves the transfer of a pathogen through a contaminated intermediate object or person
A
Indirect contact
14
Q
Inanimate objects that may serve to transfer pathogens from one person to another are called_________
A
fomites
15
Q
It is a form of contact transmission, but the mechanism of transfer of the pathogen is distinct, and additional prevention measures are required.
A
Droplet transmission
16
Q
Organisms that are transmitted by respiratory droplets include
A
influenza and Neisseria meningitidis
17
Q
Transmission occurs when infectious droplets are propelled (usually what distance) and are deposited on another person’s mouth or nose.
A
≤3 feet through the air
18
Q
occurs via the spread of airborne droplet nuclei.
A
Airborne transmission
19
Q
These are small particles (≤5 µm) of evaporated droplets containing infectious microorganisms that can remain suspended in the air for long periods
A
airborne droplet nuclei
20
Q
Examples of pathogens transmitted via the airborne route include
A
Mycobacterium tuberculosis, varicella-zoster virus (chickenpox), and rubeola virus (measles).
21
Q
Types of aerosol transmission
A
obligate, preferential, opportunistic
22
Q
Under natural conditions, disease occurs after transmission of the microorganism through small-particle aerosols.
A
Obligate transmission
23
Q
Natural infection results from transmission through multiple routes, but small-particle aerosols predominate
A
Preferential transmission
24
Microorganisms that cause disease through other routes but under certain environmental conditions may be transmitted via fine-particle aerosol (e.g., SARS transmission via an aerosol plume that originated from sewage in the Amoy Gardens housing complex).
Opportunistic transmission
25
occurs via exposure to pathogens in contaminated food, water, or medications
(e.g., heparin solution).
Common vehicle transmission
26
Transmission of infectious diseases from insects and rats and other vermin occurs but is of less significance in U.S. health care facilities.
Vector-borne
27
It is the most difficult and least feasible approach to infection control.
Decreasing inherent host susceptibility to infection
28
Hospital efforts at this level focus mainly on
employee immunization and chemoprophylaxis
29
Meaning of OSHA
Occupational Safety and Health Administration
30
The best way to decrease host susceptibility to a device-related infection is
first to_______ and second_________
limit device use, to ensure that devices are placed and maintained appropriately
31
defined as the use of multiple different evidence-based best practices to prevent device-related infection
Prevention bundles
32
Infection control procedures designed to remove environmental pathogens fall into two major categories:
general sanitation measures and specialized equipment processing
33
aims to reduce the number of pathogens to a safe level. This reduction is achieved through sanitary laundry management, food preparation, and housekeeping.
General sanitation
34
The goal of______ is to decontaminate equipment capable of spreading infection.
Equipment processing involves cleaning, disinfection, and sterilization (when necessary).
specialized equipment processing
35
Methods that kill bacteria are______, whereas methods and techniques that
inhibit the growth of bacteria are_______ . Methods that destroy spores are__________ , and methods that destroy viruses are_______
bactericidal, bacteriostatic, sporicidal, virucidal
36
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There are two tiers of HICPAC and the Centers for Disease Control
and Prevention (CDC) transmission precautions:
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standard precautions and transmission-based precautions.
37
These precautions are intended to be applied to the care of all patients in all health care settings all the time. This is the primary strategy for the prevention of healthcare-associated transmission of infections among patients
and health care personnel.
Standard precautions
38
refers to various barriers and respirators used alone or in combination to
protect mucous membranes, skin, and clothing from contact with infectious agents
PPE
39
It includes handwashing with either plain or antiseptic-containing soap and water for at least 15 seconds and the use of alcohol-based products (gels, rinses, and foams) containing an emollient that does not require the use of water.
Hand hygiene
40
It is an important component of standard precautions because the mucous membranes of the eyes, nose, and mouth are particularly vulnerable to some types of pathogens.
Face protection
41
It protect mucosal surfaces against splashes or sprays
Masks
42
It protects caregivers from contamination when contacting blood, body fluids, secretions, excretions, mucous membranes, and nonintact the skin of patients and when handling or touching visibly or potentially contaminated patient care equipment and environmental surfaces
Gloves
43
Caregivers should wear sterile gloves whenever performing______. A single pair of________ (e.g., latex, vinyl, nitrile) may be used for routine patient care.
invasive procedures, non-sterile disposable gloves
44
It (use of NIOSH-approved N-95 or higher-level respirator) is intended for diseases (e.g., M. tuberculosis, SARS, smallpox) that could be transmitted through the airborne route.
Respiratory protection
45
The term respiratory protection has a regulatory context that includes components of the program required by OSHA to protect workers:
1. medical clearance to wear a respirator, (2) provision and use of appropriate NIOSH-approved fit-tested respirators, and (3) education in respirator use.
46
It also provides barrier protection and can prevent the contamination of clothing and exposed body areas from blood and body fluid contact and transmissible pathogens (e.g., respiratory syncytial virus and Clostridium difficile).
Isolation gowns and other apparel (aprons, leg coverings,
| boots, or shoe covers)
47
The elements of respiratory hygiene/cough etiquette include
(1) education of health care personnel, patients, and visitors; (2) posted signs in language appropriate to the population served with instructions for patients and accompanying family members or friends; (3) source control measures (covering the mouth and nose with a tissue when coughing or placing a surgical mask on a coughing person when possible); (4) hand hygiene after contact with respiratory secretions; and (5) spatial separation (≥3 feet from persons with respiratory infections in common waiting areas)
48
refers to isolation techniques intended to reduce the risk of selected infectious agents transmitted by “small droplets” of aerosol particles (e.g., M. tuberculosis).
AI or Airborne Isolation
49
A specialized engineering approach to protect highly immunocompromised patients is a________. A________ is used for patients with allogeneic hematologic stem cell transplants to minimize fungal spore counts in the air.
protective environment, protective environment
50
It is a practice of grouping patients with the same infection (or colonized with the same organism) together to confine care geographically and prevent transmission to other patients.
Cohorting
51
Removal of all foreign material (e.g., soil, organic material) from objects
Cleaning
52
Inactivation of all microorganisms except bacterial spores (with sufficient exposure times, spores may also be destroyed)
Disinfection,
| high-level
53
Complete destruction of all forms of microbial life
Sterilization
54
Inactivation of all vegetative bacteria, most viruses, most fungi, and M. tuberculosis, without destruction of bacterial spores
Disinfection,
| intermediate-level
55
Inactivation of most bacteria, some viruses, and fungi, without destruction of resistant microorganisms such as Mycobacterium tuberculosis or bacterial spores
Disinfection,
| low-level
56
Inactivation of most pathogenic organisms, excluding spores
Disinfection
| general term
57
The five key components to bronchoscope reprocessing are
cleaning, disinfecting, rinsing, drying, and storage
58
What bronchoscope offers many advantages over manual disinfection because they automate several
steps.
```
Automated
bronchoscope reprocessors (ABRs)
```
59
In what year does , who published his approach to disinfection
and sterilization, which was based on the degree of risk of
infection involved in the use of the item in patient care.
1968, Spaulding
60
These items are categorized based on the high risk of infection if such an item is contaminated with pathogens, including bacterial spores (e.g., items that enter sterile tissue or the vascular system).
Critical items
61
Most of these critical items should be purchased
sterile or be sterilized, by steam sterilization if possible
62
These items come into contact with mucous membranes or nonintact skin; this includes most respiratory equipment.
Semicritical
63
These items should be free of all microorganisms before use (bacterial spores may be present). Semicritical items require at least________ using chemical disinfectants.
high-level disinfection
64
These items come into contact with intact skin (an effective barrier to
most microbes) but not mucous membranes
Noncritical items
65
It is the first step in all equipment processing. It involves removing
dirt and organic material from equipment, usually by washing.
Cleaning
66
Examples of critical items
```
surgical devices
Intravascular catheters
Implants
Heart-lung bypass components
Dialysis components
Bronchoscope forceps/brushes
```
67
Examples of semicritical
```
Bronchoscopes
Oral, nasal, and tracheal airways
Ventilator circuits/humidifiers
PFT mouthpieces and tubing
Nebulizers and their reservoirs
Resuscitation bags
Laryngoscope blades/stylets
Pressure, gas, or temperature probes
```
68
Examples of noncritical items
Face masks Detergent washing
Blood pressure cuffs
Ventilators
69
Describes a process that destroys the vegetative form of all pathogenic organisms on an inanimate object except bacterial spores
Disinfection
70
By definition, disinfection differs from sterilization by its lack of_______
sporicidal activity
71
The most common physical method of disinfection is
pasteurization
72
It involves the application of chemical solutions to contaminated surfaces or equipment
Chemical disinfection
73
destroys all microorganisms on the surface of an article or in a fluid, which prevents transmission of pathogens associated with the use of that item.
Sterilization
74
Physical methods include various forms of_______ .Chemical methods of sterilization include_______
heat (steam) and ionizing radiation, low-temperature sterilization technologies such as ethylene oxide (EtO) gas.
75
It is the most common, most efficient, and easiest sterilization method.
Moist heat in the form of steam under pressure
76
It (steam sterilization) is the application of steam under pressure. It is efficient, quick, cheap, clean, and reliable.
Autoclaving
77
The combination most commonly used for autoclaving is psi at ° C
15, 121
78
It is a modification of conventional steam sterilization in which the item is placed in an open tray or a specially designed container to allow for rapid penetration of steam.
Flash “steam sterilization”
79
are needed for sterilizing temperature-sensitive and moisture-sensitive medical devices and equipment
Low-temperature (<60° C) sterilants
80
Low-temperature sterilant technology includes
EtO, hydrochlorofluorocarbon, hydrogen peroxide gas plasma, and peracetic acid
81
It is a colorless, toxic gas and potent sterilizing agent. Because it is active at ambient temperatures and is harmless to rubber and plastics,
EtO
82
EtO must be removed from equipment after sterilization
via a process called_______ .______ is used to sterilize critical
(and sometimes semicritical) items that cannot be steam
sterilized
aeration, EtO
83
It has an efficiency rate of 99.97%, and the use of ensheathed suction catheters, help reduce endotracheal tube contamination.
high-efficiency particulate air/aerosol (HEPA) filters
84
It poses the most significant contamination risk, particularly in systems using
heated humidifiers
The external ventilator circuitry
85
are a source for colonizing both the airways of intubated patients and the hands of medical personnel
Bag-mask devices
86
_______suctioning increases the risk of infection. Proper
| handwashing and gloving help minimize this risk.
Tracheal suctioning
87
To minimize the risk of cross-contamination during suctioning with an open system, a_______ should be used on each patient.
fresh, sterile single-use catheter
88
In-use_________ have a contamination rate of 33%
nondisposable oxygen humidifiers
89
Three major issues are involved in using disposable
| devices:
cost, quality, and reuse
90
It is an ongoing process of monitoring patients and health care personnel for the acquisition of infection or colonization of pathogens, or both.
Surveillance
91
What are the five key recommended components of an infection prevention
program
Surveillance, investigation, prevention, control, and
| reporting
92
It is a tool to provide HAI data on patients to provide outcome measurements either to ensure that there is no ongoing problem or to detect problems and intervene to prevent transmission of pathogens in the health care environment.
Surveillance
93
It fulfills a central role in surveillance for HAIs and community-acquired
pathogens (e.g., influenza) that are important for the infection control practitioner
The hospital microbiology laboratory
94
organisms in active growth. These organisms pose the greatest hazard for infection via respiratory therapy equipment because the most common equipment contaminants are not spore-forming bacteria
Vegetative organism
95
organisms in a resting, resistant stage. These are very difficult to kill but pose little threat to infection via respiratory therapy equipment. Examples of
spore-forming bacteria are Clostridium and Bacillus.
Spores
96
The killing of all vegetative forms of organisms but not spores. Agents that disinfect equipment are called disinfectants.
Disinfection
97
The killing of all organisms, both vegetative and spores. An agent that sterilizes equipment is called a sterilant.
Sterilization
98
It is used for differential staining of bacteria. Gram-positive bacteria stain a_______ ; gram-negative bacteria stain a______ color.
The Gram stain method, purple-black color. pink
99
Three main classes of bacteria
Cocci: Sphere-shaped bacteria
Spirillum: Spiral-shaped bacteria
Bacilli: Rod-shaped bacteria
100
Gram- negative bacteria causing pneumonia
Klebsiella pneumoniae, Pseudomonas aeruginosa, Legionella species, Serratia marcescens, Haemophilus influenzae
101
are the bacteria most frequently encountered on respiratory equipment
Bacilli
