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Patient Care > Infection Control > Flashcards

Infection Control Flashcards

1
Q

OSHA

A

occupational safety and health administration

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2
Q

OSHA is a US government agency under the

A

department of labor

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3
Q

what is OSHAs mission

A

to ensure safety in the workplace

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4
Q

1986 OSHA began to develop

A

the new blood borne pathogens standards

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5
Q

in 1991,

A

mandatory blood borne pathogen standards were made

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6
Q

CDC

A

center for disease control and prevention

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7
Q

CDC is the – — — agency

A

US public health

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8
Q

what does the CDC review

A

current scientific information

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9
Q

CDC creates

A

recommendations

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10
Q

what trends does the CDC track?

A

disease trends across the country

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11
Q

what does the CDC serve as a primary investigator for?

A

when disease outbreak threatens public health

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12
Q

infection prevention and control refers to the policies and procedures used to

A

minimize the risk of spreading infections in the healthcare setting

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13
Q

chain of infection

A

process by which infectious diseases are transmitted

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14
Q

three opponents of a chain of infection

A

a causative agent
a susceptible host
a mode of transmission
all three components are necessary for infection to spread. infection control strategies are intended to break one or more of the links, thereby preventing disease transmission

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15
Q

causative agent

A

any microorganism in sufficient numbers capable of causing disease (pathogen)

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16
Q

causative agents can include a variety of (4)

A

viruses
bacteria
protozoa
fungi

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17
Q

pathogens can be present in

A

blood or OPIM

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18
Q

blood borne pathogens of concern in dentistry (3)

not typical of a blood borne pathogen (1)

A

hep B virus: HBV
hep C virus: HCV
human immunodeficiency virus: HIV

Sars CoV 2

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19
Q

susceptible host

A

a person who lacks the effective resistance to a particular pathogen

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20
Q

factors that influence a persons level of susceptibility (5)

A 
age
physical conditions 
medications
immunization
underlying medical conditions
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21
Q

mode of transmission

A

the mechanism by which the pathogen makes its way to the host

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22
Q

types of mode of transmission (3)

A

direction contact: occurs when a pathogen is transmitted directly from an infected person to you
indirect contact: occurs when an inanimate object serves as a temporary reservoir for the pathogen
airborne: when the pathogen is airborne via droplet spatter or aerosols

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23
Q

three main ways in which covid 19 is spread

A

breathing in air when close to an infected person who is exhaling small droplets and particles that contain the virus
having these small droplets and particles that contain virus land of the eyes, nose, or mouth, especially through splashes and sprays like a cough
touching eyes, nose, or mouth with hands that have the virus on them

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24
Q

droplet transmission

A

coughs and sneezes can spread droplets of saliva and mucus

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25
Q

airborne transmission

A

tiny particles possibly produced by talking, are suspended in the air for longer and travel further

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26
Q

potential routes of transmission (3)

A

patient to DHCP
DHCP to patient
patient to patient

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27
Q

standard precautions are the minimum infection control practices that apply to all patient care in any setting where health care is delivered, whether or not a patient is suspected or confirmed as having an infection. the purpose of standard precautions is to

A

decrease the risk of transmission of blood borne and other pathogens from both known and unknown sources

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28
Q

transmission based precautions are used in addition to standard precautions for patients with

A

known or suspected infection

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29
Q

what is an essential part of a disease prevention and infectious control program?

A

immunizations

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30
Q

ACIP provide national guidelines for immunization of

A

health care providers

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31
Q

ACIP recommend the all health care providers be vaccinated or have documented immunity to these diseases (6)

A 
HBV
influenza 
measles 
mumps 
rubella 
chicken pox (varicella)
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32
Q

hep B vaccination is required of all employees who will have

A

patient contact and employees working with infectious instruments and or materials that are exposed to blood, saliva, OPIM

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33
Q

OSHAs blood borne pathogen standard in 1991 mandated that all employers must offer the

A

hep B vaccine to employees without cost within 10 working days if they are potentially exposed at work to blood or OPIM

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34
Q

what if the DHCP provider declines the hep B vaccination?

A

must sign a declination statement and educate on the risk of exposure

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35
Q

overall, the risk of exposure to TB for the DHCP is low; however, both the CDC and ADA agree dental practices should have a

A

TB control program appropriate for their level of risk

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36
Q

covid 19 CDC recommendations (4)

A
  1. assessment: is the DHCP or the patient at risk
  2. availability of PPEs
  3. stay informed (changes daily)
  4. provide care in the safest way
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37
Q

elements of standard precautions (5)

A 
hand hygiene 
personal protective equipment 
safe injection practices 
safe handling of potentially contaminated equipment or surfaces in the patient area 
respiratory hygiene/cough etiquette
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38
Q

single most important way t reduce the risk of disease transmission

A

hand hygiene

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39
Q

according to the CDC, when do hands need to be cleaned? (3)

A

when visibly dirty
after touching contaminated objects with bare hands
before and after patient treatment (before glove placement and after glove removal)

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40
Q

how should you wash your hands?

A

Wet your hands with clean running water (warm or cold) and apply soap.Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.Scrubyour hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.Rinseyour hands well under clean, running water.Dry your hands using a clean towel or air dry them.Turn off water using the paper towel and to open the door as you exit

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41
Q

if hands are visibly soiled with blood or opim (3)

if hands are not visibly soiled (3)

A

use soap and water
use anti-microbial soap and water
do NOT use an alcohol based hand rub

use soap and water
use anti-microbial soap and water
use an alcohol based hand rub

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42
Q

handwash

A

washing hands with plain soap and water

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43
Q

antiseptic hand wash

A

washing hands with water and an antimicrobial soap

ex. chlorhexidine, iodine, iodophors, chloroxylenol, triclosan

44
Q

alcohol hand rub

A

rubbing hands with an alcohol containing preparation (at least 60% alcohol)

45
Q

surgical antisepsis

A

handwashing with an antiseptic soap and an alcohol-based hand rub before operations by surgical personnel

46
Q

personal protective equipment protects the skin and mucous membranes from

A

exposure to infectious materials in spray or splatter

47
Q

PPE consists of (4)

A

gloves
surgical masks
protective eyewear/face shields
protective clothing

48
Q

optimizing the supply of PPE during shortages (3)

A
  1. conventional capacity
  2. contingency capacity
  3. crisis capacity
49
Q

masks before covid 19

A

Should cover both the nose and the mouthShould fit snugly against the faceIf you have facial hair, keep well groomed in order for the mask to be worn effectivelyChange it between patients or immediately if it gets wetRemove it as soon as treatment is overAvoid touching the mask, touch only the elastic or cloth ties

50
Q

levels of facemarks (3)

A

ASTM level 1: low risk of fluid exposure
ASTM level 2: moderate risk of fluid exposure
ASTM level 3: high risk of fluid exposure

51
Q

guidelines for wearing a respirator

A

Must have a written respiratory protection policyYou must be medically cleared to wear the respiratorMust be fit tested for the respiratorNo facial hairKnow the schedules for cleaning, disinfecting, storing, inspecting, repairing, and discarding Must be properly trained in the proper use of respirators

52
Q

gloves

A

Minimize the risk of health care personnel acquiring infections from patientsPrevent microbial flora from being transmitted from health care personnel to patients Reduce contamination of the hands of health care personnel by microbial flora that can be transmitted from one patient to another It is not a substitute for handwashing!

53
Q

glove considerations

A

Remove gloves that are torn, cut or punctured Do not wash, disinfect, or sterilize gloves for reuse Use sterile gloves when performing surgical proceduresAllergies to certain glove materialKeep finger nails short, minimize or eliminate jewelryAlways change gloves between patientsUse utility gloves for cleanup and disinfection

54
Q

protective eyewear and face shields

A

Shields the eyes of dhcp from spatter and debris generated from dental proceduresprotective eyewear and face shields should be cleaned with soap and water as needed.If visibly soiled, disinfect between patients according to the manufacturer’s instructionBecause many dental procedures produce projectiles from various dental materials used, protective eyewear for the patient is advised

55
Q

protective clothing

A

Wear gowns, lab coats, or uniforms that cover skin and personal clothing likely to become soiled with blood, saliva, or infectious material Change if visibly soiled Remove all barriers before leaving the work area

56
Q

the CDC defines occupational exposure to bloodborne pathogens in dentistry as a

A

percutaneous injury or contact of mucous membrane or non-intact skin with blood, saliva, tissue, or other body builds that are potentially infectious

57
Q

ways to prevent occupational exposures (3)

A

standard precautions
engineering controls
work practice controls

58
Q

engineering controls

A

technology based measures that eliminate hazards through safer designs that isolate or remove the blood borne pathogens hazard from the work place

59
Q

engineering controls rely on the

A

devices technology, rather than the users technique

60
Q

work practice controls

A

procedures that reduce the likelihood of exposure by altering the way in which a task is performed

61
Q

post exposure management protocols

A

dental practices should have a comprehensive written plan to facilitate prompt reporting, evaluations, counseling, treatment, and medical follow up of all occupational exposures

62
Q

post-exposure management protocols should

A

describe the type of blood or OPIM contact that may place dental members at risk for bloodborne infections
describe procedures for prompt reporting and evaluating such exposures
identify a healthcare professional who is qualified to provide counseling, medical evaluations, and procedures in accordance with the most current recommendations of the US Public Health Service

63
Q

DHCP with hep B

A

How is the patient at risk
✓the DHCP must be sufficiently viremic
✓the DHCP must have an open wound that allows exposure to their blood or other infectious bodily fluids
✓the providers blood or infectious bodily fluid must come into direct contact with a patients wound

specified exposure-prone procedures
✓Major oral surgery procedures would be overseen

Expert panel
✓Responsible for providing oversight of the infected DHCP’s practice

64
Q

notification to patient

A

no notification necessary

In addition, the Consult Subcommittee determined that there was no scientific or ethical basis for the restrictions that some medical and dental schools have placed on HBV-infected students and concluded that such restrictions were detrimental to the professions as well as to the individual students.

65
Q

after covid related exposure, you cannot return until

A

at least 10 days have passed since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medicine

66
Q

oral surgical procedures present a risk for

A

microorganisms to enter the body

67
Q

oral surgical procedures involve the

A

incision, excision, or reflection of tissue that exposes normally sterile areas of the oral cavity

68
Q

the ADA considers these procedures as surgical and therefore require surgical gloves (5)

A 
biopsy
periodontal surgery
apical surgery
implant surgery 
surgical extractions
69
Q

for surgical hand antisepsis, you must use

A

an antimicrobial soap or if you use a non-antimicrobial soap you must follow up with an alcohol based hand rub

must scrub the hands, fingers, and forearms

alcohol-based hand rubs should contain chlorhexidine, quaternary ammonium compounds, octenidine, or triclosan to achieve germincidal persistent activity

70
Q

use sterile saline or sterile water as a —/— when performing surgical procedures

A

coolant/irrigator

71
Q

how to deliver sterile irrigating fluids

A

use devices designed for the delivery of sterile irrigating fluids

72
Q

cleansing

A

reduces the number or microorganisms present

73
Q

disinfection

A

less lethal to pathogenic organisms than sterilization

74
Q

sterilization

A

the process that kills all types and forms of microorganisms

75
Q

classification of patient care items (3)

A

critical
semi-critical
non-critical

76
Q

sterilization process (4)

A

decontamination
inspection and packaging
sterilization
storage

77
Q

decontamination

A

Make safe by removing or reducing contamination by infectious organisms or other harmful substances; the reduction of contamination to an acceptable level.

78
Q

an item that has been disinfected is less likely to transmit infection than

A

one that hasn’t

79
Q

there is only a reduction in the number of microorganisms. therefore you still need to

A

wear your PPE

80
Q

Without thorough cleaning, any — matter remaining on the instruments can protect microorganisms during the sterilization process; sterilization cannot be assured, even with longer sterilization times.

A

organic

81
Q

packaging after inspection is the final step before the instruments

A

go into sterilization

82
Q

wraps

A

porous material that allow steam to penetrate

83
Q

pouches

A

special medical grade bag that allows steam to penetrate

84
Q

steam is achieved by

A

exposing products to saturated steam at high temperatures

85
Q

dry utilizes

A

hot air that is either free from water vapor, or has very little of it

86
Q

chemical refers to a technique of sterilization making use of a

A

chemical agent

87
Q

where to store sterilized packages

A

behind closed doors or inside drawers to prevent packages being compromised
use event related practices

88
Q

sterilization monitoring (3)

A

mechanical
chemical
biological

89
Q

1 reason for a failed spore test

A

overloading

have the machine inspected
take it out of service
repeat the spore test
go over proper loading

90
Q

types of environmental surfaces (2)

A

clinical contact

housekeeping

91
Q

cleaning clinical contact surfaces

A

Risk of transmitting infections greater than for housekeeping surfacesSurface barriers can be used and changed between patientsORClean then disinfect using an EPA-registered low-(HIV/HBV claim) to intermediate-level (tuberculocidal claim) hospital disinfectantMust wear appropriate ppe

92
Q

cleaning housekeeping surfaces

A

Routinely clean with soap and water or an EPA-registered hospital disinfectant / detergentClean mops and cloths and allow to dry thoroughly before re-usingPrepare fresh cleaning and disinfecting solutions daily and per manufacturer recommendations

93
Q

general cleaning recommendations

A

Use barrier precautions (e.g., heavy-duty utility gloves, masks, protective eyewear) when cleaning and disinfecting environmental surfacesPhysical removal of microorganisms by cleaning is as important as the disinfection processFollow manufacturer’s instructions for proper use of EPA-registered hospital disinfectantsDo not use sterilant/high-level disinfectants on environmental surfaces

94
Q

medical waste

A

not considered infectious, thus can be discarded in regular trash

95
Q

regulated medical waste

A

poses a potential risk of infection during handling and disposal

96
Q

the processes for regulated waste include

A

autoclaving and incineration

97
Q

are extracted teeth considered regulated medical waste?

A

yes

do not incinerate extracted teeth containing amalgam
Clean and disinfect before sending to lab for shade comparison

98
Q

can extracted teeth be given back to the patient?

A

yes

99
Q

handling extracted teeth in educational settings (4)

A

Remove visible blood and debris
Maintain hydration
Autoclave (teeth with no amalgam)
Use Standard Precautions

100
Q

dental water quality for routine dental treatment

A

water should be regulatory standards for drinking water

<500 CFU/mL of heterotrophic water bacteria

101
Q

Waterlines are the narrow-bore plastic tubing that carries the water to the

A

high speed handpiece, air/water syringe, and the ultrasonic scaler

102
Q

biofilm

A

thin, slimy film of microorganisms that adhere to the interior surface of waterlines

103
Q

dental unit waster systems must bar regularly maintained to minimize

A

microorganisms and biofilm colonizing

104
Q

urge manufacturers to continue to develop accessory components, retrofitted for current

A

dental units

105
Q

urge manufacturers in the US to have future units, equipped with

A

separate water reservoir independent of the public water supply

106
Q

how to improve water quality (4)

A

independent water reservoirs
chemical treatment
daily draining and air purging
and point of use filters

Patient Care (15 decks)

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