Infection Control Flashcards
1
Q
Microbe/Microorganism
A
Small organism not visible to naked eye
2
Q
Nonpathogens
A
Microorganisms that are part of the normal flora of body. Maintain body processes
3
Q
Pathogens
A
Cause infection and disease
4
Q
Aerobic
A
Requires oxygen to live
5
Q
Anaerobic
A
Live and reproduce without oxygen
6
Q
Six main types of microorganisms
A
Bacteria, Protozoa, fungi, rickettsia, viruses, helminths
7
Q
Bacteria
A
- Simple, one-celled organisms.
- Multiply rapidly.
- classified by shape and arrangement
8
Q
Cocci
A
Round or spherical bacteria
9
Q
Diplococci
A
Cocci that occur in pairs
- (gonorrhea, meningitis, pneumonia)
10
Q
Streptococci
A
- Cocci in chains
- (strep throat, rheumatic fever)
11
Q
Staphylococci
A
- Cocci in clusters or groups.
- Most common pyogenic (pus-producing) microorganisms.
12
Q
Bacilli
A
- Rod-shaped bacteria.
- Occur single, pairs, chains.
- Have flagella.
- Form spores.
- (TB, tetanus, whooping cough)
13
Q
Flagella
A
Thread-like projections that allow microorganisms to move (in bacilli)
14
Q
Superbugs
A
Bacteria resistant to several drugs.
15
Q
Protozoa
A
- One-celled animal-like organisms.
- Found in decayed materials, animal or bird feces, contaminated water, insect bites.
- Many contain flagella.
- Pathogenic cause malaria and more
16
Q
Fungi
A
- Simple plant-life organisms.
- Live on dead organic matter.
- Yeast and mold can be pathogenic.
- Ringworm, athlete’s foot, etc.
- antifungal medication used to treat NOT antibiotics
17
Q
Rickettsiae
A
- Parasitic organisms (must live in cells of other organisms) .
- Found in fleas, lice, ticks.
- Transmitted through bites.
- Typhus fever.
- Antibiotics to treat
18
Q
Viruses
A
- Smallest microorganisms, only visible under an electron microscope.
- Can’t reproduce unless inside another cell.
- Spread through blood and other secretions/fluids.
- Difficult to kill due to resistance.
- Not affected by antibiotics.
- Common cold, measles, chicken pox, influenza.
19
Q
Viruses that infected animals and mutated to affect humans
A
- SARS(coronavirus variant)
- West Nile virus(mosquito borne)
- Monkeypox(monkeys and rodents)
- Ebola(primates)
- H5N1(birds)
- H1N1/swine flu(hogs. Global pandemic in 2009)
20
Q
Main viral disease of major concern
A
Hepatitis B(serum hepatitis), Hepatitis C, Acquired immune deficiency syndrome(AIDS)
21
Q
Hepatitis B
A
- Caused by HBV.
- Transmitted by blood, serum, other secretions.
- Affects liver, can lead to destruction or scarring of liver cells.
- Vaccine available and required to be provided to health care workers (can refuse)
22
Q
Hepatitis C
A
- Caused by HCV.
- Transmitted by blood and blood containing fluids.
- Many asymptomatic cases.
- Can cause serious liver damage.
- No preventive immunization.
23
Q
AIDS
A
- Caused by human immunodeficiency virus.
- suppresses immune system
- people who have cannot fight off cancers and infections that would not affect the average person
- no cure or vaccine
24
Q
Helminths
A
- multicellular parasitic organisms
- commonly called worms or flukes
- transmitted when eggs or larvae are ingested through contaminated food or through bites of infected insects
- some can penetrate the skin to enter
- hookworm, ascariasis, trichinella spiralis, enterobiasis, pork tapeworm
25
Endogenous infection/disease
Originates within the body (congenital, metabolic, tumors)
26
Exogenous infection/disease
Originates outside the body(radiation, chemical agents, trauma, electric shock, temperature extremes)
27
Hospital-acquired or healthcare-associated infection (HAI)
- formerly known as nosocomial infections
- acquired by individuals in a healthcare facility
- usually present in the facility and transmitted by workers
- many of these pathogens are anti-biotic resistant, can cause serious infections(staphylococcus, enterococci)
- infection preventionists run programs to prevent these infections
28
Opportunistic infections
- Occur when body’s defenses are weak
- usually do not occur in individuals with intact immune systems
- candidiasis, Kaposi’s sarcoma
29
Chain of Infection
Conditions that must be met for disease to occur and spread:
1. Infectious agent
2. Reservoir
3. Portal of exit
4. Mode of transmission
5. Portal of entry
6. Susceptible host
Breaking the chain of infection will stop the spread of disease
30
Infectious agent
Any pathogen that can cause a disease
31
Reservoir
- An area where an infectious agent can live
- body, animals, environment, fomites(objects contaminated with infectious material)
32
Portal of exit
- A way for the infectious agent to escape the reservoir
- Urine, feces, saliva, blood, tears, discharge, draining wounds, etc.
33
More of transmission
- The way the infectious agent can be transmitted to another reservoir or host where it can live
- direct contact, contact with secretion, contaminated hands, indirect contact(droplets, contaminated equipment), bites
34
More of transmission
- The way the infectious agent can be transmitted to another reservoir or host where it can live
- direct contact, contact with secretion, contaminated hands, indirect contact(droplets, contaminated equipment), bites
35
Portal of entry
- A way for the agent to enter a new reservoir or host
- breaks in the skin or mucous membranes, respiratory tract, digestive tract, circulatory tract
36
Susceptible Host
Person likely to get an infection or disease, usually due to weak body defenses
37
Defense Mechanisms against infectious agents
- mucous membranes
- cilia
- coughing and sneezing
- HCL
- tears
- fever
- inflammation
- immune response
38
Aseptic Techniques
Major ways to break the chain of infection:
- hand washing
- personal hygiene
- use of disposable gloves
- proper cleaning and disinfection
39
Asepsis
The absence of pathogens
40
Sterile
Free from ALL organisms, both pathogenic and non pathogenic
41
Contaminated
Organisms and pathogens are present
42
Levels of aseptic control
1. Antisepsis
2. Disinfection
3. Sterilization
43
Antisepsis
- prevents or inhibits the growth of pathogenic organisms
- not effective against spires or viruses
- alcohol and betadine
44
Disinfection
- uses chemical disinfectants to destroy or kill pathogenic organisms
- not always effective against spores or viruses
- can irritate or damage skin, mainly used on objects
- bleach solutions and zephirin
45
Sterilization
- process that destroys all microorganisms including spores and viruses
- steam under pressure, gas, radiation, chemicals, autoclave
46
Bioterrorism
The use of microorganisms or biological agents as weapons to infect humans animals or plants. Examples include:
- tartar army throwing bodies of dead plague victims over walls in 1346
- British procured Indians with blankets and handkerchiefs with smallpox in 1763
- Germans used animal and human pathogens in WWI
- Japanese military experimented with different pathogens with prisoners in WWII
- US, Canada, Soviet Union, UK developed biological weapons programs till 1960s
- release of sarin gas in Tokyo, 1995
- anthrax through mail in US, 2001
47
Characteristics of Biologic agents
- inexpensive and readily available/easy to produce
- spread through air and inhaled, or spread through food and water
- survives sunlight, drying, heat
- causes death or severe disability and public panic
- easily transmitted
- difficult to prevent/has no effective treatment
48
High priority bioterrorism agents
- smallpox
- anthrax
- plague
- botulism
- tularemia
- hemorrhagic fever
Any pathogenic microorganisms can be used in a bioterrorism attack
49
Major aspects of preparation for bioterrorism
- community based surveillance
- notification of the public if a high risk situation is detected
- strict measures and public education
- funding for studying pathogenic organisms, developing vaccines, etc.
- strict guidelines and restrictions for purchasing and transporting pathogens
- mass immunization
- increased protection if food and water supplies
- training personnel to diagnose and treat properly
- establishing emergency policies
- investigation of threats
Improving healthcare facilities’ ability to deal with an attack
- improving communications
50
Hand washing
- single most important method used to practice aseptic technique
- most effective way to prevent the spread of infection
51
Regular hand washing
-plain soap and water
- routine cleaning of the hands
- visibly dirty or soiled with body fluids
52
Antiseptic handwashing
- anti microbial soap and water
- before invasive species, in critical care units, caring for patients on precautions, other circumstances
53
Antiseptic hand rubs(waterless hand washing)
- alcohol based cleaners
- not visibly dirty, not soiled with bloods or fluids
54
Five essential times to wash hands
- before touching a patient
- begin a clean or aseptic procedure
- after body fluid exposure or risk of exposure
- after touching a patient
- after touching a patients surroundings
55
Other times to wash hands
- when arriving and before leaving the facility
- after contact with patients intact skin
- before moving from contaminated site to clean site
- any times hands become contaminated during a procedure
- before and after the use of gloves
- any times gloves are torn
- before and after handling a specimen
- after contact with any soiled or contaminated item
- after picking up any item off the floor
- after personal use of the bathroom
- after coughing, sneezing, or using tissue
- before and after and contact with mouth or mucous membranes
56
Principles of hand washing
- soap is a cleansing agent, removes germs through sudsy action and alkali content, pathogens are caught in suds and rinsed. Bar soap can contain microbes
- warm water is less damaging they hot water. Creates better lather than cold water
- friction must be used the help rub pathogen from the surface of skin
- all surfaces in the hands must be cleaned
- fingertips just be pointed downwards. Prevents water getting on firearms and recontaminating clean hands
- dry paper towel must be used to turn faucet on and off. Prevents contamination of hands. Pathogens travel easier through a wet towel
57
Nail cleaning
- nails must also be washed with an orange stick or brush
- if nails are not visibly dirty, they can be rubbed against the palm of hand
- artificial nails can harbor organisms and king nails can puncture gloves
58
Waterless hand cleaning
- proven safe
- provide antisepsis and have a moisturizer to prevent drying
- rub hands vigorously, apply to all areas of hand
59
Blood borne pathogens
Pathogens present in blood. Blood and other fluids are a major way pathogens are spread
60
Blood borne pathogen standards
- develop written exposure control plan
- identify all employees who have occupational exposure to blood or potentially infectious materials
- Provide HBV virus free to all who have exposure
- personal protective equipment(PPE) available in appropriate sizes in accessible locations
- adequate hand washing facilities and supplies
- worksite is clean and sanitary. Decontaminate surfaces that come into contact with infectious material or blood, dispose correctly
- enforce no eating, drinking, etc. in areas that can become contaminated
- appropriate containers labeled and color coded for sharps and other wastes.
- signs at the entrance to areas with bio hazardous material exposure: label materials with biohazard symbol
- medical evaluations for employees who had an exposure
- training about regulations and biohazards
61
Needle stick Safety Act
Employers are required to:
- use safer medical devices(retracting needles, shielded catheters)
- update exposure control plans when new equipment is introduced
- employees exposed to injuries from contaminated sharks must be included in a multidisciplinary team that selects safer devices.
- maintain sharps injury log
62
Standard Precautions
Rules developed by the CDC to prevent the spread of
infection
Must be used in situations in which providers may come into contact with:
- blood or blood containing fluids
- fluids, secretions, excretions
- mucous membranes
- non intact skin
- tissue or cell specimens
63
Basic rules of standard precautions
Hand washing:
- before and after contact with patient.
- if Contaminated with blood or fluids
- before and after using gloves
Gloves:
- whenever contact with blood, fluids, etc. is possible.
- handling contaminated items, performing invasive procedures.
- change between patients or if contaminated
Gowns:
- must be worn during procedures that can cause splashing of blood or fluids
- only worn once
- not worn out of patient rooms or care areas
Mask and Eye protection:
- must be worn during procedures that produce splashes or sprays of blood or fluids
- prevents exposure of mucous membranes to pathogens.
- masks should be worn once, then discarded, change every 30 minutes.
- eyewear can be cleaned, disinfected, and reused
Sharps:
- extreme care must be taken
- disposable needles just be uncalled and attached to a syringe, placed in container, which just not be emptied or reused.
- spills must be cleaned immediately. Gloves must be worn to dispose of waste. Injuries just be reported immediately
64
Autoclave
A piece of equipment that uses steam under pressure or gas to sterilize equipment or supplies
- most efficient way of sterilizing most articles. Destroys ALL microorganisms
- autoclave indications are used to identify sterilized articles
- different articles require different times and pressures, different loads
- sterilized items should be stored in clean areas
65
Chemical Disinfection
Process in which chemicals are used for aseptic control, most do not kill spores or viruses(hence disinfection)
- used to disinfect instruments that don’t penetrate body tissue(dental instruments, scissors) and items that would be destroyed in an autoclave
66
Chemical Disinfection Solutions
- Some solutions must be diluted or mixed
- Items should be separate
- some can be reused others must be discarded
Common Solutions:
- 90% isopropyl alcohol
- formaldehyde-alcohol
- 2% phenolic germicide
- 10% bleach solution
67
Ultrasonic units
Used to remove dirt, debris, etc from instruments before sterilization. Does NOT sterilize
- uses sound waves. Produces microscopic bubbles which explode when impacting objects (cavitation), drive solution onto object
-all solutions are toxic
68
Surgical asepsis
Procedures that keep an object or area free from living organisms
69
Sterile field
Designated area free from all microorganisms
- clean, uncluttered area required when working with sterile supplies
- sterile objects can’t touch no sterile objects. Considered not sterile anymore
- don’t reach overtop a field. Can cause microbes to fall
- avoid coughing, sneezing, etc.
- all sterile items must be checked carefully. Should not be more than 30 days after sterilization
70
Techniques to remove articles from sterile wrapping
Drop Technique:
- partially open wrapper and hold upside down until articles drop onto field
- gauze pads, dressings, small items
Mitten Technique:
- Wrapper is opened and loose ends are grasped around wrist with opposite hand.
- bowls, drapes, linen
Transfer forceps:
- Sterile forceps are used to grasp articles, pointed downward
- cotton balls, small items, articles that cannot be removed otherwise
71
Communicable Disease
Caused by pathogenic organisms that can be easily transmitted (Tuberculosis, wound infections)
Spread by:
- direct contact with patient
- contact with dirty linen, equipment, supplies
- contact with blood, fluids, etc.
72
Epidemic
Occurs when a communicable disease spreads rapidly and affects a large amount of people at the same time
73
Pandemic
Outbreak of disease over a wide area, affects large proportion of population(larger epidemic)
74
Transmission-based precautions
Method of caring for patients who have communicable diseases.
- Provide extra protection against specific diseases or pathogens to prevent their spread.
- type of precautions depend on causative organism of disease, how it is transmitted and whether the pathogen is antibiotic resistant
75
Clean
Objects don’t contain disease producing organisms. Minimal chance of spreading disease
76
4 main types of precautions
Standard precautions, airborne precautions, droplet precautions, contact precautions
77
Standard Precautions
- used on all patients
- patient must be placed in private room f they contaminate environment or do not assist in maintaining hygiene
78
Airborne precautions
- Used for patients known or suspected to be infected with pathogens transmitted by airborne droplet nuclei. Particles of evaporated droplets that contain microbes, remain in air or dust particles(measles, chickenpox, TB)
In addition to standard precautions:
- patient must be placed in an airborne infection isolated room (AIIR), door shut
- air in room must be filtered before circulated to other areas, or discharged outside
- each person must wear respiratory protection
- people susceptible to measles or chicken pox should not enter
- patient should not be moved. If essential, patient must wear surgical mask
79
Droplet Precautions
Used for patients known or suspected to be infected by pathogens transmitted by large droplets expelled by coughing, talking, etc. (pneumonia)
- in addition to standard precautions:
- patient should be placed in private room. If not available, 3 feet should separate patient
- masks must be worn when entering
- if transport is essential, patient must wear surgical mask
80
Contact Precautions
Must be followed for any patient known or suspected to be infected with epidemiological microorganisms that can be transmitted through direct or indirect contact (GI, respiratory, skin, or wound infections caused by multi-drug resistant organisms)
In addition to standard precautions:
- patient should be placed in private room. If not available, place in room with patient with active infection of same organism
- gloves just be worn when entering
- gloves must be changed after having contact with any material that may contain high concentrations of microbe
- gloves must be removed before leaving room, hands washed with anti microbial agent
- gown must be worn, removed before leaving
- transport of patient only when essential
- room and items should be cleaned daily
- patient-care equipment should only be used for that patient, left in that room. If not possible, equipment must be cleaned and disinfected before use on other patient
81
Ebola Virus Disease (EVD) Precautions
First outbreak to reach epidemic proportions was in West Africa, 2014
Caused strict CDC guidelines:
- patient should be placed in AIIR, restricted visitation
- equipment is dedicated to the patient. Use of needles and blood draws are limited
- POE is priority. Double gloves, masks. Hygiene is essential. PPE should be removed in separate room
82
Protective or Reverse Isolation
Refers to methods used to protect certain patients from organisms present in environment. Mainly used for immunocompromised patients.
In addition to standard precautions:
- patient is usually placed in clean and disinfected room
- frequent disinfection while room is occupied
- anyone entering must wear clean or sterile gowns, gloves, masks
- all equipment should be clean, disinfected, or sterile before brought in
- special filters may be used to purify the air
- every effort to protect patient from microbes
