Infection Control Flashcards
What is an infection?
an invasion of the body/part of body by a pathogenic agent producing an injurious effect
What are pathogens?
Include Examples of Pathogens
microorganisms capable of causing disease
Ex:
- Bacteria
- Fungi
- Virus
- Parasite
What are three ways you can categorize bacteria ?
- By Shape
- By Staining
- By Oxygen Requirement for growth
What are the different shapes of bacteria?
- Cocci (spherical)
- Bacilli (rod-shaped)
- Spirochetes (corkscrew)
What are the different types of gram staining for bacteria?
- Gram-Positive: Thick cell wall (Stains Violet)
- Gram-Negative: Complex cell wall (do not stain)
What are the different types of oxygen needs for bacteria?
- Aerobic (need oxygen)
- Anaerobic (can live without oxygen)
Funal infections are typically ________ to treatment.
resistant
What is the most prevalent pathogen in the hospital?
Bacteria
What are fungi?
Name examples of Fungi?
- Plant-like organisms (mold and yeast) found in air, soil, and water
- Ex: Ringworm, Athletes foot
What are viruses?
Name some examples of Viruses.
Smallest of all microorganisms (needs to be seen with electron microscope)
- Ex: Covid-19, Comon Cold, Hep. A/B/C, HIV
What are parasites?
Name examples of Parasites
- Organisms that live on or in a host and rely on it for nourishment
- Protozoa (Malaria, Taxoplasmosis)
- Helminths (worms, flatworms, round)
What are oppurtunistic pathogens?
Name an example of oppurtunistic pathogens.
- microorganisms that may become pathogenic in certain circumstances
- Ex: E. coli in intestine moves to the urinary tract, and now PT has UTI
What is virulence?
Name an example of Virulence
- Degree of pathogenicity; increased ability to produce disease
- Ex: COVID-19 continues to mutate = more virulent
What are the causes Health-care associated infections?
caused by organisms acquired from other people (exogenous) or organisms from microbial life within a person (endogenous)
What are Health-care associated infections?
an infection acquired in the hospital during the course of treatment for other infections; anything acquired after 72hr of admission
Compare Nosocomial Infections & Iatrogenic infections
Nosocomial (Simialr to HAI):
- Infection taking place/originating while in hospital
Iatrogenic Infectios:
- Acquired as a direct result of treatment/procedure
- Ex: Indwelling foley catheter can cause a SEVERE catheter associated UTI (CAUTI)
What is Cleansing?
Soap and water; Wear gloves
What is Disinfecting?
Usign chemical preparations to destroy pathogenic organisms except SPORES
What is Sterilizing?
destorys all microorganisms including spores via moist heat, gas, radiation
What are the 3 factors affecting an organismâs potential to produce disease?
- # of organisms/virulence
- Competece of PT immune system
- Length, intimacy of contact b/w human, pathogen
Describe Chain of Reaction:
Infectious Agent
(Description, Intervention)
Description:
- Pathogen that causes infection
- (Bacteria, fungi, virus, parasite)
Intervention:
- HH
- Sterilization
- Antimicrobial drugs
Describe Chain of Infection:
Reservoir
(Description, Intervention)
Description:
- Where the infectious agent lives/multiplies
- (human, water, soil, milk, animals, fomites)
Intervention:
- Transmission-Based Precautions
- Sterilization/Disposable supplies
Describe Chain of Infection:
Portal of Exit
(from reservoir)
(Description, Intervention)
Description:
- How infectious agent leaves the reservoir
- (broken skin, mucous membrane, GI, GU, RT, blood/tissue)
Intervention:
- HH
- PPE (Gloves if contact w body fluids)
- Cover nose/mouth when sneezing
- Dry intact dressing
Describe Chain of Infection:
Means of Transmission
(Description, Intervention)
Description:
- Direct Contact
- Indirect Contact (fomites, airborne/droplet, vectors)
Intervention:
- HH
- Pesticides
- Adequate refrigerations
Describe Chain of Infection:
Portal of Entry
(Description, Intervention)
Description:
- How infectious agent enters susceptible host
- (broken skin, mucous membranes, GI, GU, RT, blood/tissue)
Intervention:
- HH
- PPE
- Proper disposal of needles/sharps
Describe Chain of Infection:
Susceptible Host
(Description, Intervention)
Description:
- Person at risk for infection
- (ex: elderly/very young, immunocompromised, ill)
Intervention:
- Immunization
- Screen healthcare staff
Compare Direct Contact vs. Indirect Contact
Direct Contact:
- infection person/carrier tranmission to susceptible host via touching, biting, scratching, etc
Indirect Contact:
- contact with any contaminated substance/object (ex: fomite)
Airborne Transmission
Small droplets (less than 5 Ξm), long distance
Droplet Transmission
Large droplets (greater than 5 Ξm), 3 ft
Vector Transmission
What are example of Vectors?
What diseases do they transmit?
Athropods; living creatures that transmit an infectious agent to a human, usually insects
- Malaria and West Nile Virus (mosquitos), Lyme Disease (ticks)
What are the four stages of infection?
- Incubation Period
- Prodromal Period
- Full Stage of Illness
- Convalescent Period
I
PLAY
FORTNITE
CONSTANTLY
What occurs during Incubation Period?
- Pathogens enter and multiply
- PT is asymptomatic
- Length of Incubation period varies:
-> Covid-19: 2-14 days
-> Cold: 1-2 days
-> Tetanus: 2-21 days
What occurs in the Prodromal Phase?
Nonspecific/vague SXS, like fever, malasise, and fatigue
Patients are the most contagious during the ________ ________.
Prodromal Phase
What occurs during the Full Stage of Illness?
Specific SXS develop, manisfesting as local or systemic responses
What occurs during the Convalescent Period?
- The PT recovers
- S/XS of the illness disappear
- PT returns to their pre-illness state
What is Innate (Native/Non-specific) Immunity?
What two groups make up Innate (Native/Non-specific) Immunity?
Innate Immunity: restrict entry of foreign antigen via activation of phagocytosis, complement, inflammation and has no immunological memory
- Physiologic
- Inflammatory
Name the components of Physiologic Barriers.
- Mucus
- Macrophages
- Intact Skin (first line of defence)
- Cilia
- Gastric Activity
- Normal Flora
- Flush of Urine
What is the Inflammatory Response of Innate Immunity?
defensive response to injury and infection and aims to destroy microorganisms, prevent spread, and promote repair
Describe the process of the Vascular and Cellular stage of an Inflammatory Response
Vascular Stage:
- Small BV constrict -> vasodilation of arterioles/venules -> increased blood flow -> results in redness and heat. Histamine is released, increasing vessel permeability, which allows protein-rich fluid to pour into the area, causing swelling, pain, and loss of function
Cellular Stage:
- Neutrophils (phagocytes) move to the area -> engulf organisms and consume cell debris.
Exudate, which may be clear (serous), contain red blood cells (sanguineous), or contain pus (purulent), is released from the wound. Damaged cells are then repaired by regeneration or scar tissue formation
What is Adaptive Immunity?
What types of immunity make up Adaptive Immunity?
Body makes Ab in response to Ag and has immunological memory
- Humoral Immunity
- Cell Mediated Immunity
Compare Humoral Immunity vs Cell Mediated Immunity
Include Cell Types and Mechanism of Action
Humoral Immunity
- Cell Type: Involves B- Lymphocyes
- MOA: Produces specific Ab against Ag (IgG, IgA, IgM, IgD, IgE)
- Ag-Ab (immune) complex formed and eliminated from body
Cell Mediated Immunity
- Cell Type: Involves T-lymphocyte (Helper T Cell; Cytotoxic T Cell)
- MOA: Increase # of lymphocytes and destroy cells (APC/Macrophages)
Compare Active Immunity vs Passive Immunity:
Active Immunity: Ab produce in response to Ag (immunization)
Passive Immunity: Ab produced by external source (moms Ab pass through placenta/breast milk)
What are the S/SX of Inflammation (Infection)
- Pain
- Heat
- Swelling (edema)
- Redness (erythema)
- Impaired Fxn
Describe Isolation Precautions:
Airborne Precautions
(Pathogen size, Transmission Method, Diseases, PPE, Room Precautions, Transport Precautions, Visitor Precautions)
Pathogen Size:
- Small (less than 5 Ξm), long distance
Transmission Method:
- Infected person cough, sneezes, talks, and droplet nuclie (reidual particles float in air)
Diseases:
MTV
- Measles (Rubeola)
- TB
- Varicella (Chickenpox)
- Herpes Zoster (Shingles)
- Covid-19
- Smallpox
- SARS
PPE:
- N95 ALWAYS + any additional PPE necessary (standard PPE)
Room Precautions:
- Private room
- Negative air pressure:
-> ðŦ6-12 air-change/hr (AIIR) - Direct exhaust outside OR HEPA filtration if air recirculated
Transport Precautions:
- Limit transport
-> PT must wear surgical mask if leaving
Visitor Precautions:
- Visitor must wear PPE, including Mask
Describe Isolation Precautions:
Droplet Precautions
(Pathogen size, Transmission Method, Diseases, PPE, Room Precautions, Transport Precautions, Visitor Precautions)
Pathogen Size:
- Large (greater than 5Ξm)
- short distance (3ft)
Transmission Method:
- Infected person cough, sneezes, talks
Diseases:
PIMP
- Pneumonia
-> Adenovirus
-> Influenza Type B
-> Streptococcus Type A - Influenza
- Meningitis
- Mumps
- Pertusis (whooping cough)
- Diptheria
- Rubella (German Measles)
- SARS
PPE:
- Wear surgical mask at all times + any additional PPE necessary (standard precaution)
Room Precautions:
- Private room or group with people that have same DZ
- Door can stay open
Transport Precautions:
- Limit transport
-> PT must wear surgical mask if leaving
Visitor Precautions:
- Keep visitor and infected person 3 ft away
Describe Isolation Precautions:
Contact Precautions
(Transmission Method, Diseases, PPE, Room Precautions)
Pathogen Size:
- X
Transmission Method:
- Direct/Indirect Contact
Diseases:
Used on PT with MDRO
- Covid-19
- MRSA
- C. diff
- VRE
- CRE
- CRAB
- Norovirus
- Rotovirus
PPE:
- Gloves and gown ALWYS + follow standard precautions
- Disposable PPE (BP cuff & Stethoscope)
- Hand hygiene for diarrhea (C. diff): SOAP AND WATER ONLY
Room Precautions:
- Private room OR Group w PT of same DZ
Transport Precautions:
- X
Visitor Precautions:
- X
Describe Isolation Intervention:
Protective Environment
(Diseases, PPE, Room Precautions, Transport Precautions, Visitor Precautions)
What are protective enviroments also known as?
Pathogen Size:
Transmission Method:
Diseases:
- Protects PTS who are not infectious but high susceptible to get infection (immunocompromised)
PPE:
- Follow hospital protocols (have on proper PPE before entering protective environment)
Room Precautions:
- Private room
- Positive airflow ; ðŦ12+ air exchange/hr
- HEPA filtration for incoming air
Transport Precautions:
- Mask required if PT if out of room
Visitor Precautions:
- Restricted visits (do not bring flowers/gifts)
AKA:
- Reverse Ioslation
- Neutropenic Precaution
What are Standard Precautions?
- Precautions used for every PT at ALL times when in contact with body fluids/secretions (except perspiration), broken skin, mucous membranes
-> Routine disinfection/cleaning procedures (?)
-> May require additional PPE: Hand hygiene, Mask/Gloves/Gown (if necessary), etc
What are the new additoins to Standard Precautions?
- Respiratory hygiene/cough etiquette
- Safe injection practices
- Wear a mask during spinal canal punctures
Describe Infection Control for:
Covid-19
(Precaution Type, Room Precautions, Transport Precaustions, Visitor Precautions)
Type of Precautions:
- Use Standard Precautions, Airbone Precautions, and Contact Precautions
-> Include eye ptotection
Room Precautions:
- Adequate ventilated single rooms/wards
- If single rooms not available, suspected Covid-19 PT should be grouped together with beds atleast 1 meter apart
Transport Precautions:
- Place facemask on suspected PT
Visitor Precautions:
- Management/exclusion
Provide Examples of Blood-Borne pathogens
- HIV
- Hep B/C
- MRSA
- Syphillis
- Malaria
Describe Blood-Borne Disease:
Hepatitis B Virus (HBV)
(Mode of Transmission, Treatment, Prevention)
Mode of Tranmission:
Parenteral Contact
- Infected blood & blood products
- Contaminated needles
- Transplacental
- Sexual contact
Treatment:
- Supportive TX with acute hepatitis
Prevention:
- HBV vaccine given at 0, 1, & 6 months
- Use PPE
Describe Blood-Borne Disease:
Hepatitis C Virus (HCV)
(Mode of Transmission, Treatment, Prevention)
Mode of Tranmission:
Parenteral Contact
- Skin breaking Activities
-> (tattooing, unsterilized equipment) - Infected blood & blood products
- Contaminated needles
- Transplacental
- Sexual contact
Treatment:
- Supportive TX
- If liver failure occurs
-> TX: Interferon and Ribavirin
â> If condition worsens:
â> Liver Transplant
Prevention:
- No Vaccine
- Use PPE
Describe Blood-Borne Disease:
Human Immunodeficiency (HIV)
(Mode of Transmission, Treatment, Prevention)
Mode of Tranmission:
Parenteral Contact
- Bodily fluids
- Unteriled Equipment
- Exposure to cuts/scratches on hands
- Infected blood & blood products
- Contaminated needles
- Transplacental
- Sexual contact
Treatment:
- Anti-retrovirals
- Nucleoside reeverse transcriptase inhibitors
- Non-nucleoside reverse transcriptase
- Protease inhibitors
- CCR5
- Other TX
Prevention:
- No Vaccine
- Use PPE
Measures to Prevent Blood-Borne Pathogen Exposure:
Standard Precautions
- Hand Hyigiene/PPE
- Safe Injection Practices:
-> Use single dose vials
-> Use disposable needles & syringes
â> avoid recapping needles
-> Prevent contamination of injection eq. & medication
â> place needles/sharps/scaples in puncture-resistant containers - Respiratory Hygiene/Cough Ettiquette
-> Use resuscitation bags
Post-Exposure Management for Blood-Borne Pathogen:
HBV, HCV, HIV
- Wash off contaminated area
- Report incident to immediate supervisor
- Follow hospital policy for exposure
- Begin TX if indicated:
HBV
-> TX: ASAP, No later than 7 days
-> Hepatitis B Immune Globulin (alone or with Hep. B Vaccine)
HCV
-> No TX
HIV
-> Post-exposure prophylaxis (PEP) after high risk exposure
â> Discuss with physician
â> Start within 72 hours, Lasts 4 weeks
Post-Exposure Management for Blood-Borne Pathogen:
Needlestick
wash area with soap and water
Post-Exposure Management for Blood-Borne Pathogen:
Splashes
- Flush nose, mouth and skin with water
- Irragate eyes with clean water, sterile saline, or sterile irrigants
T/F:
You want to discard gloves outside of PT room.
FALSE
T/F
Hand Hygiene is optional after removing gloves.
FALSE.
- Hand hygiene must be performed after removing gloves
Gowns should be used when your uniform is likely to be _______.
soiled
What mask should be used for Airborne Transmitted DZ? Droplet Tranmitted DZ?
Airborne:
- N95
Droplet:
- Surgical Mask
Goggles are used if ____ may occur.
splatters
Faceshields are used for ____ and other ______.
splatters; hazards
When disposing of soiled biohazard equipment, you should________, ________ if its leaking, use ________ for body secretions and place in ________ containers
- bag
- double-bag
- red biohazard bags
- designated
List the supporting defenses for a Susceptible Host
- Hygiene (skin care, bathing, oral hygiene)
- Healthy Nutriton
- Fluid (promote circulation, esp UTI)
- Rest, sleep, decrease stress
- Exercise
- ## Immunizations
