Infection Control 2 Flashcards
contamination is the presence of
any microorganism
is contamination or infection more common?
contamination
bugs=
colonization
infection is cellular injury as a result of (3)
competitive metabolism
toxin production
immune related reaction
pathogen
infectious agent
pathogen
very common:
less common:
hazardous:
caries, periodontal disease
herpes, candida
HIV, hep B
virulence
ability to cause infection and damage ‘easily colonizes, grows rapidly, produces harmful substances, evades/counters body defenses
dose
number of cells of a contaminant
types of innate resistance (3)
physical (skin, mucous membrane)
mechanical (secretions, cilia)
chemical (stomach acid)
acquired resistance
cell-mediated (antibiotics)
immunity
a condition of being able to resist a particular disease especially through preventing development of a pathogenic microorganism
development of disease transmission
source (infected individual)
escape of microbes from source
spread of microbe to new person
entry of microbe into person
requirements of disease transmission (4)
susceptible host
pathogen (sufficient numbers)
portal of entry
mode of transmission
modes of transmission (4)
direct
droplet
inhalation
indirect
direct transmission
broken skin, mucosal contact
droplet transmission
sneezing, coughing
inhalation transmission
suspended microorganisms
indirect transmission
contaminated instruments, surfaces
stages of an infection (4)
incubation
prodromal
acute or period of illness
convalescent or decline
incubation
the time between exposure to a pathogenic organism and when signs and symptoms are first apparent
prodromal
the period between the appearance of initial symptoms and the full development, early signs and symptoms of a disease appear nit mot yet clinically specific or serve
acute or period of illness
signs and symptoms of the disease are most obvious, specific and severe
convalescent or decline
number of pathogens begins to decrease, and the signs and symptoms of illness decline. however, during this period, patients may become susceptible to developing secondary infections because their immune systems have been weakened by the primary infection
causes of disease emergence (5)
microbial changes breakdown in public health measures ecological changes changes in human demographics/behaviors international travels and commerce
sanitization is the process of
physical cleaning to reduce the quantity of microbes and bioburden
sanitization uses
surfaces:
instruments:
disinfectant and paper towels on surfaces
soap and brush on instruments, ultrasonic on instruments
sanitization should be done before
sterilization and disinfection
sterilization
destruction of all microbial forms (including spores)
types of sterilization (3)
heat
filtration
radiation
most common type of sterilization
heat
asepsis is
the exclusion of harmful microorganisms
asepsis is the condition in which
septic (infective) material is absent
asepsis includes the absence of (3)
bacteria, viruses, and other microorganisms
asepsis is typical during
surgery
antiseptics are used on
living tissue
antiseptics as alcohol
coagulates the protein in bacteria
–% solution with water penetrates bacteria and is more effective than 100%
30%
disinfection
destruction of pathogenic microbes
disinfection doesn’t destroy
spores and certain resistant microorganisms
what is our target for cubicle preparation?
disinfection
spauldings classification system
categorizes patient care items by their potential risk of infection
critical items in spauldings classification system
pierce the skin or mucosa
explorers, scalpels, burs. scalers
critical items need
sterilization
semi critical items in spauldings classification system
non-sharp items that enter the oral cavity
amalgam condensers, mirrors, reusable impression traps
semi critical items need
sterilization or high level disinfection
in spauldings classification system, dental handpick must be
heat sterilized
- an exception
- not just high level disinfectant
- handpieces that can’t be heat sterilized shouldn’t be used
non critical items in spauldings classification system
items that don’t enter the oral cavity, but may be touched
bracket table, counter tops, chair controls, light handles., computer keyboard
non critical items need
disinfection or plastic barrier
liquid chemical requirements (5)
surface (or item) cleaned of debris bio burden first adequate contact time correct temperature correct pH correct concentration
high level disinfectant destroys or inactivates
almost all microbial life
high level disinfectant does not kill
spores
high level disinfectant requires extended contact of
3-10 hours
high level disinfectant is also called
chemical sterilants
what type of items use high level disinfectant?
heat sensitive critical and semi critical items
mainly medical items
endoscopes
is high level disinfectant used in dentistry?
NO
intermediate level disinfectant destroys (4)
mycobacterium TB
viruses
fungi
vegetative bacteria
what is used at UMKC to disinfect dental operators surfaces?
intermediate level disinfectant
is alcohol acceptable for instruments or surfaces?
no
does alcohol kill spores?
no
alcohol does not work in the presence of
blood and saliva
low level disinfectant
kills some viruses and fungi
used for floors and walls in dental operators and general house cleaning
administrative controls are the policies, procedures, and enforcement measures targeted at
reducing the risk of occupational exposure to infectious persons
engineering controls are devices which
isolate or remove the risk of exposure to bloodline pathogens in a workplace
examples of engineering controls (3)
instrument cassettes
sharp containers
needed recapping devices
work practice controls
procedures that reduce the likelihood of exposure to infectious materials by altering the manner in which a test is performed
examples of work practice controls (2)
recapping a needle using the one-handed scoop technique
replacing sharps containers when they are full
OSHA: regulated waste (4)
Blood or OPIM in liquid or semi-liquid state
Items caked w/ dried blood or OPIM that may release it
Contaminated sharps
Pathological /microbiologic waste w/ blood or OPIM
regulated medical waste: UMKC (special handling: red biohazard bag) (5)
Solid waste soaked or saturated with blood or saliva contaminated sharp items Anesthetic carpules Scalpel blades Surgically removed hard and soft tissue
guidelines=
standard of care, often written info state laws
original dental CDC guidelines
1986
revised since
patient to DHCP is
most likely
DHCP to patient is
very rare
patient to patient is
very rare
standard precautions
we treat every as if they are infectious
old term: universal
CDC guidelines are concerned with
blood
other body fluids
other body fluids include (3)
blood or not
secretions, saliva
exceptions (except sweat)
mucous membrane exposure
oral
nasal
latex allergy (3)
Type I (immediate) hypersensitivity to natural rubber latex protein
Reactions may include nose, eye, and skin reactions
More serious reactions may include respiratory distress–rarely shock or death
irritant contact dermatitis
not an allergy
dry, itchy, irritated areas
allergic contact dermatitis
type IV delayed hypersensitivity
may result from allergy to chemicals used in glove manufacturing
minimizing contact dermatitis and latex allergy
dry hands completely before donning gloves
use only latex free gloves (we do)
use only gloves w/o powder (we do)
ultrasonic cleaners
Use high-frequency sounds waves and cavitation to loosen and remove debris
16x more effective than hand scrubbing
Less potential to injure self with instrument
instrument sterilization options (4)
Steam autoclave Dry heat Chemical vapor (Ethylene oxide) Chemical immersion (Gluteraldehydes, Quaternary ammonium compounds)
autoclave
Steam under pressure
Most common
Standard cycle: 250º F. @ 15 psi for 20 min
disadvantages to autoclave (2)
dulls cutting edges
rust
flash sterilizers
steam
273º / 30 psi for 3-10 min
Not intended to be used as sole or primary method of sterilization
We don’t have this
dry heat
320º F. (160º C.) for 2 hrs
338º F. (170º C.) for 1 hr.
dry heat advantages (2)
Doesn’t dull cutting edges
Won’t rust (if instruments completely dry)
dry heat disadvantages (3)
long cycle
handpicks won’t tolerate
poor penetration
chemiclave
Steam under pressure with chemical vapor
often formaldehyde
chemiclave
advantage
disadvantage
shorter cycle
chemical vapor hazardous