Infection Control Flashcards
Nonsocomial Infection
-a hospital acquired infection
Pandemic
-infection that is widespread and affects a large area
Epidemic
-an infection that is localized
Where is fungi found?
- surface of skin
- they like dark, moist places
Can fungi grow even if illness is not present?
yes
How are fungal infections treated?
-topical medication
What are some examples of fungal infections?
- ringworm (worst)
- athletes foot
- yeast infection
- oral thrush
Parasites
- single celled
- divide within a host
Do parasites need a host?
Yes, but their eggs can survive outside of one.
How are parasites contracted?
- ingestion (food and water)
- water contaminated with feces
- stepping in infected feces
- broken skin (penetrate through cut or scratch)
What is a possible illness caused by mosquito bites?
malaria
Is malaria severe?
Yes, it can lead to death.
Protozoa
-toxoplasmosis from food which causes dysentery
What is dysentery?
-bloody, foul smelling diarrhea
Giardiasis
-contracted from contaminated water with the protozoa giardia
Helminths
-roundworms and tapeworms in/on body
Ectoparasites
- mites, fleas, ticks, lice
- live on skin
What area of the body does C. Diff. infect?
- GI tract
- Lg intestine
Why is C. Diff. a concern?
- soap and water is the only thing that can clean it
- not easy to kill with antibiotics
What are the 3 protective isolations?
- airborne
- contact
- droplet
What items are used for PPE?
- gloves
- mask
- gown
- goggles
- face shield
When is it important to change gloves?
- torn
- soiled
- dirty
- leaving a room
What does PPE stand for?
personal protective equipment
Which strain of influenza causes an epidemic?
A, B
Which strain of influenza causes a pandemic?
A
Which part of a population do pandemics affect?
- everyone
- especially children, elderly, and those with compromised immune system
When do you uncover sharps?
-right before you use it
When do you put the cover back on sharps?
never
When do you remove a needle from a syringe?
never
When do you dispose of sharps?
ASAP after use
What are essential criteria for a sharps container?
- lid
- biohazard sign
- puncture proof
- opening
- fill line
What are potential hazards of sharps?
- injury
- infecting yourself
- infecting someone else
What factors could decrease someone’s immunity?
- youth
- old age
- illness
- fatigue
- stress
- certain treatments or medications
What do you do following a blood exposure?
- blood work of source blood (investigation)
- clean with soap and water
- if you have a cut, make it bleed
- report it ASAP
Bacteria
- mostly good
- survives almost anywhere
- no membrane
- treated with antibiotics
Virus
- bad
- requires a host
- protein coat
- treated with vaccine
What are some examples of bacterial infections?
- pneumonia
- meningitis
- food poisoning
What are some examples of virus’?
- hepatitis
- chicken pox
- HIV
- influenza
- ebola
- rabis
RPAP
Routine Practices and Precautions
What does MRSA stand for?
Methicillin Resistant Staphylococcus Aureus
-aka staph infection
What part of the body does MRSA affect?
- skin
- boils, blisters, peeling skin
- can spread to blood, bones, heart, lungs, etc.
Why is MRSA a concern?
- resistant to antibiotics
- usually occurs in people who are already in hospital or care home
- associated with invasive procedures (surgeries)
What does VRE stand for?
Vancomycin Resistant Enterococcus
What area of the body does VRE affect?
- intestines
- female genital tract
- urinary tract
- bloodstream
- wounds associated with catheters or surgical procedures
Why is VRE a concern?
- resistant to antibiotics
- more difficult to treat
Pathogen
-bacteria, virus, fungi, parasite, etc. that cause disease
Infection
-invasion of an organism’s body tissues by disease causing agents
Infectious Disease
-disorders caused by organisms (bacteria, virus’, fungi, parasites) that cause disease in humans
Host
-human, animal, etc.
Microbe
-microscopic organism which can exist in it’s single celled form or in a body
Are antibiotics affective for virus’?
No.
Antiseptic
-stops the growth of bacteria
Disinfectant
-kills bacteria
Incubation Period
-the time you are infected, but not showing symptoms
What do isolation signs tell us?
- stop
- find a nurse
- what PPE is needed
- what kind of isolation it is
DMARDs
Disease Modifying Anti-Rheumatic Drugs
Examples of Disinfectants
- bleach
- lysol wipes
- vinegar (natural)
Examples of Antiseptics
- mouthwash
- alcohol
- polysporin
- iodine
- creams for infections
Droplet Diseases
- pertussis (whooping cough)
- meningcoccal disease
Contact Diseases
- MRSA
- VRE
- norovirus
- C. Diff.
Airborne Diseases
- TB
- measles
- chicken pox
- shingles
Droplet Precautions
- private room or 2m with a curtain pulled
- staff wear mask and eye wear
- patient wears mask when leaving room
Contact Precautions
- private room or with people with same disease
- staff wear gloves and gowns
Airborne Precautions
- negative pressure room
- staff wear N95 mask
- patients wear a mask out of room
What are some current challenges keeping up with infection control programs? (5)
- new infections
- resistant organisms
- drug cost increase
- staff shortages
- making sure everyone is following standard practices
Under what circumstances must you wash with soap and water rather than sanitizer? (5)
- visibly dirty
- after the washroom
- after using harmful chemicals
- before eating or preparing food
- if hands are wet
- when in contact with C. Diff.
When to put on PPE.
-before contact with patient
When to take off PPE.
- at doorway, before leaving
- mask outside of room
What order to you put on (don) PPE?
- gown
- mask
- goggles
- gloves
What order do you take off (doff) PPE?
- gloves
- goggles
- gown
- mask
Expanded Precautions
- patient is known to have infection
- airborne, contact, droplet
Standard (universal) Precautions
- assuming what a patient may have
- assuming blood or bodily fluid is contaminated
- proper PPE to prevent transmission, depending on what the patient may have
Antigen Shift
-new subtype
Antigen Drift
-mutation
Phases 1-3 of Influenza
- mostly animals
- some humans
What occurs in phase 4 of influenza?
- human to human transmission
- increased cases
- almost at peak
What occurs in stages 4 and 5 of influenza to cause a pandemic?
-widespread transmission
What occurs in stages 5 and 6 of influenza to cause a pandemic?
-widespread transmission
What occurs in the post pandemic phase of influenza?
-disease activity is at normal seasonal levels
How long before the flu vaccine is effective?
- at least 2 weeks
- can take 4 to 6
What is in the flu vaccine?
- part of the virus
- chicken egg proteins
What types of the flu does the flu vaccine cover?
- influenza A
- influenza B
What are 3 major blood borne pathogens?
- hepatitis B
- hepatitis C
- HIV
Symptoms of Cold
- sneezing
- stuffy nose
- sore throat
Before disinfection, what percentage of probes are found to have bacteria on them?
- 8%
- 36 different species
Routine US Procedures
- wiping probe, handle and cord after every patient
- intra cavity probe must undergo high level disinfection (HLD)
What do you do if a patient is on isolation precautions?
-HLD (high level disinfection)
Sani Cloth Plus
- kills most bacteria while still maintaining the transducer
- kills E Coli, MRSA, TB, Pseudomonas, Staph Aureus, Salmonella, VRE, Herpes Simplex, Influenza A and RSV
Problems in US Dept.
- time
- space
- training
- knowledge
- clear identifiers
Benefits of the Trophon EPR
- safe (enclosed)
- protects environment and workers
- no special equipment needed
- more effective (staff can multitask)
- easy to use
- compact
- easily moved
How to Use the Trophon
- push ON in upper right corner
- screen will message WARMING UP and once completed the screen will say LOAD PROBE
- the probe must be CLEAN and DRY
How to Position the Probe in the Trophon
- open chamber door
- the probe is help by 2 clamps
- short sleeve at the back of the handle covering the electrical cable (probe gland)
Probe Gland
-part of the trophon that covers the electrical cable
Method to Load Probe in Trophon
- put on gloves
- hold probe by hand
- press top of probe gland into the gland seal
- push the probe electrical cable into the cable clamp (@ top of chamber)
- probe must be straight (not touching walls or bottom of chamber)
- put in chemical indicator
- close chamber door
The Chemical Indicator
- a single use chemical indicator is used for each disinfection cycle
- indicator should be red when placed on the floor of the device chamber
- colour assessment charts for successful disinfection is different for each box of chemical indicators (only 1 box may be open at a time)
What do you do if trophon states CYCLE FAILED?
-start new disinfection cycle from the beginning
What do you do if trophon states CYCLE COMPLETE?
-manual inspection of the chemical indicator and probe
Where is the trophon cartilage inserted and what does it contain?
- on side of device
- hydrogen peroxide for HLD
How does the trophon work?
-ultra fine hydrogen peroxide mist enters the chamber via side ports and gently swirls around to cover the entire surface of the probe and it’s handle
PSHSA
Public Service Health and Safety Association
Infection Control Program
- update immunizations
- staff influenza vaccination
- TB screening
- exposure prevention and management
- post exposure prophylaxis
- health and safety education
RPAP
Routine Practices And Precautions
-practices that all patients, staff and visitors need to follow
PHO
Public Health Ontario
PIDAC
Provincial Infectious Disease Advisory Committee
PHAC
Public Health Agency of Canada
JHSC
Joint Health and Safety Committee
How often is inspection ventilation systems done?
-every 6 months
How many complete air exchanged do negative pressure rooms have per hour?
12
What is a blood borne pathogen?
-infectious microorganisms in the human body that can cause disease in humans
Examples of Blood Borne Pathogens
- hepatitis B (HBV)
- hepatitis C (HBV)
- human immunodeficiency virus (HIV)
How can infected blood enter your system?
- mucous membranes
- blood
- body fluids
Potentially Infected Fluids
- semen
- vaginal secretions
- CSF
- synovial fluid
- pleural and peritoneal fluid
- amniotic fluid
- saliva
Do most exposures result in infection?
No.
What do we do following a blood exposure?
- wash needle sticks and cuts with soap and water
- flush splashes to nose mouth or skin with water
- irrigate eyes with water or saline
How can occupational exposures be prevented?
- wear PPE
- conscious of environment you’re in
- proper handling of sharps
3 Most Common Blood Borne Pathogens
1) HBV (hepatitis B virus)
2) HCV (hepatitis C virus)
3) HIV (human immunodeficiency virus)
Is HBV spread from sharing utensils, pools, hugging, kissing, coughing or sneezing?
No.
How can the public contract HCV?
- blood
- sex
Is it easier to catch the flu or HCV?
-flu
How can HIV be contracted?
- blood exposures
- sex
If you have received the Hep B vaccine and developed immunity, could you still get the infection?
No.
Is there a risk of HBV exposure to intact skin?
No.
How many more times infectious is HBV than HIV?
50 to 100 times
Is there a risk of HCV to intact skin?
No.
What is the risk of exposure to non intact skin for HIV?
-less than 0.1%
The annual number of occupational HBV infections has decreased by ___% since the availability of the Hep B vaccine. (1982)
95%
__% of healthcare workers have HCV.
1
__% of US population have HCV
3
In a period of 16 years, CDC has received reports of ___ documented cases and ___ possible cases of occupationally acquired HIV infection.
57
138
Treatment for HBV Exposure
- vaccine
- should be tested 1 to 2 months after to make sure vaccine is effective
- hep b immune globulin (HBIG)
HCV Treatment
-immune globulin and antiviral therapy are not recommended after exposure
HIV Treatment
-PEP (post exposure prophylaxis)
What if the exposure to blood is from someone whose infection status is unknown?
- ask if they are infected
- test their blood
- if they do not allow, we assume they are infected
How soon should treatment start after a blood exposure?
ASAP
HIV Drug Risks
- may have serious side affects when interacting with other medications
- very important to tell person managing any medications you are taking
Can pregnant/breast feeding women receive the Hep B vaccine or HBIG?
Yes, there is no harm to the fetus.
Signs of Hepatitis
-liver is unable to process lyric acid (accumulates in blood)
HIV Follow Up
- ASAP
- report any flu symptoms (fever, muscle aches, tiredness, swollen glands, etc.)
What are the precautions during follow up period of HBV?
-none after receiving treatment
What are the precautions during follow up period for HCV?
- none
- risk of infection is low
What are the precautions during follow up period for HIV?
-for the first 6 to 12 weeks take all precautions to prevent transmission
How many times do our hands touch our face an hour?
50
What do sterile trays prevent?
-transmission of microorganisms to patients
When are sterile trays to be opened?
-directly before exam
When opening a sterile tray, which flap do we open last?
-the one closest to us
