Infection Control Manual Flashcards
Who is the first point of contact for exposure notification?
Duty safety officers
What are the OSHA Standard and NFPA standard relevant to BBP?
OSHA BP Standard 29 CFR 1910.1030 and NFPA 1581
Endemic?
refers to levels of a disease that are normally found within a given population
Engineering controls?
in the context applied in this text, refers to the equipment that is designed to isolate or remove BBP hazard from the workplace
Environmental Surface?
Interior pt care areas, both stationary and in vehicles, and other surfaces not designed for intrusive contact with the pt or contact with mucosal tissue
Epidemic?
refers to diseases that “visit” a population, or are not in natural occurrence or amount relative to what is expected to be seen
Epidemiology
the medical discipline that studies the prevalence and effort of disease on populations
Occupational exposure?
“reasonably anticipated contact” by way of injection, ingestion, or absorption through skin, eye, mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials, or inhalation of airborne pathogens, that may result from the performance of an employee’s duties
Parenteral exposure?
piercing of the mucous membranes or the skin barrier due to such events as needle sticks, human bites, animal bites, cuts and abrasions
Percutaneous?
The piercing of unbroken skin by needle punctures, but also refers to topical absorption through the skin
Work Practice Controls
adoption of actions that reduce the likelihood of exposure by altering the manner in which a task is performed
What are some examples of engineering controls?
- Sharps with engineered injury protection
- needless systems
- containers holding infections products made of plastic instead of glass
What are some examples of work practice controls?
- protocols that direct use of PPE
- Hand hygiene regimens
- handling of sharps by only the provider who initiates use of the device
What are the primary means of minimizing occupational exposures?
Engineering and work practice controls
How long must medical records of occupational exposure be kept for all employees?
30 years past the employee’s date of separation from that organization
How do FRD personnel make record of an exposure event?
FRD-314 Infectious Disease Exposure Report
How often shall BBP training be given?
When hired and annual refresher
What shall standard are pt care gloves certified to?
NFPA 1999
What shall a PIC kit contain?
- 2 pairs of gloves
- 2 or more N95 masks
- eye protection
- disposable sleeves
- portable barrier device for mouth to mouth
- waterless hand sanitizer
- trauma shears
- penlight
When do PIC kits get inspected?
As part of monthly gear inspection
Exam gloves are considered part of the uniform and shall be kept?
Belt worn glove pouch
N95 shall be worn for the following
- Pt’s physical condition or medical hx suggests they have an airborne infectious disease
- Suspicion or confirmation of the existence of active pulmonary TB, meningitis, chicken pox, measles, whooping cough, and any other suspected illness of airborne transmission
- procedures with high risk of body fluid aerosolization to include intubation and suctioning, childbirth, cannulation and tamponading of blood vessels under abnormally high pressure and where the potential for blood or body fluid splashing or spitting exists
What changes almost every “risk” splash exposure to “non risk”?
wearing eye protection
OSHA mandates what about PPE provided to those who work in environments that could potentially contaminate the PPE with infectious soiling?
must be removed prior to leaving that workplace and that it is the responsibility of the employer to provide means to launder that PPE.
Per OSHA’s mandate for wear and laundering PPE does it matter if the PPE becomes soiled or not?
no, only whether or not the garment is worn where it could possibly become contaminated
Can uniforms worn during the work day be worn or laundered at home?
No
Light Contamination?
considered to be non-penetrating soiling of the outer surface layer of the fabric
Heavy Contamination?
considered wet soiling that soaks through the fabric
Gross Contamination?
refers to large areas of the fabric soaked through all layers, and soiling with particulate matter such as vomit
Uniforms that sustain light contamination are cleaned how?
station washing machine
Uniforms that sustain heavy contamination are washed how?
Rinsed of visible soiling in the station slop sink prior to being washed in the washing machine
Uniforms that sustain gross contamination are washed how?
Gross decon prior to washing: rinsed in slop sink with large amounts of flowing and draining water, and then soaked with an antibacterial prewash agent in the station laundry slop sink prior to being washing in the washing machine
After the slop sink is used for the removal of potentially infectious contaminated soiling how is it to be cleaned?
Disinfected with bleach solution
When using the washing machine and dryer what settings shall be used?
Hot water and Hot dry
What provides the measure of disinfection when washing and drying?
The hot heat setting of the dryer and drying to complete dryness
If suppression PPE sustains blood or fluid contamination how shall it be cleaned?
sent to gear center
Prior to sending any gear to gear center for cleaning following a contamination what shall be done?
Gross decon, double red bagged and marked biohazard.
What is the single goal of all components of an infection control plan?
reduce exposures to personnel
Standard Precautions definitions fall into two categories:
Work Practice Controls: good hang hygine, cleaning and disinfecting regimens, management of biohazard waste, sharps injury prevention
PPE
What are the practical means by which barriers are placed to minimize or eliminate the potential for transmission of disease through occupational exposures?
work practice controls and engineering controls
What are work practice controls?
prescribed practices employed by personnel either as personal habits or as regimens described in protocol
What are engineering controls?
safety features built into products used in injury prone environments specifically for the purpose of limiting injury or exposure
What is the most significant barrier to transmission of infectious diseases?
Good hand hygiene
When using waterless antimicrobial hand cleanser if hand washing facilities are not available is it necessary to wash hands with soap and water once such facilities are avaliable?
yes
Shall IV’s, IM and SQ needle therapies be done in a moving vehicle?
Not unless there is a life-saving need
If a citizen requests sharp disposal where shall they be directed?
Their personal physician or to the VA Dept of Environmental Quality
If a “risk” exposure occurs and the pt refuses both offer of transport and blood draw who is to be called and what are they to do?
Safety officer or ICPO and they are to initiate the process of gaining a court order for the drawing of the source pt blood
What is the only approved medical waste storage in fire stations?
Sharps containers on pt transport units
Are P2 shuttles to be disposed of into the 8 quart container?
No, they shall be disposed of per incident at the hospital
At what point shall the 8 quart containers be disposed of?
When they become approx. 2/3 full
All contaminated non-sharps items are to be placed?
In biohazard labeled red bags, with grossly contaminated items doubled red bagged.
Can any infectious waste be left at the incident scene?
No
Can non infectious trash be left at the incident scene?
No, and if not transported to the hospital for disposal it may be disposed of in FD dumpsters, however under no circumstances is any trash generated at the incident scene allowed to be disposed of into fire station living area trash cans
What color is the biohazard label?
fluorescent orange
What is a substitute for a biohazard label?
red bags or red containers
Can FRD personnel assist in the collection, removal or transportation or body parts, tissue remnants or bone fragments?
No
What is the most effective way to assure proper disinfection of larger pieces of equipment such as backboards?
Using a 1 part bleach to 9 parts water solution, allowed to remain wet for a maximum of 10 minutes, flushed with water and towel dried
What act provides first responder coverage for exposures?
Ryan White act
All FRD providers that are determined to have had a source pt found to be positive for any disease for which there is presumptive coverage in VA law what needs to be completed?
online injury/illness claim with the employer’s worker’ comp claim administrator
Risk exposure?
exposure to BBP as a specific event in which there is contact with the eye, mouth, other mucous membranes, non-intact skin, intact skin for a period longer than 30 minutes, or parenteral contact with blood or other potentially infectious material of another person that results from the performance of the employee’s duties
Non-Risk Exposure?
blood or body fluid contact with intact skin for less than thirty minutes, to the work uniform, or PPE
Airborne pathogen “risk” exposure
any unprotected contact with a person known or suspected of having active TB, meningitis of unknown etiology, varicella zoster (chicken pox), measles, pertussis (whooping cough), or other airborne transmission pathogen
Non-Risk airborne exposure
if a N95 was worn
Airbone droplets pathogens are:
dependent on the respiratory droplet for transmission and have an effective range of the distance it can be coughed or sneezed, generally 6’
Airborne particle pathogens can be kept afloat by?
ventilation system air movement
For exposures from blood and body fluid splashes, vomit and spit providers shall immediately?
flush or rinse the foreign substance from their eyes, mouth or skin
Any skin area affected shall be? (animal bites too)
thoroughly washed with soap and water and thoroughly flushed
Who makes the determination if it is a risk or non-risk exposure?
The safety officer
If an exposure occurs and the source patient refuses transport to the hospital what is the crew to do?
- notify EMS super, and SO (can be made over radio but no mention of exposure shall be given, encouraged to call UFO to make this notification)
- stay with the source pt unless safety issue
Shall an infectious disease exposure event by logged in the station log book?
No
Shall an exposure be referenced in the incident narrative of the PCR?
yes, generalized and shall not make identification by name of exposed personnel
If you get exposed off duty and cannot reach a SO who are you to call?
UFOD
If you are exposed while providing service while off duty, out of area is it considered part of duty service?
Yes, no difference in while at work or not
Treatment vs. Prophylaxis ?
treatment refers to management of a condition that is already established
prophylaxis refers to medical management as a protective counter measure to the development of the condition
Potentially infectious exposure events to the “ordinary disease of life” will require personnel to use what kind of leave?
sick leave, the course of the disease will be transient and of short duration and those the use of s/l is appropriate
What do we do for a good sam exposure?
Notify SO who notified health department, fill out a FRD 399 “Good Samaritain” Possible Citizen Exposure Report
Where do we obtain FRD 399 from?
online ordering
IF an FRD employee is bite by any animal with an injury that breaks the skin what must happen?
Go to the hospital for treatment, and a full injury packet must be filled out
