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Patient Care I > Infection Prevention > Flashcards

Infection Prevention Flashcards

1
Q

In a dental setting what serves as a reservoir for pathogens

A

air water and fomites

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2
Q

Healthcare associated infection (HAI)

A

refers to an infection acquired during the delivery of healthcare in any setting

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3
Q

microorganisms in the mouth and respiratory tract can be transported in ___

A

aerosols, slash/spatter, during dental procedures

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4
Q

Chain of infection (3 elements)

A
  1. a source or reservoir (contaminated air water or fomites
  2. susceptible host (portal of entry receptive to the agent/exposure to an adequate number of sufficiently
    virulent microorganisms)
  3. Mod of transportation (agent from the source to the host)
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5
Q

Infection control strategies intend to do what?

A

break one or more of the links -> preventing disease transmission

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6
Q

Pathogens associated with healthcare are derived from?

A

primarily human sources BUT contaminated objects and environmental sources are also implicated

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7
Q

Who can pass on pathogens

A

someone with an acute infection, in the incubation (subclinical) phase, or is asymptomatic

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8
Q

Factors that affect someone’s susceptibility

A

age
physical conditions
medications
underlying medical conditions
immunizations

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9
Q

consequences of being a susceptible host

A
  1. infected but remain asymptomatic
  2. colonization to symptomatic disease either immediately or after a period of asymptomatic latency
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10
Q

Aerosols

A

a liquid or solid particle less than 50 micrometers in diameter

stay airborne for an extended period before settling on environmental surfaces or enter respiratory tract through inhalation

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11
Q

droplets and droplet nuclei

A

0.5 - 1.0 micrometers in diameter have potential to enter lungs and settle within the pulmonary alveoli (HIGH RISK of infection transmission in the dental office)

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12
Q

Splash and Splatter

A

a mixture of air, water, and/or solid substances larger than 50 micrometers in diameter and are visible to the naked eye (ex. Blood; sneezes)

only airborne briefly - limited penetration to the respiratory system

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13
Q

droplets

A

airborne particles of moisture > 5 unit microns

limited to 3 feet of the source

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14
Q

droplet nuclei

A

residuals of droplets ranging from 1-5 unit microns that dry out while suspended in air.

droplet nuclei may remain in the air indefinitely and travel beyond 3ft from source.

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15
Q

Human hair is how big?

A

60-120 microns wide

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16
Q

percentage of nuclei in the dental office is less than 5 microns in size

A

95%

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17
Q

what size of microns can reach the epiglottis area of the throat?

A

5-10 micron

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18
Q

what size can reach deep down into the bronchi?

A

<5 microns

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19
Q

high speed handpieces ; ultrasonic scalers ; air/water syringes =

A

aerosols

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20
Q

dental plaque is major source of microorganisms, containing how many pathogens?

A

more than 700 known pathogens

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21
Q

how are pathogens transferred

A

direct or indirect contact

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22
Q

direct contact

A

transmission occurs when pathogens are transferred between individuals WITHOUT a contaminated intermediate

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23
Q

what could be a contaminated intermediate?

A

person
object
environmental surface

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24
Q

Indirect contact

A

transmission occurs when pathogens are transferred between individuals VIA a contaminated intermediate person object or surface

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25
Q

Respiratory Transmission

A

ALSO CALLED airborne transmission

may result from inhalation of droplets from inhalation of droplet nuclei

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26
Q

Direct Transmission happens through

A

broken skin
mucosal contact

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27
Q

Indirect transmission happens through

A

contaminated instruments
surfaces

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28
Q

Droplet transmission through

A

sneezing
coughing

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29
Q

Virulence is

A

ability to cause infection and damage

easily colonizes
grows rapidly
produces harmful substances
evades / counters body’s defenses

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30
Q

2 types of resistance

A

Innate
Acquired

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31
Q

Innate resistance is

A

physical (skin, mucous membranes)
Mechanical (secretions, cilia)
Chemical (stomach acid)

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32
Q

Acquired resistance is

A

cell-mediated (antibodies)

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33
Q

Immunity is

A

a condition of being able to resist a particular disease especially through preventing development of a pathogenic microorganism

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34
Q

Requirements for infection

A

Susceptible host
pathogen (sufficient numbers)
Portal of entry
mode of transportation

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35
Q

stages of infection

A

incubation
prodromal
acute or period of illness
convalescent or decline

36
Q

incubation

A

the time between exposure and sings and symptoms

37
Q

prodromal

A

the period between the appearance of initial symptoms and the full development

early signs and symptoms - not yet clinically specific or severe

38
Q

acute or period of illness

A

the signs and symptoms of the disease are most obvious specific and severe

39
Q

convalescent or decline

A

of pathogens begin to decrease

signs and symptoms decline

patients may become susceptible to developing secondary infections because their immune systems have been weakened

40
Q

Causes of disease emergence

A

microbial changes

breakdown in public health measures

ecological changes

changes in human demographics behaviors

international travel and commerce

41
Q

sanitization

A

process of physical cleaning to reduce the quantity of microbes and bioburden

42
Q

process of sanitization

A

use of disinfectant and paper towel on surfaces

use of soap and brush on instruments

ultrasonic on instruments

*ALL should be done BEFORE sterilization or disinfection

43
Q

Sterilization

A

Destruction of ALL microbial forms (including spores)

term intends absolutely destruction but probability of pathogenic or other organisms can never be reduced to zero

44
Q

kinds of sterilization

A

heat (most common - used at SOD)
filtration
radiation
chemical

45
Q

In oral healthcare settings the primary sterilizing methods are

A

steam under pressure
dry heat

46
Q

what are used to sterilize heat sensitive instruments

A

germicides like chemical sterilant and high/intermediate/low level disinfectants

47
Q

Antiseptics

A

a substance that stops or slows down the growth of microorganisms

used on living tissue
ex. skin / mucous membranes

48
Q

Alcohol as an antiseptic

A

alcohol coagulates the protein in bacteria

30% solution with water penetrates bacteria and is more effective than 100%

49
Q

Disinfection

A

less lethal than sterilization

doesn’t destroy spores and certain resistance microorganisms

applied to inanimate objects and environmental surfaces
(our target for cubical preparation)

50
Q

Disinfectants are not used on what?

A

Skin

not used for tissue antisepsis due to it being toxic to skin

51
Q

Liquid chemical disinfectant requirements

A

surface must be cleared of debris first

adequate contact time

correct temperature

correct pH

correct concentration

52
Q

High level disinfectant

A

kills ALL pathogens but not all bacterial spores

extended contact (3-10 hours)

use on environmental surfaces is inappropriate

AKA chemical sterilant

53
Q

High level disinfectant is used for

A

heat sensitive critical and semi critical items

*Not used in dentistry

54
Q

Intermediate level disinfectant

A

destroys Mycobacterium TB ; most fungi ; most viruses ; vegetative bacteria

does NOT kill bacterial spores

labeled as tuberculocidal disinfectants

55
Q

What doe we use to disinfect dental operative surfaces at UMKC

A

intermediate level disinfectant (cavicide)

56
Q

surface disinfectant categories (2)

A

dual quaternaries

alcohol

57
Q

dual quaternaries

A

surface disinfectant

most types in this category

use at UMKC

58
Q

Alcohol

A

surface disinfectant

Unacceptable for instruments and surfaces

evaporates rapidly

does NOT kill spores

does not work in presence of blood and saliva

59
Q

Low level disinfectant

A

kills most vegetative bacteria and some viruses and fungi

used for floors and walls in dental settings

60
Q

what categorization system is used for sharps and instruments

A

spaulding’s classification system

*categories by potential risk of infection

61
Q

According to spaulding patient care items can be categorized as

A

critical
semi critical
non critical

62
Q

critical items

A

penetrate soft AND hard tissues

confer a high degree of risk for infection if contaminated with pathogens

EX. explorers ; scalpels ; burs ; scalers ; needles ; carpules

*must be sterilized

63
Q

semi critical items

A

contact but do not penetrate (non sharp items that enter the oral cavity

EX. amalgam condensers ; mirrors ; reusable impression trays ; hand pieces ; suctions

*must be sterilized or for heat sensitive high level disinection

64
Q

non critical items

A

items that do not enter the oral cavity but may be touched

come in contact with skin but not mucous membranes

EX. bracket table ; counter tops ; chair controls ; light handles ; computer keyboard ; tray ; door knobs

*require disinfectant or plastic barrier

65
Q

What happened in response to the HIV epidemic in the mid 1980s

A

all blood and body fluids contaminated with blood were to be treated as infectious

66
Q

in 1996 the CDC expanded universal precautions into what?

A

the concept of standard precautions

67
Q

standard precautions

A

basically treat everyone as infectious

68
Q

Controls to infection prevention (3)

A

administrative controls
engineering controls
work practice controls

69
Q

Administrative controls are

A

policies procedures and enforcement measures targeted at reducing the risk of occupational exposure to infectious persons

70
Q

Engineering controls are

A

devices that isolate or remove the risk of exposure to bloodborne pathogens in a workplace

EX. instrument cassettes ; sharps containers ; needle recapping devices

71
Q

Work practice controls are

A

procedures that reduce the likelihood of exposure to infectious materials by altering the manner in which a task is performed

ex. replacing sharps container when full ; recapping a needle using the one handed scoop technique

72
Q

OSHA: regulated waste

A

blood or other potentially infectious material in liquid or semi liquid state

items caked with dried blood that may release it

contaminated sharps

pathological / microbiologic waste with blood or other potentially infectious material

73
Q

Regulated medical waste ; UMKC Red biohazard bag

A

solid waste soaked/saturated with blood or saliva

*dripping or squeezable dried on fluid that could flake off

contaminated sharp items

anesthetic carpules

surgically removed hard and soft tissue

74
Q

Ultrasonic cleaners

A

use high frequency sound waves and cavitation to loosen and remove debris

16x more effective than scrubbing

less potential to injure self

*visible debris must be removed to not interfere with sterilization and disinfection process

75
Q

Autoclave

A

steam under pressure

most dependable

most common

standard cycle 250 F ; 15 PSI ; 20min

dulls instruments

76
Q

Flash Sterilizers

A

Steam

273 F ; 20 PSI ; 3-10 min

not intended for sole method of sterilization

77
Q

Dry Heat

A

320 F ; 2 hr
338 ; 1 hr

long cycle
handpieces wont tolerate
poor penetration
doesn’t dull cutting edge

78
Q

Chemiclave

A

Steam under pressure with chemical vapor

shorter cycle and less corrosive

chemical vapor is hazardous

79
Q

Sterilization monitoring is done by

A

Spore testing weekly

spore test results should be maintained for at least 1 year

80
Q

common reason to fail a spore test is

A

overloading the sterilizer

81
Q

3 types of latex reactions

A

irritant contact dermatitis
allergic contact dermatitis
immediate allergic reaction (latex hypersensitivity)

82
Q

what percentage of health care workers have some form of latex allergy

A

5-10%

83
Q

Irritant Contact dermatitis

A

not an allergic skin reaction

least threatening type

due to repeated exposures

dry itchy burning irritated areas

84
Q

allergic contact dermatitis

A

Type IV delayed reaction hypersensitivity may take 23-48 hours to develop from time of exposure

may result from allergy to chemicals used in glove manufacturing

more severe reaction can spread and lasts longer

85
Q

latex allergy

A

type 1 (immediate) hypersensitivity to natural rubber latex proteins

reactions include nose, eyes, and skin reactions

more serious reactions include urticaria bronchospasm/respiratory distress

rarely shock or death

86
Q

how to minimize contact dermatitis

A

dry hands completely before donning gloves

only use latex free gloves

only use gloves WITHOUT powder

Patient Care I (6 decks)

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