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CPS Late 2018 > Infection prevention and control in paediatric office settings > Flashcards

Infection prevention and control in paediatric office settings Flashcards

1
Q

3 principles to prevent transmission

A
  • assume all bodily fluids contain pathogens
  • screen for sx
  • source containment
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2
Q

Give the precaution type and duration: MRSA

A

contact; if pts assessed at risk to transmit

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3
Q

Give the precaution type and duration: bird flu

A

droplet + contact; 14 days from onset

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4
Q

Give the precaution type and duration: enterovirual infection (supsected or diagnosed)…including HAND FOOT MOUTH

A

contact; for duration of illness

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5
Q

Give the precaution type and duration: gasteroenteritis

A

contact; for duration or symptoms or until infectious cause ruled out

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6
Q

Give the precaution type and duration: Hep A or E (diagnosed or suspected)

A

contact until viral infection ruled out OR if hep A diagnosed: 7days after onset of hepatitis

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7
Q

Give the precaution type and duration: measles (diagnosed

A

airbrone; 4 days after onset of rash…if immunocompromised for whole duration of illness

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8
Q

Give the precaution type and duration:

measles CONTACT who is non-immune and in the incubation period

A

airbone; 5 days after first day of exposure- 21 days after last day of exposure

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9
Q

Give the precaution type and duration: meningitis (bact, vir) suspected or diagnosed

A

DROPLET until 24 hours after receiving antibx

CONTACT for whole illness

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10
Q

Give the precaution type and duration: mumps

A

droplet; 9 days after onset of swelling

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11
Q

Give the precaution type and duration: mumps contact who’s nonimmune and in incubation period

A

droplet: from 10 days after first day of exposure–> 26 days after last day of expsoure

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12
Q

Give the precaution type and duration: pertussis (dx or supsected)

A

droplet until 5 days of appropraite antibx received or pertussis ruled out

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13
Q

Give the precaution type and duration: petechial or ecchymotic rash with fever (suspected meningococcemia)

A

droplet until 24 h of antibx received or meningococcus ruled out

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14
Q

Give the precaution type and duration: contact who is nonimmune and in incubation period

A

droplet; From 7 days after the first day of exposure to 21 days after last day of exposure

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15
Q

Give the precaution type and duration: SARS MERS-CoV

A

droplet + contact + N95

To 10 days after resolution of fever

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16
Q

Give the precaution type and duration: scabies

A

Contact Until initial therapy applied

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17
Q

Give the precaution type and duration: skin infection with extensive lesions/abscess/drainage not covered or contained

A

contact; for duration of drainage or until exudative lesions are healed

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18
Q

Give the precaution type and duration:GAS impetigo lesions not covered

A

contact; until 24 h of appropraite therpay

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19
Q

Give the precaution type and duration:invasive GAS (pharyngitis, pneymonia, scarlet fever)

A

droplet until 24 hours antibx

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20
Q

Give the precaution type and duration: TB (dx or suspected)

A

airbone until assessed as non infectoius

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21
Q

Give the precaution type and duration: varicella

A

airbone plus contact until lesoisn crusted and dried or varicella is ruled out

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22
Q

Give the precaution type and duration:varicella contact who is nonimmune and incubation pateint

A

airbone; from 8 days until fisrt day of expos–> 21 days after last day of exposure….to 28 days if given VZIG

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23
Q

Give the precaution type and duration:viral resp tract infection

A

drop + contact for duartion or illness or until viral inection ruled out

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24
Q

Give the precaution type and duration: zoster not covered

A

airbone plus contact until lesiosn crusted adn dried or zoster ruled out

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25
Q

contact precautions: how?

A

gloves, gowns, distinfection of surfaces…most common

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26
Q

give 3 egs of dx’s needed droplet precuations (surgical mask)

A

H flu
N meningitidis
B pertussis

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27
Q

Give 3 egs of dx’s needing droplet + contact precautions

A 
TSV
influenza
parainfluenza
rhinovirus
adenovirus
SARS coronarvirus
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28
Q

3 egs of dx’s requiring airborne precuations

A

varicella, measles, TB, smallpox

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29
Q

which dx’s can go from contact-> airbone precautions with bronchoscopy, intubation

A

SARS coronavirus
MERS
avian flu
viral hemorrahgic fever

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30
Q

medical equipment: explain cirtical vs semicritical vs nonccritial

A

crtiical : must be sterile because –> sterile body space (eg: needle); semicritical: requires high level infection to remove everything except bacterial sports (touches mucous membranes or nonintact skin or thorugh whihc isnpired air flows, eg: laryngoscope; noncritical: low-level disinfection b/c only in contact with intact skin (eg stethoscope)

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31
Q

ways to sterilize equipment?

A

Steam, dry heat, chemical sterilants

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32
Q

ways for high-level disinfection?

A

Pasteurization, 2% glutaraldehyde, 0.55% ortho-phthalaldehyde, 6% to 7.5% hydrogen peroxide with or without peracetic acid*

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33
Q

ways to intermediate-level disinfect?

A

70% to 90% ethyl or isopropyl alcohol (immersion >5 min), sodium hypochlorite 5.25% diluted 1:50 to 1:500 (immersion >10 min), 3% hydrogen peroxide, 0.5% accelerated hydrogen peroxide, quaternary ammonium products, iodine, iodophors, phenolics, disinfectant wipes *,†

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34
Q

clean surfaces, knobs in office how?

A

detergent + water or disninfectant wipes

35
Q

what if stethoscope has blood on it?

A

use sodium hypochlorite diluted 1:10 to 1:100 or 70% to 90% alcohol.

36
Q

need to know what about phenolics?

A

should not be used for items that will be in direct contact with the skin of newborns.

37
Q

give 2 suggested admin policies

A

develop infection control policy and review every 2 years; ongoing education for personel; establish system fo communcation with public health

38
Q

3 things to incoproate in office design

A

avoid carpeting; ensure sinks + soap and waterless hand hygiene products avaialbe in all pt areas; signs with resp etiquette; ventilation at least 6 air changes per hour

39
Q

how can you triage pts?

A
  • put immunocompromised pts in exam room right away
  • parents should tell receptionist right away if suspect child contangious
  • segregate symptomatic infectoius children ASAP
  • if travel alert for resp infectoius, ask about rravel ouside canada in past 21 days before sx (ask the same thing for household ocntacts)
40
Q

options for toys in waiting rooms:

A
  • don’t keep toys unless they can be appropiattely cleaned
  • ask parents to bring toys from home
  • provided only toys with smooth solid surfaces
  • ask parents to supervise kids and place used toys in designated bin for cleaning
  • provide books taht kids can take home or dispose of after use
41
Q

give 4x when personell should clean hands

A
  • immed before/after pt contact
  • before moving to a clean body site from a contaminated body site during care of same pt
  • after contact with blood, body fluids
  • after directly touching a live vaccine
  • after touching a surface likely to be contaminated
  • before invasive procedures
  • after removing gloves
42
Q

alchohol based hand risnses should contain what % isopropyl or ehtyl alcohol

A

60-90% isopropyl or ethyl alchohol

43
Q

are gloves needed for giving vaccines?

A

no

44
Q

3 times when gloves are needed

A

If anticipating direct hand contact with blood, body fluids, secretions or excretions, or with items contaminated by any of these substances.
For direct hand contact with mucous membranes or nonintact skin.
For direct hand contact with a patient when the health care provider has an open lesion on the hand.

45
Q

how should spills be cleaned?

A

promptly and cleaned with detergent followed by bleach (a 1:10 to 1:100 dilution of household bleach, using the higher concentration for larger spills

46
Q

clean stethoscopes, otoscope handles how?

A

alcohol, disinfectant wipes, or soap and water

47
Q

pulse oximetry, base of thermoeter should be cleaned how often?

A

daily and when soiled

48
Q

computer mice and keyboards should be cleaned how often?

A

daily; consider these contaminated

49
Q

if examining table soiled with body fluids clean how?

A

1:100 bleach solution

50
Q

clean exam tables, tx chairs, sinks, door knobs how often?

A

daily

51
Q

washrooms could be cleaned how often?

A

daily

52
Q

clean surfaces taht are not usually an infection risk (eg: floors) how often?

A

weekly; but cupboards, walls, windows, air vents can be cleaned yearly

53
Q

disinfect toys how?

A

1:100 bleach + soap and water + air dry…or dishwasher

54
Q

toys should be cleaned how often?

A

between pts= ideal; otherwise, at end of the end

55
Q

preferred agent to clean skin for venipuncture and vaccines?

A

70% alcohol

56
Q

clean skin how for inserting IV catheter or doing invasive procedure or taking blood cultures?

A

2% chlorhexidine, chlorhexidine in 70% alcohol, 10% povidone-iodine or an alcoholic tincture of iodine should be used. Povidone-iodine should be left to dry for 2 minutes [2

57
Q

antiseptics should ideally be SINGLE use. if multi-use, do what?

A

label them with the date and discard after 28 days of use

58
Q

do what for pts with suspected measles, varicella, disseminated zoster or contagious TB?

A
  • place directly in exam room
  • use a negative pressure room
  • keep exam room door closed
59
Q

for suspected measles or varicella (airborne precautions, NOT TB!), personnel should do what?

A
  • no mask needed if immune

- if not immune, do not enter room

60
Q

after airborne-dx patient leaves room, do what?

A
  • leave room for 70 min for air ventilation if 6 air changes/hour
  • or, if air exchange rate not known, only use room for immune pts for remainder of the day
61
Q

do what for droplet precuations (meningitis, pertussis, rubella, mumps, meningococcal infection)

A
  • place in room immediately or separate from other pts from 1-2 m
  • have pt wear surgical mask when outside of the room (same for any resp infection); if infant, cover their nose with mouth and tissue
62
Q

for droplet transmission, when is eye protection needed?

A

should be considered for care of patients with respiratory tract infections (RTIs) who are coughing at the time of the interaction or if a procedure is performed that may result in coughing [1][5][6]. When eye protection is not available, wear gloves and keep hands away from the eyes during patient care.

63
Q

who needs contact precautions? (4)

A

Infectious diarrhea.
Extensive, skin lesions which are not covered (e.g., varicella, zoster), or wound drainage not contained by dressings.
Selected patients colonized with antibiotic-resistant organisms (AROs), such as MRSA and VRE (see below).
Children with a documented or suspected viral RTI who cannot control their respiratory secretions adequately.

64
Q

how to manage antibiotic resistant organism?

A

-usually hand hygiene enough; consider contact precautions (case by case)

65
Q

do what for pts with suspected ebola?

A
  • contact public health
  • if low risk (early stage or healing): droplet + eye + contact precuations
  • if advanced disease (bleeding, vomiting, incontiennce): more extensive protective apparel to cover ALL exposed skin. use airborne precautions for aerosol-generating procedures.
66
Q

5 things HCPs should be immune to

A

measles, mumps, rubella, varicella, hep B, polio

67
Q

what should HCP do if have cold

A
  • go to work
  • no contact with high-risk pts
  • wear surgical mask
  • wash hands after contact with resp tract secretions and before every contact with pt/pt care equipment
68
Q

personnel with blood-borne viral infections should do what

A

not perform procedures with high risk of transmission of blood

69
Q

infections where not allowed to come to work

A

influenza, measles, mumps, pertussis, TB(active), varicella

70
Q

infections where restrictions in place until symptoms resolves/ lesiosn healed/crusted?

A

colds, gastroenttisi (or deemed not contagoius), HSV. herpetic whitlow, influena,MSSA (unless lesions covered), MRSA (and assessed for risk fo trnasmission), varicella,

71
Q

infections where can’t work with pts

A

conjunctivitis, gastro, hep A, herpetic whitlow, pediculosis, scabies, MSSA if lesions on hands/can’t be covered, MRSA, GAS, zoster if not covered

72
Q

infections where HCPS are exclused from working with high risk pts only

A

colds, HSV (if lesions not covered, includes babies adn nonimmune peopel), Zoster (even if lesions covered– for babies, preg women, and nonimmune immunocomp pts)

73
Q

when can people with conjunctivitis work with pts again?

A

when exudates resolves

74
Q

when can ppl with hep A work with pts again?

A

1 week after onset of jaundice

75
Q

when can people iwth measles return to office?

A

4 days after onset of rash

76
Q

when can people iwth mumps return to office?

A

9 days after onset of parotitis

77
Q

when can people with pediculosis work with pts again?

A

when one treatment completed (<24h)

78
Q

when can people with pertussis return to work?

A

after antibx x 5 days

79
Q

when can ppl with rubella return to work?

A

7 days after onset of rash

80
Q

when can people with scabies return to pt care?

A

after one tx completed <24 h

81
Q

when can people with GAS return to pt care?

A

once treated for 24 h

82
Q

when can people dx’ed with active tb return to office?

A

when assessed as non-infectious

83
Q

who is considered a high risk pt?

A

hemodynamically significant congenital heart disease or chronic lung disease, neonates and immunocompromised patients.

CPS Late 2018 (8 decks)

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