Infection Prevention & Control Flashcards
0
Q
The loss of independence, earnings and life is a ? effect of infection?
A
Personal
1
Q
What are the 3 main effects of infection?
A
Personal
Cost to Work Place
Cost to the Health Service
2
Q
The temporary loss of a staff member and the cost of sick pay is a ? effect of infection?
A
Cost to Workplace
3
Q
The cost of drugs, in-patient stay and reputation are ? effects of infection?
A
Cost to Health Services
4
Q
What are the 6 steps in the chain of infection?
How many do we need to get rid of to prevent it?
A
Susceptible Host Infectious Agent Reservoir Means of Exit Route of Spread Means of Entry
JUST ONE
5
Q
What are a susceptible host, infectious agent, reservoir, means of exit, mode of spread and means of entry steps of?
What are some ways we can get rid of one?
A
Chain of Infection
Host - immunisation
Reservoir - cleaning
Mode of spread - cover
6
Q
What are the 2 sources of infection?
A
Endogenous
Exogenous
7
Q
What are ENdogenous sources of infection?
A
EN - FROM WITHIN - normal flora
e.g. e.coli and UTIs
8
Q
What is an EXogenous source of infection?
A
From an EXTERNAL source such as a person or animal
or even object like curtains covered in spores
9
Q
What can blood/blood products, urine, faeces, vomit, pus, wound exudate, synovial fluid, breast milk, pericardial fluid, skin scales and saliva be viewed as?
A
A source of infection - a source of pathogen/reservoir
10
Q
What are the 4 main routes of transmission of infection?
A
CONTACT
AIRBORNE
FAECEL ORAL
BLOOD AND BODY FLUID
11
Q
What route of transmission are MRSA, scabies and headlice infections transmitted by?
A
Contact
12
Q
What route of transmission are influenza, pulmonary TB and chicken pox transported by?
A
Airborne
13
Q
What route of transmission are salmonella and campylobacter transported by?
A
Faecel-oral
14
Q
What route of transmission are hepatitis C and B and HIV transported by?
A
Blood and body fluid
15
Q
What are pyrexia (high temp), pain redness & swelling, pus production, tachycardia and confusion potential signs of?
A
Infection
16
Q
PPPTC - What are the general signs of infection?
A
Pyrexia - immune system does this to kill organism (reduce with paracetamol) Pain and swelling Pus Production - dead microorganisms Tachycardia Confusion
17
Q
What are specific symptoms of eye infection?
A
Pain, redness, crustiness and pus
Note babies sometimes have sticky eye and not an infection
18
Q
What are the common symptoms of chest infections?
A
High temperature, pain, breathlessness and cough
19
Q
What are the main symptoms of wound infection?
A
Pain, pus, swelling, heat in skin
although dressing can bring pus to surface
20
Q
What are the main symptoms of UTIs?
A
confusion in elderly, incontinence in kids, pain, burning, bloody/cloudy, smelly
21
Q
What are the main symptoms of Genital Tract Infections?
A
Discharge, Pain when weeing and sex, lesions
22
Q
Why do we need to combine BOTH signs and symptoms of an infection with the presence of an organism before treating it?
i.e. why do we not treat infections that we can see from gram-staining when there are not symptoms?
A
Sometimes bacteria are not causing harm and are just colonised - NOT an infection
Also cannot treat without testing - need to check which bacteria to treat correctly
23
Q
What proportion of infections can we prevent?
A
15-30%
24
Infection control. What is the significance of the figure 15-30%?
The amount of infections we can prevent
25
Standard infection control precautions which are applied to all patients and their body fluids, whether they are known to have an infection or not, are what?
Standard Precautions
26
If we do not know if someone has an infection, do we use standard precautions?
Yes - STANDARD.
| They were developed from universal precautions in 1980s to prevent AIDs transmission - ASSUME EVERYONE HAS SOMETHING
27
What are hand hygiene, the use of PPE, sharps management and decontamination examples of?
Standard Precautions
28
Name the standard precautions HUDS
Hand Hygiene
Use of PPE
Decontamination
Sharps Management
29
Hand hygiene was discovered in 1847. How important is is in the intervention of cross control infection?
The most important
30
What is the most important intervention in the control of cross infection?
Hand Hygeine
31
What standard precaution saves lives, but has the poorest compliance and practice rates?
Hand hygeine
32
What should you do after going to the toilet, preparing food, removing gloves, after a task where contamination was likely, before aseptic procedures, before leaving work...?
Wash hands
33
How many shots of soap do you need?
1
34
Name 5 key points of hand washing
| W1WRD
```
Wet Hands first
1 shot of soap
wash all areas
rinse thoroughly - no bubbles
dry properly
```
35
Why is it important to wash hands properly?
To minimise skin irritation. Damaged hands = more microorganisms
36
Why can't you wear stoned rings or watches?
Stoned rings may tear gloves, increase bacterial counts, can become contaminated and make glove donning difficult.
Watches mean you cannot wash wrists
37
Where are most microbes found on the hand?
Nails
38
Why can't you wear false nails?
Inhibit hygiene, lift at edges, pathogen carriage, moisture between real and false nail, can tear gloves and higher bacteria
39
What are transient and resident types of?
Flora
40
What gets rid of transient flora?
Routine hand hygiene: soap and water
Transient = temporary, from touch
41
What gets rid of resident flora?
Surgical hand wash - aqueous antiseptic
42
What soap should we never use?
Bar Soap. It is contaminated
43
What soap do we use most of the time?
Liquid Soap
44
What soap do we use for surgery?
Aqueous Aseptic
45
What are the 3 types of aqueous aseptic (surgical scrub)?
Put in order of strength
BLUE - triclocyl - don't use much as people use at home - resistant
PINK - chlorhexidene/hibiscrub - good
BROWN - iodine betadine - good but irritant
46
Where must alcohol hand rub be available? Why?
At the point of care.
| It increases compliance of hand hygeine
47
Alcohol hand rub is not a replacement for washing.
| Name 4 reasons why:
If have blood on hand it will not wash off or kill microbes.
It will not kill spores like c.diff
If does not dry it puts tiny holes in gloves
Moisturiser builds up and stops alcohol working
48
What is the maximum amount of times you should use alcohol hand rub before washing hands again.
Why?
3-4
The alcohol stops working as moisturiser builds up
49
What are the 3 methods of hand drying?
Cloth Towel
Electric Hand Drier
Paper Towels
50
Why should you try and use paper towels to dry hands?
Cloth towels stay wet and contaminated, dryers blow faecal matter onto hands
51
Patient hand hygiene is implicated in the spread of infection and outbreaks.
What should you ensure?
They have to access to facilities
Make patient wash hands after toilet/before eating
Take them to a sink or give a wetwipe after vomiting in container
52
What types of PPE are there?
Gloves
Aprons
Eye/Face protection
Theatre Gear
53
What should you use when there is risk of contact or contamination with blood, other body fluids, mucous membranes or breaks in the skin?
PPE
54
Gloves are single use.
When should you change them?
What should you do after removal?
```
Change between patients and
between activities (don't want to move flora around)
```
Decontaminate hands after removal
55
What types of drugs are suitable for everything?
Latex and Nitrile
56
Aprons are single use. When should you change them?
Change between patients.
| Do not re-use on same patient
57
When would you use non-sterile gloves?
for short tasks or things like cleaning and handling disinfectant
58
When do you us vinyl gloves?
For things not involving blood or body fluids coming straight out the body
59
When do you use latex and nitrile gloves?
For procedures involving blood and bodily fluids
60
When do you use nonsterile gloves and an apron?
Tasks that do not have fluids coming directly out the body.
If cleaning up a soiled bed, removing a device or cleaning blood from floor or even taking blood, it does not need to be sterile
61
When do you use sterile gloves and apron?
When involving body fluids and inserting things, e.g. catheter, aseptic technique, wound dressings and central line management.
Going INTO body
62
When may you use face protection?
Tracheal suctioning, Pulmonary TB
63
What procedure do you wear lots of PPE?
Surgical procedures in theatre
64
List 2 types of face/eye protection. What do they avoid?
Goggles, face visors.
| They avoid splashing in eyes and mouth
65
In relation to sharps management, what should you NOT do with a needle after use?
Re sheath it
66
What should you do after using a needle?
Dispose SAFELY and IMMEDIATELY
67
What should you not pass from hand to hand or to other people?
Naked sharps
68
What should you ensure is closed when not in use and is out of reach of vulnerable people?
Sharps Bin also should not be on floor
69
List the 5 stages of sharps management
| EWCRO
```
Encourage bleeding
Wash it
Cover it
Report it
Occupational health
```
70
Why do you encourage bleeding before washing a sharps injury?
What should you cover it with?
To get any bacteria squeezed out.
| Waterproof dressing
71
Are clean uniforms and isolation standard precautions?
NO
72
GLOVES - STERILE AND NON STERILE
| VINYL OR LATEX/NITRILE?
STERILE - GOING IN BODY like a catheter or wound dressing
NON STERILE - other stuff like taking blood
LATEX - blood or body fluids
VINYL - other stuff
73
Out of decontamination and isolation, is either of them a standard precaution?
Decontamination - YES do with everyone
Isolation - NO
74
Cleaning, disinfection and sterilisation are examples of what?
Decontamination
75
Describe low risk equipment
Items in contact with healthy, intact skin or not in contact with patient
(clean)
76
What method do you decontaminate low risk equipment, intermediate risk and high risk equipment?
Low - clean
Intermediate - disinfect
High - Sterilise
77
Define intermediate risk equipment
Items in contact with mucous membranes, contaminated body fluids or on immunocompromised patient
disinfect
78
Define high risk equipment
Items in contact with broken skin or mucous membranes or introduced into a sterile body cavity (surgical)
sterilisation
79
Which intermediate risk piece of equipment do you actually sterilise?
Cervical speculum
80
What do you call the removal of accumulated deposits by washing with a cleaning solution,
that reduces the number of organisms and removes dirt, grease and organic matter?
Cleaning
81
What do you call partial removal or destruction of organisms to reduce them to a safe level,
but does not remove all viruses or spores (vaginal and c.diff)
and is done by chemicals and heat?
Disinfection
82
What process is the complete removal or destruction of all organisms including spores NOT prions,
using an autocalve?
Sterilisation
83
What type of instrument do we use for prions?
Single use
84
What type of substance includes chlorine releasing agents, alcohol (liquid and wipes) and quaternary ammonium compounds (dettol)?
Disinfectant
85
What must you do to an item before disinfecting it?
Clean it - to deactivate microorganisms
86
After adding water to a disinfectant, how long can you keep it before throwing it out?
24 hours
87
What should you pay special attention to when using disinfectants?
Special precautions and manufacturers instructions
(to check what actually does or what it may damage)
Only to use on medium risk items
And avoid use of sprays - children get asthma from breathing in
NOT on beds - damages plastic and fluids contaminate
88
MDA August 2000 states that single use items must not be re-used.
What can it affect if you do?
Safety, performance, effectiveness and infection control
Legal implications are would take away responsibility of manufacturer if went wrong
89
What does the symbol 2 with a cross mean?
Single use
90
What does it mean when an item is single patient use?
Only reuse on same patient and dispose after patient has finished
such as oxygen or nebuliser masks
91
What might you do to dying patients, people with disturbed or disturbing sleep, someone at increased risk of developing an infection or someone with a transmissible infection?
ISOLATION
92
What is source isolation/barrier nursing?
When a patient has a known/suspected infection and you want to isolate the SOURCE of infection which is the patient
93
What 5 infections are source isolation required for?
```
MRSA
C.diff
TB
Norovirus
Chickenpox
Measles
```
94
When would you isolate in a single room and when would you cohort?
Single room - one patient source isolation
| Cohort - lots of people source isolating with same condition
95
Why do we not cohort source isolate diarrhoea?
Can be caused by different things like c.diff or norovirus
96
Can we cohort TB?
NO - cross infect different issues and resistances
97
What normal standard precautions are used in source isolation?
PPE before going in, take off and wash hands before coming out
98
Why should you decontaminate/clean equipment when patients are isolated?
cleaners don't like going in
99
In source isolation, what is important about laundry management?
Take to skip
100
Additional precautions may be taken for some infections when source isolating (e.g. masks and no cohorting), staff/visitor restrictions (e.g. chicken pox), and communication with staff and patients and visitors about what is going on.
When may we use negative pressure rooms?
Multiresistant TB
2 sets of doors so ventilation won't let out.
leave trolley outside
101
What should you note when source isolating?
Check not spread to other patients who may also need isolating, if diarrhoea or airborne, rearrange other appointments, patient information and psychological effects of being by self.
102
What is protective isolation?
Positive pressure isolation (stops contaminated air coming in).
It involves washing hands and donning clothing before entering room but check where stored.
Staff restrictions - do not go in even with sniffles. Normal standard precautions and be aware of asepsis an endogenous risk.
103
When do you use a negative or positive pressure room?
Negative - source - individual and or cohort for TB
put clothing on outside and take off before coming out
Positive - protective
sterile clothing outside and take off after coming out
