Infection, prevention & control

Question 1

Sources of infections

Answer 1

Endogenous - originate from within an organism, tissue or cell
Exogenous - originate outside the organism
Environmental

Question 2

Sources of pathogens

Answer 2

Blood, urine, faeces, vomit, pus, wound exudate, synovial fluid, breast milk, pericardial fluid, skin scales, saliva

Question 3

Routes of transmission

Answer 3

Contact eg. MRSA, scabies, head lice
Airborne eg. influenza, pulmonary TB, chicken pox
Faecal-oral eg. Salmonella
Blood/bodily fluid eg. hepatitis B and C, HIV

Question 4

Hand hygiene

Answer 4

5 moments of hand hygiene
No rings, watches, long nails, bare below the elbows
Types of flora:
> transient - routine hand hygiene of soap and water
> resident - surgical hand wash of antiseptic

Question 5

Use of Personal Protective Equipment (PPE)

Answer 5

Gloves:
- single use, change between patients, change between different activities on same patient
- decontaminate hands after removal
- types of gloves -
> plastic (no protection)
> vinyl (not appropriate for blood contact/duration activities)
> latex (best protection, sensitivity problems)
> nitrile (expensive)
> neoprene (expensive, used in theatre)
Aprons:
- single use, change between patients, don’t reuse on same patient
Face/eye protection:
- goggles/face visors
- eg. theatres, delivery suites, taking out catheters
Donning order: apron, mask, eye protection, gloves
Removal order: gloves, apron, eye protection, mask

Question 6

Sharps management

Answer 6

Sharps injury management:

• encourage bleeding
• wash it
• cover it
• report it
• occupational health

Question 7

Waste containers - BAGS

Answer 7

Orange - infectious/potentially infectious soft waste contaminated with blood/body fluids eg. dressings, gloves, aprons
Yellow - infectious/potentially infectious clinical waste contaminated with chemicals/pharmaceuticals eg. IV bags, medicated dressings
Tiger bags (yellow and black) - non-infectious recognisable healthcare waste eg. gloves, aprons, nappies not contaminated with chemicals/body fluids/medicines

Question 8

Waste containers - SEALED UNITS

Answer 8

Red lids - anatomical waste

Blue lids - out of date stock/patient returns/ pharmaceutical waste

Question 9

Waste containers - SHARPS BINS

Answer 9

Yellow lids - needles, syringes

Purple lids - cytotoxic sharps

Question 10

Decontamination

Answer 10

Low risk equipment:
- items in contact with healthy, intact skin/ not in contact with patient
- method used is cleaning
Intermediate risk equipment:
- items in contact with mucus membranes contaminated with body fluids or have been in contact with an immunocompromised patient
- method used is disinfection
High risk equipment:
- items in contact with broken skin or mucus membrane or introduced into a sterile body cavity
- method used is sterilisation

Question 11

Cleaning, Disinfection and Sterilization

Answer 11

Cleaning - removal of accumulated deposits by using a cleaning solution, decreases number of organisms, moves dirt and grease
Disinfection - partial removal/destruction of organisms by heat or chemicals to decrease them to a safe level, doesn’t kill all viruses/spores
Sterilization - complete removal/destruction of all organisms including spores, used on surgical equipment

Question 12

Disinfectants

Answer 12

Include chlorine releasing agents, alcohol liquid and wipes, quaternary ammonium compounds
Always clean items before disinfection
Label with time and date opened, throw away after 24 hours

Question 13

Isolation

Answer 13

Reasons:
- dying patients, disturbing sleep, increased risk of developing infection, having a transmissible infection
Source isolation:
- where a patient who has a know/suspected infection is put into a single room/cohorting
- standard precautions apply eg. PPE, hand washing, decontamination, laundry management, staff/visitor restrictions, negative pressure rooms
Protective isolation:
- use of positive pressure rooms
- use of PPE, hand washing before and after entering and leaving room