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OSCE PREP > IPC > Flashcards

IPC Flashcards

1
Q

What are the links in the chain of infection?

A
  • infectious agent
  • reservoir
  • portal of exit
  • mode of transmission
  • portal of entry
  • susceptible host
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2
Q

What is the Spaulding Classification?

A

They classify medical instruments based on their associated risks.

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3
Q

What is critical Spaulding level?

A
  • high risk
  • require heat sterilisation if not single use
  • items in contact with normally sterile body sites, ie pierce skin or mucosa - ie forceps / periodontal scaler / burs / probe
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4
Q

What is semi-critical Spaulding level?

A
  • medium risk
  • require high level disinfection
  • items in contact with intact mucous membranes / skin
  • ie dental handpiece / mirror / 3in1 / amalgam compactor
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5
Q

What is non-critical Spaulding level?

A
  • low risk
  • only intact skin
  • 2 classifications
  • clinical contact areas are touched by a contaminated glove - ie dental light / light cure / drawer handles
  • housekeeping areas - ie walls / floors / lights / dental chair
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6
Q

How can the reservoir be reduced?

A
  • surface design (ie no seams)
  • surface material
    - easily cleanable / non absorbent
  • cleaning and disinfection
  • surgery shouldn’t be cluttered and nothing should be left on surfaces
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7
Q

What is the definition of a detergent?

A
  • synthetic organic water soluble agents that have a wetting agent, and can emulsify and hold soil
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8
Q

What is high level disinfection?

A
  • takes hours

- kills all microbes except bacterial spores

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9
Q

What is low level disinfection?

A
  • takes less than 10 minutes

- kills most microbes

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10
Q

How is aerosol controlled?

A
  • high volume aspiration

- rubber dam

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11
Q

What are the five moments for hand hygiene?

A
  • before touching a patient
  • before a clean/aseptic procedure
  • after a bodily fluid exposure risk
  • after touching a patient
  • after touching a patient’s surroundings
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12
Q

Give an example for breaking each of the links in the chain of infection.

A
  • infectious agent = none
  • reservoir = cleaning / design of surfaces
  • portal of exit = aerosol control
  • mode of transmission = hand hygiene
  • portal of entry = PPE
  • susceptible host = vaccinations
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13
Q

What is the black waste stream?

A
  • trivial risk

- domestic waste

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14
Q

What is the orange waste stream?

A
  • low risk
  • items likely contaminated with blood / bodily fluids
  • PPE
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15
Q

What is the yellow waste stream?

A
  • high risk

- sharps / medical devices / anatomical tissues

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16
Q

What is a sharp?

A
  • item used in healthcare that could injury either the patient or the operator
  • bur / probe / endo file / forceps / scalpel
17
Q

Who is responsible for sharps disposal?

A
  • operator

- even if the task is delegated (eg to a nurse) the operator remains responsible

18
Q

What are the different types of sharps container?

A
  • orange lid = no pharmaceutical drugs eg scalpels / burs

- blue lid = contains pharmaceutical drugs eg LA cartridge and needle

19
Q

How are sharps containers made safe for use?

A
  • temporary closure should remain in place when not in use
  • lid should be firmly closed
  • do not fill above the line, once the line is reached the permanent closure mechanism should be used
  • details of when / who / where the container was assembled and closed should be recorded on it
20
Q

What is the procedure if a sharps injury occurs?

A
  • stop
  • inform patient
  • remove gloves and check for injury
  • report to the senior clinician
  • risk assessment carried out by senior clinician
  • blood tests done off site
  • datix completed
21
Q

How do you treat a sharps injury?

A

AWARE

  • apply pressure
  • wash don’t scrub
  • assess type of injury
  • risk of source blood?
  • establish contact
22
Q

What is the chance of contracting a BBV?

A
  • 1 in 3 for HBV
  • 1 in 30 for HCV
  • 1 in 300 for HIV
23
Q

What is the course of action for HBV exposure?

A
  • baseline bloods
  • PEP
  • no need for PEP if positive response to the vaccine
24
Q

What is the course of treatment of HIV exposure?

A
  • baseline bloods
  • antiretroviral medication for 28 days (very toxic)
  • follow up 12 weeks post-exposure
25
Q

What are the steps to safely deal with a spillage?

A
  • cordon area off
  • assess type of spillage
  • collect correct equipment
  • PPE
  • disinfect
26
Q

What do you use to disinfect a spillage of blood?

A
  • chlorine granules onto the spillage (sodium hypochlorite)
  • 10,000 ppm of available chlorine
  • leave for amount of time specified on the manufacturers instructions / or 3 minutes
  • wipe up and use detergent on the area
27
Q

What do you use to disinfect a spillage of bodily fluid not containing blood?

A
  • wipe up spillage (do not apply chlorine releasing agents to urine etc)
  • use 1,000 ppm chlorine solution
  • follow manufactures instructions
  • use detergent on the area
28
Q

What are the steps of hand washing?

A
  1. Palms together
  2. Pal on the back of each hand
  3. Fingers interlocked
  4. Fingertips in clasped motion
  5. Thumbs and wrists (up to elbows)
  6. Nails in the palm

OSCE PREP (13 decks)

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