Lecture 10: Individual Competencies, MRSA Flashcards
Define:
Competency
An ability or skill; a skill needed to perform in a particular role, knowledge in a particular domain, or a value that can be expressed in action, or a combination of these 3
Competencies are combinations of what 3 components
Values
Knowledge
Skills
Define:
Values
Broad preferences concerning useful, worthy, and important courses of action and outcomes
(What ought to be. Reflects personal views of excellence. Refects a persons sense of right and wrong. Difficult to change and are rooted in familu, spiritual and cultural socialization)
Define:
Knowledge
Key technical and contextual information, theories, and concepts need to be competent
(Easist of the three components of competency to gain)
Define:
Skills
Specific behavioral practices needed to be proficient in the workplace
(Requires practice in realistic settings)
Competencies are discussed in the same framework as ______________
characteristics of an effective team
What should be done to produce characteristics in individual members?
Parallel the characteristics of effective teams with the specific expectations of individual members to produce those characteristics
Interprofessional Education Collaborative Expert Panel, 2011 (IECEP) is made up of what 6 professional associations?
- American Association of Colleges of Nursing
- Association of American Medical Colleges
- American Association of Colleges of Osteopathic Medicine
- American Association of Colleges of Pharmacy
- American Dental Education Association
- Association of Schools of Public Health
IECEP sought to bring focus onto ___________
“The Triple Aim”
- Improving the experience of care
- Improving the health of populations
- Reducing the per capita cost of health care
Define:
Interprofessional Education
When students from 2 or more professions learn about, from, and with each other to enable effective collaboration and improve health outcomes
Define:
Interprofessoinal Team Work
The levels of cooperation, coordination, and collaboration characterizing the relationships between professions in delivering patient-centered care
Define:
Interprofessional Team-Based Care
Care delivered by intentionally created, usually relatively small work groups in health care who are recognized by others as well as by themselves as having a collective identity and shared responsibility for a patient or group of patients (e.g., rapid response team, palliative care team, primary care team, and operating room team).
Define:
Professional competencies in health care
Integrated enactment of knowledge, skills, values, and attitudes that define the areas of work of a particular health profession applied in specific care contexts.
Define:
Interprofessional competencies in health care
Integrated enactment of knowledge, skills, values, and attitudes that define working together across the professions, with other health care workers, and with patients, along with families and communities, as appropriate to improve health outcomes in specific care contexts.
T/F
Values are deeply held and difficult to change.
T
They often are rooted in family, spiritual, and cultural socialization, established over several years, particularly the younger years.
Which of the three competencies is easiest to gain?
Knowledge
Competencies for Individuals are organized into what 4 categories
- Patient focus
- Team orientation
- Collaboration
- Team management
Competencies: Patient Focus
- Foundation is respect
- Respect the interest of patients and families as defineid by them
- Actively solicit and integrate the input of patients and families in the design, implementation and evaluation of services
- Perform professional roles in a respectful way
- Cultural sensitivity is key to effective communication when patients are from different cultures
Patient Focus:
Respect for patients involves 2 individual behaviors:
- Soliciting and acting on patient and family input
2. Performing roles in a culturally sensitive manner
Competencies: Team Orientation
- Actively contribute to the formation of commonly agreed values, goals, and processes for doing the workd of the team.
- Contribute positive social climate
- Acknowledge shared responsibility
- Understand the characteristics of effective teams and common pitfalls
- Understand the competencies of effective team members and one’s PERSONAL strength and weaknesses relative to the competencies
- Communication is key
(Showing up isn’t enough, actively contribute)
Competencies: Collaboration
- Respect other members of the team
- Value others contributions
- Be able to explain ones own position and role in the team
- Understand others roles and positions in the team
- Work interdependently with other team memebers
- Communicate effectively
- Refrain from agressive/demeaning behavior that could inhibit communication
- Apply the principles and methods of evidence based practive
Proactively seeking other professional’s contributions is a sign of _______
collaborative behavior
Competencies: Management
- Each individual is responsible for contributing to functional and social aspects of the team
- Team members use their insights into the team in order to pick new members who will be a good fit
- Can effectively orient new team members and make them feel welcome
- Individuals need to balance social vs task needs
- Be wary of forming sub groups
- Participate in evaluation and improvement of team performance through self and team evaluation
- Value the potential positive nature of conflict; take constructive steps to address conflict; know common sources of conflict; know strategies to deal with conflict; set guidelines for addressing conflict; work to resolve disagreements; establish a safe environment for diverse opinions; and allow all members to feel their viewpoints have been heard
Gram Positive or Gram Negative:
Lipopolysaccharide outer membrane
Gram Negative
Gram Positive or Gram Negative:
Thin Peptidoglycan
Gram Negative
Gram Positive or Grame Negative:
Thick Peptidoglycan
Gram Positive
Describe staining process
- Bacteria is heat fixed or dried oto slide
- Stain with crystal violent (precipitated with iodine)
- Wash and remove unbound with acetone-based decoloizer and water
- Stain with safranin (red) to any decolorized cells)
Gram-positive bacteria stain_____
Purple. With crystal violet
(the first crystal violet stain gets trapped in a thick, cross-linked, meshlike structure, called the peptidoglycan layer)
Gram-negative bacteria turn_____
Red. With Safranin
(have a thin peptidoglycan layer that does not retain the crystal violet stain, so the cells must be counterstained with safranin and turned red)
Gram Positive or Gram Negative:
Outer membrane
Gram Negative
Gram Positive or Gram Negative:
Endotoxin
Gram Negative
Cell wall:
Gram Positive and Gram Negative
Gram Positive: Thick
Gram Negative: Thin
Gram Positive or Gram Negative:
Teichoic acid
Gram Positive
Gram Positive or Gram Negative:
Sporulation
Gram Positive
Capsule:
Gram Positive and Gram Negative
Gram Positive: Sometimes present
Gram Negative: Sometimes present
Lysozyme:
Gram Positive and Gram Negative
Gram Positive: Sensitive
Gram Negative: Resisitant
Antibacterial activity of penicillin:
Gram Positive and Gram Negative
Gram Positive: More susceptible
Gram Negative: More resistant
Exotoxin production:
Gram Positive and Gram Negative
Gram Positive: Some strains
Gram Negative: Some strains
Which bacterial gram type is suspectible to pencillin
Gram positive
Which bacterial gram type can do sporulation
Gram positve
Descibe:
Staphylococcus aureus
- Gram positive cocci
- Grape like clusters
- Most common and most virulent of the staphylococci
- Infections produced byS aureusare typified by acute, aggressive, locally destructive purulent lesions
T/F
All persons have staphylococci present on their skin
T
About 30 percent of people are consistent carriers in the nares of adults
Staphylococcus aureus
Disease causing processes
- Toxin mediated: Toxic shock syndrome, scalded skin syndrome, food poisoning
- Bacterial Growth Mediated: purulent infections, pneumonia, endocarditis, septic arthritis, osteomyelitis, etc.
What are some of the many toxins S. aureus produces
- cytolytic
- exfoliative
- enterotoxins (food poisoning)
Food poisoning caused by ingestion of staphylococcal enterotoxin-contaminated food causes what symptoms
- Acute vomiting and diarrhea (within 1-5 hours)
- Prostration (exhaustion) but no fever
- Rapid recovery only old or sick
Toxic shock syndrome is caused by _______ toxin
TSST-1 toxin
S. Aureus Toxic Shock Syndrome symtoms
- Fever greater than 102F
- Hypotension
- Macular rash
- Multisystem involvement
S. Aureus Treatment
- Purulent infection = Drainage of pus
- Food poisining = Supportive care
- Toxic Shock = Penicillin or vancomycin (if MRSA) PLUS clindamycin
Clindamycin works how?
Inhibits protein synthesis and is thought to have actions against the TSST-1 toxin
What is the frug of choise for S. Aureus Treatment?
Penicillin remains the drug of choice against susceptible strains if the laboratory can reliably test for penicillin susceptibility
MRSA
(Methicillin resistant Staphylococcus aureus) resistance is mediated by _____________
Resistance is mediated by the PBP-2a protein, which is a penicillin-binding protein
(1. Encoded by the mecA gene
2. This protein does not interact with beta lactam antibiotics like penicillin which allows for continued formation of the cell wall)
What is Methicillin
Methicillin is a synthetic penicillin developed in 1960, MRSA was described in 1961
Descibe:
PBP-2a protein
- Encoded by the mecA gene
- This protein does not interact with beta lactam antibiotics like penicillin which allows for continued formation of the cell wall
MRSA Treatment
Vancomycin
MRSA symptoms
MRSA does not have any special presentation; it is simply more resistant to antibiotics and thus requires special attention to the administered treatment
Where does MRSA “live”
Lives on fomites in the hospital so handwashing/sanitizing is important
What defines a hospital acquired MRSA infection?
Defined as hospital acquired if an MRSA infection develops more than 48 hours after admission
