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LTC-CIP > Prevention and Control of Infectious and Communicable Diseases > Flashcards

Prevention and Control of Infectious and Communicable Diseases Flashcards

1
Q

In the application of HACCP, is microbiological testing an effective means of monitoring CCPs?

A

no because of the time required to obtain results

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2
Q

How are CCPs monitored?

A

through physical and chemical tests and visual observations

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3
Q

Properly designed HACCP systems consider what hazards?

A

physical, chemical, and biological

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4
Q

Define critical control point

A

a step at which a control can be applied and is essential to prevent or eliminate a food safety hazard or reduce it to an acceptable level

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5
Q

define critical limit

A

a maximum or minimum value to which a parameter must be controlled at a CCP to reduce the hazard

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6
Q

define HACCP

A

a systematic approach to the identification, evaluation, and control of food safety hazards

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7
Q

What are the 7 HACCP principles?

A
  1. conduct a hazard analysis
  2. determine the CCPs
  3. establish critical limits
  4. establish monitoring procedures
  5. establish corrective actions
  6. establish verification procedures
  7. establish record keeping and documentation procedures
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8
Q

Why are LTC residents at increased risk for gastroenteritis?

A

age-related decrease in gastric acid, proton pump inhibitors, and other anti acids

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9
Q

What is the most common cause of gastroenteritis in the US?

A

Norovirus

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10
Q

Which foods are commonly involved in foodborne norovirus outbreaks?

A

leafy greens, shellfish, fresh fruits

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11
Q

Why is foodborne illness more serious for the elderly?

A

Risk of dehydration

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12
Q

What are some steps to foodborne outbreak investigation?

A
  1. detect the outbreak
  2. define and find cases
  3. generate a hypothesis
  4. test the hypothesis
  5. determine source of contamination
  6. control the outbreak
  7. decide the outbreak is over
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13
Q

Why is ab therapy for Salmonella only recommended for those with severe illness or at risk for complications?

A

it can prolong the duration of excretion of non-typhoidal salmonella

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14
Q

True or false. Antibiotic resistance for Salmonella is increasing?

A

True

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15
Q

which rugs are used to treat salmonella?

A

ampicillin, fluroquinolones, third generation cephlasporins

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16
Q

Which animals are likely to harbor Salmonella?

A

reptiles and young birds

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17
Q

what is clostridium perfringens?

A

a spore-forming, gram positive bacterium that may produce toxins causing disease in the intestines

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18
Q

where is C. perfringens found?

A

the digestive tracts or humans and animals and environmental sources

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19
Q

Which foodborne illness develop with 6-24 hours and last less than 24 hours?

A

C. perfringens

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20
Q

People with ____ typically do not have fever or vomiting

A

C. perfringens

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21
Q

Which foodborne illness is NOT transmitted from one person to another?

A

C. perfringens

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22
Q

What are sources of C. perfringens infection?

A

beef, poultry, gravies, and dried or precooked foods. Often occurs when foods are prepared in large quantities and kept warm for a while before serving

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23
Q

Foods should be kept warmer than ____ or cooler than ___ to prevent growth of C. preferingens that survived the initial cooking process

A

140F (60C) or 41F (5C)

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24
Q

leftover foods should be stored at what temp?

A

40F (4C)

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25
Q

Which food borne illness may cause bloody diarrhea?

A

campylobacter

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26
Q

A resident with listeriosis would usually have what symptoms?

A

fever and muscle aches, sometimes preceded by diarrhea or GI

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27
Q

True or false. Most people with listeriosis usually do not have an invasive infection (meaning bacteria spread beyond the GI tract)

A

False

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28
Q

What are common invasive presentations of listeriosis?

A

meningitis and septecemia

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29
Q

True or false. Hand rub is accptable in food prep areas

A

False. Use hand washing

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30
Q

True or false. Ready to eat foods can be handled with bare hands

A

False

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31
Q

Who provides regulations for linen management?

A

CMS

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32
Q

What are some general inspection critieria for laundry?

A

-a physical barrier between clean and soiled linen areas
-to avoid re-contamination of clean linen, ventilation should not move from soiled processing areas to clean laundry areas
-clean and disinfectant carts, shelves, and folding tables
-procedure for handling sharps found in linen
-hand hygiene products and washing sinks available to laundry personnel
-train personnel on PPE
-procedure for cleaning utility gloves between use
-laundry equipment is checked and maintained and this information documented

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33
Q

Is chlorine bleach required for all laundry?

A

No

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34
Q

do laundry detergents have to state they are antimicrobial?

A

No

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35
Q

Is ozonated water acceptable for laundry processing?

A

Yes

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36
Q

What is the cleaning process for linen with lice or scabies?

A

Wash and dry at high temps. Treating with an insecticide is not necessary

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37
Q

What are infection measures for gait belts?

A

have one dedicated to the resident and clean between resident uses

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38
Q

What info should the IP know about the lab?

A

-types of tests and normal ranges for each
-turnaround times
-holding and transport
-specimen collection procedures
-methods of reporting results
-tests not performed

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39
Q

How should urine for culture be obtained?

A

freshly voided or from the catheter/ not from the drainage bag

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40
Q

residents with indwelling urinary catheter should have the device changed before collection if it has been in place for longer than how long?

A

14 days

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41
Q

True or false. You should assign multidose vials to a single resident where possible

A

True

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42
Q

True or false. You should disinfect vial hubs prior to use

A

true

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43
Q

True or false. Footcare is outside of the life enrichment scope and should only be performed by authorized individuals

A

True

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44
Q

True or false. designated nail care tools are ideal

A

True

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45
Q

Should transport vehicle drivers have bloodborne pathogen training and hep B vaccination?

A

Yes

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46
Q

True or false. Dogs should be discouraged from licking and patients should not give treats to dogs

A

True

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47
Q

Which animals should not be LTC pets?

A

stray, wild, or feral animals. Reptiles, snakes, amphibians, and turtles. Monkeys and nonhuman primates, guinea pigs, rats, chinchillas, mice, hedhehogs, ferrets, sugar gliders

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48
Q

Which residents should be vaccinated against hepatitis b?

A

those who have diabetes, kidney or liver disease

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49
Q

CMS requires which vaccines be oferred to new admissions?

A

Influenza and pneumococcal

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50
Q

Pneumonococcal vaccination is recommended as

A

a series of two different vaccines (PCV13 and PPSV23)

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51
Q

What are recommended vaccines fr LTC residents?

A

-influenza
-td
-tdap
-shingles
-pneumococcal
-hep B (select residents)

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52
Q

what time of year is Influenza vaccine recommended?

A

September to May

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53
Q

Which vaccine info is required to be recorded?

A

-edition date of the VIS
-date VIS provided
-name, address, and title of the person who gave the vaccine
-date of administration
-vaccine manufacturer and LOT
-consent obtained
-type and name of vaccine
-LTC facilitys address

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54
Q

Is there a federal requirement for informed or written consent prior to vaccination?

A

No

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55
Q

do influenza and pneumovax require a written physician order?

A

No

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56
Q

do some states have informed consent laws?

A

Yes

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57
Q

Depending on which vaccine is given, adverse events have to be reported. The VAERS requires what information?

A

-type of vax
-timing of vax
-onset of adverse event
-current illnesses or medication
-past history of adverse events following vaccination

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58
Q

Refigerated vaccines must be stored at what temp?

A

36F-46F

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59
Q

True or false. Blood glucose monitors can spread hep B between patients because Hep B is environmentally stable and blood that can’t be seen with the naked eye can transmit

A

True

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60
Q

Which flu vaccines can be given to adults 65+?

A

standard or high dose, trivalent or quadrivalent, unadjuvanted or adjuvanted

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61
Q

Medicare pays for what vaccines?

A

influenza, hep b if you’re at intermediate to high risk, and pneumonococcal

62
Q

What temp should whole meats be cooked to?

A

145F

63
Q

What temp should ground meats be cooked to?

A

160F

64
Q

What temp should poultry be cooked to?

A

165F

65
Q

What are the effects of botulism on the body?

A

stops the bodys control of muscle movement including the muscles that help you breathe

66
Q

True or false. Botulism creates toxic spores

A

True

67
Q

What are the 3 types of botulism?

A
  1. foodborne botulism
  2. infant botulism
  3. wound botulism
68
Q

Where does botulism typically come from?

A

improperly home-canned, preserved, or fermented foods

69
Q

What are some foods that have caused Salmonella?

A

Eggs, cucumbers, chicken, raw tuna, sprouts, pre-cut melon

70
Q

What are some foods people who are more likely to get food poisoning should not eat?

A

-undercooked or raw animal foods
-raw or lightly cooked sprouts
-unpasteurized milk or juices
-soft cheeses unless made with pasteurized milk

71
Q

What are 5 signs of severe food poisoning?

A
  1. fever 103F
  2. bloody diarrhea
  3. vomitting so hard you can’t keep liquids down
  4. diarrhea lasting more than 3 days
  5. signs of dehydration
72
Q

What are some germs commonly found in meat?

A

salmonella, e.coli, yersinia

73
Q

what are some germs commonly found in poultry?

A

salmonella, campylobacter, c. perfringens

74
Q

Which bacteria can raw milk carry?

A

salmonella, campylobacter, cryptosporidium, e.coli, listeria, and brucella

75
Q

Which germs can raw seafood contain?

A

vibrio and norovirus

76
Q

Fish with fins should be cooked to what temp?

A

145F

77
Q

Which germs can you get from raw flour?

A

salmonella and e. coli

78
Q

How long does a refigerator keep food safe during a power outage if you don’t open the door?

A

4 hours

79
Q

True or false. A full freezer will keep food safe for 48 hours (or 24 if half full) without power if you don’t open the door

A

True

80
Q

_____ alcohol has a slightly greater activity against bacteria and ____ alcohol has a greater activity against viruses

A

isopropyl; ethyl

81
Q

ABHR must contain what range of ethyl or isoproperyl alcohol?

A

60-95%

82
Q

What are some methods for monitoring hand hygiene adherence?

A
  1. directly observe HH opportunities and adherence
  2. monitor the volume of HH products used per 1000 patient days
  3. video monitoring or sensing devices
83
Q

What are 5 fundemental elements needed to prevent the transmission of infectious agents?

A

-internal communiction
-extneral communication’-administrative support
-adequate IPAC staffing
-education

84
Q

How many air exchanges per hour are needed in an airborne isolation room?

A

6-12 exhausted outside

85
Q

True or false. A patient on airborne precautions must wear an N95 to leave their room

A

False. They need to wear only a surgical mask.

86
Q

What is a protective environment?

A

it is recommended for allogenic hematopoietic stem cell transplant recipients to reduce the risk of invasvie envrionmental fungal infections and other opportunistic infections.

87
Q

what environmental controls are used to create a protective environment?

A

filter incoming air with HEPA filtration that is at positive pressure with relation to the corridor at 12 air exchanges per hour.

88
Q

what environmetnal measures are used for a protective environment?

A

-clean rooms with techniques that minimize dust
-avoid upholstered furnishings
-wet dust horizontal surfaces
-prohit dried and fresh flowers or potted plants

89
Q

How do you implement airborne precautions in the protected environment?

A

-anteroom must be present
-hepa filter in the anterroom
-positive air pressure

90
Q

Asepsis is defined as

A

the process of preventing contact with microbes

91
Q

True or false. Alcohol has no residual antimicrobial effect but immediately lowers bacterial counts

A

True

92
Q

True or false. CHG has residual effects and is approved for hand asepsis

A

True

93
Q

What are antiseptic agents?

A

antimicrobial substances applied to the skin to reduce microbial flora

94
Q

True or false. OSHA requires employers provide appropriate PPE to workers who could be exposed to blood and infectious materials

A

True

95
Q

Which sections of OSHA make employers responsible for ensuring that required PPE is worn by the worker?

A

25 and 27

96
Q

Under what section of the OHSA do workers have a duty to wear or use the PPE required by law and the employer?

A

Section 28

97
Q

True or false. Workers must report any missing or defective PPE to the supervisor

A

True

98
Q

When is hand hygiene with soap and water recommended?

A

-when hands are visibly soiled
-when preparing food
-contact with c.diff or Norovirus

99
Q

why is ABHR the gold standard for HH?

A

-rapid antimicrobial effect
-reduce dryer of users skin

-more convineint
-leave minimal to no residue
-do not contribute to antibiotic resistance

100
Q

selection of hand hygiene products should be based on what?

A

-cost effectiveness
-smell
-conistency/feel of product
-color
-ease of lathering

101
Q

what should some components of a PPE training program be?

A

-when PPE is worn
-what PPE to wear
-how to don, remove, adjust, and wear each type of PPE
-care, maintenance, useful life, and storage of PPE
=how and when PPE should be safely disposed of
-limitations of each type of PPE
-competency reassessment (no less than annually)

102
Q

what are the 3 primary reasons for using PPE in LTC?

A
  1. resident care
  2. cleaning and disinfecting the facility (especially resident rooms)
  3. cleaning and disinfecting reusable equipment, devices, and the environment
103
Q

what are 2 OSHA PPE regulations?

A
  1. BBP standard
  2. respiratory protection standard
104
Q

what is outlined in the BBP standard?

A

-masks, eye protection, face shields, and gowns are mandated to be worn at no cost to the employee when there is a risk of the employee to blood
-maintain appropriate PPE, reappraisal of PPE stock, selection, and provision

105
Q

when does NIOSH require an N95 be worn?

A

for airborne precautions or seasonal influenza if an aerosol-generating procedure

106
Q

what is the donning sequence?

A

gown
mask
shield or googles
gloves

107
Q

what is the doffing sequence?

A

gloves
sani
goggles or shield
gown
sani
mask
wash hands or use ABHR after removing all PPE

108
Q

Where do you dipose of PPE?

A

before leaving the patients room

109
Q

where do you dispose of an N95?

A

after leaving the room

110
Q

what are 3 factors for evaluating PPE?

A

-availability and accessibility
-storage
-correct usage

111
Q

if re-capping a needle is necessary what technique should be used?

A

one-handed

112
Q

safety devices of needles must be engaged ____ after use

A

immediately

113
Q

part of respiratory etiquette means wear a mask if unable to maintain spatial separation ___ feet between beds

A

3

114
Q

what are standard precautions for resuscitation?

A

use motuhpiece, resuscitation bag, or ventilation devices to prevent contact with mouth and oral secretions

115
Q

what are some factors to consider when implementing TBP?

A

-administrative support
-infection prevention staffing
-communication
-policies and procedures
-education
-infrastructure

116
Q

what is the hierarchy of controls for TBP?

A
  1. PPE
  2. Administrative controls
  3. engineering controls
  4. substitution
  5. elimination
117
Q

what are some components of droplet precautions?

A

-3 to 6 feet distance of transmission
-masks and eye protection for staff
-residents wear a surgical mask

118
Q

what PPE has to be worn on airborne precautions?

A

-massks and N95 (addition of gloves and gown based on PCRA)
-washout period
-resident wears a surgical mask when mobilizing

119
Q

what are some high contact situations for EBP?

A

-bathing/showering
-bathroom assistance
-dressing/changing clothes
-wound or device care
-changing linens

120
Q

what are intensified precautions?

A

Used when both SP and TBP fail to halt transmission of infectious organisms

121
Q

what are examples of when to implement intensified precautions?

A

-cohorting infected and colonized residents
-dedicating staff to care for isolated or cohorted residents
-restricting new admission or closing affected nursing units
-increasing and enhancing environmental cleaning and disinfection procedures
-performing active surveillance cultures

122
Q

foods purchased and prepared must meet ___ requirements

A

FDA

123
Q

frozen foods should be kept at what temps?

A

-10 to 0F

124
Q

eggs should be stored at what temp?

A

45F or 40F for best quality

125
Q

dairy products, meat, poultry, and shellfish should be stored at what temp?

A

32 to 41F

126
Q

dry storage should be what temp?

A

50 to 70F

127
Q

fruits and vegetables should be stored at what temp?

A

32 to 41F

128
Q

what are the steps to a foodborne outbreak control investigation?

A
  1. detecting
  2. defining case and notifying the health department
  3. hypothesis generation
  4. testing the hypothesis
  5. find the point of contamination
  6. control the OB
  7. declare over
129
Q

which FBI lasts less than 24 hours and is not passed person to person?

A

clostridium perfringens

130
Q

which FBI is a risk to LTC residents participating in pet therapy>

A

salmonella

131
Q

almost everyone diagnosed with this FBI has an inasvive infection that spreads beyond the GI tract and common presentations are meningitis and septicemia

A

listeria

132
Q

this foodborne illness has a seasonal infection risk

A

cyclospora (a parasite found in tropical and subtropical regions)

133
Q

cyclospora is linked to what foods?

A

imported fresh produce, raspberries, basil, snow peas, cilantro (not frozen or canned produce)

134
Q

what is onychomycosis?

A

dust control measure, proper PPE and cleaning and disinfectant after podiatric treatment

135
Q

what are some IPAC practices for podiatric care?

A

-sterilie/disifnect equipment using HLD
-diabetic foot ulcers are treatment in outpatient poditary
-mechanism of reporting for residents with infection post procedure
-dedicated treatment spaces
-checklist and observation tool to measure adherence to IPC policies

136
Q

what are IPAC rules for cosmetic nail and hair care?

A

-disposable product, cleaning guidelines, chemical use and storage, salon safety rules
-EPA approved disinfectant
-personnel to only perform services within scope
-proper PPE when nail care is done

137
Q

what are some risks for residents and dental HPC?

A

blood and oral/respiratory excretions, improper reprocessing, poor water quality, sharps

138
Q

what are some IPAC dental care policies?

A

-regulation requires assessment of oral health of residents on admission then on regular schedule (quarterly/annually) through outside services
-toothbrush replaced every 3 months. Use antimicrobial alcohol rinse to clean brushes

139
Q

what are routes of transmission for dental care?

A

-direct contact
-indirect contact
-aerosols

140
Q

Which agency regulates antiseptic agents?

A

FDA

141
Q

alcohols concetration of ABHR should be

A

60-95%

142
Q

what are examples of when soap and water should be used

A

-after caring for a patient with GI or a spore forming organism
-after using the restroom
-before eating or preparing food

143
Q

what area of the hands harbors high bacteria concentrations?

A

subungual

144
Q

large droplets travel ____feet whereas small droplets travel ____ feet

A

1-3; 3-6

145
Q

where does air from an AIIR get exhausted?

A

outside

146
Q

do transport staff of a patient on airborne precautions need to wear respiratory protection?

A

no if the patient is masked and all skin lesions are covered

147
Q

when should a patient wear an N95?

A

patients leaving a protected environment during times of construction

148
Q

what do you do if a patient in a protective environment needs to be on airborne precautions and an anteroom is not available?

A

place in an airborne room and use a HEPA filer inside to filter fungal sproes

149
Q

which product has persistent effects and is approved for hand antisepsis?

A

CHG

150
Q

what are some elements of a respiratory hygiene program?

A

-education
-signs
-controls
-hand hygeine locations

151
Q

what is antimicrobial soap?

A

soap that contains an antiseptic agent

152
Q

What is a control point?

A

any step at which biological, physical, or chemical factors can be controlled

LTC-CIP (9 decks)

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