Prevention/controlling Transmission Of Infectious Agents Flashcards by Brad Krier

Category A bioterrorism agents:

Easily transmitted, high mortality/public health impact, panic.

Be past:
Botulism, Ebola/viral hemorrhagic, plague, anthrax, smallpox, tularemia(francisella tularensis)

How well did you know this?

Not at all

Perfectly

Category B bioterrorism agents

Moderately easy to disseminate, moderate morbidity/low mortality, require enhanced surveillance

Brucellosis, clostridium perfringes, glandes, Q fever, ricin, food and water safety threats, typhus, etc

How well did you know this?

Not at all

Perfectly

Category C bioterrorism agents

Emerging pathogens that could be engendered for mass dissemination.

Available, easy to produce, potentially high mortality and morbidity.

Nipha virus, hanta virus

How well did you know this?

Not at all

Perfectly

bioterrorism agents not spread from person to person

Anthrax, botulism, ricin, tularemia, viral encephalitis, q-fever(except rare occasions)

How well did you know this?

Not at all

Perfectly

Smallpox precautions

Airborne and contact

How well did you know this?

Not at all

Perfectly

Ebola precautions

Contact, standard

How well did you know this?

Not at all

Perfectly

Pneumonic plague precautions

Droplet (and standard)

How well did you know this?

Not at all

Perfectly

Strategies for VAP reduction

Elevate head of bed 30-40 degrees
Daily antiseptic of the mouth
Peptic ulcer disease prophylaxis 
Deep vein thrombosis prophylaxis 
Daily sedation vacations
Ensuring cuff pressure 
Turn patient side to side every 2 hours

How well did you know this?

Not at all

Perfectly

Operating rooms environment

Positive pressure to adjacent areas

15 air changes per hour- 3 of which must be fresh air

How well did you know this?

Not at all

Perfectly

The 3rd most common HAI?

SSIs

How well did you know this?

Not at all

Perfectly

Airborne precautions require how many air exchanges per hour?

12- with direct exhaust to outside.

It says 6 to 12 but I am saying 12.

How well did you know this?

Not at all

Perfectly

For any waste to be capable of causing infections- the following are required

Presence of a pathogen if sufficient virulence and dose
Portal of entry for the organism into the body
Susceptible host

How well did you know this?

Not at all

Perfectly

What ensures a timely notification for the IP for early planing of construction efforts?

Construction and renovation policy (CRP)

How well did you know this?

Not at all

Perfectly

Neisseria meningitides is a gram negative diplodoci. What precautions are indicated?

Standard plus Droplet for first 24 hours of antibiotic treatment

How well did you know this?

Not at all

Perfectly

Cauti prevention

Documented of need for cath
Collection is a closed system
Urine bag is below the level of patient bladder
Tubing is free of loops

How well did you know this?

Not at all

Perfectly

List the mechanical barriers to infection

Intact skin, mucous membranes, cilia, bacterial flora

How well did you know this?

Not at all

Perfectly

What is the most common hai in pediatric wards

Rsv

How well did you know this?

Not at all

Perfectly

Suspect tb patients should stay in isolation until

Another diagnosis is made to explain condition or 3 consecutive negative sputum collected 8-24 hours apart and one should be early morning

How well did you know this?

Not at all

Perfectly

Ways Ip can support anti microbial stewardship

Calculate infection rates of Mdro
Calculate incidence based on culture results
Use molecular typing for outbreaks
Detect asymptomatic carriers using active surveillance cultures

How well did you know this?

Not at all

Perfectly

What is the first thing that should be done when hemodialysis water cultures are over the limit?

Disinfect the system with 48 hours of report

How well did you know this?

Not at all

Perfectly

What are risk factors for tb transmission

Cavitation disease, smear positive, cough

Improper ventilation, improper rooming, and improper respirator n95 use.

Surgical mask on patient reduces risk

How well did you know this?

Not at all

Perfectly

According to ACIP which of the following should receive hep b vaccine

Multiple sex partners/msm
Adults with diabetes
Residents and staff of facilities for development delayed persons

How well did you know this?

Not at all

Perfectly

Why should healthcare workers with patient contact from wearing artificial nails

They are more likely to have more gram negative bacteria under their bails compared to natural nails

What recommendation regarding mask wearing for staff with documented immunity when caring for a patient in airborne precautions for varicella?

No mask is needed. The same is true for measles

Infections of short term IV devices (fewer than 10 days) are associated with what?

Percutanious transmission during insertion Extraluinal transmission Contamination if iv fluids In contrast long term device infections are generally from contaminated Cather hub and liminal fluid

What should be stressed in the annual evaluation of the ip program?

Outline the achievements and activities of the program | The value of the program to the organization

Activities to reduce CRE transmission

Place colonized patients in contact precaution Minimize device use Use antibiotics appropriately Notify provider of positive results Do not do universal screening- focus on high risk- icu, long term care

Multi dose vial for eye drops

Should not be used on multiple patients if they have infection of the eye. If no infection and it does not have contact with patient conjunctiva or tears it can be shared and must be used in 28 days

To improve hand hygiene compliance you should use multiple strategies including:

Provide evidence based info about hand contamination Effect of hand hygiene products on skin Info about association between hand hygiene practices and transmission of infection.

Which federal agencies have published regulations regarding infection and medical or regulated waste?

EPA, OSHA, DOT

What should be included when planning for active surveillance cultures?

Additional staff for lab and obtaining culture Ensuring turnaround time for results Mechanism to communicate results to provides Monitoring adherence to contact precautions Measure outcomes to evaluate effectiveness

According to cdc what precautions should be used for insertion of central lines?

Cap, mask, sterile gloves, sterile gown, and sterile full body drape

———— contact involves the transfer of infectious agent through a contaminated intermediate object or person

Indirect Examples include inadequately cleaned equipment, hands of hcw if not cleaned, food and water contamination

True or false- stopcocks can increase contamination rate of central lines?

True

What are the recommendations for pregnant with influenza in labor?

Droplet precautions Surgical mask and hand hygiene prior to contact with baby All persons within 3 ft of mom should mask

Which vein is associated with lower risk of clabsi

Subclavian

What are the 3 risk factors for postpartum urinary tract infections

Induction of labor Cesarean delivery Tocolysis. Not twin births!

Non infectious postoperative endophthalmitis is most often associated with:

Toxic anterior segment syndrome TASS

Malassezia furfur is most associated with

lipid infusions

Strategies to prevent infection of dialysis access site include

Utilizing an AV graft if a fistula cannot be established Using a tunneled cuff catheter for acute dialysis less than 3 weeks Using femoral catheters on bedbound patients only and for less than 5 days Jugular preferred over subclavian (opposite for clabsi prevention)

What is the recommended follow up for patient admitted with wound culture positive for mycobacterium marinum

No follow up required. Not transmissible

Is decolonization of MRSA positive patient prior to surgery a strategy to reduce transmission of infections in healthcare setting?

No. It is to prevent SSIs in individual patients

What are the highest risk antibiotics for c diff

Third generation cephalosporin

Prevention strategies to reduce SSI

Administer antimicrobial prophylaxis in accordance with evidence based guidance. Hour prior to incision, 2 hrs for vancomycin and flouroquinilones Identify and treat remote infections before elective operations.

Activities to reduce the bioload of microorganisms on pts skin:

Washing from clean to less clean areas Preop shower using antimicrobial soap Washing with antimicrobial soap to reduce carriage of resistant organism Active surveillance for epi significant organism Maintained good oral hygiene Encourage good genital area cleaning Good hand hygiene Treatment of remote site infections prior to surgery Personal risk reduction like smoking secession, weight loss

Patients that received small pox vaccine need what precautions

Standard. Unless Eczema vaccinatum or generalized vaccinia - which would warrant contact precautions

Patients with rapid neurological degradation and positive results of either EEG (sharp wave complexes), 14-3-3 CSF assay, or mri .

Creutzfeldt Jakob disease

Privacy curtains should be changed and cleaned:

On a routine schedule and whenever soiled | Changed after a patient on contact isolation is transferred or discharged

What isolations precautions are indicated when unknown agent causes severe illness with rapidly progressing respiratory symptoms?

Airborne. Called syndrome based isolation precautions

The greatest concern in emergency situation with a patient with non traditional body piercing is

Not being familiar with the opening mechanism to remove it

Sterile gloves are required for:

Central line dressing changes Dressing change with bedside debridement Trach suctioning not within closed sheath

Factors that increase risk for HAI

Type of patient care activity Mode of transmission/pathogenicity of the infectious agent Patients host defenses Duration of exposure

Hep B HBsAg can be detected

During acute and chronic HBV infection Also may result 7-30 days after receiving Hep B vaccination

How long does s. Aureus like MRSA live on surfaces

``` Up to 12 months C diff: 5 months VRE: 46 months Klebsia: 30 months Noro: 2 weeks Pseudomonas/Acinobactor: 11/16 months ```

When/how often does CDC recommend changing floor mopping solution

Every 3 rooms and at least every 60 minutes

An organisms ability to enter tissue is its

Infectivity