Prevetning and Controlling Transmission Of Infectious Agents Flashcards

1
Q

Reservoir strep penumo

A

Human

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2
Q

Animal reservoirs for influenza

A

Swine, birds

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3
Q

Reservoir for worms

A

Dogs

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4
Q

Animal reservoir for salmonella

A

Turtles and snakes

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5
Q

Animal reservoir for rabies

A

Bats and raccoons

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6
Q

Reservoir for babesia

A

Ticks

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7
Q

Reservoir for Rocky mountain spotted fever

A

Tick

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8
Q

Reservoir for West Nile virus

A

Mosquito

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9
Q

Reservoir for cryptosporodia

A

Water, food

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10
Q

Reservoir for salmonella

A

Food

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11
Q

Reservoir for listeria

A

Food

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12
Q

Reservoir for staph aureus

A

Human

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13
Q

Reservoir for c diff

A

Human (can also be in env)

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14
Q

Reservoir for aspergillus

A

Dust in env

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15
Q

Reservoir for legionella

A

Water

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16
Q

Reservoir for cryptococcus fungi

A

Soil

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17
Q

Reservoir for coccidiodes

A

Soil

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18
Q

Reservoir for sporothrix

A

Plants

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19
Q

Portals of exit in humans

A

Sneezing
Coughing
Saliva
Vomit
Diarrhea
Open wounds
Semen

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20
Q

Examples of portals of entry

A

Indwelling urinary catheters
IV devices including central lines
Ventilators
Surgical procedures

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21
Q

Basic steps to prevent the transmission of microbes between HCP, patients, and the environment.

A

Standard precautions

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22
Q

Describe standard precautions

A

Used for care of ALL patients, in ALL healthcare settings

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23
Q

Transmission of infection requires these 3 elements:

A

Mode of transmission, vulnerable host, source of infection

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24
Q

Standard precautions protect both HCP and patients from infection, and prevents the spread of microbes between hosts through …

A

Direct Person to person transmission or indirect person to environment to person transmission

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25
Q

Basics of standard precautions

A
  1. Hand hygiene
  2. PPE
  3. Resp hygiene/ cough etiquette
  4. Safe work practices
  5. Env cleaning
  6. Safe injection practices
  7. Patient placement
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26
Q

Single most effective measure that can be taken to decrease the transmission of organisms

A

Hand hygiene

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27
Q

When is soap and water required?

A

Outbreaks of C. Diff and norovirus, bacillus anthracis

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28
Q

Moments for hand hygiene

A
  1. After contact with blood, body fluids, secretions, and excretions
  2. After touching contaminated items
  3. Before AND after using gloves or other PPE
  4. Between contact with each patient
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29
Q

What it is important to use soap and water for spore forming organisms

A

Soap and water washes the spores away that are resistant to the chemicals

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30
Q

Purpose of PPE

A

Protect skin, eyes, mucous membranes, airways, and clothing from infectious agents

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31
Q

When should gowns be worn?

A

When performing patient care activities or procedures in which exposed skin or clothing can be exposed to any patient blood, body fluids, secretions, or excretions

When handling equipment or env surfaces that have been contaminated

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32
Q

Difference in gowns in regular HCP settings versus surgery and trauma

A

Surgery - fluid proof (see larger amounts of blood)

Reg healthcare- fluid resistant

33
Q

When should gloves be worn?

A

When touching mucous membranes or non-intaxt skin of a patient

When touching patient blood, body fluids, secretions or excretions or

When handling equipment that has been contaminated

34
Q

When should masks be worn?

A

For sprays of blood or bodily fluids, particularly resp secretions

35
Q

What is the purpose of surgical masks?

A

Protect the patient from infectious agents possibly in the HCPs nose or mouth during sterile procedures

36
Q

When to wear eye protection (goggles or face shields)

A

When sprays or splashed of resp secretions, blood, or body fluids my feet until eyes, face, or mucous membranes

37
Q

Specific examples of sterile procedures when HCP should wear surgical mask

A
  • Insertion if catheter
  • Injections into spinal or epidural spaces during lumbar puncture procedures
38
Q

True or false- glasses offer adequate eye protection

A

False

39
Q

What is source control?

A

Usually mask, protects others from the wearers resp droplets/ infectious agents

40
Q

Describe the competents of respiratory hygiene/ cough etiquette

A
  • educate on signs and symptoms of respiratory illness
  • post signs at facility entries
  • source control accessible
  • hand hygiene easily accessible (esp entrance/ waiting areas)
  • those with resp symptoms sit at least 3 ft from others
41
Q

Special considerations for resp hygiene for HCP

A

If HCP symptomatic, refrain from providing patient care

If HCP must provide care, wear mask as source control

42
Q

Examples of safe work practices

A
  • don’t touch mucous membranes
  • position patients to avoid splatters/ sprays
  • PPE positioned properly
  • barriers used for resuscitation
43
Q

Standard precautions for env cleaning- direction to clean

A

Top to bottom
Clean to dirty

44
Q

How often should noncritical equipment be cleaned?

A

After each patient use

45
Q

Best practices for soiled and contaminated equipment

A

-handle to prevent microbe transfer to HCP and env
- store separately from clean equip

46
Q

Examples of noncritical items

A

Vital signs machines (like pulse oximeters and reusable blood pressure cuffs), blood glucometer devoces

47
Q

What are the rules of safe injection practices?

A
  • one needle, one syringe, one time
  • open sterile package immediately before use and keep from contamination
    -single dose vials preferred
  • never recap, bend, or break used needles
  • engage safety devices immediately after use
  • dispose of in sharps container
48
Q

What is the rule for the diaphragm of the vial before injection?

A

The diaphragm (rubber part at top) must be disinfected with antiseptic (typically alcohol wipe) immediately before accessing with a needle

49
Q

Advice for recapping needles

A

Avoid recapping
If you must, then use 1 hand technique

50
Q

When should safety devices on syringes be activated?

A

Immediately after injection given

51
Q

Disposing of used sharps

A

Dispose of in puncture resistant container designated for sharps disposal

52
Q

Under what circumstances should a patient have a single room?

A
  1. Increase risk for transmission
  2. Likely to contaminate the environment
  3. Not able to maintain appropriate hygiene
  4. At increased risk for acquiring infections (immunocompromised)
  5. At increased risk of developing adverse outcomes following an infection
53
Q

Another name for transmission based pecautions

A

Isolation pecautions

54
Q

True or false, standard precautions still apply when implementing transmission based precautions

A

True

55
Q

Why screen for organisms that can colonize like MRSA or VRE

A

Unidentified patients who are colonized or infected with infectious agents represent a risk to other patients and hcp

56
Q

What are the different types of transmission based precautions

A

Contact precautions
Droplet precautions
Airborne precautions
Protective environment

57
Q

Can you implement multiple types of transmission based precautions at the same time?

A

Yes

58
Q

When should contact precautions be used?

A

VRE, MRSA, ESBL, C Diff

59
Q

What are contact precautions

A
  • single room
  • PPE- gown and gloves
  • dedicated or disposable equip
  • clean hands before entering and after leaving
  • limit transport outside of room to medically necessary purposes
  • clean daily with focus on high touch areas and areas close to patient
60
Q

What additional precautions are needed for C Diff

A
  • spore forming oeganidms require disinfectant with 1:10 bleach solution
  • gloves!
  • soap and water during outbreaks to physically wash spores from hands
61
Q

Does abhr kill spores? E

A

No

62
Q

What organisms are droplet precautions commonly used for

A

Influenza
RSV
Pertussis
Bacterial meningitis due to neisseria meningitis or haemophilus influenzae

63
Q

What are the droplet precautions

A
  • single room
  • mask and eye protection
  • limit transport
  • when outside of room, patient to wear mask
  • clean daily with focus on high touch areas
64
Q

When are airborne precautions used?

A

TB, varicella, measles

65
Q

Room for airborne precautions

A

Airborne infection isolation room

66
Q

How many air exchanges per hour does an AIIR have? Where does exhaust go?

A

6-12, directly exhausted outside

67
Q

PPE for airborne precautions

A

N95 if higher resp, or PAPR

68
Q

Airborne precautions

A
  • AIIR
  • N95
  • limit transport
  • patient wears mask outside of room
  • clean daily with focus on high touch areas
  • door stays closed
69
Q

Another name for protective environment

A

Reverse isolation

70
Q

Who is a protected environment recommended for?

A

Patients with weakened immune system to reduce the risk of invasive, opportunistic pathogens

71
Q

Example of patient who would need a protective env

A

Allogenic hematopetic stem cell transplant recipient

72
Q

Type of filtration and number of air exchanges for protective environment

A

hEPA filtration
12 air exchanges per hour

73
Q

Bathing method on protective environment

A

Baths instead of showers to prevent aersolizarion

74
Q

Any changes to nutrition for protective environment?

A

No

75
Q

What PPE in protective env?

A

Droplet/ contact PPE

76
Q

Rules for plants in protective environment

A

No fresh flowers or potted plants

77
Q

When to use droplet for meningitis

A

N. meningitidis or haemophilus influenzae

78
Q
A