Prevetning and Controlling Transmission Of Infectious Agents Flashcards
1
Q
Reservoir strep penumo
A
Human
2
Q
Animal reservoirs for influenza
A
Swine, birds
3
Q
Reservoir for worms
A
Dogs
4
Q
Animal reservoir for salmonella
A
Turtles and snakes
5
Q
Animal reservoir for rabies
A
Bats and raccoons
6
Q
Reservoir for babesia
A
Ticks
7
Q
Reservoir for Rocky mountain spotted fever
A
Tick
8
Q
Reservoir for West Nile virus
A
Mosquito
9
Q
Reservoir for cryptosporodia
A
Water, food
10
Q
Reservoir for salmonella
A
Food
11
Q
Reservoir for listeria
A
Food
12
Q
Reservoir for staph aureus
A
Human
13
Q
Reservoir for c diff
A
Human (can also be in env)
14
Q
Reservoir for aspergillus
A
Dust in env
15
Q
Reservoir for legionella
A
Water
16
Q
Reservoir for cryptococcus fungi
A
Soil
17
Q
Reservoir for coccidiodes
A
Soil
18
Q
Reservoir for sporothrix
A
Plants
19
Q
Portals of exit in humans
A
Sneezing
Coughing
Saliva
Vomit
Diarrhea
Open wounds
Semen
20
Q
Examples of portals of entry
A
Indwelling urinary catheters
IV devices including central lines
Ventilators
Surgical procedures
21
Q
Basic steps to prevent the transmission of microbes between HCP, patients, and the environment.
A
Standard precautions
22
Q
Describe standard precautions
A
Used for care of ALL patients, in ALL healthcare settings
23
Q
Transmission of infection requires these 3 elements:
A
Mode of transmission, vulnerable host, source of infection
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
25
Basics of standard precautions
1. Hand hygiene
2. PPE
3. Resp hygiene/ cough etiquette
4. Safe work practices
5. Env cleaning
6. Safe injection practices
7. Patient placement
26
Single most effective measure that can be taken to decrease the transmission of organisms
Hand hygiene
27
When is soap and water required?
Outbreaks of C. Diff and norovirus, bacillus anthracis
28
Moments for hand hygiene
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
29
What it is important to use soap and water for spore forming organisms
Soap and water washes the spores away that are resistant to the chemicals
30
Purpose of PPE
Protect skin, eyes, mucous membranes, airways, and clothing from infectious agents
31
When should gowns be worn?
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
32
Difference in gowns in regular HCP settings versus surgery and trauma
Surgery - fluid proof (see larger amounts of blood)
Reg healthcare- fluid resistant
33
When should gloves be worn?
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
When should masks be worn?
For sprays of blood or bodily fluids, particularly resp secretions
35
What is the purpose of surgical masks?
Protect the patient from infectious agents possibly in the HCPs nose or mouth during sterile procedures
36
When to wear eye protection (goggles or face shields)
When sprays or splashed of resp secretions, blood, or body fluids my feet until eyes, face, or mucous membranes
37
Specific examples of sterile procedures when HCP should wear surgical mask
- Insertion if catheter
- Injections into spinal or epidural spaces during lumbar puncture procedures
38
True or false- glasses offer adequate eye protection
False
39
What is source control?
Usually mask, protects others from the wearers resp droplets/ infectious agents
40
Describe the competents of respiratory hygiene/ cough etiquette
- 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
Special considerations for resp hygiene for HCP
If HCP symptomatic, refrain from providing patient care
If HCP must provide care, wear mask as source control
42
Examples of safe work practices
- don't touch mucous membranes
- position patients to avoid splatters/ sprays
- PPE positioned properly
- barriers used for resuscitation
43
Standard precautions for env cleaning- direction to clean
Top to bottom
Clean to dirty
44
How often should noncritical equipment be cleaned?
After each patient use
45
Best practices for soiled and contaminated equipment
-handle to prevent microbe transfer to HCP and env
- store separately from clean equip
46
Examples of noncritical items
Vital signs machines (like pulse oximeters and reusable blood pressure cuffs), blood glucometer devoces
47
What are the rules of safe injection practices?
- 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
What is the rule for the diaphragm of the vial before injection?
The diaphragm (rubber part at top) must be disinfected with antiseptic (typically alcohol wipe) immediately before accessing with a needle
49
Advice for recapping needles
Avoid recapping
If you must, then use 1 hand technique
50
When should safety devices on syringes be activated?
Immediately after injection given
51
Disposing of used sharps
Dispose of in puncture resistant container designated for sharps disposal
52
Under what circumstances should a patient have a single room?
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
Another name for transmission based pecautions
Isolation pecautions
54
True or false, standard precautions still apply when implementing transmission based precautions
True
55
Why screen for organisms that can colonize like MRSA or VRE
Unidentified patients who are colonized or infected with infectious agents represent a risk to other patients and hcp
56
What are the different types of transmission based precautions
Contact precautions
Droplet precautions
Airborne precautions
Protective environment
57
Can you implement multiple types of transmission based precautions at the same time?
Yes
58
When should contact precautions be used?
VRE, MRSA, ESBL, C Diff
59
What are contact precautions
- 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
What additional precautions are needed for C Diff
- spore forming oeganidms require disinfectant with 1:10 bleach solution
- gloves!
- soap and water during outbreaks to physically wash spores from hands
61
Does abhr kill spores? E
No
62
What organisms are droplet precautions commonly used for
Influenza
RSV
Pertussis
Bacterial meningitis due to neisseria meningitis or haemophilus influenzae
63
What are the droplet precautions
- 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
When are airborne precautions used?
TB, varicella, measles
65
Room for airborne precautions
Airborne infection isolation room
66
How many air exchanges per hour does an AIIR have? Where does exhaust go?
6-12, directly exhausted outside
67
PPE for airborne precautions
N95 if higher resp, or PAPR
68
Airborne precautions
- AIIR
- N95
- limit transport
- patient wears mask outside of room
- clean daily with focus on high touch areas
- door stays closed
69
Another name for protective environment
Reverse isolation
70
Who is a protected environment recommended for?
Patients with weakened immune system to reduce the risk of invasive, opportunistic pathogens
71
Example of patient who would need a protective env
Allogenic hematopetic stem cell transplant recipient
72
Type of filtration and number of air exchanges for protective environment
hEPA filtration
12 air exchanges per hour
73
Bathing method on protective environment
Baths instead of showers to prevent aersolizarion
74
Any changes to nutrition for protective environment?
No
75
What PPE in protective env?
Droplet/ contact PPE
76
Rules for plants in protective environment
No fresh flowers or potted plants
77
When to use droplet for meningitis
N. meningitidis or haemophilus influenzae
78
