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NPTE > Safety and Protection; Professional Responsibilities; Research > Flashcards

Safety and Protection; Professional Responsibilities; Research Flashcards

1
Q

Standard precautions

A

for the care of all patients regardless of infection or diagnosis

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2
Q

Transmission based precautions

A

airborne
droplet
contact

These are in addition to standard precautions

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3
Q

Airborne Precautions

A

Private negative pressure room

N95 or higher respirator when entering room. Pt should be wearing surgical mask.

examples: measles, varicella (chickenpox), TB, SARS

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4
Q

Droplet Precautions

A

Requires close contact; infectious agents travel 3-6 feet or less

Private room but door can be open

Pts in the same room need to be 3 ft apart

Pt and healthcare professional need to be wearing a mask especially when going to be 3-6 feet apart

examples: meningitis, pneumonia, sepsis, flu, mumps, strep

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5
Q

Contact Precautions

A

skin-to-skin transmission

Private room

Pts in same room should be 3 ft apart

Gloves and gown

examples: GI, respiratory, skin or wound infections (C-diff, E coli, MRSA)

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6
Q

Donning PPE

A

hand hygiene
gown
mask
goggles
gloves

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7
Q

Doffing PPE

A

gloves
goggles
gown
mask
hand hygiene

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8
Q

Sterile field

A

gowns are only sterile in the front from the waist up, including sleeves

only top of surfaces are sterile

talking, sneezing or coughing will contaminate the sterile field

do not turn your back to a sterile field; constant observation of sterile field is required.

If object on the sterile field becomes contaminated the field is considered non-sterile and should be discarded.

Sterile fields should be prepared as close to the treatment time as possible

Anything that falls below the waist is considered contaminated

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9
Q

Asepsis

A

elimination of microorganisms that cause infection and the creation of sterile field

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10
Q

Nosocomial infection

A

hospital acquired

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11
Q

PT response to allergic reaction

A

First try to remove source.
Then check airway
Then Epipen if have it

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12
Q

PT response to Autonomic Dysreflexia

A

First placed in upright position
identify noxious stimulus
monitor vitals and call for assistance

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13
Q

PT response to a burn

A

Initially remove source
Liquid chemical-dilute with water
Powder chemical- brush off
Thermal burn- under cool tap water
Burn covers a large area- cold water should not be used as it can increase risk for hypothermia.
Electrical burn-HR and RR should be assessed

All clothing or jewelry near burn should be removed unless it is in the burn itself.

Clean towel or dressing over wound to prevent infection.

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14
Q

PT response to fractures

A

peripheral pulses and sensation should be assessed distal to injury

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15
Q

Signs of Ketoacidosis that occurs with hyperglycemia

A

fruity breath
deep, labored breathing
N/V
dry tongue

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16
Q

If there is arterial bleeding…

A

intermittent pressure to artery proximal to site of injury
If blood flow is excessive, then extremity should be elevated above level of heart.
Prolonged pressure with tourniquet should be avoided.
After 10 minutes of steady pressure, call EMS.

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17
Q

After seizure do what with pts head

A

turn to side in case they vomit

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18
Q

Positioning of pt when in shock

A

supine with feet elevated above the level of head

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19
Q

Fowler’s position

A

supine with HOB elevated between 45-60 degrees with knees supported

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20
Q

Semi-fowler’s position

A

supine with HOB elevated 30-45 degrees

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21
Q

Fowler’s positions and its variations are used for

A

cardiac conditions
respiratory conditions
breathing difficulties
those with NG tube

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22
Q

Trendelenburg is used for

A

postural drainage
hypotension
medical emergencies like hypovolemic shock

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23
Q

Workstation recs:
Monitor size
Monitor display direction
Monitor set how far
How many exercise breaks
Space under desk

A

18-20 in

10 degrees below horizontal

at least 20 inches away

30 second breaks every hour

30 in wide
19 in deep
27 in high
2-3 inches between top of thighs and desk

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24
Q

Elbows should be bent to what when working

A

90-120 degrees

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25
Q

Employment provisions for disabilities (Title I) applies to who?

Title II, Public accommodations applies to who?

A

employers of 15 or more

all businesses regardless of size

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26
Q

ADA does not require employers to make accommodations that pose what

A

undue hardship
(significantly difficult or expensive)

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27
Q

Ramps should possess

A

12 inches of horizontal run for each inch of vertical rize.
8.3% grade

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28
Q

Ramp should be
how wide?
with ….. if rise is greater than 6 inches or horizontal run of greater than 72 inches.
Needs a level ….. at the top and bottom. If ramp changes direction, the landing area must be a minimum of what?

A

36 inches

HR

landing

5x5

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29
Q

Doorways need to be how wide?
Deep?

Thresholds in doorways need to be less than ___ inch for sliding doors and less than ___ inches for regular doors.

Hallway clearance needs…

W/c turning radius: width and length

A

32 inches

24 inches

3/4

1/2

36 inches

60 inches

78 inches

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30
Q

Validity

A

closeness to the truth

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31
Q

Impact

A

size of effect

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32
Q

Applicability

A

usefulness in clinical practice

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33
Q

PICO

A

Patient or problem
Intervention
Comparison
Outcome

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34
Q

Levels of Evidence Hierarchy from most reliable to least

A

systematic reviews and meta-analyses

RCTs

Cohort studies

case control studies

cross-sectional studies

case series

case reports

ideas/opinions

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35
Q

Cohort study

A

longitudinal, observational study

prospectively or retrospectively from historical records

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36
Q

The measure of association between exposure and disease in cohort studies is known as

A

the relative risk

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37
Q

Limitations of cohort studies

A

excessive length
influence of other lifestyle variables

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38
Q

Case control study

A

retrospective, observational study

already have a particular disease matched with a comparison group of individuals without the disease

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39
Q

Measure of association between exposure and occurrence of disease in case control studies is the

A

odds ratio

(the ratio of odds of exposure in disease subjects to the odds of exposure in non-diseased subjects)

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40
Q

Cross-sectional study

A

observational study where the data or observations are made at only one point in time and all subjects are tested at relatively the same time

aims to describe relationships between a disease or condition and factors of interest that exist in a specified population at a given time.

These studies cannot distinguish between newly occurring and long-established conditions, nor can they identify causal relationships.

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41
Q

Case reports or case series cannot

A

test hypotheses or establish cause and effect relationsips

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42
Q

Exploratory research

A

examines dimensions of a phenomenon of interest and its relationships to other factors.

Examples: cohort studies, case control studies, historical research and methodological studies

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43
Q

Descriptive research

A

recording, analyzing, and interpreting conditions that exist for the purpose of classification and understanding a clinical phenomenon.

Examples: developmental research, normative research, qualitative research, case report, case series

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44
Q

Experimental research

A

Comparing 2 or more conditions for the purpose of determining cause and effect relationships between independent or dependent variables.

Examples: RCTs, quasi-experimental studies and single-subject designs

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45
Q

Assent

A

childs affirmative agreement to participate in research.

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46
Q

A childs failure to object should

A

not be construed as agreement

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47
Q

Belmont Report articulated three ethical principles that guide human subjects’ research

A

respect
beneficence
justice

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48
Q

Continuous data

A

can assume any value along a continuous scale

Examples: ROM, distance, weight, time

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49
Q

Discrete data

A

measured in whole units

Examples: HR, those diagnosed with cancer, # of PT visits

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50
Q

Dichotomous data

A

type of discrete data with only two values

Examples: pass or fail, smoker or non-smoker

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51
Q

Qualitative data

A

Examples: eye color, blood type and hand dominance

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52
Q

Nominal

A

each object or person can only be assigned to one category.
Qualitative

Examples: blood type, type of breath sound, type of arthritis

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53
Q

Ordinal

A

ranking

Examples: MMT, level of assistance, pain

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54
Q

Interval

A

Intervals between adjacent values are equal but there is no true zero point.

Examples: temp, some developmental and functional status tests

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55
Q

Ratio

A

intervals between adjacent values and there is a true zero point.

Examples: ROM, distance, time, nerve conduction velocity

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56
Q

Reliability

A

reproducibility or repeatability of measurements

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57
Q

Internal consistency

A

measurement relates to function

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58
Q

Intrarater reliability

A

same person

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59
Q

Interrater reliability

A

more than one person

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60
Q

Test-retest reliability

A

same individual on separate occasions

61
Q

Validity

A

degree to which a useful or meaningful interpretation can be inferred from a measurement

62
Q

Face validity

A

tests what its supposed to

63
Q

Content validity

A

measurement reflects meaningful elements of a construct and items test the interested elements

Examples: MPQ has more content validity than a visual analog scale because it assesses location, quality and duration of pain

64
Q

Construct validity

A

theoretical construct is measured by a test

Examples: MMT have this for nerve innervation if there is a relationship between scores and EMG testing

65
Q

Criterion-related validity

A

established by comparing it to a different measurement that is considered the gold standard

66
Q

Concurrent validity

A

form of criterion

interpretation is justified by comparing measurement to the gold standard at the same time.

Examples: HR by palpation and ECG if they are associated

67
Q

Predictive validity

A

form of criterion

if a measurement is considered predictive of future behavior

Example: GRE or GPA for admission to predict future academic success

68
Q

Prescriptive validity

A

form of criterion

measurement suggests the form of treatment each person should receive based on successful outcome of treatment.

Examples: measurement of asystole on ECG if patients with this arrhythmia are successfully revived with CPR.

69
Q

Sampling error

A

chance between statistic calculated from a sample and true value of the parameter in population

70
Q

Sampling with replacement

A

putting those selected for the sample back into population before next unit is drawn.

This results in units having an equal chance of being selected

Rarely used on human subjects

71
Q

Sampling without replacement

A

not replacing and results in decreasing size of population

72
Q

Simple random sampling

A

table of random numbers or random number generator

not the most statistically efficient method

73
Q

Systematic sampling

A

taking every nth subject

74
Q

Stratified random sampling

A

divided into subgroups (strata) then a simple random sample is done.

this helps with representation of key subgroups of population

75
Q

Cluster sampling

A

clustered together and then random clusters are sampled

76
Q

Non-probability sampling

A

does not involve random selection

77
Q

Independent variable

A

intervention or condition

78
Q

Dependent variable

A

outcome or response

79
Q

Completely randomized design

A

randomly assigned and each group receives a unique intervention and they are compared at the end.

80
Q

Crossover design

A

subject receives both treatments in random order with a period of no treatment

81
Q

Factorial design

A

two or more independent variables investigated

82
Q

Repeated measures design

A

subjects are tested under all conditions and each person acts as their own control.

83
Q

Sequential clinical trial

A

data analyzed as they become available so trial can be stopped as soon as evidence is sufficient to show a difference

84
Q

Quasi-experimental design

A

one without control group, random assignment or both

85
Q

One group pretest and posttest design

A

time is independent variable, with two levels (pretest and posttest)

86
Q

One way repeated measures design over time

A

measurements made on one group of subjects at multiple, prescribed time intervals

Intervention can be administered once or may be repeated

87
Q

Time series design

A

multiple measurements made before and after treatment to observe patterns or trends during pre and post treatment periods

88
Q

Internal validity is when there is

A

confidence that the intervention caused the outcome

89
Q

Double blind

A

subjects and some of the research team are unaware of hypothesis and group each subject was assigned to

90
Q

Triple blind

A

subject, some of the research team and data analyzers unaware

91
Q

When an effective treatment is available, it is

A

unethical to use placebo

92
Q

Matching pairing classical example

A

identical twins

93
Q

Intention to treat analysis

A

all subjects randomly assigned to one of the treatments are analyzed together regardless of whether they received or completed treatment

94
Q

External validity

A

degree to which the results of research can be generalizable to populations or circumstances beyond those in the study

95
Q

Hawthorne effect

A

untreated subjects experience changes just by participating in study.

96
Q

Alternate hypothesis

A

differs from null hypothesis.

97
Q

Null hypothesis

A

statistical hypothesis

98
Q

p-value

A

probability that a particular statistical result could have happened by chance.

99
Q

When the p-value is smaller than the stated alpha value the null hypothesis

A

is rejected

100
Q

When p-value is larger than states alpha value, the null hypothesis

A

is accepted

101
Q

Alpha level

A

significance level

probability of rejecting the null when it is true (chance of committing a type I error)

Traditional values= 0.05- 0.01

102
Q

Type I error (alpha error)

A

wrongly deciding to reject the null hypothesis
concluding there is a difference when there isnt.

a false positive

103
Q

If the level of significance is set at 0.01 there is a ___% chance of a Type I error.

A

1

104
Q

Type II error (beta error)

A

wrongly deciding to not reject the null hypothesis

deciding there is no difference when there is

a false negative

105
Q

Statistical power

A

refers to chance that a statistical test will lead to rejection of false null hypothesis

106
Q

Larger the effect size, the more likely it will be

A

statistically significant

107
Q

Effect size index:
<0.1=
0.1-0.3=
0.3-0.5=
>0.5=

A

trivial effect

small effect

moderate effect

large effect

108
Q

Minimal clinically important difference

A

smallest difference in a patient’s conditions that the patient or clinician considers worthwhile

109
Q

Minimal detectable difference

A

smallest difference or change that would be statistically significant

110
Q

Parameter

A

greek letters for mean, standard deviation

111
Q

Statistic

A

english letters used for mean and standard deviation

112
Q

Forest plots are used in

A

meta-analyses

113
Q

Histogram is a

A

frequency distribution

114
Q

Line graphs

A

relationship between two or more quantitative variables

variable on y-axis=dependent variable
x-axis= independent

ideal for showing trends

115
Q

Scatter plot

A

relationship between two quantitative variables

116
Q

Step and leaf plots

A

observe entire distribution of data without losing any information

117
Q

Descriptive stats

A

summarize or describe important characteristics of a population

118
Q

Kurtosis

A

peakedness of a distribution

119
Q

Within a normal distribution:
68% of all values fall within ___ SD.
95% of all values fall within ___SD.
99% of all values fall within ___SD.

A

1
2
3

120
Q

Negatively skewed distribution

A

mean and median are to the left of mode and left tail is elongated

121
Q

Positively skewed distribution

A

mean and median are to the right of mode and right tail is elongated

122
Q

20th percentile is

A

value or score below which 20% of scores are found

123
Q

Standard Deviation

A

measure of the spread or dispersion of data

124
Q

Inferential stats

A

uses sample data to make inferences about a population

test hypotheses

parametric or nonparametric

125
Q

ANOVA

A

test the equality of means between two or more populations

126
Q

One way ANOVA

A

one independent variable is examined

127
Q

Two way ANOVA

A

two or more independent variables examined

128
Q

Regression analysis

A

predicts change in one or more independent variables affecting dependent variables

129
Q

Confidence interval

A

range of values used to estimate a population parameter

130
Q

Confidence level

A

probability that the confidence interval actually contains the unknown population parameter.

131
Q

Pearson product moment correlation (r)

A

-1.0- +1.0

Positive sign= two variables increase or decrease together
Negative sign= increase in one variable is associated with decrease in other

0= no relationship

132
Q

t-test

A

estimates a population mean or compares two means when the population is normally distributed and variance is unknown

133
Q

paired t-test

A

samples are matched pairs

134
Q

independent t-test

A

differences between male and females for example because cannot be in both groups

135
Q

z-test

A

estimating the mean or comparing two means

136
Q

Nonparametric

A

do not assume that samples come from populations that are normally distributed and do not assume homogeneity of variance

usually applied to nominal, ordinal, interval or ratio data are not normal

137
Q

Kruskal-Wallis test

A

equivalent to one way ANOVA

138
Q

Mann-Whitney test

A

alternative to independent t-test

139
Q

Spearman rank correlation coefficient

A

equivalent to Pearson product

140
Q

Wilcoxon Signed Rank test

A

alternative to dependent or paired t-test

141
Q

Sensitivity

A

test positive for those that have the disease

142
Q

Specificity

A

test negative for those that do not have the disease

143
Q

SpPin

A

test with high specificity= positive diagnostic test rules in the diagnosis.

144
Q

SnNout

A

test with high sensitivity=negative diagnostic test rules out the diagnosis

145
Q

Relative risk of 1.0=
greater than 1.0=
less than 1.0=
aka

A

event is equally probable in both groups

exposure increases risk

exposure decreases risk

risk ratio

146
Q

Odds ratio of 1.0=
>1.0=
<1.0=
aka

A

exposure probably does not increase risk of developing disease

exposure may increase risk of getting disease

may reduce risk

relative odds

147
Q

Number needed to treat

A

of patients that need to be treated to prevent one bad outcome or result in one good additional outcome.

ideal number=1

higher the number the less effective the treatment

148
Q
A

NPTE (54 decks)

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