Safety in Health Care Settings (Final) Flashcards
What is the normal flora?
microorganisms that live in particular parts of our body and is normal
What could happen if normal flora is transferred to a different part of our body?
could cause harm
Which are the most common microorganisms?
bacteria, viruses and fungi
Define pathogens
microorganisms that cause disease
Define infection
microorganisms that cause disease in humans
In what conditions do pathogens live best?
- body temperature
- in the dark
- moist places
- where there is a food supply
- rich oxygen supply=aerobes
- no oxygen supply=anaerobes
What is becoming dangerous for immunocompromised patients?
- bacteria that change their cellular composition to protect themselves from antibiotics
- called multi-resistant organisms
How does the chain of infection work?
When an infection is transmitted from one infected host to another susceptible host and becomes a source of pathogens, then past on again.
Identify the cycle of the chain of infection.
Pathogen, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host, pathogen
Name the most common portals of entry into the human body.
- respiratory tract
- gastrointestinal tract
- genitourinary tract
- circulatory tract
- cuts and breaks in skin
- from mother to unborn child
Name the most common portals of exit from the human body.
- urine
- feces
- respiratory excretions
- draining wounds
- blood
- excretions
- saliva
- tears
What are the modes of transmission?
- direct contact
- indirect contact (intermediate object)
- droplet / airborne(sneezing or coughing)
- common vehicle (single contaminated source like food, medication or equipment)
- vectorborne (transmission by insects or animals)
What increases a patient’s susceptibility to becoming a host for pathogens?
- age
- poor nutrition
- stress
- lack of sleep
- medical treatments
- contact with others
- open wounds
Define nosocomial infection
an infection that an individual acquires after admission to a health care facility
What defenses does the body have to fight infection?
- skin (MOST IMPORTANT)
- mucous membranes
- cilia
- coughing and sneezing
- tears
- stomach acid
- fever
- inflammatory response
- immune response
Identify the signs and symptoms observed when an infection develops.
- fever
- pain
- fatigue
- vomiting
- diarrhea
- rash
- swelling
It is imperative to prevent infection from spreading from:
- the patient to the health care provider
- the health care provider to the patient
- patient to patient
Define clean
- least capable of preventing spread of infection
- physically removes dirt, debris, and sometimes germs with the help of soap and water
- does not kill the pathogens
- only lowers the pathogen count
Define disinfection
- second best method of preventing spread of infection
- physically removes with the help of chemicals (alcohols or chlorines)
- kills a high percentage of pathogens present on an object, stopping them from reproducing, but does not kill spores
- does not mean that it cleans a surface with dirt or debris
Define sterilization
- best method of preventing spread of infection
- kills ALL living organisms, even spores -goal is to achieve asepsis where all pathogens are absent
- achieved by heat, high pressure, filtration, radiation, or chemicals
Define asepsis
-living pathogens are absent
Define medical asepsis / clean technique
-performance of cleanliness procedures to destroy or limit the spread of harmful microorganisms by destroying chain of infection
True or false. It id possible to remove all microorganisms from the body or environment.
False
List common aseptic measures.
Wash your hands :
- after bathroom
- after contact with blood or body fluids
- before and after giving care
- visibly soiled hands
- touching objects that are contaminated
- before and after preparing food
- before and after wearing disposable gloves
- before and after feeding a client
Aseptic measures for disease prevention in the hospital during the reservoir stage
- maintaining your own personal hygiene
- ensure to have all vaccinations up to date -disposing of contaminated objects appropriately
Aseptic measures for disease prevention in the hospital during the portal of exit stage
- when coughing or sneezing, cover nose and mouth, then immediately wash hands
- when required, wear protective equipment
- frequently check yourself for any open wounds
Aseptic measures for disease prevention in the hospital during the mode of transmission stage
- keeping proper hand hygiene for yourself and the clients
- ensure clients have their own personal care equipment, and are not shared amongst each other
- starting to clean with the cleanest area first, then moving along to the dirtiest area at the end
Aseptic measures for disease prevention in the hospital during the portal of entry stage
- ensuring clean, dry, and wrinkle-free linens for the clients to prevent skin damage
- providing skin and oral hygiene for the client to prevent damaged skin and mucous membranes
- ensure clients do not lie on tubes that could damage their skin
Which procedure is important in the prevention of nosocomial infections?
hand washing
Give reasons why some health care providers do not wash their hands?
- lack of time
- understaffing
- inaccessibility to sinks
- inadequate handwashing supplies
- belief that it is unnecessary when wearing gloves
True or false? It is not necessary to remove rings before handwashing
false
True or false?When washing hands,you should stand as close to the sink as possible
false
True or false? It is important to ensure that you clean your nails, fingers, between them, front and back, and up to the wrists
true
True or false? When washing your hands, keep your hands and forearms lower than your elbows
true
True or false? Dry your hands beginning at the wrist and ending with your fingers.
false
True or false?It is friction and running water that make your handwashing technique effective
true
Define fungi
microbes that live only on organic matter
Define contamination
the process of being exposed to pathogens
Define nosocomial
an infection that is obtained after an individual is admitted to a health care institution
Define portal of entry
where pathogens enter a new host’s body
Define sterile
free of all microbes, pathogens and non pathogens
Define medical asepsis
another name for clean technique
Define routine practices
guidelines to prevent the spread of infection
Define infection
a disease state caused by the invasion and growth of microbes in the body
Define reservoir
the environment in which pathogens live and grow
Define pathogen
a microbe that can cause infection
Define surgical asepsis
practices that keep equipment and supplies free of all microbes
Define multi-resistant organism (MRO)
a strain of bacteria that is very difficult to treat with regular antibiotics
What two parts is the Infection Control Guidelines divided into?
- Routine practices
2. Additional precautions based on mode of transmission
What were the guidelines when treating people with blood-borne pathogens in the past?
“Universal precautions” was applied to ALL patients even those not diagnosed with infectious diseases. ALL were treated.
What is “routine practices”
- to emphasize the level of care to be provided for all patients.
- directed primarily to blood and body fluid transmission of diseases
Meaning of PPE
Personal protection equipment
How is PPE chosen?
-by mode of transmission of the organism and type of interaction anticipated with the patient
Name the practices in the Routine practices.
1) Handwashing PPE 2) Gloves 3) Mask 4) Gowns 5) Accomodation 6) Patient care equipment 7) Respiratory Etiquette
Handwashing
- after any direct contact with a patient
- before eating, after toileting, when soiled
- plain soap
Gloves
- not a substitute for handwashing
- not required when skin is intact, for bathing, turning, feeding, etc
- required for blood, body fluids, soiled items
- changed between care activities
- not reused or washed
- hands must be washed before and after putting gloves
True or false. It is acceptable to walk around with gloves on or when performing duties which do not require them.
False
True or false. Double gloving is not required.
True
Latex allergies
- low risk, but health care providers at higher risk due to constant exposure to latex
- skin irritation to severe and life threatening emergencies
- ask patients if they have a sensitivity to latex
Mask
protects mucous membranes of eyes and respiratory tract
-wear when dealing with blood or body fluids
Gowns
- routine use not recommended
- protect uncovered skin, prevent soiling clothing
Accomodation
- private rooms not usually required
- for patients who soil environment or hygiene can’t be maintained
Patient Care Equipment
- equipment should not be shared in high risk areas (ICU)
- soiled equipment must be washed properly
- handle needles with care
- personal care supplies must not be shared between patients
Respiratory Etiquette for patients
- cover cough
- cover mouth and nose
- place tissues in waste basket
- use surgical mask to protect others
- clean hands
Additional precautions and guidelines for Home Care Workers
- wash hands with soap and water before and after contact with patient
- wash soiled clothes in hot water and bleach
- wash table tops with soap and disinfectant
- wash carpet with powdered laundry soap
- soiled disposable items must be thrown in heavy duty plastic bags
- needles in hard plastic containers
- use soft-bristled toothbrushes to clean patient’s teeth
Additional precautions based on mode of transmission
- separate patients with transmissible diseases or infections from contact with others
- “isolation precautions”
Airborne precautions
- single room, keep door closed
- enter room with mask
- wash hands before and after contact with patient
- patient must wear mask too
Droplet precautions
- maintain 1 meter distance between patients, door can remain open
- wear mask when 1 meter from patient
- wash hands before and after contact with patient
- patient must wear mask too
Contact precautions
- maintain 1 meter distance between patients, door can remain open
- disinfect equipment or use for that patient only
- wear a gown
- wear gloves
- wash hands after removing gloves and touching contaminated items
- wheelchair only when essential
List the general rules for transmission-based precautions
- wear personal protective equipment
- collect all equipment needed before entering isolation room
- prevent contamination of equipment and supplies
- wash floors with disinfectant
- prevent drafts
- double bag items
- do not touch hair, mouth, eyes
- do not shake linen
- use paper towel to turn off faucets
Steps to washing hands
- remove rings and watch
- use cleaning agent
- use warm water
- stand away from the sink
- keep hands and forearms lower than elbows
- use friction by rubbing hands
- wash hands for 15 to 20 seconds
- was and dry all surface areas of fingers, wrists
Where are needles, syringes and other sharp objects disposed of?
In a rigid puncture resistant container
What do you do if you’re in doubt about any infection control practice?
Refer to the infection control manual in your facility or call the infection control nurse
Explain the gloving process.
- Remove all rings and watches
- Wash hands before
- Put them on without tearing
- Keep hands and forearms lower than elbows
- Remove gloves by pulling down and turning inside out
- Discard gloves in garbage
- Wash hands after removing
Explain the isolation procedures
- Remove watch and jewellery
- Wash hands
- Follow isolation guidelines as posted
- Put face mask on as required
- Pick up clean gown, hold out and allows to unfold (do not shake)
- Put hands and arms through sleeve
- Tie string at neck, then waist
- Put on gloves and ensures covers sleeves of gown
- Provide care to patient
- Remove and discard gloves
- Wash hands
- Remove gown skin to skin technique (untie neck string, place fingers of one hand under opposite cuff and pull cuff over hand, uses gown covered hand to pull gown off arms
- Turn gown inside out
- Roll gown up and away from body
- Dispose in garbage or laundry hamper
- Wash hands
- Open door to room using paper towel
- Remove and discard mask
- Perform hand hygiene
Name the order when putting on personal protective equipment
- Wash hands
- mask
- goggles
- gown
- gloves
Name the order when taking off personal protective equipment
- Gloves
- Gown
- Wash hands
- Goggles or face shield
- Mask
- Hand hygiene
Define communicable disease / contagious or infectious disease
Disease that can be spread from one person to another
Discuss the following communicable disease: common cold
- highly contagious infection in upper respiratory tract
- transmitted by droplet secretions from nose and mouth
- no medication, cure or vaccine
- sneezing, runny nose, fever
- wash hands, drink lots of fluids, sleep, keep warm
Discuss the following communicable disease: influenza (flu)
- viral infection of respiratory tract
- fever, chills, cough, muscular pain
- transmission by droplets and secretion from nose and mouth
- no cure, but vaccinations exist
- wash hands, avoid contact
- health care providers must get flu shot each year
Discuss the following communicable disease: enteric diseases
- pathogens in stomach or intestine
- excess fluid loss through vomiting and diarrhea = dehydration
Name three types of enteric diseases
- Food poisoning
- Food borne infections
- Viral infections
How can you prevent enteric diseases?
- hand washing
- proper disposal of body wastes
- disinfection
- careful food preparation
Discuss the following communicable disease: acquired immune deficiency syndrome (AIDS)
- immune system attacked by HIV and damaged = body can’t fight back
- mild illness or none
- spread by body fluids, sex, sharing needles
- not easily transmitted or contagious
- can’t live outside body