Standard Precautions Lecture

Question 1

Universal/Standard precautions

Answer 1

Infection control practices used to prevent transmission of infectious agents transmitted via blood, body secretions, non-intact skin, or mucus membranes not only to healthcare providers but also patients and hospital/clinic guests through assumption that all fluids listed are infectious with all blood borne pathogens, implemented standard in all patient care interactions

Question 2

What bodily fluids do standard precautions ignore?

Answer 2

-Feces, nasal secretions, vomit, saliva, sweat, tears, and urine (unless containing frank blood)

Question 3

3 types of standard precautions

Answer 3

Primary - Immunizations, PPE, work practices
Secondary - Post exposure prophylaxis (PEP)
Expanded - Techniques specific to highly contagious diseases to limit exposure such as negative pressure rooms or isolation

Question 4

Occupational exposure

Answer 4

Exposure to blood (concentrated or frank), or other body fluids to which standard precautions apply as a result of work

Question 5

3 Common modes of exposure

Answer 5

1) Percutaneous injury - penetration of skin by needle or other sharp object formerly in contact with blood/body fluid/etc
2) Mucus membrane exposure - Contact of mucus membrane (eyes, nose, mouth) with fluid, tissues, or specimen
3) Non-intact skin exposure - Contact with fluid, tissues, or specimen

Question 6

What bodily fluids to standard precautions typically include?

Answer 6

-Semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, and amniotic fluid

Question 7

What is the overwhelming majority of exposure types?

Answer 7

Percutaneous injury

Question 8

Transmission based precautions

Answer 8

Secondary tier of techniques to be used in conjunction with standard precautions in regards to patients with specific infectious agents such as airborne, droplet, or contact

Question 9

Examples of airborne transmitted pathogens

Answer 9

• Mycobacterium tuberculosis
• Varicella virus
• Measles, mumps, influenza
• Pertussis
• Anthrax

Question 10

N-95 respirator

Answer 10

Very efficient respiratory protective devices that block 95% of .3 micron or greater particles

Question 11

Examples of droplet transmitted pathogens

Answer 11

• Adenovirus
• Measles
• Mumps
• Influenza
• Mycoplasma pneumoneae
• Diptheria
• Pertussis
• Niesseria meningitidis

Question 12

Examples of contact transmitted pathogens

Answer 12

• HIV
• HBV
• HCV
• MDR Bacteria (multiple drug resistant)
• MRSA
• VRSA (vancomycin resistant staph aureus)
• Cdiff
• Herpes
• Ecoli

Question 13

Seroconversion

Answer 13

Time period in which a specific antibody develops and becomes detectable in blood, transition from seronegative to seropositive, indicative of exposure

Question 14

Disease with highest seroconversion rate post needle stick injury (NSI)

Answer 14

Hepatitis B (up to 30%)

Question 15

Incidence of hepatitis B occupational infection has decreased because of…

Answer 15

The hepB vaccine introduction

Question 16

Most common type of hepatitis in clinical practice

Answer 16

HepC

Question 17

Side effects of HCV exposure

Answer 17

Chronic hepatitis (70-80% of patients)
Cirrhosis of liver (20%) and increased risk of liver cancer
Liver cancer (5%)

Question 18

Issue with labeling specimens of potential/confirmed infected patients

Answer 18

Assume that those not labelled require less care - all should be treated with same level of standard precaution

Question 19

Steps to handle blood spill

Answer 19

1) Clean area with absorptive towels
2) clean area with soap and water
3) Disinfect area with 1:10 solution of bleach

Question 20

Steps to handle contaminated reusable equipment

Answer 20

Heat sterilization or mycobacteriocidal cleanser

Question 21

If something is falling…

Answer 21

let it drop

Question 22

Places where gloves/gown should not be worn and why

Answer 22

• Nurses station
• Hallways
• Near clean supplies

This exposes these clean areas with pathogens potentially from the contaminated gown/gloves

Question 23

Sharp resonsibility

Answer 23

The user, unless delegated to someone else present in the room at the time

Question 24

Percentage of healthcare workers who do not engage in adequate infection control measures

Answer 24

> 50%

Question 25

Steps of management following an exposure

Answer 25

1) defining type of exposure
2) appropriately evaluating donor and recipient at time of exposure
3) Follow up care for at least 1 year after exposure

Question 26

Post exposure prophylaxis

Answer 26

Steps taken after exposure to a pathogen to prevent becoming infected

Question 27

HIV PEP

Answer 27

Anti-retroviral medical treatment

Question 28

HBV PEP

Answer 28

HepB vaccine, sometimes with additional immune globin

Question 29

What is the protocol following a needle stick of an LHU student?

Answer 29

Inform the supervising physician and program director immediately, as well as your faculty advisor, then inform either Glennon health services or your physician immediately and follow up with them on procedural steps

Question 30

What environmental factors cause a provider to be predisposed to injury?

Answer 30

Fatigue, poor technique, distraction, unfamiliar equipment, uncooperative patients, etc.