Study Prompts Flashcards
1
Q
toxic anterior segment syndrome
A
acute inflammation of the eye that can occur following cataract surgery
2
Q
toxic anterior segment syndrome implicated substances
A
impurities of autoclae steam, heat stable endotoxin, irritants on the surface of intraocular surgical instruments
3
Q
liquid sterilization
A
gluteraldehyde, hydrogen peroxide, peracetic acid
for items that are critical and heat sensitive
4
Q
Liquid sterilization considerations
A
items cannot be wrapped, may need to be rinsed after so sterility is lost, used only when item cannot be sterilized in another manner
5
Q
biological indicator
A
standardized, contained populaiton of mircobes that is included in a sterilization cycle to indicate whether the cycle was successful
may contain spore forming bacteria or other highly resistant microbes
Incubated after sterilizaation
only correct method of assuring that a steam sterilizer has reached the correct conditions to ensure sterility of products
6
Q
biological indicator process failure
A
deduce the source of the failure and if its the resulf of a single load that was not run on the correct cycle- no recall necessary
indicates the load was not processed correctly and must be reprocessed
7
Q
enzymatic detergent after each use
A
discard as products arent antimicrobial and will not retard growth
8
Q
highly infectious tissues
A
brain, dura matter, pituitary tissue, spinal cord, eye
9
Q
low infectivity tissues
A
lung, liver, kidney, spleen, lymph, CSF
10
Q
proper storage of sterile, reprocessed items
A
18” below the ceiling
8-10” above the floor
2” from th ewall
solid bottom on the rack
11
Q
aseptic techniques
A
process for keeping away disease producing micro, may be used in any clinical setting
12
Q
endoscopy associated infections
A
report to IP, physician, public health agency, manufacturer of endoscope, disinfectant/sterilant, washer
13
Q
mechanical cleaning equipment
A
uses automated cleaning and rinsing to remove soiling from items
verification should be weekly, preferably daily, installation, after repair, and all cycles should be tested when changing cleaning chem
14
Q
instrument sterilization
A
results in instruments being free of all microbes (including sporeS)
15
Q
PPV
A
TP/(Tp+FP)
16
Q
NPV
A
TN/(TN+FN)
17
Q
HLD
A
destroys all micro except high numbers of bacterial spores
heat sensitive, semicritical items
18
Q
intermediate level disinfection
A
destroys vegetative bacteria, mycobacteria, most viruses, most fungi but not spores
Non-critical items w visible blood
liquid contact with tuberculociddal activity
19
Q
low level disinfection
A
destroys vegetative bacteria, some fungi and viruses
liquid contact
noncritical items with no blood
20
Q
power
A
integral part of mgmt and leadership
coercive,expert, legitimate, referent
reward=ability to grant another person something that they desire or remove things the person does not
21
Q
strep b
A
most likely to cause infant sepsis after labor
increases risk of preterm which increaes risk of infection
22
Q
c diff collection rules
A
samples must be within 1-2 hours, 10-20 ml stool, passed in clean and dry container
23
Q
noninfectious endoopthalmitis causes
A
retained native material or toxic agents
24
Q
bacterial vs viral infection
A
WBC indicate tyle (low neutrophil and high lymphocyte= viral)
25
ELISA HSV ID
presumptive when 1:128
26
mitigation
funding a program to vaccinate ppl against smallpox in an outbreak
27
myco pneu
most common pneu in school children
28
pediculosis in peds
contact until 24 hours post treatment
29
category 1a
strongly supported by cdc
30
cleaning category 1a
sterilize anthing entering sterile tissue
31
acinetobacter baumanni
aerobic, gram - bacilli
32
UTi post partum risk factors
c-section, tocolysis, induction
33
appropriate abx use recommendations
not necessary to maintain antimicro above MIC
34
antibiogram interpretation
percentage of samples sensitive to x
35
fishbone diagram
ID, explore and display all causes
36
affinity diagram
gathers large amonths of ideas/opinions/issues and organizes them into groupings based on relationships
37
pareto chart
individ values are rperesented in descending order by bar and cumulative total by line
38
positive bio indicator
test again w paired indicators from diff manufacturers and eval
39
potential occupational azquisition
review worker's comp, EH should build case
40
cold food storage
41F/5C degrees or lower
41
robust PI team
performes housewide infection rates
42
IP quality eval
avg time btw receiving lap reports of mdros and isolation of patients
43
patient follow up for rapid hiv
western blot
44
program eval elemnets for efficacy and impact
appropriateness of desgn, adeuquacy of team, knowledge of participants
45
improved hydrogen peroxide
has anioinic and or nonanionic surfactants
46
cms iso precautions
standard
47
mycoplasma pneu precautions
droplet during symptoms
48
CAUTI indication
positive dipstick for leukocyte esterase/nitrite, pyuria, micro on gram stain, positive ur cx 10^3+ but less than 10^5
no more than 3 org
49
classig measles sign
koplik spots
50
cost benefit analysis
all measures expressed in monetary terms
51
cre strategies
place all colonized on precautions, min invasive devices, communicate results
52
culturally diff group to presnt to
outline ed program and ask audience to work together to ID culturally appropriate examples
53
decon
reders items safe for handling wo protective attire
54
disinfection product resistance
reduced susceptibility can occur, antimicro levels used are sufficient to inactivate
55
event-related storage of sterile iems
not based on expiration
56
gram pos cocci in pairs and chains
enterococcus faecium
57
HCP prophylaxis for crusted scabies
with evidence of infestation (pruritic rash)
58
HCP w HIV
exposure prone invasive proc should not be performed until counsel w expert review panel is sought
59
health belief model
understand and preduct health ass behavior, percieved susceptibility, perceived severity, perceived benefits, perceived barriers, age, gender
for whom the interation is being designed
60
hep b vaccination rec
heterosexuals w multi sex partners, men having sex w men, dvp disabled persons, diabetes
61
HH compliance discussion
info on hand contamination, info on ass btw hh and infections, effects of hh on skin
62
high risk ssi
asa physical status classification of 3,4,5
operation classified as contaminated/dirty
operation lasting llonger than the duration cut point in min
63
how an ip can support antimicro stewardship
monitor prevalence and emergenc,e calc incidence on basis of clinical results, calculate mdro infection rates, use molecular typing for outbreaks, detect asymptomatic carriers w active surv
64
infectious waste
ie agar plates used for testing sputum samples
65
initial outbreak investigation
preparing line list and epi curve
| notifying key partners
66
insufficient construction planning
compromised air quality or water contaminated w water ass org
67
mdro threat level urgent
cre, candida auris, c diff, crab, n gonnorrhoeae
68
measles rash
3-7D post symptoms
69
neg IgG or IgM for measles
may be infected, may not have dvp an immune response until 72 hours post rash onset
70
nsi rate
```
# blood collection devices used (if many dif staff)
#/full time nurses otherwise
```
71
opa
fast acting, no activation req, does not coag blood or fix tissues to surfaces, eye irritant, slow sporicidal activity
72
SSI action in ambulatory proc
revise surv plan
73
HVAC shutdown
relocate immunocompromised and provide emergency back up ventilation for other rooms
74
single use reprocessing
visit reprocessing companies
| must be reprocessed at 3rd party facility if FDA guidelines are followed
75
needlestick exposure
wash area first
76
highest filtering efficiency
diffusion
77
category b bioterrorism
mod ease of disseminating, sp req for dz surv, mod morbidity rates, low mortality (ie. thyphus)
78
acceptable upper limit of relative humidity for fungal growth
60%
79
dialysis IP
use AV graft if fistula cannot be est, tunneled cuff for 3+ wek use, femoral cath in bedbound for 5D+
80
myco marinum
needs no further work up
81
varicella exposure
determine active case w physician first
82
crypto kill in water
high temp flush
83
run chart
determines avg over time and shows changes in the avg (demonstrates sp cause variation)
req at least 20 data points
84
reg over construction
OSHA only
85
pneumatic tube blood spill
est method to ID spill
86
meningococcal meningitis incubation
2-10D
87
Legionairres suspicion
all water sites to which the patient was exposed shoul dbe cultured
88
written instructional objective
learner outcomes in measurable terms using action verbs
89
surface cleaning
physical removal
90
IP strategy for dispersed outpatient settings
dvp communicaiton btw sites
91
annual risk assessment
eval prev goals, ID risks based on area/pop, risks related to services provided
92
biomedical waste
anything bloody or potentially so
93
mopping
s stroke, never redip
94
healthcare personell
all paid/unpaid persons in setting w potential exposure
| any individ who has potential to acquire/transmit dz in course of work
95
ETO efficacy
gas concentration, temp, relative humidity, exposure time
96
anthrax terminal cleaning protocol
standard terminal cleaning protocol
97
bed bug kill heat and time
118 F for 1 hour
98
biological indicator positive first action
retrieve unused items from load
99
anthrax sign
mediastinal widening or pleural efusion
100
MRSA Cap signs
hyemoptysis and multilobar infiltrate
101
cat bite most likely org
pasteurella
more likely to become infected
highly pathogenic, induce progressive soft tissue infecitons w rapid onset
102
performance measures
evidence based, well defied, clinically important for patient pop (easily understood and applied definition)
103
pneumonic plague isolaiton
surgical mask, door may be open
104
tool to investigate a potnetial outbreak w med vial quality
RCA
105
scabies precautions
contact up to 24 hrs post treatment
106
short term iv devices BSI cause
cutaneous origin, from insertion site, gain access extraluminally, contaminated luminal fluid
107
delphi technique
expert group judgement prior to project
108
syndromic surv
detection of individ and pop health indicators that are discernible before confirmed diagnoses are made
109
tattoo/piercing dz concerns
not related to popularity making it more socially acceptable
110
tb collection tiems
3x, 8 hours apart, liquid media
111
time off for varicella exposure
28 days (return on 29th)
112
vaccine req when giving vaccine
copy of vaccine info statement
med exemptions in all states
no fed req for informed consent
113
gluteraldyhyde
inexpensive, respiratory irritant, irritating odor, slow mycobacterial activity unless activated, coag blood and fixes tissues to surfaces, contact dermatitis
114
IgM Hep A detectable
5-10 days post exposure
115
pertusis incubation
7-10d
116
scabies incubation
10d (usually 4-6 wks)
117
flu b
has been associated with large epidemics
118
core cap measures (non-vented)
o2 assessment w/in 24 hours before or after arrival to hospital, patients over 65 screened for pneumococcal vaccine, blood cx performed in ED before abx admined, abx timing, abx selection, adult smoking sessation advice, flu vaccine
119
healthcare relatedocular infections of intact epithelium
n gonorrhoeae, n meningitidis, srep pneu, listeria monocytogenes, corynebacterium dophtheriae
120
tpn contaminatn
fungi, coag neg staph, staph saprophyticus, staph epi, e coli, pneudomonas aeruginosa
121
obligate intracellular parasites
viruses, chlamydia, rickettsiaa, coxiella, mycobacteria, q fever, epidemic typhus
122
cell type indicative of bacterial infeciton susceptiblity
neutrophil
123
incorrectly reject null
type 1 error
124
measure of dispersion
SD
125
frequency polygon
graph of freq distribution w values of the variable on the x and number of obs on the y, connected w straight line
126
kaposis sarcoma
human herpesvirus 8
127
active surv cx planning
addtl personnel to obtain cx, addtl lab personnel, ensuring TAT for results, monitoring adherence to contact precautions, providing a mech for communicating results to providers, measuring outcomes to eval the effectiveness of ASC and contact precautions
128
laboring mom w flu
does not need to wear mask during labor and delivery
129
food handling restriciton for hep a
until 7D post jaundice
130
tb testing
qft-g is a blood assay, intradermal TST
131
MMR rec for those pborn pre 1957
test for immunity and vaccinate a needed
132
HBV exposure for those who have only 1 vaccine
complete series and provide immunoglobulin
133
adverse event
patient harm resulting from treatment (falls, improper med admin, infection, physical or psychological injury
134
safe medical device act agency
FDA
135
percent HAIs resulting in death
4%
136
model for improvement
setting aims, est measures, and selecting changes that will make an improvement
plan, do study, act cycle
137
mode element of FMEA
way of operating or using a system or process or a way or manner in which a thing is done
way or manner in which something (failure) can happen
failure mode= way the failure occurs and its impact on a process
138
IP busines plan
demonstrate whther the expanded program will be worth the investment
139
strategic goal
org process of defining its strategy and making decisions on allocating its resourcees to pursue this strat
setting goals, determining actions, and mobilizing resources
clean measurable goal that is focused on the future and provides direction for its dept
140
discrepancies btw current and desired job performance
investigated and clarified before ID a corective action
141
human factors
enviro, org, and job elements
human an dindivid char that influence behavior at work in a way that can affect health and safety
focus on improving efficiency, creativity, productivity, and job satisfaction
142
what ed and training approach should the IP recommend for improving HH
implemenation of a mentoring program based on peer to peer instruction and coaching
143
QI measure for IP
analysis of program eval scores for classes
144
professional competency
communication, values, reasoning, teamwork, knowledge, skill
145
research methods features
time period of the study, clear criteria for defining cases and controls, methods of quality assurance
146
item analysis
process for examining students test scores to assess the quality of the individ test questions and the test itself
useful for improving qualiity of the test and increasing the instructors skill in test construction
147
water temp for laundry
160F for 25 min minimum
148
programs that need to include employee ed
risk assessment, program plan, annual budget and allocation of resource
149
legionella prevention
hot water for 124+, cold at 68
150
agency approving antiseptics
FDA
151
Hydrogen peroxide vapor
cannot be used during occupation
| HVAC needds to be turned off to keep vapor effective
152
most likely to improve IP
thoroughly cleaning and disinfecting all surfaces in a room that have potentially come into contact w hands
153
ultrasonics
fine cleaning of instruments
154
AAMI ST79 mechanical cleaner verification
weekly (if not daily) at install, major reparis, when changing cleaning chem
155
Saline cleaning
cannot be used on items to be sterilized
156
3rd party reprocessor survey
observe cleaning and econ, inspeciton and testing, sterilizaiton load prep
157
Preveiosly infected and now immune hep B
Anti-HBc (core indicates actual infection) and Anti-HBs
158
available immunoglobulin preps
hep a, measles, polio, rubella, hep b, rabies, varicella
159
how long can bed bugs survive without feeding
1 yr
160
best classroom setup for teacher and class interaction
horseshoe w writing surfaces
161
biggest concern w unk jewelry in emergency
not being familiar w the opening mech to remove it
162
bioterrorism resp event precautions
only airborne
163
blood bank most likely surveyor
fda
164
bridge btw thoery and actual practice
case study- builds lerner skills
165
c diff can last on surfaces for
5 months
166
CHG for PICC
30s dry time and low incidence allergies
167
cryptosporidium disinfectant
6% hydrogen peroxide (for all protozoa)- resistant to chlorine
168
decon SPD air exchange rate
10/hr, vent outside
169
dirty endoscope carrying case
discard after use
170
endoscopy cleaning process
HLD, rinse w sterile water, flish channels w 70-90% alcohol, dry using forced air
171
flu vaccine highest priority
hcp working w high risk patients (ie lung transplant)
172
frequency histograms and polygons most useful with
interval scale and ratio scale
173
HBsAg dialysis
separate patients by room or area, dedicate machine and equip, exclude from reprocessing programs
174
hep c sexual transmission risk
low, 1.3-27% in long term partners
175
high sensitivity
most ppl who actually have dz have a positive result and few have negative
176
high touch surface cleaning freq in patient room
3x/day (2 for low touch)
177
highest needlestick tranmission risk
hollow-bore needles that can be filled with blood, UV stylet stick
178
HIV vs HBV
hiv transmission after percutaneous exposure has been 0.3% vs 22-31% for HBV
179
hydrogen peroxide vapor efficacy against spores
ineffective
180
incidence density
total # new cases over period of time each was observed
181
legionella sources
drinking water distribution (water faucets, ice machines, water devices, water source exposure)
182
measles confirmation
positive IgM, 4x increase in IgG or hemagglutination inhibition or neutralizing ab, positive pcr
183
measles virus proper handling
transport on ice and place in cx or freeze at -70 until placed in cx, room temp or less cold lowers infectiviity and can cause false negative
184
most common intrapartum infection
GBS (strep agalactiae)
common in genitals
neurologic sequelae and death possible
185
most common UTI org
e coli
186
negative control amplified DNA
inaccurate, should not produce any amplification signal
187
OR floor turn over clean
3-4 ft perimeter around the table unless larger area IDed
188
prevention strategies to reduce ssis
admin abx prophylaxis, ID and treat remote infections before operation, reducing skin bioburden (or active surv culturing)
189
pesudomembranous colitis diagnosis
c diff toxin assay and/or colonoscopy
190
quality of care measure example
hep b imunity rates
| evals compliance w desired care
191
rocky mountain spottend fever ab test
weil-feliz agglutination
| differentiates rickettsial ab
192
RR
incidence of 1/incidence of 2
193
scarlet fever
1-7D incubation
GAS
diffuse red rash on Dday 2 that fades
194
self managed team
small, autonomous groups who determine, plan, and manage daily activities with little or no supervision
cost saving and increases productivity
195
special cause variance
lies more than 3 standard deviations outside the mean
196
spinal fluid assay, eeg, and mri test for
CJD (typical eeg, positive assay, high signal abnormalities)
197
ssi lowest risk
elective proc, non-dirty or contaminated wound, anaesthesiology score less than 3, shorter proc time
198
varicella exposure
VZIG and exclude from work days 10-28
199
viral load in hiv patient
increases in antiretroviral phase ,decreases in asymptomatic infection, increases as patient progresses to AIDS
200
when to restrict employee from patient contact
small, painful vesicular lesion on fingertip (indicates herpes)
201
norwegian scabies
```
crusted scabies, highly contagious
pruritic lesions on hands, webs of fingers, wrists, extensor surfaces, and outer feet, armbits, butt, and waist
contact until 24 hrs post treatment
infestagion of mite sarcoptes scabies
incubation 4-6 weeks
reinfestation 1-3 days
environmental fomites as well
```
202
sarcoptes scabies
not a vector of infectious agents
| humans are natural reservior
203
guidelines for transporting specimen
w/in 2 hours of collection
204
TB testing
positive indicates exposure
QFT-G: blood assay, 80% cx confirmed
TST: intradermal, for remote exposures and children <5
Test at time of exposure and 12 wks post
Chest xray for those prior positive and symptomatic
IGRA blood test for those w BCG vaccine
205
mantoux induration positive
>5 for immunocompromised, recent contact, fibrotic change on cxr
10 mm- recent arrival from high prevalent country, injection drug user, resident/employee of high risk congregate settings, myco lab personnel, high risk, medically underserved minority, children <4
>15 no risk factors
206
hep a igm detectability
5-10 days post exposure
207
hep a food service worker restriction
until 7d post jaundice
208
hep a shedding period
2-4 wks before and 1-3 weeks post jaundice
209
hep a symptoms by age
70% asymptomatic in children <6
| Jaundice in 70%+ adults
210
hep a incubation
avg 4 weeks
211
hep a prodromal phase
nonsp symptoms prior to jaundice, 1-2 wks
212
hep a precautions
contact only for incontinent or diapered patietns
213
hep a prophylaxis
household or sex contacts or outbreaks
214
pertussis
bordatella pertussis, gram neg aerobic pleomorphic bacillus
| cyclic outbreaks
215
pertussis incubation period
10-14 days
| 7-10 days for immunocopromised (range of 6-21
216
pertussis paroxysmal stage
whooping cough 1-6 wks (up to 10)
217
pertussis communicable stage
1.5 weeks prior to cough and 3 weeks after
218
pertussis precautions
droplet
219
pertussis employee work exemption
furlough symptomatic employees through the first 5D of therapy
220
initial element in virulence
ability to survive in external enviro during transit btw hosts
221
second element in virulence
mech for transmission to new host
222
ssi mgmt
open and drain incision
debride
implement antimicro mgmt as needed
manage open wound
223
western blot for HIV
HIV ab in serum
224
bacterial meningitis
```
elevated opening pressure
cloudy csf
predominant neutrophils
1000+ WBC/mm
low-normal glucose
elevated protein concentration
```
225
fungal meningitis
variable opening pressure, low glucose, predominant lymphocyts, variable WBC
elevated protein
positive india ink gram stain
226
viral meningitis
normal opening pressure, normal glucose
predominant lymphocytes
<100 WBC/mm
normal-elevated protein
227
CDI
gram + anaerobic bacillus
15-25% recurrence
10D vanc treatment
228
flu shedding period
1-2D post infection
| lasts less than 5 days usually
229
flu incubation
1-4 days
230
flu staff furlough
5D post diagnosis or duration of illness
231
CDI risk factors
prophylactic abx, protein pump inhibitor, GI surgery, LOS, serious underlying illness, immunocompromised, advanced age
232
MDRO colonization/infection risk factors
antimicro therapy in last 90 d, current hospitalization of 5+days, immunosuppressed, high freq resistance in community or unit, HA PNEU
233
cap quality measures
o2 assessment win 24 hours
pneumococcal vaccine screen for patients over 65
abx timing (win 6 hours)
abx selection
blood cx in ED prior to admin of abx, abx election, smoking cessation, flu vaccine
234
aspiration prevention measures
oropharyngeal cleaning and decon w aseptic agent
orotracheal intubation unless contraindicated rather than nasotracheal
head of bed elevated at 30-45 degrees
stress ulcer prophylaxis
use of noninvasive vent when possible
235
immunocompromised status
HIV w CD4 <200, leukemia/lymphoma, neutropenia, splenectomy, early post transplant, cytotoxic chemo, high dose steroid therapy
236
malnutrition effect of body's immune system
```
altered intestinal bacteria
tissue integrity impairment
mucosal secretions decreased
respiratory tract celia decreased
stomach acid secretion decreased
```
237
lyme disease endemic areas
New England, mid-Atlantic, upper Midwest, ,N Cali
238
lyme disease
borrelia burgdorferi
spirochete
black legged ticks
239
lyme symptoms
fever, HA, fatigue, erythema migrans
| can spread to joints, heart, nervous system
240
lyme incubation
7-14d post bite
241
lyme peak exposure
june-august
242
Lyme IgG and IgM
IgM 2-4 post erythema, IgG 6 wks post dz
243
ESBL
beta lactamases in common gram neg bacteria (e coli and klebsiella)
resistant to all beta lactams (cephalosporin and monobactams) except carbapenem and cephamycins
244
mechanical barriers to infection
intact skin, mucous membranes, cilia
245
chem barriers to infection
fatty acids in sweat, saliva, nasal secretions, and tears
246
pathogenic intracellular bacteria
listeria monocytogenes, salmonella, mycobacterium, nocardia, legionella, rodococcus equi, pseudomonas pseudomallei
247
cell mediated immunity dysfx susceptibility
pathogenic intracellular bacteria
248
biofilm
substance preventing water soluble elements from reaching pathogens, polymeric conglomeration of extracellular DNA, protein, and polysaccharides
249
h pylori
gram neg, responsible for chronic antral gastritis
250
gram stain
determines peptidoglycans
| gram positive=thick andpurple (iodine not removed in alcohol wash)
251
bacterial spores
formed by gram pos usually
252
staph aureus
most rapid onset of symptoms of food poisoning (1-6 hrs)
| 1-2D ill
253
neutrophil
depletion provides best indication of susceptibility to most bacterial infections
most abundant WBC
formed by stem cells in the bone marrow
short lived, highly motile
254
neutropenia
depletion
255
salmonella
crampying, abd pain, diarrhea within 12 hr-3 days
| 4-7 days ill
256
HIV time to measurable ab
1-3 month
257
HIV exposure
PEP immediately
258
90D SSI surv
craniotomy, CABG, BRST, CARD< FUS< FX< HER< HPRO, KPRO
259
30D SSI surv
c sec, lami, appy, billi, colo, hyst, ovry
260
process measure
focuses on process or the steps in a process that lead to a sp outcome
eval compliance w desired care or support practices to monitor variaction
ie. appropriate abx dosage
261
conditions to be met to benchmark data to other facilities
standardized definitions are used consistently
adequate training of personnel to collect store manage and analyze data
data are calculated using same methodology as nationally validated system
262
chi square test
eval effect of a var on outcome, calc OR or RR, if each cell of the table is greater than 5
(observed freq-expected)^2/expected
263
fishers exact test
data are small in numbers
used for analysis of contingency tables
valid for all sample sizes
264
statistical process control charts
monitor process of care
facilitate the determination of variation, monitor outcomes
helpful in determining special cause or common cause variations
265
sensitivity
tp/(tp+FN)
266
dup
dup
267
mesokurtic
bell shaped, 0
268
leptokurtic
peaked curve, +
269
platykurtic
flat curve, -
270
power increases when
sample size increases, sig level increases, true value of ther parapmeter being tested is further from the value in the null
271
confounding var
extraneous var that systematically varies w indep and influences dep var
272
causality criteria
```
strength of ass- higher incidence among exposed
consistency- obs in numerous studies
specificity- 1 factor and 1 dz
temporality- exposure before dz
biological gradient
plausibility
coherence- known info about bio spectrum of dz and ass factor
analogy
causality- similar ass shown causal
```
273
frequency polygon
useful for showing 2 sets of data on a sinlge graph
uses connecting lines and data points
graph of freq distribution w values of the var on the x axxis and # obs on the y
data points plotted at the midpoints of the intervals and connected w a straight line
274
human herpesvirus
```
kaposis sarcoma- systemic tumor w cutanious lesions
found on skin and spread elsewhere
significant mortality and morbidity
transmitted via saliva
contact precautions
```
275
coccidioidomycosis
10-50% ppl in endemic areas exposed
inhalation of airborne spores of coccidiodes immitus or pasadassi
native to arid and desert areas in N. America, C. America, and S. America
Found at lower elevations that receive less than 20 in of rain yearly in warm, sandy soil
lieves 4-12 in below surface
276
population attributable risk percent
proportion of a dz that could be prevented by eliminating the exposure in the entire study pop
RR-1/RR
277
Relative risk
(a/(a+b))/(c/(c+d))
278
dup
dup
279
domestic poultry flu strains
H5N1
280
swine flu strains
H1N1, H3N2, H1N2
281
PPV
tp/(tp+fp)
282
NPV
tn/(tn+FN)
283
very low prevalence of dz effect on PPV and NPV
PPV lowered
| NPV increased
284
norovirus
sever dz more common in older adults, young children and immunocompromised
increases in winter months
lasts 5D
Shed 3wks
incubate 12-48 hours
abdominal cramping w/wo nausea, vomitting, diarrhea
285
attributable risk
difference in rate of a condition btw exposed and unexposed
| incidence in exposed (# exposed w dz/total exposed)-incidence in unexposed)
286
postmortem care of deseased TB patient
approved mask necessary for resp protection
287
fungal infection high risk patients
burn, premature NICU baby, bone marrow transplant
288
smallpox
N95
vaccine not harmful to pregnant
7-17D incubation
fever, headache, papules, pustular vesicles
isolate until scaps separate
highest fatality rate of all bioterrorism agents
289
HVAC outbreak cx considerations
ID purpose of cx and appropriate methods before hand
anticipate decisions and planned actions to results of culturing before undertaking process
determine whether there are existing standards to interpret results
290
abx timeout
win 24-*48 hrs of cx results being available
291
vent bundle
```
head 30-45 degrees
peptic ulcer dz prophylaxis
DVT prophylaxis
oral care w aseptic agent
sedation vacations to assess ability to breath on own
circuits changed only when soiled/malfx
periodically training condensate in tuing
respiratory filter only for tb
```
292
neisseria meningitis precautions
droplet until 24 hours post therapy
293
neisseria PEP
intensive exposure without precautions (mouth to mouth, intubation, endotracheal tube mgmt, close examination of oropharynx)
294
neisseria morphology
gram - diplococci
295
publishing fed agencies in the us pertaining to infection and medical or regulated waste
EPA, FDA, US DOT
296
factors that must bre present for contaminated waste to be capable of causing infection
dose and host susceptibility
portal of entry
presence and virulence of a pathogen
297
airborne iso room req
negative airflow, exaust outside, daily monitoring of air pressure w visual indications
298
effective strat to curb abx resistance
formulary restriction, auto stop orders, abx cycling
299
active surv cx plan
provide addtl personnel to obtain cx
addtl personnel to process cx
provide a mech for communicating results to providers
measure outcome to eval the effectiveness of the asc program and contact precautions
300
flu oubtreak in acute care setting measures
perform rapid flu test for patients and personnel w recent onset of symptoms
restrict staff mvmt from areas of facility having outbreaks
restrict or limit elective med and surg admits
301
communication to patients before flu vaccine
annual formulation to protect against most likely flu strains
inactivated flu contains noninfectious viral components and cannot cause flu
fever, malaise, myalgia, and other systemic symptoms can occur after vaccine
302
CVC indication
chemo, dialysis, TPN, long term abx
303
CVC infection factors
```
site
catheter material
sterile precautions
skin prep/heavy colonization
stopcocks
hub contamination
inexperienced operator
giudewire exchange through old catheter
CHG
```
304
CDC CVC rec
min # ports and lumens
use totally implantable for long term use
use subclavian access for nontunnelled
HD should use jugular or femoral route
cuffed catheter for long term dialysis
cap, mask, sterile gown, gloves
chg
antimicro/antiseptic impregnated catheters for long term use when other strat have failed
catheter shouldnt be removed for fever alone
no routine replacement
guidewire replacement shouldnt be used for replacement of infected catheter
305
CJD
85-95% sporadic
PrP gene turns to sheets
mean onset 50-70 yo
7-9 months onset to death
306
how can IPs use the epi triangle during outbreak investigation
examine host factors (changes in immunity or procs win pop served)
307
risk factors for young girls to dvp UTI
bubble bath w prolonged soaking, excessive urine holding, delayed bladder emptying
308
maternal milk withholding
breast abcess, HIV, west nile
309
hep c natl rec
screening and testing blood donors
viral inactivation of plasma derived products
risk reduction counseling and screening of persons at risk of HCV infection
adherence to st precautions and safe work practices
310
HCW immunizaiton program
hep a, hep b, flu, measles, mumps, rubella, tetanus, pertussis, varicella
311
vaccine storage
central area of the unit, away from walls, vents, coils
not on top shelf
enough room to store years largest inventory wo crowding
calibrated thermometer
unit must be dedicated to vaccines
35-46 F- otherwise potency reduced
312
hep b postexposure unvaccinated or known nonresponder and positive source or unk
HBIG and series
313
hep b postexposure unvaccinated and negative or unk source
vaccine series
314
hep b post exposure unk ab and positive source or unk
test exposed and follow recc
315
varicella
```
rash 15d post exposure
rash in 3-4D
airborne, lesions contact
PNEU 30% more fatal in women
fetal death result of sever maternal infection
```
316
varicella work exclusion
day 10-21
317
varicella immunity proof
2 doses of varicella
lab evidence immunity
lab confirmation of dz
318
mmr immunization proof
1+ vaccine post 1st bday
lab evidence of immunity
history of dz based on healthcare diagnosis
birth before 1957 (unless wo evidence of immunity)
319
anthrax working restrictions
inhalation anthrax not transmissible among humans
| no restrictions
320
dup
dup
321
fda
dvp, implements, monitors, enforces standards for safety, effeectiveness, and labelling of all drugs and biologics
322
JC IP standars
min risk for dvmt of an HAI through an orf wide IP program
ID risk for the acquisition and transmission of infectious agents on an ongoing basis
effective mgmt of the IP program
collab of reps from relevant components and fx win the org
allocation of adequate resources to the IP program
323
dup
dup
324
human factor limits
limited memory capacity (5-7 pieces for short term)
neg effects of stress and cog tunnel vision
neg influence of fatigue and sensory overload
overdep on multitasking skills in complex work enviro
325
model for improvement
setting aims, est measures, selecting changes that will make an improvement
testing the selected changes in a plan, do study, act cycle
small scale testing followed by refinement and more testing until changes are ready on a larger scale
326
FMEA tool
proactive, preventive approach to ID potential failures and opporutnities for error
327
mode way of operating
manner in which something can happen (failure)
| way failure occurs and its impact on the process
328
increased infeciton risk
low nurse staffing levels
| use of nonpermanent staff
329
IP busines splan
formal statement of a set of business goals, resasons they are attainable and plan to reach them
decision making tools and cost and revenue est are central
IP needs to demonstrate whether the expanded program will be worth the investment
330
strategic planning
process for defining stragety or direction and making decsions on allocating resources
setting goals, determining actions to acheive them, mobilize resources to execute actions
planned obj that a dept or org strives to achieve
ie implment an electronic surv system in the next 3 years
331
fx mgmt
most common type
person w mgmt authroity over an org unit within a bus, company, or org
ongoing responsibilites and arent usually directly affiliated w project teams, other than ensuring goals and obj align w org strat and vision
332
quality improvement
systematic and continuous actions leading to measurable improvemtn in healthcare services and health status of targeting patient groups
data is cornerstone
describe how well current systems are working and what happens when changes are applied and document success
doesnt include dept sp goals
333
action planning
determine what tactic the org will use to accomplish goals, who is responsible, timeline, resources and eval criteria
334
item analysis
process of examining student test scores in order to assess the quality of the individ test questions and test itself
useful for improving quality of hte test and increasing instructor in test construction and IDin areas needing improvement or emphaiss
335
enabling factors to capture capaicty to change
necessary skills and capability
necessary resources
managed by training and coaching for skill dvmt or by helping ppl obtain access
ppl must be motivated to change
336
disinfectant consideration
ease of use, efficacy, acceptabiligy, safety, cost
337
hot water washing for laundry
160F for min of 25 minutes
338
OR airflow
noninductional unidirectional infusion of air w supply over table and exhaust near floor at periphery
laminar isnt appropriate as airflow rate is high and may induce hypothermia
339
AIIR
maintained under neg air pressure
min of 12 air exchanges per hour
visible means of monitoring air flow (for new construction)
anterooms not req but must be room for hand washing and storage/disposal of PPE
if dedicated neg air room, should exhaust directly outside
340
legionella
occurs throug hinhalation of aerosols
| optimum growth temp 77-108F
341
antispetics
antimicro agents safe for use on skin
342
detergents
tend to be more enviro friendly, less toxic, and less likely to cause resp reactions than disinfectants
343
disinfectants
must be used on horizontal surfaces and high touch
| accepable for cleaning floor provided occupant was not on iso
344
just in tiem teaching
```
increase learning during class time, enhance motivation, encourage practice, enable instructor to fine tune classroom activities to meet needs
motivate students to examine knowledge and get ready to modify, add, and apply it
```
345
professional competency
communication, values, reasoning, teamwork, knowledge, skill
346
behaviorism
combines elements of philosophy, methodology, and theory
focuses on change in external behavior achieved through large amount of repetition of desired actions, reward of good habits, and discourages bad habits
347
OSHA
safeguards workers against helaht hazards caused by bloodborne pathogens
exposure ocntrol plans, universal precautions, engineering and work flow practice controls, PPE< housekeeping, lab, hep B, post exposure follow up, hazard communication, recordkeeping
348
lit eval
is question important, appropriate, and clearly stated
study pop appropriate and adequately described
choise of design applicbale
selection and exclusion criteria described
outcoems equally and evaluated and blinded
proportion lost to follow up
stat tests
sample size
confouding factors taken into account
data to provide answer
conclusions reasonable and justified
other explanations account for observed results
349
internal validity
```
how well an experiment is done, whehter it avoids systematic errors
strong evidence for causality
proc described
results report data
discussion assesses bias
```
350
healthcare learning
req training activities that address literacy, cultural diversity, cross training, and tech advances
informed by learning theories and the ed needs of the pop
creative and flexible
351
strategic plans
determine the direction an org will go in the future and what the org must do in order to reach the goal, mission, or vision
analysis of the org
forming conclusions about what an org must do as a result of issues facing the org
352
GLOVE ONLY ON DOMINATN HAND WHILE SUCTIONING AIRWAY OF A PATIENT MECHANICALLY VENTILATED. IP SUSPECTS…
NURSE HAS INADEQUATE CONCERN OF PERSONAL RISK
353
LAB DOES NOT TEST FOR LEGIONELLA. LEGIONELLA HAS NOT BEEN DIAGNOSED. IP SHOULD…
DISCUSS CONCERNS ABOUT MISSING CASES OF LEGIONELLA WITH THE ICC
354
IP NOTICES SEVERAL NEWBORNS READMITTED WITH STAPH. FIRST THING
GATHER DATA ON NEONATAL READMITS TO ID POST DISCHARGE INFECTIONS
355
IP ASKED TO DVP A PERFOMRANCE MASURE DESIGNED TO HAVE A SIG IMPACT ON HEALTH OPO MISSION OF PROVIDING HIGHEST STANDARD OF CARE. WHAT IS THE BEST SELECTION
REDUCE CAUTIS IN LONGTERM CARE FACILITY
356
CAP INDICATOR
HIGH WBC
357
IP annual safety module on disease transmission and iso. What focuses psychomotor skills
mock isolation with mannequin in contact and have staff don and doff
358
monther collection and storage of milk
milk should be kept by mother to avoid mistakes
359
care of hcildren with HIV inservice
determine if there are existing program materials that would meet ed needs
360
computer based training advantage
user interaction
361
specimen that should be protected fromair exposure
lung abcess aspirate
362
urinary catheter standardization first step
after cost analysis conducted
363
cystic fibrosis patient concerning organism
burkholderia cepacia
364
hav infeciton rate review
current prevalence data in community served by facility
365
new ic program rec
purchase of data management software for survellance
366
hep b vaccine series started 2 years ago with 2 doses received. What now
give 3rd dose and check ab after 1 month
367
effective bioterrorism response
facilitate response plan based on obvious signs and unusual occurences
368
B19 DNA
fifth disease
369
fifth disease
parvovirus, distinctive face rash, airborne and contact
370
most important characteristic for establishing a definsible manual for legal or accredidaation purposes
tailor published recs to fit needs of the facility and reflect actual practice
371
workplace initiativs directly linked to profesional and reg stadards as well as a facilities policies and procs are base don
competency based ed
372
most feasible presentation with 48 hour notice
prepare hand outss and prepare overhead transparencies
373
bar soap risk
no documented risk, racks that allow water drainage must be provided
374
single use open suction catheter vs multi use closed system catheter
no reco for the preferential use of either
375
IG offering for hep a patient
household contacts
376
best tool for identifying potential process failure
flow chart
377
multi drug resistant diphtheroid most likely source
SKIN
378
ICP OUTBREAK MANUSCRIPT PREPARATION
WRITE REPORT USING RESEARCH PROCESS
379
MOST IMPORTANT IC MEASURE FOR ELDERLY LONG TERM CARE RESIDENTS
PRESERVING AND ENHANCING HOST DEFENSES
380
WATER QUALITY GUIDELINES
INSTALLMENT OF NONSPLASH FLOOR DRAINS W HORIZONTAL FLOW FLUSH BOWL IN DEDICATED SYSTOSCOPY ROOMS, SINCE NO MAJOR SURGERIES ARE DONE HERE
381
SEWER BACK UP INTO CLEAN AREA OF CENTRAL SERVICE ACTION
DETERMINE HIGHEST LEVEL OF CONTAMINATION IN THIS AREAS, REMOVE SUPPLIES AT AND BELOW LEVEL AND REPROCESS
382
OCC EXPOSURE REQUIRING FOLLOW UP SCREENING FOR A PRENANT HCW
active tb
383
C DIFF INCREASE CONTRIBUTING SOURCE
CONVERSION FROM EAR TO RECTAL THERMOMETERS
384
RYAN WHITE COMPREHENSIVE AIDS RESOURCE EMERGENCY ACT REQ NOTIFICATION OF AN EMERGENCY RESPONSE EMPLOYEE WHEN EXPOSED TO..
INFECITOUS, POTENTIALLY FATAL DISEAES
385
RESERVOIR MOST DIFFICULT TO CONTROL AND CONTAIN
ENDOGENOUS FLORA
386
JOB CLASSIFICATION WITH MINIMAL EXPOSURE RISK TO A BLOODBORNE PATHOGEN
REC THERAPY
387
MOST LIKELY PATHOGEN FOR A FEVER, COUGH, AND PULMONARY INFILTRATE FUNGUS AFTER VACATIONING IN S. CALI
COCCIDIOIDES IMMITUS
388
HEP G AND HEP B SIMILARITIES
SEXUALLY TRANSMITTED
389
UNDERLYING CONDITION FOR PATIENT WITH LOW GRADE FEVER, PREVIOUSLY ADMITTED BI-MONTHLY, DIAGNOSED WITH CANDIDA
hiv
390
INCREASED INFECTION RISK AT FREE STANDING ENDOSCOPY CENTER
USING SEPARATE CONTAINER AND FRESHLY PREPARED SOLUTIONS TO PERFORM HLD OF REUSABLE BIOPSY FORCEPTS
391
BEST METHOD TO ENHANCE ADHERENCE TO REGS AND STANDARDS
LINK COMPLIANCE W PERFORMANCE EVAL
392
STATEMENT EXAMPLE: TO PROTECT THE PATIENTS THROUGH DVMT, IMPLEMENTATION, AND EVAL OF EVIDENCE BASED IP AND C PROGRAM
objective
