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IPC > Summary - IPC Module 5 > Flashcards

Summary - IPC Module 5 Flashcards

1
Q

Who should use Routine Practices

A

All Health Care workers (HCW) to protect themselves, patients and visitors

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2
Q

When should Routine practices be used

A

Whenever you expetct to have contact with:

-blood
-any body fluid including secretions and excretions (except sweat)
-mucous membranes
-non-intact skin

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3
Q

What are Routine Practices?

A

Procedures applied consistentily to all patients because there is no way of telling who is infections and wdho is not, so assume all patients to be infectious.

Also called Standard Practice / Precautions

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4
Q

Fluids Included in Routine Practice Precautions

A

-blood and blood products
-vaginal secretions
-breast milk
-semen
-saliva
-tears
-sputum
-vomitus
-feces
-spinal fluid
-synovial fluid
-pleural fluid
-peritoneal fluid
-pericardial fluid
-amniotic fluid
-nasal secretions
-urine

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5
Q

Fluids NOT currently included in Routine Practice

A

sweat (perspiration)

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6
Q

Guidlines for Routine Practice Include Recommendations for:

A

-hand washing
-gloves
-mask and eye protection
- face sheild
-gowns
-patient care equipment
-environmental control
-linen
-occupational health and blood borne pathogens
-patient placement

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7
Q

Personal Protective Equipment (PPE)

A

-gloves
-mask
-eye protection/face shields
-protective clothing - gowns, aprons

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8
Q

Gloves - when?

A

-touching blood, body fluids, excretions and secretions
-touching / cleaning contminated items
-performing invasive procedures (phlebotomy, starting IVs)
-performing test procedures
-handling patient specimens
-touching mucous membranes and non intact skin

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9
Q

Gloves - Remove / Wash?

A

-promply after use
-before next patient
-when soiled or damaged.. if heavily contaminated with body fluid, place in biohazard container as per institutional policy
-when touching non-contaminated items and enviromental surfaces (phones / keyboards)

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10
Q

Gloves - Selection criteria

A

-suitable to task
-fit well
-of good quality & thickness
-no holes
-vinyl now used extensively due to latex allergies

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11
Q

Contact Dermatitis

A

-may be caused by allergy to latex, powder, chemicals or other non-related cause

-avoid if possible because:
*breaks the protective barrier provied by skin
*Staphyloccoccus aureus infections follow making condition worse and a reservoir of infections bacteria

-preventative measures:
*take action before out of control
*barrier cream on hands
*cotton liners
*gloves without powder
*different type of latex e.g. low protein
*vinyl gloves

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12
Q

How to remove gloves

A

do without exposing hands to outer glove surface / discard appropriately

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13
Q

Masks - When?

A

if danger of aerosols or splashes of infectious material

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14
Q

Mask Types

A

-procedure/surgical/HEPA/N95 Respirator/Airline (external air source)

-Procedure / surgical & N95 (for airborne) must common

  • N95 masks must be fit tested
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15
Q

Mask - How to use

A

-cover nose, mouth and under chin
-metal nosepiece at top
-White (smoothest side) is in - against wearer’s skin
-coloured (fluid resistant side) is always out
-pleats downward away from nose (called “waterfall” pleats)
-use once and discard
-do not wear around neck
-replace if wet
-HEPA/N95 for airborn infections such as tuberculosis
-If ties - tie top first - untie bottom first

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16
Q

Googles / Face Shield - When?

A

-danger of splashes of infectious material on mucous membranes of eyes / nose / mouth

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17
Q

Gown / Apron - When?

A

-if danger of contamination with infectious material
-to prevent transfer of microbes between patients

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18
Q

Gown / Apron - Use

A

-tied down back with waiste tied at back
-when noted on the door
-anticipate splashes
-patient has MRSA

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19
Q

Gown / Apron - Removal

A

-gloves off first
-untie back then waist
-shoulders loose as untie back
-remove arms avoiding contact with outer surface
-fold gown with outer surface in
-place in proper container

20
Q

Put on PPE (Donning PPE)

A

-hand hygiene
-gown
-mask
-eye/face protection
-gloves

21
Q

Take off PPE (Doffing PPE)

A

-gloves
-gown
-hand hygiene
-eye / face protection
-mask
-hand hygiene

22
Q

Hand Hygeiene
options

A

a. soap and water
b. Alcohol based hand rubs some now have hydrogen peroxide

23
Q

4 Moments of Hand Hygiene

A
  1. Before inital patient / patient environment contact
  2. Before aseptic procedure
  3. After body fluid exposure
  4. After patient / patient environment contact (single most important procedure to prevet nosocomial infections)
24
Q

When to do Hand Hygiene?

A
  • when hands contact blood or body fluids
    -when hands contact contaminated equipment
    -before anad after removing gloves
    -after a tear or suspected leak
    -before leaving work area
    -between patients
    -after bathroom
    -after blowing nose, etc.
    -before eating and drinking
    -at end of work shift
25
Q

Soaps for Hand Washing

A

-non-antibacterial
*reduces surface tension (wetting agent) allowing bacteria to be washed away
*use for routine hand washing

-anti-bacterial
*reduces surface tension and kills some microbes
*use for:
-critical care units/nurseries
-emergency, operating, delivery and medication rooms; area where surgical and diagnostic testing performed
-burn, dialysis and transplant units
-after contact with patients with antibiotic resistant bacteria

26
Q

Alcohol hand cleansers (ABHR - alcohol based hand rubs)

A

-70% ethanol or isopropyl is best

  1. dispense (about 5 ml) into palm
  2. rub finger nails / pour into other palm / rub nails
  3. rub fingers/ palms/ backs of hands
  4. air dry
27
Q

Routine Procedure for Hand Washing

A
  1. remove gloves
    2.adjust water, wet hands
  2. apply enough soap to give lather, rub fingernails in palm, pour to opposite hand, rub nails / scrub each finger (dont forget thumb) all parts of hands and wrists for 10-60 seconds..hands down but not under water
  3. rinse hands under running water.. wrists to finger tips
  4. pat dry hands with paper towel
28
Q

Care of Needles

A

-activate safety device - discard immediately after use - do not recap
-use puncture resistant container - discard with 3/4 full

29
Q

Clean up of Needles

A

-uncontaminated broken glass:
*broom/dust pan or wet paper towel → broken glass discard

-contaminated broken glass:
*decontaminate 10 min before cleaning up → biohazard broken glass discard

30
Q

Blood / Body Fluid Spill Clean up - patient care and client areas

A

Can use icintinent pads / absorbant wipes / paper towels for clean up

Large spills:
-wear suitable PPE (gloves, gown, goggles, mask, booties, etc.)
-contain spill then sweep or scoop (use disinfectant absorbant if possible) → clean up - put in plastic lined biohazard container
-decontaminate with disenfecatnat (eg. 1/100 fresh bleach) for 10 mins
-clean up

Moderate spills:
-wear suitable PPE (gloves, gown/goggles)
-wipe up with paper towels → plastic lined biohazard container
-decontaminate with disenfectant (e.g. 1/100 fresh leach) for 10 mins
-clean up

Small spills / dried blood or body fluid:
-wear suitable PPE (gloves as a minimum)
-decontaminate with disenfectant soaked paper towel or disenfectant wipe → plastic lined biohazard container

31
Q

Laboratory Specimen Spills

A

-wear suitable PPE (gloves as a minimum)
-decontaminate with disenfectant (eg. 1/10 fresh bleach) clean up with paper towel → plastic lined biohazard container
-decontaminate surface for 10 mins with fresh disenfectant
-clean up

32
Q

Biohazardous Waste

A

-anything contaminated with blood or body fluids
-DO NOT DISCARD in regular garbage
-place in container with Biohazard symbol

33
Q

Laundry (linen)

A

-place in leak proof bags if wet
-handle carefully → regular laundry

34
Q

Collecting and Transporting Laboratory Specimens

A

-wear appropriate PPE when collecting
-avoid containating collection container and requisition
-store in sealed container

35
Q

Occupational (Significant) Exposure to Blood and Body Fluids - What is it?

A

-skin is pierced by a contaminated needle or sharp objet
-blood or body fluid spashes on mucous membrane
-blood or body fluid → non intact skin
-human bite

36
Q

Occupational (Significant) Exposure to Blood & Body Fluids - Protocol

A

a. First Aid is required
b. Allow (encourage) bleeding
c. Wash with Soap / antiseptic and water
d. Bandage if necessary
e. Flush mucosal surfaces with lots of water
f. Report incident immediately to: supervisor → occupational health → emergency department

37
Q

Added Precautions (Transmission Based Isolation Procedures) - Why?

A

to minimize the spread of infection in the health care setting
- separate patients with transmissible infections
-protect immunocompromised patients

38
Q

Added Precautions (Transmission Based Isolation Procedures) - Who makes decision?

A
  • physicians and infection control and prevention practitioners
39
Q

Added Precautions (Transmission Based Isolation Procedures) - How do I known what to do?

A

Read and follow posted procedures

Look at the procedure and the patient and assess the need for:

-hand washing
-protective clothing (eg. Gowns)
-gloves
-eye protection
- mask

NOTE: If you are only going to talk to the patient and not perform a procedure then follow the Transmission Based Precautions as posted. If you are going to be doing a procedure on the patient, then you must follow Routine Practice PLUS the posted precautions.

40
Q

CDC Guidelines
Routine Practice + Added Precautions (Transmission Based Isolation Procedures)

A

-airborne
-droplet
-contact

designed to protect hospital environment and other people from patient’s infectious microorganisms

Specific guidelines for each type of transmission based isolation precautions

41
Q

Types of Rooms for Isolation

A

Negative Pressure - air flows into room from hallway
*keeps microorganisms from leaving room and spreading in to hallways (eg. Tuberculosis)
*rooms have Hepa filtration system to remove microorganisms from room air
*Keep door closed as much as possible

Positive Pressure Rooms
*air is allowed to flow from the room in to the hallway
*protects immunosuppressed patients from outside microorganisms

42
Q

Negative Pressure Rooms protects who?

A

Protects others

43
Q

Positive Pressure Rooms protects who?

A

Protects patient

44
Q

Protective Environment (formerly called Reverse) Isolation – designed to?

A

Protect patient from hospital and other peoples microorganisms

-burn units, immunosurpressed patients, transplant patients

-usually includes: private room, hand washing espeically before entering room, gloves, gown ;
-contaiminated articles not brought into room

45
Q

Disposal of Items from Isolation Rooms

A

-Supplies and Equipment:
*have dedicated equipment for patient
*leave in room = thermometers, tourniquets, blood pressure cuff, blood collection, exercize and other theraputic equiment
-equipment that is removed must be bagged for discard or bagged and transported to cleaning area before reuse

Serving Food Trays - usually only gloves required
*leftover food and disposable dishes discarded into dedicated trash
*non-disposable dishes bagged for transport to clean up area

46
Q

Patient Movement - Transporting the Patient Out of Isolation

A

-avoid if possible - check protocol
-surgical mask on patient of airborne or droplet isolation
-if contact isolation - cover draining areas
-protect wheelchair with sheet
-recieving department must be notified

47
Q
A

IPC (18 decks)

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