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N106 - Nursing Practice > Week 1: Isolation > Flashcards

Week 1: Isolation Flashcards

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1
Q

What is asepsis?

A

Process for keeping away disease-producing microorganisms.

2 types of asepsis:
Medical asepsis + Surgical asepsis

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2
Q

What is the main difference between disinfection and sterilization?

A

Disinfection - elimination of pathogens except for bacterial spores.

Sterilization - including spores.

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3
Q

What is the key difference between critical items, semicritical items, and noncritical items when it comes to disinfecting/sterilization? Give examples of each:

A

Critical - instruments enter sterile tissue or the vascular system. Example: surgical instruments, an intravascular catheter (IV line), urinary catheters, needles.

Semi-critical - devices that come in contact with mucous membranes or nonintact skin but do not penetrate them. Example: thermometers, resp therapy equipment, endotracheal tubes, GI endoscopes, vaginal and nasal specula.

Non-critical - items that touch only skin (not mucous membranes) or do not directly touch the patient. Example: bedpans, urinals, commodes, BP cuffs, linens, stethoscopes, eating utensils.

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4
Q

What are the 3 categories of additional (isolation) precautions (tier two)?

A

Contact
Airborne
Droplet

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5
Q

What are the 2 tiers of precations

A

1st tier - routine practices

2nd tier - additional precautions (isolation - 3 categories)

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6
Q

What distinguishes a contact precaution from a droplet or airborne precaution?

A

Contact: direct/indirect
Droplet: > 5 microns
Airborne: < 5 or equal to microns

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7
Q

Droplet precautions are used for which infectious agents? Give examples of diseases that are transmitted by droplets.

A

Infectious agents: > 5 microns (transmitted by droplets produced by coughing, sneezing, or talking)

Eg. influenza, covid19, diphtheria (pharyngeal), rubella, pertussis, mumps, meningococcal pneumonia, sepsis

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8
Q

Airborne precautions are used for which infectious agents? Give examples of diseases that are transmitted airborne.

A

Infectious agents: < 5 or equal to microns.

Ex. measles, chickenpox (varicella), disseminated zoster, TB

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9
Q

Contact precautions are used for which infectious agents? Give examples of diseases that are transmitted by contact.

A

Infectious agents transmitted via direct or in-direct contact.

Ex. MRSA, VRE, bed bugs, wound infections, clostridium difficile, norovirus, CPO & CPE (drug-resistant organisms)

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10
Q

For an airborne precaution, what barrier protections are implemented?

A
  • single room: negative pressure, the DOOR CLOSED, vented to the outside or special filter.
  • everyone wears an N95 mask (taken ff outside the room)
  • pt only our for essential procedures (wears a mask)
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11
Q

For a droplet precaution, what barrier protections are implemented?

A
  • single room or cohort patients; DOOR CAN BE OPEN.
  • cohort patients 2 M apart, the door only open if bed 2 M apart from the door
  • gloves, gown, MASKS, and EYEWEAR must be worn
  • pt only our for essential procedures (wears a mask)
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12
Q

For a contact precaution, what barrier protections are implemented?

A
  • single room or cohort pts.
  • DOOR MAY BE OPEN
  • gown/glove if direct contact
  • dedicated equipment or disinfect after use
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13
Q

For a contact plus precaution, what barrier protections are implemented?

A
  • single room or cohort pts.
  • DOOR MAY BE OPEN
  • gown/glove if direct contact
  • dedicated equipment or disinfect after use
  • must wear mask/eye-protection if pt vomiting, coughing, etc.
  • enhanced housekeeping procedures
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14
Q

For an enhanced contact precaution, what barrier protections are implemented?

A
  • SINGLE ROOM
  • gloves/gown for ALL entries
  • dedicated equipment, limited transport of pt
  • dedicated nursing required
  • enhanced housekeeping procedures
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15
Q

List the 3 different contact precaution types and diseases for each:

A

Contact precautions (MRSA, VRE, bed bugs, wound infections)

Plus contact precautions (Cdiff, norovirus)

Enhanced contact precautions (CPO & CPE (drug-resistant organisms))

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16
Q

What purpose do isolation precautions serve and when are they intended?

A

They are designed to contain pathogens in one area (usually pt’s room), and they are only for those with highly transmissible or epidemiologically significant pathogens.

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17
Q

Good to know:

List the adverse effects of isolation (from isolation precautions)?

A
  • psychological consequences (depression, anxiety, anger, hostility, loneliness, neglect, and low self-esteem).
  • physiological decline (falls, malnutrition, pressure injuries, fluid/electrolyte imbalances).
  • inattention from health care (longer to answer the call bell, lack of explanations, and less time being spent with the pts, RESULTING in increased incontinence).
  • decreased physio/OT/recreational therapy
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18
Q

What entails PPE?

A

Gloves (non-sterile)
Facial protection (mask (procedural/N95)
Gown

Shoe & hair covers prn

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19
Q

Briefly explain the purpose of each PPE item:

Gloves
Mask
N95 mask
Gown

A

Gloves: prevent transmission of pathogens by direct and indirect contact. Must be changed between tasks. Hand hygiene is a MUST after removal.

Mask: Pathogens cannot enter the mouth or nose. Must be snug. Keep talking to a minimum when transporting pts to reduce respiratory airflow.

N95 masks: Airborne diseases (TB, measles, herpes zoster)

Gown: Prevents contamination of clothes and protects health care workers and visitors from coming in contact with infected material, blood, or body fluid.

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20
Q

Define infection:

A

physiological ATTACK from microorganisms on body tissues and systems.

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21
Q

Define immunity:

A

the physiological REACTION to an antigen. The state of being insusceptible to specific diseases.

22
Q

What are the 2 core isolation principles?

A
  1. to contain pathogens

2. to protect pts, visitors, and health care workers

23
Q

Define microorganism

A

a microscopic organism, especially a bacterium, virus, or fungus.

24
Q

Define pathogen

A

a bacterium, virus, or another microorganism that can cause disease.

25
Q

Define infection

A

The invasion and growth of germs in the body. The germs may be bacteria, viruses, yeast, fungi, or other microorganisms

26
Q

Define nosocomial

A

A nosocomial infection is contracted because of an infection or toxin that exists in a certain location, such as a hospital.

27
Q

Define virulence

A

The severity or harmfulness of a disease

28
Q

Define colonization

A

The presence of bacteria on a body surface (like on the skin, mouth, intestines or airway) without causing disease in the person.

29
Q

Define epidemiology

A

Epidemiological studies measure the risk of illness or death in an exposed population compared to that risk in an identical, unexposed population (for example, a population of the same age, sex, race, and social status as the exposed population).

30
Q

What does ARO’s stand for?

A

Antibiotic-resistant organisms

31
Q

What does MDRO’s stand for?

A

multiple drug-resistant organisms

32
Q

What does MRSA stand for?

A

Methicillin-resistant staphylococcus aureus

33
Q

What does VRE stand for?

A

Vancomycin-resistant enterococci

34
Q

What does CDAD stand for?

A

clostridium difficile associated diarrhea

35
Q

What does HAI’s stand for?

A

hospital-acquired infections

36
Q

What does CAUTI’s stand for?

A

catheter-associated UTI’s

37
Q

What does AGMP stand for?

A

aerosol-generating medical procedure

38
Q

List the modes of transmission of disease (5)

A

Contact - direct/ndirect
Droplet > 5 microns
Airborne < or equal to 5 microns
Vehicle transmission - when substances such as soil, water, or air carry the pathogens to a new host.
Vector transmission - infections by the bite of an infected arthropod species such as mosquitoes, ticks, etc.

39
Q

Briefly explain 1st tier of precautions:

A
  • routine precautions (designed for all pts)
  • handwashing
  • PPEs (gloves, gown, eyewear) if contact with blood or body fluids
  • linen, sharps, equipment disposal to prevent illnesses/infections
40
Q

Briefly explain 2nd tier of precautions:

A

ISOLATION precautions: contact, contact plus, enhanced contact, droplet, airborne, and cytotoxic precautions (for immunocompromised pts)

  • PPE and barrier protection as per specific precaution.
41
Q

What additional steps are taken for immunocompromised pts (chemo pts, post-transplant, HIV/AIDs)

A
  • 4 moments of hand hygiene
  • PPE per point of care risk assessment
  • restrict visitors
  • dedicated pt equipment
  • single room if possible
  • must not be placed with pts who are risk factors for transmission (tubes, wounds, etc)
42
Q

What does donning PPE mean?

A

Putting “on”

43
Q

What does doffing PPE mean?

A

Taking “off”

44
Q

List the steps to donning PPE?

A
  1. Hand hygiene
  2. Gown
  3. Mask (procedural/N95)
  4. eyewear
  5. gloves over cuffs
45
Q

List the steps to doffing PPE:

A
  1. Remove gloves & discard
  2. Hand hygiene (optional)
  3. Remove gown & discard
  4. Hand hygiene
  5. Remove eyewear, then mask
  6. Hang hygiene
46
Q

List the steps to doffing PPE if wearing N95 (precaution rooms):

A
  1. Remove gloves & discard
  2. Hand hygiene
  3. Remove gown & discard
  4. Hand hygiene
  5. Exit to hallway or anteroom
  6. Remove eyewear
  7. Hand hygiene
  8. Remove N95 by straps then discard
  9. Hand hygiene
47
Q

If a negative pressure room is not available to do an AGP (aerosol-generating procedure), then what extra step should be taken?

A

Placing an AGP signage on pt’s door and leaving it there (with the door closed) for 1 hour after the procedure

48
Q

If an N95 mask if required (droplet or AIrborne), where should it be removed?

A

Always outside the room

49
Q

What must any staff members delivering or collecting trays from a patient with droplet precautions do?

A

Don PPE

50
Q

What PPE is required for AGP’s?

A

N95
Face shield or goggles
Gown
Gloves

N106 - Nursing Practice (3 decks)

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