Week 6 - Infection Control in Healthcare settings

Question 1

Define infection control

Answer 1

processes and precautions taken to control the spread of infection

Question 2

What is the chain of infection

Answer 2

the cycle of which infection is continuously spread
1. infectious agent
2. Reservoir (water, food, soil, humans, animals)
3. Portal of exit
4. made of transmission (droplet, faecal-oral, vector-borne)
5. portal of entry (mouth, nose, skin cuts, eyes)
6. susceptible host (human)

Question 3

What are the potential sources of infection from patients and staff

Answer 3

Patients with
- acute phase of an infection (not that harmful) e.g. common cold
- prodromal phase of infection e.g. measles, mumps
- Healthy carriers of pathogenic organisms (not symptomatic) e.g. HIV, Hep B and C

Question 4

What are the modes of trasmission

Answer 4

• Direct
• Indirect

Question 5

What is the direct mode of transmission

Answer 5

• unprotected contact with infectious lesions or other skin infections e.g. Herpes, gonorrhea
• droplet (aerosols which turn into droplets in less than 1 m) e.g. coughing and sneezing
• Exchange of bloody fluids e.g. HIV, hepatitis

Question 6

What are the forms of indirect modes of transmission

Answer 6

• Airborne (droplets which can travel as an aerosol for more than 1m) e.g. dental aerosols
• Contaminated objects (formites) - medical instruments, clothing, surfaces

Question 7

What are the potential routes of transmission of microorganisms

Answer 7

• Infected from patients or vice verse (direct and indirect)
• equipment generate aerosols or improper sterilization
• subsequent patients at risk

Question 8

How is HIV spread

Answer 8

Infected instrument or direct injection of blood

Question 9

How is Hepatitis B spread

Answer 9

Sharps injury

Question 10

How is Hepatitis C spread

Answer 10

Re-using needles, poor infection control practices

Question 11

Define antiseptic

Answer 11

• Use for people
• type of chemical disinfectant suitable for use of skin or living tissue, used to kill or remove harmful microorganisms without damaging the tissue

Question 12

Define disinfectant

Answer 12

• not used on people
• type of chemical suitable for use on inanimate objects

Question 13

Define disinfection

Answer 13

destruction or removal of most microorganisms (usually kills bacteria, may not kill spores and viruses)

Question 14

Define sterilization

Answer 14

Complete destruction or removal of all microorganisms including spores and viruses

Question 15

Define biocide

Answer 15

chemical capable of killing microbe

Question 16

What does critical level risk mean

Answer 16

the item penetrates sterile tissue, body cavity or blood stream

Question 17

How do you clean critical level risk items

Answer 17

sterilisation

Question 18

Examples of critical level risk items

Answer 18

surgical instruments
needles
periodontal scalers
implants

Question 19

What is a semi critical level of risk item

Answer 19

an item which comes in contact with mucous membranes or non intact skin

Question 20

How do you clean semi critical level risk items

Answer 20

single use
sterilization
high level chemical disinfection

Question 21

Examples of semi critical level risk items

Answer 21

dental mouth mirrors
amalgam condensers
dental handpieces

Question 22

What are non-critical level of risk items

Answer 22

items which only come in contact with intact skin

Question 23

How do you clean non critical level risk items

Answer 23

cleaning
decontamination

Question 24

Examples of non critical level risk items

Answer 24

x ray heads
bib chain
alginate spatula
protective eyewear

Question 26

What are the approaches to prevent infection in healthcare settings

Answer 26

- removal of microorganisms from the environment - removal of organisms from patient care equipment

Question 27

Methods for the removal of microorganisms from the environment

Answer 27

- cleaning - disinfection

Question 28

What are the methods to removal organisms from patient care equipment

Answer 28

- cleaning, disinfection and/or sterilisation

Question 29

ways which instruments and equipment can be cleaned

Answer 29

- automated washer - ultrasonic bath - manual

Question 30

Methods to disinfect things

Answer 30

- heat (boiling for 5 min) - liquids (phenolic compounds, bleach, 70% alcohol

Question 31

Factors which affect liquids ability to disinfect

Answer 31

- If the organism has spores, gram-negative, non-enveloped (more resilient) - high load of bacteria - dilution/volume/contact time

Question 32

Examples of antiseptics

Answer 32

- alcohol (<100%) e.g. skin wipes - chlorhexidine - Iodine-containing

Question 33

Methods/processes for sterilisation

Answer 33

- autoclaves - filtration - hydrogen peroxide - incineration - gamma irradiation

Question 34

Requirements when storing sterile and clean equipment and tools

Answer 34

- use expiry date - re-sterilise equipment if packaging is damaged - store clean items in dry, closed or covered containment

Question 35

How should items which penetrates sterile tissue, body cavity or bloodstream be cleaned

Answer 35

sterilisation JCU - item is washed in the thermal instrument washer, is wrapped, tracked then sterilised e.g. surgical instruments, needles, periodontal scalers, implants

Question 36

How should items which come in contact with mucous membranes or non-intact skin be cleaned

Answer 36

Single use, sterilization, high level chemical disinfection JCU - the item is washed in the thermal instrument washer, is wrapped, tracked, then sterilised e.g. dental mouth mirrors, amalgam condensers, dental handpieces

Question 37

How are items which come in contact with intact skin be cleaned

Answer 37

cleaning, decontamination JCU - the item is washed in the thermal instruments washer, is wrapped, tracked, then sterilised e.g. X-ray heads, bib chain, alginate spatula, protective eyewear

Question 38

What are the standard precautions in healthcare settings

Answer 38

- treat all patients as potentially infectious - standard precautions are applies at all times - hand hygiene before and after - use of PPE - safe use of disposal of sharps routine environmental cleaning - reprocessing of reusable medical equipment and instruments