wk3- infection control in healthcare

Question 1

what are the risk factors of healthcare associated infections 4 and explain how

Answer 1

patient age- young or old is associated with suboptimal immunity to pathogen exposure

surgical procedures- disrupt the barrier integrity of the integument and create portals of entry

degree of immunosuppresion- leads to increased host susceptibility

duration of indwelling devices- increases infection risk and reason for routine resting of devices.

Question 2

types of infectious agents in the hospital setting

Answer 2

bacteria
endogenous respiratory bacteria
opportunisits
multiple drug resistant organisms

Question 3

opportunists are usually what

Answer 3

low-abundance commensals

Question 4

sources of healthcare associated infections

Answer 4

endogenous sources- in or on the host

exogenous sources- other individuals/environments

Question 5

routes of transmission for HAIs

Answer 5

contact- direct physical contact/indirect with intermediate object

common vehicle- via air, food, water

vector- to new hosts,typically an arthropod.

Question 6

what is the most common route of transmission in healthcare

Answer 6

contact transmission

Question 7

list the factors that contribute to high incidence of HAIS 5

Answer 7

microbial fators
patient susceptibility
medical procedures
movement of patients
healthcare facility

Question 8

describe how microbial factors contribute to high incidence of HAIs

Answer 8

they aid the survival, reproduction and resistance of infectious agents.

including metabolic capacity where nutrient sources an sustain survival/reproduction.

virulence factors facilitate adaptation t the environment.

Question 9

describe how patient susceptibility contributes to High HAIs

Answer 9

immune status of the host is a modifiable risk and may be negatively impacted by treatments

Question 10

describe how medical procedures contribute to high HAIs. what are these risks referred to as?

Answer 10

result in the creation of new portals of entry for infectious agents to disrupt physiological functions. these risks referred to as iatrogenic.

Question 11

describe how movement of patients contribute to HAIs

Answer 11

increases risk of exposure through the exposure of susceptible patients/staff

Question 12

describe how healthcare facilities contribute to HAIs

Answer 12

it is proportional to the size of the healthcare environment. the higher the number of patient management events, the higher the number of infectious agents circulating.

Question 13

describe the purpose of the national guidelines

Answer 13

provides the framework for healthcare workers to operate and maintain a safe working environment for themselves and their patients. The document describes the responsibilities of ALL healthcare workers

Question 14

role of health care workers 5

Answer 14

infection control strategies- risk assessment and management

quality management- focusing on compliance and education

preventing infectious disease transmission- chemical and physical control practices to interrupt the chain of infection.

infection management- requirements for different classes of agents

targeted strategies- for challenging environments with increased risk

Question 15

who is responsible for infection prevention and control

Answer 15

healthcare workers

the infection control committee

internation health agencies

Question 16

what is standard precautions?

Answer 16

minimum set of strategies implemented in healthcare facilities to reduce the exposure risk and transmission of infectious agents between individuals and the external environment. Standard precautions should be used in the handling of: blood (including dried blood); all other body substances, secretions and excretions (excluding sweat), regardless of whether they contain visible blood; non-intact skin; and mucous membranes and regardless of whether the patient has a known infectious disease.

Question 17

list standard precautions 8

Answer 17

-hand hygiene- before and after patient contact
-protective equipment- risk of bodily fluid exposure
-dispose sharps- after use
-environmental cleaning
-clean and reprocess shared equipment- after use
-respiratroy etiquette
-aseptic technique
-dispose of waste and used linen

Question 18

five moments of hand hygiene

Answer 18

1- before touching patient
2- before clean/aseptic procedure
3- after bodily fluid exposure
4- after touching patient
5-after touching patient surroundings

Question 19

list contact transmission based precautions and when / what order to do them

Answer 19

before entering room
hand hygiene
gown/apron
gloves

on leaving
dispose gloves
hand hygiene
dispose gown/apron
hand hygiene

Question 20

what is contact transmission based precations

Answer 20

Precautions used to prevent the transmission of infectious agents that are spread by touching the patient or the patient surroundings. Many of the infectious agents that require contact precautions are multiply-drug resistant.

Question 21

what is droplet transmission based precautions

Answer 21

Precautions used to prevent the transmission of infectious agents that are spread by respiratory droplets that travel short distances (up to 1.5 metres) from the source during coughing or sneezing. Many of the infectious agents that require droplet precautions cause vaccine-preventable infections.

Question 22

list droplet precautions

Answer 22

before entering
hand hygiene
surgical mask

on leaving
dispose of mask
hand hygiene

Question 23

what is airborne transmission based precautions

Answer 23

Precautions used to prevent the transmission of infectious agents that are spread by respiratory droplets travelling long distances (greater than 1.5 metres) and remaining suspended in aerosolized particles for extended periods of time after leaving the infected host during talking, laughing, coughing or sneezing. The infectious agents that require airborne precautions cause vaccine-preventable infections or represent emerging infectious diseases typically of viral zoonotic origin.

Question 24

list airborne precautions

Answer 24

before entering a room
hand hygiene
put on n95 or p2 mask
perform fit check of mask

on leaving
dispose mask
perform hand hygiene

Question 25

Role of face masks in infection prevention and control

Answer 25

they trap expelled particles and secretions and offer a physical barrier against inhalation of infectious agents

Question 26

non medical /medical face mask

Answer 26

Non-medical face masks include cloth masks and non-medical surgical masks, which are not tested and validated to Australian standards. these masks are not classified into levels or categories and if boxed, are labelled as “non-medical”.

Medical (procedure) face masks are ranked based on testing, performance and validation against Australian standards. These masks are further classified by Australian standards as Level 1-3 surgical masks (standard precautions - Level 1-3 - and droplet transmission-based precautions - Level 2 or 3), or N95 or P2 (used when airborne transmission-based precautions are required).

Question 27

describe how to correctly wear a mask

Answer 27

fitted face mask covering the nose and mouth. the folds of the face mask sit over the top of each other to allow to stretch and the flexible wire is for moulding the top of the mask around your nose.

colorful side the outer part, ear loops extend from the front.

Question 28

describe the factors that influence how the correct face mask is chosen- four F’s of mask selection

Answer 28

filtration- layers of the mask
fluid resistance- protects against bodily fluid splatter
features- ear loops/ ties
fit- worn correctly and fit tightly

Question 29

Describe the role of hand hygiene in infection and prevention control

Answer 29

-removal of transient infectious agents
-reduction in the endogenous microbiota

Question 30

Describe the difference between resident and transient skin flora

Answer 30

Resident flora (endogenous/normal regional microbiota): microorganisms residing
under the superficial cells of the stratum corneum and also found on the surface of the skin

Transient flora: infectious agents that colonise the superficial layers of the skin and are effectively removed by routine handwashing.

Question 31

Describe the spectrum of activity of commonly utilised antiseptic agents

Answer 31

immediate activity- immediately reduce the number of transient infectious agents on the hands. 60-80% alc

residual activity- The prolonged or extended antimicrobial activity that prevents the growth or survival of infectious agents including resident and transient flora over time after application of a specific antiseptic.

cumulative effect- increased antimicrobial effect with repeated applications of a given antiseptic agent, which gradually reduces resident and transient flora counts on hands after multiple uses. required for surgical procedures.

Question 32

Describe each of the three (3) hand hygiene procedures: routine/social, aseptic/clinical, surgical

Answer 32

routine/social- Alcohol based hand rub OR
Soap and water. At least 20 seconds (handrub) - used when not soiled. Up to one minute (handwash)- used when soiled. Used during non-procedural daily activities.

aseptic/clinical- Antimicrobial soap (e.g. 2% or 4% chlorhexidine gluconate). at least one minute- thoroughly. Used to remove transient infectious agents and inhibit the growth of endogenous microbiota prior to any care activity that implies a direct or indirect contact with a mucous membrane, non-intact skin, or an invasive medial device.
No infectious agents should be transmitted

surgical- Antimicrobial soap
(2% or 4% chlorhexidine glucontate, or 7.5% povidone-iodine). First wash for the day: five (5) minutes. Subsequent washes for the day: three (3) minutes. A five minute scrub which includes cleaning of the fingernails is to be undertaken as the first scrub of the day Subsequent scrubs of three minutes duration (which omit the fingernails) are undertaken between cases
Hands are kept higher than the elbows at all times to allow water to run in one direction only – from clean to dirty (hands to elbows). Used to remove transient infectious agents and inhibit the growth of endogenous microbiota prior to any care activity that implies a direct or indirect contact with a mucous membrane, non-intact skin, or sterile body sites.

Question 33

Describe three (3) causes of inefficient hand hygiene

Answer 33

missing one of the Five moments
re-contamination after performing hand hygiene
incorrect technique
incorrect choice of hand hygiene agent

Question 34

when are transmission based precautions applied in healthcare?

Answer 34

when standard precautions alone cannot prevent transmission (both standard and transmission precautions done)

Question 35

identify potential sources of infectious agents- in the community

Answer 35

people
animals
food
waste
soil
water

Question 36

identify potential sources of infectious agents- in the clinic

Answer 36

surfaces
animals (support)
waste
etc

Question 37

to interrupt transmission of infectious agents you must control (3)

Answer 37

-portal of exit from reservoir
-method of transfer to external environment
-portal of entry into a susceptible host

in some situations it can be doing one of these can stop it, other situs it must be all of these

Question 38

endogenous reservoir

Answer 38

infection that is typically inside the reservoir
eg yeast infection (increase in microbes)
unrinary tract infection- enodgenous microbiota that comes from a different area in their body

Question 39

exogenous infections

Answer 39

comes from environments, microbiota that is not your own

alot of infections caused this way through contact, droplet, airborne transmission.

Question 40

main ways of managing exposure risks 2

Answer 40

-immunisation
-safe disposal of infectious material.

Question 41

blood spills PPE and order

Answer 41

safety glasses, mask, gloves, gown

order going on….
gown first, then mask, goggles on, gloves on over gown.

Question 42

3 examples of sharps and common injuries

Answer 42

tweezers/scissors
scalpel
needles

putting it on/off (single use sharps)
incorrect disposal
moving during incision

Question 43

what are virulence factors

Answer 43

genetics of microbes. tells us the ability of a microbe to cause disease

Question 44

examples of what infectious agents can cause infectious disease via contact transmission

Answer 44

staphlycoccus can cause sepsis

Question 45

examples of an infectious agent that can cause an infectious disease through common vehicle

Answer 45

SARS-COV-2 can cause covid19

Question 46

example of mechanical and biological agent that can cause diseases via vector transmission

Answer 46

mechanical- E-coli can cause gastro
biological- mosquito can cause malaria