Infection Prevention and Control
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| Pre-hospital Directive | Patient is a DNR (Do Not Resuscitate) – Directs medical personal.
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| Contact Precautions | Means you can get infected by contacting them. This is where PPE comes in.
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| The most communicable blood-borne infection – more so than HIV | Hep B and Hep C.
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| What is an infection? | Entry & multiplication of infectious agent or pathogen in host tissues - Causes cell injury.
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| Colonization | Pathogen is present, but does not cause cell injury-contact-does not cause infection.
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| Symptomatic infection | Pathogens multiply and cause clinical s/sx – signs and symptoms are showing.
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| Asymptomatic infection | Showing no signs or symptoms. Hep A. Could be multiplying but not showing symptoms yet.
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| Infection occurs in a cycle that depends on the presence of all of the following elements: | Infectious agent, reservoir, portal of exit from reservoir, mode of transmission, portal of entry to host, susceptible host.
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| The most common reservoir is ____. | the human body
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| Name some Portals of exit from the reservoir. | Skin & mucus, respiratory tract, urinary tract (usually sterile), gastrointestinal tract, reproductive tract, and blood.
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| Name some common modes of transmission. | Direct contact, indirect contact (door handle), airborne (TB), droplet, vehicles, vector.
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| The major route of transmission for pathogens identified in the health care setting is ___. | the unwashed hands of the health care worker.
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| Susceptibility depends _____. | on the individual degree of resistance to a pathogen (immune response).
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| Some of the factors that influence a person's susceptibility (resistance) include? | age, nutritional status, presence of chronic disease, trauma, and smoking.
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| Direct Contact Transmission | Person-to-person (fecal, oral) – physical contact between source and susceptible host (Hep A, Staph) or consuming contaminated food.
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| Indirect Contact Transmission | Personal contact with contaminated inanimate object – needles, sharps, dressings, environment (Hep B, Hep C, HIV, Staph, RSV, MRSA).
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| Droplets Transmission | (sneezing or suctioning) – Large particles that travel up to 3 feet and come in contact with susceptible host – (influenza, rubella, meningitis) (coughing, sneezing, or talking).
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| Airborne Transmission | (dust/droplets remain suspended in air) – Droplet nuclei, or residue or evaporated droplets – suspended in air (e.g., coughing, sneezing) or carried on dust particles.”
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| Common vehicle Transmission | (equipment, water, blood, drugs, contaminated items, solutions, food (improperly handled, stored or cooked; fresh or thawed meats).
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| The severity of the client's illness depends on? | The extent of the infection, the pathogenicity of the microorganisms, dose of the organism, and the susceptibility of the host.
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| Incubation period | Interval between entrance of pathogen and appearance of first symptoms.
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| Prodromal stage | Interval from onset of nonspecific signs and symptoms (malaise, low-grade fever, fatigue) to more specific symptoms. (During this time, microorganisms grow and multiply, and client may be capable of spreading disease to others.)
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| Convalescence stage | Recovery period – acute symptoms of infection disappear.
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| Why is there an increased risk for infection in health care settings? | More cross-contamination, in a more susceptible state, surgeries, invasive procedures.
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| Why are older adults at greater risk of infection? | Skin breakdown, decline in immune system function, poor nutrition, unintentional weight loss, and low serum albumin levels.
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| Decline in immune system function | immune senescence.
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| Natural Body defenses against Infection are? | Normal flora, Inflammation, Vascular and cellular responses – edema, and Tissue repair.
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| Inflammatory exudates | Fluid and cells that are discharged from cells or blood vessels (e.g., pus or serum).
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| Kinds of exudates: | "Exudate may be serous (clear, like plasma), sanguineous (containing red blood cells), or purulent (containing WBCs and bacteria)."
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| Healthcare-Associated Infections (Formerly Nosocomial) can occur __. | as the result of invasive procedures, antibiotic administration, the presence of multidrug-resistant organisms, and breaks in infection prevention and control activities.
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| Iatrogenic | type of HAI - result from procedure such as starting an IV wrong or incorrect surgery.
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| Endogenous | Normal flora become altered & overgrowth occurs - "can occur when part of the client's flora becomes altered and an overgrowth results. " Example? Because of antibiotics you get yeast infection.
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| Exogenous | Organism present outside of client’s normal flora - " a postoperative infection is an exogenous infection" Example? Infection received from poor hygene.
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| What are major sites for infections? | Urinary Tract, Surgical or Traumatic Wounds, Respiratory Tract, and Bloodstream.
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| How does nutritional status affect susceptibility to infection? | When protein intake is inadequate as a result of poor diet or debilitating disease, the rate of protein breakdown exceeds that of tissue synthesis.
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| How does stress affect susceptibility to infection? | If stress continues or becomes intense, elevated cortisone levels result in decreased resistance to infection.
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| How does Medical Therapy affect susceptibility to infection? | Some drugs and medical therapies compromise immunity to infection – anti-inflammatory drugs cause protein breakdown.
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| Normal white blood cell counts? | 5000-10,000/mm3=normal, (neutrophils) – "trauma and physical stress can cause an elevation in the number of neutrophils".
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| A way Health Promotion can lower risk of infection. | Annual vaccination to protect against influenza is an important element of risk reduction.
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| What is Asepsis used for? | Control or elimination of infectious agents – hand washing, not letting sick people in room.
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| How does Acute Care reduce infection? | Treatment of an infectious process includes eliminating the infectious organisms and supporting the client's defenses.
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| Name a way to control or eliminate reservoirs | Change dressings regularly, be aware of moist, warm, environments.
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| Isolation and isolation precautions | Depending on disease, patients are isolated - MRSA patients, doesn’t mean they are alone, but away from non-contaminated patients.
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| Asepsis is? | The absence of pathogenic (disease-producing) microorganisms.
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| Aseptic technique | Procedures that assist in reducing the risk for infection.
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| Hand hygiene, using clean gloves to prevent the transfer of organisms from one client to another or to prevent direct contact with client blood or body fluids, and cleaning the environment routinely are examples of? | medical asepsis
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| During daily routine care the nurse uses basic medical aseptic techniques to ___. | break the infection chain.
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| Standard precautions apply to ___. | contact with blood, body fluid, nonintact skin, and mucous membranes from all clients. These precautions protect the client and provide protection of the health care staff as directed by the Occupational Safety and Health Administration (OSHA) (2001).
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| What is the single most important thing to prevent the spread of microorganisms? | HANDWASHING!
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| When should you wash your hands? | before and after all client contact, procedures, eating, going to bathroom, coming on shift.
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| If hands are visibly soiled use ___. | regular or antimicrobial soap for 10-15 seconds per policy using friction – don’t forget thumb.
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| If hands are not visibly soiled, use ___. | alcohol-based waterless cleanser per manufacturer’s recommendation for routine decontamination of hands.
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| Disinfection describes a process that ___. | eliminates many or all microorganisms, with the exception of bacterial spores, from inanimate objects.
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| Sterilization is ___. | the complete elimination or destruction of all microorganisms, including spores. Steam under pressure, ethylene oxide (ETO) gas, hydrogen peroxide plasma, and chemicals are the most common sterilizing agents.
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| Barrier protection, using gloves for example, is for use with all clients because? | every client has the potential to transmit infection via blood and body fluids, and the risk for infection transmission is unknown.
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| MRSA | Methicillin-Resistant Staph Aureus
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| Isolation is | the separation and restriction of movement of ill persons with contagious diseases.
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| Contact transmission is divided into what two subcategories? | direct and indirect.
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| MDRO | (Multidrug-resistant organism)
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| C-DIF | (Colstridium difficile)
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| Droplet precautions require the wearing of | a surgical mask when within 3 feet of the client, proper hand hygiene, and some dedicated-care equipment. An example would be a client with influenza, Diphtheria, rubella, scarlet fever, mumps, or pneumonia.
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| Airborne precautions | Focus on diseases that are transmitted by smaller droplets that remain in the air for long periods of time. requires a specially equipped room with a negative air flow and (HEPA) filter. – Measles, Chickenpox, TB.
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| Protective environment | Requires a specialized room with positive airflow. a HEPA filter. Not allowed to have dried and fresh flowers and potted plants in these rooms.
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| Surgical Asepsis or “Sterile technique” | Prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery - includes procedures used to eliminate all microorganisms, including pathogens and spores, from an obj
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| How can you make your hands sterile? | Wash hands and use sterile gloves.
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| Which organisms are of greatest concern for disease transmission? | HEP B AND C.
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| Standard precautions used to protect HCW from bloodborne pathogens? | Gloves, mask, PPE, wash hands, gowns.
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| What is TIER 1 for Standard Precautions? | All clients must be treated as being possibly infectious so use PPE for all clients if risk of contact with: blood or body fluids, secretions, excretions (except sweat), non-intact skin, mucous membranes, and contaminated equipment.
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| When should you wear mask & goggles or face shields? | When dealing with splashing situations like surgery, spitting, vomiting.
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| When should you wear Gowns? | Anytime you deal with contagious disease, contact w/patient.
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| Contact precautions are used to? | to protect others from contaminated clients - use gloves, gown, private room – used with MRSA, VRE, RSV, draining wounds.
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| Protective environment are ___. | “Reverse isolation” to protect clients from others.
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| Invasive procedures, such as the insertion of an IV or urinary catheter, disrupts __. | the body’s natural defense barriers.
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| Mrs. Peterson had surgery for a fractured hip, but developed pneumonia during her stay. Which type of infection is this? | An exogenous infection”.
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| When are sterile gloves necessary? | When performing a sterile procedure.
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| Hand hygiene refers to __. | hand washing (the use of soap and water), antiseptic hand washing (the use of antiseptic soap), antiseptic hand rub (the use of an alcohol-based product), and surgical hand antisepsis.
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| Hand washing is __. | a vigorous, brief rubbing together of all surfaces of the hands lathered in soap, followed by thorough rinsing.
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| The recommended duration for lathering hands is at least ___. | 10 to 15 seconds.
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| When hands are vigorously cleansed with the ____, a significantly greater reduction in the number of microbial counts on the hands results as compared with traditional hand washing. | alcohol-based hand rub
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| An exogenous infection is a type of healthcare-associated infection resulting from ___. | a diagnostic and/or therapeutic procedure.
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| An exogenous infection comes from ___. | microorganisms outside the client, such as Salmonella and Aspergillus, which do not exist as normal flora in humans, and is likely to result from a diagnostic and/or therapeutic procedure.
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| A client has an infection of the bloodstream from failure to change an inflamed IV access site. This is a ___ infection. | exogenous
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| Infection needs a method or mode of transmission like? | hands of health care workers, stethoscope, thermometer, droplet nuclei.
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| Use of sterile instruments and gloves in the operating room and special procedural areas are additional examples of____. | surgical aseptic technique
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| “______ reduces the number of microorganisms present, whereas _____ eliminates microorganisms from an area. | Medical asepsis, surgical asepsis
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| You see that the client has a gunshot wound to the chest, so you apply goggles, a mask, and a gown. What is this called? | Following standard precautions
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