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Why is it challenging to prevent transmission of infection in infants and small children
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Infants and toddlers younger than 2 years of age have decreased response to polysaccharide antigens, putting them at risk of invasive disease due to
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Set 3
| Question | Answer |
|---|---|
| Why is it challenging to prevent transmission of infection in infants and small children | Infants and small children are often asymptomatic during the communicable phase of many illnesses, especially viral respiratory infections, thereby increasing challenges to the prevention of transmission |
| Infants and toddlers younger than 2 years of age have decreased response to polysaccharide antigens, putting them at risk of invasive disease due to | Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. |
| Recognize antigens, differentiate into plasma cells that secrete antibodies (immunoglobulins), which inactivate microorganisms alone or in combination with complement or phagocytes. | B-lymphocytes (humoral immunity) |
| Help or suppress cell function. May also be cytotoxic, killing target cells that express foreign antigens. | T-lymphocytes (cellular immunity) |
| Help fight bacteria and fungi. Migrate toward site of infection (chemotaxis), ingest and kill microorganisms. | Phagocytes (includes neutrophils, eosinophils, basophils, monocytes, and macrophages) |
| A series of proteins divided into two pathways. The classical pathway enhances specific humoral immunity. The alternative pathway provides nonspecific immunity. | Complement system |
| In the United States, it is recommended that children be vaccinated at what age for varicella? | 12 to 18 months of age and again at 4 to 6 years old. A second, catch-up dose is recommended for individuals who have only received one dose |
| he most common respiratory viruses causing upper or lower respiratory infections among pediatric patients | Adenovirus, influenza, parainfluenza, RSV, rhinovirus, human metapneumovirus (hMPV), and coronavirus. Several studies have noted that coinfection with more than one respiratory virus is not uncommon in patients with bronchiolitis |
| What types of samples are sent to rule out TB in children who are unable to expectorate. | Gastric aspirates and bronchoalveolar lavage specimens are often sent for mycobacterial culture instead of sputum in these children. |
| Is use of the femoral vein for a central venous access associated with increased complications or infection among pediatric patients? | No |
| The most common uropathogens seen in pediatric population include? | Escherichia coli, Enterococcus, P. mirabilis,and Klebsiella. |
| Are CAUTIs more common in the pediatric population or adult population | Adult population |
| Children with cochlear implants should have their immunizations kept up-to-date, especially those vaccines for encapsulated bacteria such as | S. pneumoniae, H. influenzaetype B, and N. meningitidis |
| As with adults, most infections in pediatric burn patients are caused by what organism? | S. aureus, including MRSA. Gram-negative bacilli such as Pseudomonas aeruginosa and Enterobacteriaceae and fungi, including Candidaspp., have been linked to late-onset infections |
| Preexisting diseases, including immunodeficiency and diabetes, have been demonstrated to increase the risk for what type of infection in burn patients? | Fungal infections |
| The most common risk factors for infection in a burn patient include? | Age, depth and location of the burn, preexisting diseases, and use of invasive devices. Burn wounds that involve more than 30 percent of the total body surface area have an increased risk of becoming infected, as they are more heavily colonized. |
| What is the incubation period for pneumonic plague | 1-6 days, but most commonly in 2-4 days |
| What type of isolation is required for pneumonic plague? | Droplet isolation, wearing a surgical mask when working within 3 feet of the patient. Isolation can be discontinued after 48 hours of appropriate antimicrobial treatment and patient is showing signs of clinical improvement |
| What is the best method to use to evaluate the training progress of a new IP? | Compare the new IP's knowledge and skills to benchmarks based on set competencies. Education and training of new IPs should be competency based to ensure professional standards ore mer. |
| What is a cluster? | An aggregation of cases in a given area over a particular period without regard to whether the number of cases is more than expected. |
| What is the criteria for a performance measure | It should be evidenced-based, well-defined, clinically important for the patient population, and broadly applicable in different types of facilities |
| The stages of the transtheoretical model | Precontimplation, contemplation, preparation, action, and maintenance |
| Methods for legionella disinfection of the water distribution system include | Super heating and flushing with hyperchlorination (short-term solution); Copper-silver ionization (long-term); Chlorine dioxide |
| When should disinfection for legionella of a facility's water system be considered? | If there is evidence of prior cases of healthcare associated legionelliosis, greater than 30% colonization of distal sites in the water system, or prospective surveillance detects a HAI case |
| Productivity | The ratio of output to inputs in production |
| When can employee return to work after receiving VZIG | on the 29th day |
| When can a non immune HW to varicella return to work after exposure. | The HW would have to be from day 10 -21 |
| Techniques used to gather data in qualitative research include: | focus groups, participant observation, individual interviews, and field notes |
| What is qualitative research | An approach in which the researcher moves from the event or process (the phenomenon observed) to the development of theory and structure. Can be used to study HW adherence to infection prevention recommendations (hand hygiene, immunizations) |
| What is the primary method for preventing influenza and its complications | Vaccination |
| What is qualitative comparative analysis | A technique that is used to for analyzing datasets by listing and counting all the combinations of variables observed and then applying the rules of logical inference to determine which descriptive inferences or implications the data supports |
| Renders an area, device, item, or material safe to handle without protective attire | Decontamination |
| Under what circumstances should HIV-infected HW be placed under work restrictions? | Exposure-prone invasive procedures should not be performed by HW with HIV until counsel from an expert panel is sought. |
| A bacterium that is decolorized with alcohol during a gram stain and retains the counterstain is? | Gram negative |
| What is the most common organism to infect cat bites | Pasteurella spp. It is highly pathogenic inducing progressive soft tissue infections with a rapid onset (<24 hours). |
| The principles of conflict resolution | Use direct communication, listen actively, think before reacting, attack the problem, accept responsibility, look for common interest, focus on the future |
| Baseline | Defined as the number or value used as the basis for comparison |
| Distribution | The frequency and pattern of an event in a population |
| How do common point source out breaks differ from propagated outbreaks? | All cases in a common point source outbreak occur in one incubation period |
| A process where the organization or group assesses their own positive and negative points, outlines opportunities for growth and improvement, and list any threat that may impede those opputunities | SWOT analysis |
| Can be used to identify potential system failures or errors before they occur | A FEMA analysis |
| An acute colitis characterized by the formation of an adherent inflammatory membrane overlying sites of mucosal injury | Pseudomembranous colitis (PMC) |
| What organism is responsible for the majority of Pseudomembranous colitis (PMC) cases? | Clostridium difficle. |
| How do you diagnose Pseudomembranous colitis (PMC) cases? | By stool assays for Cdiff toxins or by colonoscopy biopsy of lesions |
| How does cryptococcal meningitis differ from bacterial meningitis? | Comes on more slowly, India ink will stain the polysaccharide capsule, characterized by low glucose in the CSF and predominant lymphocytes |
| How do Staphylococci and Streptococci be differentiated under the microscope? | Both are gram-positive with round spherical cell shapes but Staph are in grape like clusters and strep are form a chain due to a different binary division. |
| Frequency histograms and polygons are most useful for variables of what level of measurement? | Interval or ratio level |
| What microbes are most common in potable water | Gram-negative bacteria (legionella and pseudomonas), NT mycobacterium, protozoa, and fungi |
| Used in conjunction with an RCA to provide an accompanying explanation that presents a clear picture of both the improvements and rationale behind it. | Fishbone diagram |
| UV irradiation | Substantially reducing vegetative bacteria, 15-20 minutes to perform decontamination, all patients and staff must be removed from the room, HVAc system does not need to be disabled |
| What type of air pressure must be maintained in laundry facilities where contaminated textiles are kept | Positive pressure |
| What organism would a CSF gram-negative diplococci stain indicate | N. Meningitidis |
| The three elements of an ICRA | Processes for design, construction, and mitigation |
| The minimum amount air air exchanges required for sterile processing | 10. Should be negative pressure with 10 air exchanges/hour, and all air vent to the outside environment |
| What should a pregnant HW exposed to varicella receive if they are not immune? | VZIG, vaccination is contraindicated. |
| What are the advantages and disadvantages of improved Hydrogen peroxide? | Advantages: Low toxicity, rapid action, and high effectiveness. Safe for the humans and equipment, benign for the environment Lowest EPA toxicity category based on its oral, inhalation, and dermal toxicity Disadvantages: more expensive. |
| If VZIG is given to a non immune exposed HW, what timeframe will the be excluded from work? | From the 10th day of first exposure until 28th day after last exposure (Only 21 days if VZIG is not given). 1A recommendation |
| How many times a day does the CDC recommend high touch surfaces be clean and disinfected a day? | Three times a day. Low touch surfaces should be cleaned 2x a day. |
| How long can adult bed bugs survive without feeding? | Up to a year. Immature beg bugs can survive for several months without food. |
| Scarlet fever | Group A strep (GAS), Incubation is 1-7 days with usual symptom onset being 3 days. Usually the result a pharyngeal infection, characterized by diffuse rash that typically appears on the 2nd day of illness. sandpaper texture of the skin followed by desqu |
| What doe a test with high sensitivity indicate? | Most people who test positive have the disease, and the number of false negatives is low. |
| How long can Cdiff spores survive in the environment ? | 5 months |
| Small autonomous groups of employees who determine, plan, and manage their daily activities with little or no supervision | Self-managed or self-directed teams |
| Which has a higher risk of transmission through needle stick exposure Hep B or HIV? | Hep B. Exposure with Hep B + blood is a 22-31% chance compared to a 0.3 % chance with HIV |
| How do Control charts differ from run charts | They both plot a single line of data over time but a control chart adds upper and lower limit lines. It is more sensitive at detecting abnormalities but requires at least 25 points for reliability and validity, run charts only require 20. |
| Examples of molecular testing methods | PCR, pulse field gel electrophoresis, western blot assay, enzyme linked immunoassays, and molecular genotypic assays |
| What is the only know disinfectant against Cryptospridium parvum? | 6% hydrogen peroxide |
| Business expense for fixed assets such as buildings or equipment | Capital expenses |
| Expenses such as rent, utilities, and insurances | Operating expenses |
| What are the clinical uses of a gram-stain | May help determine the quality of the specimen, initial direction of therapy, or the need for isolation precautions |
| What does amplification of MRSA DNA in the negative PCR control mean? | Contamination of the sample. The negative control is used to detect regent or environmental contamination by either MRSA DNA or MRSA amplicons |
| What does the positive PCR control do? | Monitor for substantial reagent failure |
| Cold Agglutinins | Antibodies that cause clumping or agglutination of type O red blood cells at cold temperatures. The cold agglutinins test is used to detect antibodies that result from Mycoplasma pneumoniae infection or infectious mononucleosis. |
| Weil-Felix Agglutination | |
| A test performed to detect and differentiate rickettsial antibodies in the serum. | Weil-Felix Agglutination. A single high titer or a fourfold rise in titer between acute and convalescent samples is considered diagnostic. Useful diagnosing Rocky Mountain spotted fever, Q fever, epidemic, murine, and scrub typhus, and rickettsialpox. |
| The presence of leukocytes in the stool indicates that the cause of diarrhea is an organism or process, such as? | Salmonella, Shigella, Amoeba, Campylobacter, Helicobacter, or Yersinia infection, that is breaking the mucosal barrier of the colon. |
| Nonamplified Nucleic Acid Probes | Test depend on having a large amount of organisms present in the specimen (poor sensitivity) Detection of group A streptococcal pharyngiti,s and genital tract infections; Most common application is for confirmation of mycobacteria and dimorphic fungi |
| Human normal immunoglobulin preparation exist for which diseases | Hep A, measles, polio, and rubio |
| Specific immunoglobulin preparation exist for which diseases | Hep B, rabies, and varicella-zoster |
| Why do needle sticks from a catheter stylet have the highest risk of BBP transmission | There are hollowed-bore needles that can be filled with blood. |
| What are considered distal sites for culturing of water when Legionnaires disease is found? | Water faucets, ice machines, water used in respiratory tract devices, and water sources in which the patient is exposed. |
| The three major methods to diagnose viral infection | Direct detection in the clinical specimen, specific antibody to detect viral antibodies in the serum, and viral culture |
| What may administration of a Hep B vaccine cause? | It may result in positive HBsAg results 7-10 days following vaccination |
| The two types of challenges when implementing change | Technical and adaptive |
| Technical challenge | D efined as those that can be solved by the knowledge of the experts, Technical work is easier than adaptive work. Yet, as the "what," it is only about 20 percent of the change. |
| Adaptive challenges | Requires new learning. The greater percentage of transition, is the "how" |
| Behavioral Science Theories Applicable to Infection Prevention Practice: | Health Belief Model, Social Cognitive Theory, Transtheoretical Model, Diffusion Theory, Organizational Development Theory |
| The oldest theory specifically developed to understand and predict health-associated behavior. Done by focusing on the attitudes and beliefs of individuals. The model was actually developed in response to the failure of a free tuberculosis screening | The Health Belief Model |
| Communication messages or events that create heightened awareness regarding the need to respond in some way. Examples include checkup reminder cards received from the dentist, a caution or danger sign. | Cues to action |
| Factors that play a role in understanding the target group's learning needs and might have an impact on the design of interventions. Include age group, gender, race and ethnic group, socioeconomic status, rural or urban residence, | Modifying factors |
| The constructs of the Health Belief Model? | Perceived susceptibility, Perceived threat, (modifying factors, cues to action) Likelihood (Benefit minus barriers, self-effacecy) |
| Benefits minus barriers | In order for a behavior change to occur, the person must anticipate some gain: better health, social approval, financial savings, improved functioning, pleasure, and so forth. Gains are balanced against barriers |
| Self-efficacy | Is the person's confidence in their ability to change and to sustain it long term. An example of a self-efficacy problem is the hopelessness seen in many dieters who have failed on a long list of diets; they begin to feel they cannot be successful |
| Theory built around the interaction of the person (their knowledge, temperament, internal motives, skills), their behavior, and the environment (physical, social, organizational). | Social cognitive theory (SCT). Example, if a critical mass of the staff of a clinical unit to comply with best practice hand hygiene, the social environment will be changed, providing a tipping point to impact those staff members lagging behind |
| The interaction of the three components of the SCT is called? | Reciprocal determinism. The factors are linked, not in a one-way cycle, but in a way where each influences the other. It is intuitive that environment will influence behavior, the model asserts that behavior also exerts an influence on the environmen |
| Theory that includes Pre-contemplation (I won't), Contemplation (I might), Preparation (I will), Action (I am), Maintenance (I have) | Transtheoretical Model or Stage Theory. |
| Pre-contemplation (I won't) | Unaware, no desire no reason. IP example : Mixed communication message to highlight the problem of infection spread |
| Contemplation (I might) | Weighing change pros and cons. IP example: Communication and role modeling to show advantages |
| Preparation (I will) | Making plans to change behavior. IP example Identify resources, provide training for best practices |
| Action (I am), | Currently adopting change. IP example: Coaching, training,, reinforce self-efficacy to master best practices. Provide social reinforcement |
| Maintenance(I have) | Change made, avoiding relapse. IP example: Continued reinforcement, peer support, highlight best practice compliance |
| A behavioral change approach based on the observation that in a community there exists individuals who have found uncommon practices and behaviors that enable them to achieve better results peers, despite similarities of problems and resources | Positive Deviance |
| Positive Deviance design consists of four steps: | Define, determine, discover, and design. |
| Consist of systematic and continuous actions that lead to measurable improvement in healthcare services and the health status of the targeted population | Quality improvement |
| What must be included in evaluation methodology | The data must be gathered, tabulated, and analyzed to assess impact and make recommendations for curriculum revision before the next presentation |
| What are the goals of just in time training | To increase learning during classroom time, to enhance student motivation, to encourage students to prepare for class, and to enable the instructor to fine-tune the classroom activities to best meet student needs. |
| When should lectures be used to teach? | To convey critical information, teach new knowledge and skills, promote reflection, and to stimulate further work and learning. |
| A type of chart best suited for visually representing the overall mean score and allowing viewers to rapidly compare one group to another | A pie chart |
| A psychology approach that focuses on one particular view of learning: A change in external behavior is achieved through a large amount of desired actions | Behaviorism |
| If a study shows a high degree of internal validity what can be concluded | There is strong evidence for causality. |
| What are the penultimate standard of care used to guide practices, reduce variation, and improve quality of patient care | Standards issued by national and international authoritative sources |
| The process of examing student's test scores in order to assess quality of the individual test questions as well as the test itself. Useful for improving the quality of the test and increasing the instructor's skill in test construction | Item analysis |
| Acinetobacter | Gram-negative rod associated HAI ventilator pneumonia |
| Gram- negative cocci | Chlamydis, |
| Gram-negative rods | Klebsiella, legionella, proteus, pseudomonas, Vibrio, helicobacter, escherichia |
| Gram positive cocci | Enterococcus, Staphylococcus, Streptococcus |
| Viridans group Strep | Anginosus, gordonii, intermedius, mitis, Oralia, sanguinis |
| A term used to designate a group of three species of fungi that commonly sin disease in people | Dermatophytes |
| The three species of dermatophytes | Epidermophyton, trichopyton, microsporum |
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