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185 Cards in this Set
- Front
- Back
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The CDC is responsible for what? |
investigating, preventing and controlling disease |
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CDC stands for what? |
Centers for Disease Prevention and Control |
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QSEN stands for what? |
Quality and Safety Education fro Nurses |
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What has the QSEN initiative done? |
has identified safety as one of the leading issues in healthcare - safety includes following effective infection control practices |
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Define Infection |
a disease state that results from the presence of pathogens (disease-producing microorganisms) in or on the body |
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What are the six cyclic components resulting in an infection (in order)? |
1) Infectious Agent 2) Reservoir 3) Portal of Exit 4) Means of transmission 5) Portal of Entry 6)Susceptible host |
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What are some of the more prevalent agents that cause infection? |
Bacteria, Viruses and Fungi |
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The potential to produce disease in a person depends of what factors? |
Number of organisms; Virulence of the organism (ability to cause disease); Competence of the person's immune system; Length and intimacy of the contact between the person and the microorganism |
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What ways are bacteria categorized? |
by shape; as either gram positive or gram negative; whether they need oxygen or not |
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What are the three different shapes of bacteria? |
1) Cocci (spherical) 2) Bacilli (rod shaped) 3) Spirochetes (corkscrew shaped) |
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Why is it important to physicians to know whether bacteria is gram positive or gram negative when prescribing antibiotics ? |
Some antibiotics are classified specifically effective against only gram-positive organisms or as a broad spectrum which are effective against several groups of microorganisms |
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What does aerobic bacteria mean? |
Requires oxygen |
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What does anaerobic bacteria mean? |
Can live without oxygen |
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What is a virus? |
a tiny microorganism visible only with an electron microscope |
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What are some infections that viruses cause? |
Common cold; Hepatitis B and C; Acquired Immunodeficiency Syndrome (AIDS) |
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Do antibiotics have any effect on viruses? |
No, but there are some antiviral medications that may help some infections |
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What is Fungi? |
plant-like organisms (molds and yeasts) which are present in the air, soil and water |
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What are some examples of fungi infections? |
athlete's foot; ringworm; yeast infections |
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How are most fungal infections treated? |
with antifungal medications; however, some are resistant to treatment |
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What are parasites? |
organisms that live on or in a host and rely on it for nourishment |
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What does endemic mean? |
Occurs with predictability in on region or population |
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Normal flora is ______________________. |
microorganisms that commonly inhabit various body sites and are part of the body's natural defense system |
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What does it mean when it is said that "bacteria are opportunists"? |
certain bacteria found in one part of the body, will cause an infection in another part of the body if it finds its way there (ex. GI tract bacteria finds it way to the urinary tract and causes an infection - UTI) |
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What does it mean when a person is considered colonized? |
That person has an organism that lies dormant in/on the body that has no signs or symptoms present - once they show signs or symptoms, they are considered infected |
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What is the natural habitat of an organism for growth and multiplication? |
Reservoir |
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What does is mean when someone is a "Carrier"? |
That person is acting as a reservoir for an infectious agent and demonstrates no signs or symptoms, but can still transmit the disease |
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What are some examples of reservoirs? |
animals; soil; food; water; inanimate objects |
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What is a "Portal of Exit" and what are common exits in humans? |
the point of escape for the organism from the reservoir; respiratory, gastrointestinal, breaks in skin, blood and tissue and genitourinary tracts |
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What are examples of direct contact? |
touching, kissing, sexual intercourse |
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What is indirect contact? |
contact with an inanimate object |
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What are some examples of fomites or vehicles of transmission? |
blood, food, water and/or inanimate objects |
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What are vectors? |
nonhuman carriers that transmit organisms from one host to another through injection of their bite |
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Microorganisms can also be spread through the airborne route by _____________ |
coughs, sneezes, talks or when the organism attaches to dust particles which are then inhaled - airborne particles are smaller than droplet particles |
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What is the means of transmission for Staphylococcus aureas (bacterial "staph")? |
Contact (direct) |
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What are the reservoirs for Staphylococcus aureas (bacterial "staph")? |
Skin surface, mouth, nose and throat |
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What diseases are transmitted via Staphylococcus aureas (bacterial "Staph")? |
Wound infection, abscess, carbuncle, boil |
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What are the reservoirs for Hepatitis B virus? |
blood, feces and bodily fluids and excretions |
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What is the means of transmission for Hepatitis B virus? |
Contact (indirect) |
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What diseases are transmitted by Hepatitis B virus? |
Hepatitis B |
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What are the reservoir for HIV? |
blood, semen, vaginal secretions, breast milk
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What is the means of transmission for HIV? |
Contact (direct) - blood, semen, vaginal secretions Contact (ingestion) - breast milk |
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What disease is transmitted by HIV? |
AIDS |
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What are the reservoirs for Mycobacterium tuberculosis? |
sputum (respiratory tract); ticks (sheep, cattle, deer, mice); Contact (direct) |
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What is the means of transmission for Mycobacterium tuberculosis? |
Airborne Vectors |
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What disease is transmitted by Mycobacterium tuberculosis? |
Lyme disease; tuberculosis |
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What are the reservoirs for Escherichia coli (E. coli)? |
feces, undercooked meat (beef), unpasteurized apple juice, tomatoes, peppers, spinach
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What is the means of transmission for Escherichia coli (E. coli)? |
Contact (ingestion) |
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What disease is transmitted by Escherichia coli (E. coli)? |
E. coli infection |
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What are the reservoirs for Salmonella? |
intestinal tracts of humans and other animals, including birds |
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What is the means of transmission for Salmonella? |
Contact (ingestion) |
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What disease is transmitted by Salmonella? |
Diarrheal illness |
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What is a "Portal of Entry"? |
the point at which the organism enters a new host |
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What are common portals of entry? |
urinary, respiratory and gastrointestinal tracts and skin |
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What are the two ways that microorganisms can continue to exist? |
1) if they have an acceptable source (host) 2) if they can overcome resistance mounted by the host's defenses |
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What is susceptibility? |
the degree of resistance the potential host has to the pathogen |
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Who are more susceptible to infection? |
Elderly, young children and infants, and the immuno-compromised |
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What are the four stages of infection? |
1) Incubation period 2) Prodromal period 3) Full Stage of Illness 4) Convalescent Period |
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What is the Incubation stage of infection? |
the period between pathogen invasion in the body and appearance of symptoms of infection; number of days varies with pathogen |
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What is the Prodromal stage of infection? |
person is most infectious; early signs and symptoms ( s/s) present; lasts a few hours to several days |
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What is the "Full Stage of illness" of infection? |
presence of specific signs and symptoms (s/s); symptoms in one body area are localized while symptoms manifested throughout the body are systemic |
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What is the Convalescent stage of infection? |
the recovery period; signs and symptoms (s/s) disappear and person returns to healthy state |
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What are the three "first lines of defense"? |
normal flora, inflammatory (acute or chronic) and immune responses |
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What are the cardinal signs of acute infection? |
redness, heat, swelling, pain, lost of function (usually appearing at the site of injury or inflammation), white blood cell count increases, exudate is released from the wound (may be clear, contain red blood cells or contain pus - amount depends on the size/location of wound) |
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What happens with Humoral Immunity? |
the body responds to a foreign material found in the body (pathogen) by producing an antibody for it |
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What is Cellular immunity? |
when there is an increase in white blood cells to destroy or react with the harmful cells |
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What are some healthy habits that promote wellness and reduce risk for infection? |
sensible nutrition, adequate rest, exercise, stress-reduction techniques, good personal hygiene, safe sex practices and not sharing intravenous (IV) needles |
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What are some risk factors for infection? |
* Integrity of the skin and mucous membranes (protect the body against microbial invasion) * pH levels of the gastrointestinal and genitourinary tracts and skin (assists with warding off microbial invasion) * integrity and number of body's WBC's (provides resistance to some pathogens) * Age, race, sex, heredity (influences susceptibility) * Immunizations, natural or acquired (act to resist infection) * level of fatigue, nutritional and general health status, the presence of pre-existing illnesses, previous or current treatments, and certain medications (influences susceptibility) * Stress level if increased (may adversly affect body's normal defense mechanisms) * Use of invasive or indwelling medical devices (provide exposure to and entry for more potential sources of disease-producing organisms - especially if already with weakened defenses) |
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What age-related changes are associated with pulmonary infections? |
* decreased cough reflex * decreased elastic recoil of the lungs * decreased activity of cilia * abnormal swallowing reflexes |
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What age-related changes are associated with Urinary Tract Infections? |
* Incomplete emptying of bladder * decreased sphincter control * bladder-outlet obstruction due to enlarged prostate gland * pelvic floor relaxation due to estrogen depletion * reduced renal blood flow |
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What are the nursing strategies associated with age-related changes for Pulmonary infections? |
* Place pt in sitting position to eat and drink * encourage pt to drink plenty of fluids unless contraindicated * encourage pt to cough and deep breathe or use incentive spirometer as ordered * recommend pneumococcal vaccination once a lifetime and influenza vaccination annually |
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What are the nursing strategies associated with age-related changes for Urinary Tract infections? |
* discuss with pt need to void at regular intervals * encourage pt to drink plenty of fluids unless contraindicated * administer medications for enlarged prostrate (benign prostate hypertrophy) and estrogen depletion as ordered * if pt wears absorbent product such as incontinence pad, instruct pt to change pad frequently and perform good "pericare" * assess the UTI's (may be atypical in elderly pt) * discuss the need for pt to void immediately after sexual intercourse |
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What are the age-related changes associated with skin infections? |
* loss of elasticity * increased dryness * thinning of epidermis * slowing of cell replacement * decreased vascular supply |
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What are the nursing strategies associated with age-related changes for skin infections? |
* encourage pt to drink plenty of fluids unless contraindicated * help pt to perform good hygiene practices daily * apply lotion to skin as needed * assess frequently for any breaks in skin integrity, rashes, or changes in skin |
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What are the signs and symptoms for a localized infection? |
redness, swelling, warmth, pain or tenderness, loss of function of affected part |
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What are the signs and symptoms for a systemic infection? |
fever, increased pulse, increased respirations, lethargy, anorexia, tenderness/enlargement of lymph nodes |
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What is the normal white blood cell (leukocyte) count: |
5000-10000/mm3 |
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What is the normal count for neutrophils and how are they affected by infections? |
60-70% (increased in acute infections that produce pus; increased risk for acute bacterial infection if decreased; may increase in response to stress) |
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What is the normal count for lymphocytes and how are they affected by infections? |
20-40% (increased in chronic bacterial and viral infections) |
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What is the normal count for monocytes and how are they affected by infections? |
2-8% (increased in severe infections and functions as a scavenger or phagocyte) |
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What is the normal count for eosinophils and how are they affected by infections? |
1-4% (may be increased in allergic reaction and parasitic infection) |
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What is the normal count for basophils and how are they affected by infections? |
0.5-1% (usually unaffected by infections) |
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What happens to erthyocyte's sedimentation rate when inflammation is present in a lab tube? |
they settle more quickly to the bottom of the tube of whole blood |
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In early detection of lab tests, what would pathogens be present in? |
Urine, blood, suptum or other draining cultures |
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In the treatment and prevention of infections, what would be some nursing diagnoses to use? |
1) Risk of infection related to (r/t) presence of chronic disease; altered immune response; effects of medication; altered skin integrity; malnutrition; presence of invasive or indwelling medical device; lack of proper immunization(s) 2) social isolation rate presence of communicable disease (AIDS) 3) impaired oral mucous membranes related to ineffective dental hygiene; trauma; side effect of medication; presence of invasive medical device 3) Deficient Diversional Activity related to lack of visitors; restrictions imposed by airborne precautions 4) risk for impaired body temperature related to infectious process; disease 5) anxiety related to high risk for infection; social isolation |
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What are some possible pt outcomes of identification and planning? |
* demonstrate effective hand hygiene and good personal hygiene practices * identify the signs of an infection * maintain adequate nutritional intake * demonstrate proper disposal of soiled articles * use appropriate cleansing and disinfection techniques *demonstrate an awareness of the necessity of proper immunization * demonstrate stress-reduction techniques * verbalize an understanding of health risks associated with a latex allergy |
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What is Medical Asepsis? |
procedures and practices that reduce the number and transfer of pathogens (i.e. hand hygiene, wearing gloves) |
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What is Surgical Asepsis? |
practices used to render and keep objects and areas free from microorganisms (i.e. inserting an indwelling urinary catheter) |
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What is the most effective way to help prevent the spread of infectious agents? |
HAND WASHING!!!!!!! |
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What are the three hand hygiene methods? |
1) washing with plain soap and water 2) using antiseptic handrubs included waterless alcohol-based products 3) using surgical hand antisepsis |
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What are the 5 clearly defined moments of when to use hand hygiene according to World Health Organization (WHO)? |
1) before touching a pt 2) before a clean or aseptic procedure 3) after a body fluid exposure risk 4) after touching a pt 5) after touching pt surroundings |
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What are the two types of normal bacterial flora found on the hands? |
transient and resident |
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What is transient bacteria? |
it is easily removed with handwashing; have the potential to adjust to the environment of the skin when they are present in large numbers over a long period (not washing hands frequently) and become resident bacteria |
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What are the 5 characteristics of Transient bacteria? |
1) occurs on hands with ADL's 2) relatively few in number on clean and exposed areas of the skin 3) attached loosely on skin usually in grease, fats, or dirt 4) found in greatest number under the fingernails 5) can be pathogenic or nonpathogenic |
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What is resident bacteria? |
bacteria is hard to remove (hands become carriers); considerable friction with a brush is required to remove them; less susceptible to antiseptics than are transient bacteria |
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What are the 3 characteristics for resident bacteria? |
1) normally found in creases of the skin 2) usually stable in number and type 3) cling tenaciously to skin by adhesion and absorption |
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If a healthcare workers hands are not visibly soiled, what are recommended to use? |
Alcohol-based handrubs |
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How long should you continue rubbing your hands together while using alcohol-based handrubs? |
AT LEAST 15 seconds |
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What should a healthcare worker use while interacting with a C.diff pt and what hand hygiene method is used? |
PPE and soap and water |
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How long is required for effective handwashing? |
at least 20 seconds of scrubbing (longer for visibly soiled hands) |
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You should wash 1 inch above what if hands are not visibly soiled? |
wrists |
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If hands are contaminated, how many inches do you wash above the area of contamination? |
1 inch |
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What are Healthcare Associated Infections? |
infections developed during the course of treatment for other conditions that were not present in the patient on admission |
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What is a nosocomial infection? |
an infection that originated or took place in a hospital |
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What is an exogenous infection? |
the causative organism that is acquired from other people |
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What is an endogenous infection? |
the causative organism comes from microbial life harbored in the person |
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What is a latrogenic infection? |
results from a treatment or diagnostic procedure |
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How long does a person must stay after contracting a HAI? |
19 days longer than originally expected - Centers for Medicare and Medicaid (CMS) no longer reimburses hospitals for preventable hospital-acquired conditions |
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What are the 4 major HAI's? |
urinary tract infections (UTI); surgical site infections; bloodstream infections; pneumonia |
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What is the MOST COMMON HAI? |
Catheter-associated urinary tract infection (CAUTIs) |
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What are budles? |
evidence-based best practices that have proven positive outcomes when implemented together to prevent infection |
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What is VAP and CLABSI? |
ventilator-associated pneumonia; central line-associated bloodstream infection |
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What are the three emerging muti-drug resistant organisms? |
MRSA; VRSA; CRE |
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MRSA is what type of bacteria? |
Staphylococcus aureus bacteria |
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Where is MRSA normally found? |
nasal mucous membranes, on the skin, and in the respiratory and gastrointestinal tracts |
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1/3 of persons in the US are ____________ with "staph". |
colonized |
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What does colonized mean? |
A person is a carrier and may never get sick, but can essentially pass the organism on to others |
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What is CA-MRSA and what is it a common cause of? |
Community-associated MRSA; skin and soft tissue infections |
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Who is most at risk for MRSA and CA-MRSA? |
young children, older adults and those in close physical proximity (athletes, military personnel) |
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What is the treatment for MRSA and CA-MRSA? |
includes incision and drainage of abscesses in pt's who are afebrile and health with mild, uncomplicated abscesses (antimicrobial therapy may be needed if I & D isn't effective and systemic or serious infection is present) |
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Why should antibiotics NOT be given before would drainage (or any type of culture) is sent to the lab for MRSA and CA-MRSA? |
it can skew results causing inappropriate antibiotics to be ordered |
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Who is at risk for developing MRSA in a hospital setting? |
pt's who have had surgery or other invasive procedures; who have invasive devices; immunocompromised pts |
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What is the drug of choice for health-care associated MRSA and if a resistance is developed, what drug is used next? |
vancomycin; linezolid (Zyvox) |
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Which patient's are at the highest risk for developing vancomycin intermediate-resistant Staphylococcus aureus (VISA) and vancomycin-resistant staphylococcus aures (VRSA)? |
those with a history of kideny disease or diabetes; previous MRSA infection; presence of an invasive catheter; recent exposure to vancomycin |
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What are the risk factors for vancomycin-resistant enterococci (VRE), another hospital pathogen? |
* Compromised immune systems * recent abdominal or chest surgery * presence of urinary or central IV catheter * prolonged antibiotic use, especially with vancomycin * lengthy hospital stay, especially in an ICU |
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How is VRE spread? |
contact with feces, urine, or blood of an infected or colonized person |
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What halts the spread of VRE? |
appropriate hand hygiene and contact precautions |
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What are carbapenem antimicrobial drugs? |
broad-spectrum antibiotics and drug of choice for serious infections when an organism is resistant to other primary antbiotics - resistance to carbapenem leaves few other treatment choices |
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Who's at risk of developing carbapenem-resistant enterobacteriaceae (CRE)? |
* presence of bladder or venous catheter * requires ventilator assistance to breathe * prolonged antibiotic use * frequent hospitalizations or long-term care facility stays |
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What should you do if a patient has tested positive for CRE? |
place them on contact precautions and focus on hand hygiene and education on prevention |
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What is acinetobacter baumannii? |
a gram negative bacteria seen in wounds of soliders coming home from Iraq and Afghanistan - now spreading through healthcare facilities and continues to develop resistance to antibiotics - pt's should be placed on contact precautions |
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Who is at risk for acinetobacter baumannii? |
* has compromised immune system * older adults * has invasive devices and/or open wounds * chronically hospitalized (can live in the environment so the pt's room and all mechanical equipment used MUST be cleaned and disinfected) |
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What is Clostridium defficile? |
normal bacteria found in the intestinal tract - when antibiotics are taken for a prolonged time (especially broad spectrum), they kill good bacteria in the intestines while allows c. diff to grow out of control - when antibiotics are stopped, 20% resolve itself, but 80% will require further antibiotic treatment
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Who is at risk for C. Diff? |
older adults who are receiving medical care and taking antibiotics |
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What can spread C. Diff? |
symptomatic and non-symptomatic persons can be reservoirs, along with surfaces and objects contaiminated with feces |
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What are the most common signs/symptoms of C. Diff? |
watery diarrhea, fever, mild abdominal cramping |
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The CDC recommends what 5 things to prevent C. Diff (CDI)? |
* prescribe antibiotics cautiously * use contact precautions for anyone confirmed or suspected of CDI * use of effective hand hygiene * have room and non-disposable equipment cleaned with BLEACH or appropriate disinfectant * upon transfer out of facility, notify the new facility about the C. Diff infection |
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Define disinfecting |
destroys all pathogenic organisms except spores - used when prepping the skin for a procedure or cleaning a piece of equipment that does not enter a sterile body part |
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Define sterilizing |
destroys all microorganisms, including spores - usually performed on equipment that is entering a sterile portion of the body |
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What 6 factors influence the choice of sterilization and disinfection? |
* nature of organisms present (all supplies, linens and equipment should be treated as if infected) * number of organisms present - more present, longer it takes to destroy them * intended use of equipment (medical or surgical?) * available means for sterilization and disinfection (steam, boiling water, dry heat, radiation, ethylene oxide gas, chemical solutions) * time
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When should hands be washed when using gloves? |
before donning and after removal |
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When is it not necessary to use gloves? |
when the task doesn't involve the potential for soiling the hands with body fluids (feeding a patient, taking vital signs, etc) |
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Do you wear gloves outside of a pt's room? |
NO, unless transporting a contaminated item or a pt requiring transmission-based precautions |
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When do you double glove? |
if you are involved in a procedure during which exposure to blood or body fluids is expected, such as the OR (operating room) |
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What is the best way to prevent a latex allergy? |
Prevention |
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What makes a person a high risk for latex allergy? |
history of multiple surgeries, pt's born with spina bifida and or bowel defects, having asthma or allergies (more particularly to certain fruits or veggies) |
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Where does latex come from? |
a tree found in Malaysia |
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Why do some people develop an allergy to latex? |
they have a sensitivity to the protein found in natural rubber latex and repeated exposure to the allergy causing protein develops to allergy |
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How do you know if a pt has a latex allergy? |
symptoms are often similar to hay fever and asthma - allergic reaction can occur on the skin, in the eyes and nose, and in the lungs effecting the general ability to breath, in serious cases anaphylactic shock occur; can happen within minutes of exposure or hours |
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What are the symptoms of a latex allergy? |
skin rash (most common), sneezing, body swelling, hives or welts, itching, itchy watery eyes, difficulty breathing, coughing spells, wheezing or asthma, anaphylactic shock (severe cases) |
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Is there a treatment for a latex allergy? |
no |
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What causes an allergic reaction? |
anything with rubber, bananas, hazelnuts, powder in latex gloves (suspended in air), an object that has come in contact with the latex protein and then transferred to the pt (mild to severe cases) |
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What are some equipment/supplies that contains natural rubber latex? |
stethoscopes, blood pressure cuffs, disposable gloves, syringes, electrode pads, ambu bags, rubber bands, erasers, mouse pads, dishwashing gloves, hot water bottles, balloons, swimming goggles, rubber spatulas, expandable fabrics NOTE: latex paint DOES NOT CONTAIN the latex protein - it is man-made |
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What are gowns used for? |
worn to prevent soiling of the healthcare worker's clothes such as by a patient's blood or body fluids; donned BEFORE going into pt's room and is discarded after procedure |
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What are masks used for? |
assist with preventing the inhalation of large-particle aerosoles which can travel about 3 ft and smaller-particle droplets which can stay suspended in the air and travel longer distances - can also be used to protect the pt from healthcare worker's respiratory secretions; help prevent touching eyes, nose and mouth |
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Who should wear a mask when a pt is on airborne precautions? |
everyone entering the room (workers, visitors, etc.) - if the patient leaves the room for any reason, the pt wears the mask |
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How often should a mask be worn? |
only once and should never be lowered to the neck and then brought back up to the mouth and nose |
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Which masks filter what? |
N95 - filtered inspired and expired air (particles as small as 1mcm with 95% efficiency) surgical masks - filter expired air only |
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What is protective eyewear used for? |
should be worn anytime there is a risk of contaminating the mucous membranes of the eyes (splattering of blood or bodily fluids) |
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What do standard precautions apply to? |
everyone whether infected or not; blood, all body fluids, secretions and excretions except sweat, not intact skin and mucous membranes |
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what are some standard precautions? |
follow hand hygiene; wear clean non-sterile gloves; wear PPE; follow respiratory/hygiene cough etiquette; never recap a needle; use safe injection practices; wear face masks when placing catheters or injecting material into the spinal or epidural space; handle contaminated objects carefully; review room assignments carefully |
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What are airborne precautions and what are they used for? |
used for pt's who have infections that spread through the air (tuberculosis (TB), varicella (chicken pox), rubeola (measles), and possible SARS (severe acute respiratory syndrome); pt in private room with NEGATIVE AIR PRESSURE and keep door closed with close monitor of inside air, wear masks/respirators, transport pt only when necessary |
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What does negative air pressure mean? |
6-12 air changes per hour |
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What are droplet precautions and when is it used? |
used when infection that is spread by large-particle droplets such as a rubella, mumps, diptheria, and the adenovirus and respiratory syncytial virus (RSV) in infants and young children; private room used (door can stay open), PPE used for everyone, transport only when needed and mask is worn by pt, keep visitors 3 feet from infected person |
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What are contact precautions and when is it used? |
used for infected or colonized by a multi-drug resistant organism (MDRO); private room, wear PPE and remove before leaving pt's room, limit movement of pt outside of room, avoid sharing pt-care equipment |
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Sensory deprivation and loss of self-esteem can occur with what? |
transmission-based precautions |
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What may lead to inconsistent recording of vital signs, irregular documentation and less patient monitoring when a pt is in transmission-based precautions? |
staff and visitors being inclined to spend less time with the pt due to fear or inconvenience |
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What are the 4 things you should teach patients and their families? |
1) Precautions are temporary 2) Precautions and PPE worn by the staff protect the patient, caregiver, and other patients 3) proper hand hygiene before and after visiting the patient is the most effective measure of preventing spread of the infection 4) Continued explanations about procedures and continued updates on progress help to minimize anxiety
*** ALL EDUCATION SHOULD BE DOCUMENTED IN PT CARE PLAN - IF IT WASN'T DOCUMENTED, IT WASN'T DONE!!*** |
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What are some ethical debates going on right now regarding concerns towards infection risks? |
* should all hospital pt's routinely be tested for HCV infections? * should HBV testing be mandatory for all foreign-born residents of the US? * should health care workers infected with HIV be permitted to perform exposure-prone invasive procedures? * should you address hand hygiene with another RN whom you have noticed never washes her hands after removing gloves? * should pregnant healthcare workers be expected to care for patients with infectious diseases? |
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What is an Infection Preventionist's job? |
*develop a plan to reduce the occurrences of HAIs * collaborate with state and local health departments regarding recommended or mandatory reporting of HAIs * developing a plan to respond to an act of bioterrorism * evaluate new products * provide routine consultations to staff and pt's regarding infection control issues |
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Medical asepsis is appropriate for most procedures in the home, except for what which require what?
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self injection and venous catheter care which require surgical asepsis |
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What are recommended medical asepsis practices to teach patients to use in the home? |
*wash hands before and after prepping and cooking food, using restroom, etc * wash raw fruits and veggies before serving * use pasteurized milk and fruit juice * use individual personal care items |
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Who developed the Bloodborne Pathogens Standard in 1991 and why? |
OSHA; to protect healthcare workers from exposure or risk of exposure to pathogens such as HIV and Hepatitis B (HBV) |
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What is the Needlestick Safety and Prevention Act? |
provides guidelines for employers about how healthcare practitioners should participate in decisions and ensure safe practice regarding needlestick injuries and bloodborne exposures - most healthcare facilities now purchase needles that have built-in safety features such as needleless, protected or recessed IV systems |
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When should you report any needlestick injury or accidental exposure to blood or body fluids so that appropriate interventions can be implemented? |
IMMEDIATELY!!! |
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What is neutropenic precautions? |
is used to protect the patient whose immune system is compromised - they are more at risk for infection, especially from microorganisms harbored by their own bodies * ensure caregivers are healthy *restrict visitors who have colds or contagious illnesses * avoid collection of standing water in the room (no flowers, no humidifiers, no fresh fruit) |
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What are some ways to disinfect in the home? |
use boiling water; household disinfectants such as bleach, isopropyl alcohol (70%), or acetic acid (white vinegar) |
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How should a sterile package be opened? |
on a flat surface or while in the hands |
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What should you do if a sterile item won't be used immediately? |
should be re-covered by touching only the outside of the wrapper and reversing the opening order |
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Once a sterile bottle of solution is opened, what should it be labeled with if it is to be reused? |
date and time it was opened |
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How long are most sterile solutions considered sterile? |
24 hours after opening |
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Where should you grasp a sterile bottle when pouring and why? |
the label should be in the palm of the hand to prevent any liquid from pouring over the label and making it illegible |
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What can items placed in a sterile field be touched with? |
sterile forceps or with hands wearing sterile gloves |
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What is used to extended a sterile field? |
sterile drape |
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How many inches can you touch on a sterile drape if gloves are not being worn? |
1 inch on the outer part ONLY! |
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Do you reach over a drape when adding or working in a sterile field and why? |
no, because it contaminates the sterile field |
