Ioe Undergraduate Cross Infection Prevention

Front 1

what is infection prevention and control

Back 1

The management and measures put in place to prevent the transmission and spread of pathogenic micro-organisms in the clinical environment

Front 2

what are the 3 main Management and Measures

Back 2

Standard Precautions

Clinical Practice

Decontamination

Front 3

define

colonisation



infection

Back 3

Colonisation - the presence of a micro-organism at a body site or in a patient without host response




Infection – symptoms and signs caused by pathogenic (harmful) micro-organisms. These include local evidence if inflammation, systemic effects and presence of raised inflammatory markers.

Front 4

state the 4 infectious agents

Back 4

Bacteria
Fungi
Viruses
Other parasites
Prions

Front 5

outline the formulae 'risk of infection'

Back 5

Risk of infection = dose + time + virulence (of microorganism)
host susceptibility

Front 6

E. coli can divide every....

Back 6

20 minutes

Front 7

. One day of bacterial ‘evolution’ is equal to

Back 7

72human generations (1,440 years

Front 8

The most common and devastating bacterial disease is

Back 8

is tuberculosis which affects about 2 million people mostly in sub-Saharan Africa

Front 9

Life threatening fungal infections in humans most often occur in

Back 9

immuno compromised patients or vulnerable patients with a weakened immune system, although fungi are common problems in the immuno competent populations as causative agents of skin, nail or yeast infections for example thrush and athletes foot.

Front 10

Some notable pathogenic viruses cause many of the child hood diseases such as

Back 10

diseases such as mumps, measles and chicken pox and blood borne viral infections: HIV , Hep B and C. They also cause influenza and viral gastro enteritis infections both of which have the potential to impact on the trust as they can cause large outbreaks affecting both staff and patients.

Front 11

Prions are infectious pathogens which are abnormal proteins cause

Back 11

Transmissible Spongiform encephalopathy infections.

Front 12

We cannot completely remove all causative agents but we can control some by careful use of

Back 12

use of antimicrobial drugs, vaccination programmes, health promotion, good sanitation and decontamination.

Front 13

Micro-organisms/agents potentially posing risk within dentistry?

Back 13

Mycobacterium tuberculosis
Multiple resistant organisms (e.g. MRSA)
Herpes Simplex
Human Transmissible Spongiform Encephalopathies (TSE)

Front 14

outline the chain of infection

Back 14

infectious agent>>>reservoir>>>>susceptible individual>>>>portal of entry>>>>>method of transmission>>>exit

Front 15

infection can occur in two ways? explain each one

Back 15

Endogenous (SELF) Infection
When your own flora (commensals) move from their normal body site and take up residence in another part of the body infection may result
e.g. Staph. aureus – skin flora … wound infections
E.coli – bowel flora … urinary tract infections




Exogenous (CROSS) Infection
If you are exposed to micro-organisms from a source other than your own body. Includes spread via staff, patients or visitors.
e.g. gastroenteritis, ‘flu,
insect bite, needlestick injury

Front 16

Other Reservoirs of Infection include?

Back 16

Environment/equipment

Food and drink

Animals

Front 17

define reservoir

Back 17

The reservoir is a place where the micro-organism has all the things
it needs to grow and multiply including warmth and moisture

Front 18

outline a A person whose resistance to infection is reduced in some way

Back 18

Immunosuppressant

Malnourishment

Antibiotics

Surgery

Cannulation

Chemotherapy

Front 19

how can micro organisms enter a person

Back 19

Orifice – mouth, nose, eyes etc.

Medical/invasive Devices



Broken skin – cuts, wounds

Front 20

How micro- organisms can spread in Dentistry

Back 20

Direct Contact
Indirect Contact
Splatter
Aerosolization

Front 21

how can we stop the chain of infection

Back 21

remove a link

Front 22

state the standard precautions

Back 22

Hand hygiene

Broken skin

Use of personal protective
equipment (PPE)

Safe sharps management

Disinfection of blood and body fluid
spillages

Safe disposal of waste and linen

Front 23

what can we do to stop cross infection in clinical practice

list all the point

Back 23

Use Standard Precautions at all times

Treat all patients as potentially infective

Risk assess procedures

Keep clinical activity in identified clinical areas (zoning)

Aseptic technique

Clean contact surfaces in the unit/surgery between patient use

Flush DUWL for 30 seconds at the beginning of the session, between and after patient treatment

Front 24

exposure can occur in what 2 ways, give examples

Back 24

Percutaneous Injuries:
Used Needle
Bites
Wounds from Sharp Items e.g. contaminated instruments, files, reamers and blades



Mucocutaneous Exposure:
Splashes into the eyes, mouth or other mucus membranes

Front 25

what is Probability of Acquiring BBVs after a Percutaneous Injury with a Contaminated Sharp

Back 25

HIV
Risk I in 300 (0.3%)




HBV (e Ag +ve)
Risk 1 in 3 (30%)
Much more
transmissible
than HIV
Vaccine available



HCV RNA +
Risk 1 in 30 (3%)
Majority affected
become chronic
developing hepatocellular
carcinoma or cirrhosis

Front 26

What is meant by non exposure

Back 26

Injuries from unused needles or sharps


Exposure of unbroken skin to blood and body fluids

Front 27

what should be done following a needle stick injury

Back 27

First Aid First
Bleed it
Wash it
Cover it
Report it
Then follow the LTHT needle stick policy

Front 28

what should be done after first aid

Back 28

Report to Clinician/supervisor/dental nurse

Commence IR1(electronically)

Have your blood taken for: Hepatitis titre level and storage

Contact Occupational Health (you may require support from clinician/supervisor/nurse when phoning )

Front 29

what should decontamination procedures consider

Back 29

The method of decontamination that is selected should take account of the infection risk from the reprocessed device to the patient.”

Front 30

define


cleaning

disinfection

sterilization

Back 30

Cleaning: A process that physically removes contamination and many micro-organisms using detergent

Disinfection: A process that reduces the number of micro organisms to a level at which they are not harmful

Sterilization: a process that removes or destroys all micro-organisms, including spores

Front 31

explain how these terms apply in dentistry

Back 31

Cleaning - Dental Unit and Equipment

Disinfection – Dental Unit Waterlines
Body fluid spills

Sterilization – Dental Instruments

Front 32

What needs cleaning between use?

Back 32

Work surface (use of water impermeable drape to prevent strike
through)
Bracket table (use of water impermeable drape to prevent strike
through)
Flexes (e.g. hand pieces, three in one)
Light
Instrument control panel
Dental chair
Spittoon

Front 33

difficulty of biofilms

Back 33

Bio films: These are usually formed by bacteria but can also be due to fungi. Once formed, bio films can be difficult to eradicate.

Front 34

explain DUWLs in the Dental Institute

Back 34

All chairs have an independent bottled water system

Initially ‘shocked’ with the product ‘BRS forte’ to remove existing bio-films

Majority of DUWLs are maintained with a 1%
solution of Alpron

Using Oxygenal 6 on three dental chairs – two concentrations - treatment and intensive disinfection solution

Microbiologically tested (accept <100 cfu/ml

Front 35

How to mix Oxygenal 6

Back 35

Treatment Solution (0.02%)
Add 5mls of Oxygenal to 1,500mls drinking water
Intensive Disinfection Solution (weekends and BH)
Add 35mls of Oxygenal to 1 litre drinking water