Unit 1 (Infection Control)
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Microorganisms that cause disease are called:
pathogens or pathogenic organisms
Pathogens secrete organic substances called ________ which produce the side effets that tell us something is wrong.
Name some side effects of exotoxins secreted by pathogens:
- high body temperature (fever)
- nausea or vomiting
What are 6 classifications of microorganisms?
What is the most common harmful microorganism found in hospitals?
Microorganisms that live in the body and aid in skin preservation, digestion, and increased immunity are called:
normal microbial flora
Name some common bacterial infections:
- strep throat
- bacterial pneumonia
- food poisoning
- infectuous diarreah
- staph infection
- hemolytic uremia
- e. coli
- necrotizing fasciitis
How are bacteria classified?
Name the three main classifications of bacteria and what they are called:
- spherical, called cocci
- rod-shaped, called bacilli
- spiral, called spirilla or spirochetes
By using a staining process, bacteria can be subclassified as:
- Gram-positive or Gram-negative
- acid-fast or nonacid-fast
Name some bacteria and their subclassifications based on staining:
- e. coli - gram-negative
- strep - gram-positive
- staph - gram-positive
- m. tuberculosis - acid-fast
What do you call bacteria that require oxygen to grow?
What do you call bacteria that require a lack of oxygen to grow?
What do you call adaptive bacteria that can grow either with or without oxygen?
What is a resistant form of bacterium that is produced within the cell when environmental conditions are unfavorable, only to germinate when conditions improve?
Name some common viral diseases:
- common cold (rhinovirus)
- infectious mononucleosis (and Epstein-Barr)
- varicella (chicken pox and shingles)
What are the smallest microorganisms known to produce sickness in humans?
What types of forms do fungi exist in?
Name some common fungal infections:
- Athlete's foot
- systemic infection
- fungal pneumonia
Name some positive functions of fungi:
- the production of alcohol
- the flavor of cheese
- the lightness of bread
- the production of the antibiotic penicillin
- the process of organic decomposition
What are the smallest and least understood of all microbes and when were they discovered?
What are prions thought to play a role in?
- mad cow disease
- Creutzfeldt-Jakob disease
- Alzheimer's disease
**attacks on the CNS
What are complex single-celled animals that generally exist as free-living organisms, a few of which are parasitic and live within the human body?
Name some conditions caused by protozoa:
- Trichomonas vaginallis
- giardiasis (small bowerl infection)
Any animal or plant that nourishes another organism allowing it to grow:
Name three factors that help determine if an infection will occur:
- amount of contamination (# of organisms)
- type of microorganisms
- length of time exposed
List the necessary parts of the cycle of infection:
- an infectious organism
- a reservoir of infection
- a susceptible host
- a means of transmittion (portal of entry/exit)
The extablishment and growth of a microorganism on or in a host:
The ability of an organism to overcome the body's natural immune system is referred to as its:
A microorganism's likeliness to cause disease is its:
A microorganism's ability to enter tissue is its:
Two names for the environment where a microorganism can live until it finds a host:
- Reservoir of infection
- A "carrier" of a disease (ex. Typhoid Mary)
What is another term for a hospital aquired infection (H.A.I.)?
Name people who are more prone to becoming a host:
- transplant patients
- geriatric patients
- people with poor hygiene
As humans, what makes us a favorable host environment?
- the nutrients and metabolites in our bodies
- temperature varies throughout our bodies
- pH levels vary throughout our bodies
- the varying body fluids available
What are the four main modes of transmission?
- direct contact
- indirect contact
- airborne contamination
- droplet contamination
Name three examples of indirect contact:
- vehicle - a medium like food, water, drugs, blood
- vector - bites/stings from arthropod, insect
- fomite - inanimate objects like items, surfaces
What determines airborne contamination?
- the microbes are suspended in the air for long periods of time (smaller than 5 microns)
- wear a heppa filter
What determines droplet contamination?
- the microbes travel 3 feet or less in the air (larger than 5 microns)
- wear a surgical mask
What three defenses from invasion of microorganisms does the body have?
- natural resistance (skin/mucous membranes), the 1st line of defense and the lymphatic system (phagocytosis), the 2nd line of defense
- acquired resistance (active immunity)
- passive immunity (short term)
The process of our body forming antibodies to a specific disease or illness that we have been exposed to:
acquired immunity or long-term immunity
When a specific infection is treated with antibodies after an exposure, _______________ immunity occurs?
passive immunity or short-term immunity
Name some major infectious diseases and their mode of transmission (4):
- HIV and AIDS - bloodborne
- Hepatitis - bloodborne
- Tuberculosis - airborne
- Anthrax - direct contact/respiratory
How does HIV become AIDS?
HIV has 5 stages. Phase 1 is the inital infection, with no symptoms, but is still contagious after a few days. Antibodies might not show up until 3-6 months. Virus worsens until eventually Phase 5 is reached, which is full-blown AIDS (death usually occurs withing 3 years of reaching Phase 5)
What is an important right of the HIV/AIDS patient that must be considered?
the right to confidentiality. Patient charts must be kept discrete and kept where only direct caregivers have access. Patient's diagnosis shouldn't be discussed with anyone except immediate and direct caregivers.
Describe prophylactic treatment of exposure to HIV/AIDS:
- report immediately and fill out an incident report.
- base blood sample drawn from caregiver and patient involved.
- Prophylactic tratment begun immediately - within 2 hours.
- blood samples drawn at 6 months and 1 year.
HBV has its primary effect on the:
When did the CDC establish Universal Precautions?
What is the core practice of Universal Precautions?
All patients are treated as though potentially infectious.
What was Universal Precautions upgraded to, and when?
- Body Substance Precautions
Eventually the CDC combined the features of Universal Precautions and Body Substance Precautions into what entity and when?
What does tier 1 of Standard Precautions cover?
- all body fluids
- secretions and excretions (except sweat)
- non-intact skin
- mucous membranes
What does tier 2 of Standard Precautions cover?
Name some conditions that must be met for the Occupational Exposure to Bloodborne Pathogens standard. Also, who created it, and when?
- OSHA created it in 1991
- exposure control plan
- - engineering controls
- - work practice controls
- PPE & clothing
- labeling of Biohazard substances
- annual bloodborne pathogen training
- Hep B vaccinations
- Medical treatment for Occupational Exposure
What Act did congress pass in November 2000 closely followed by new systems from OSHA, effective in 2001?
- Needlestick Safety and Prevention Act
- OSHA integrated the use of needleless systems and SESIPs
A pathologic state resulting from the presence of microorganisms defines:
What deals with reducing the probability of infectious organisms being transmitted to a susceptible individual?
What is the process of reducing the total number of organisms?
What involves the destruction of pathogens by using chemical materials?
(disinfection = applied to an inanimate object)
What is the recommended material for cleanup of blood or body fluids?
- a solution of 10 parts water, 1 part bleach
- CDC recommendations
What is the process of treating items with heat, gas, or chemicals to make them germ-free?
sterilization or surgical asepsis
When a disinfectant is applied topically to the skin it is:
Give some examples of an antiseptic:
- corhexodine (sp?)
What is the single most impartant measure to reduce the risks of transmitting organisms from one person to another?
Name some important reasons for wearing gloves:
- to provide a protective barrier
- to reduce likelihood of transmission from sick healthcare provider to the patient
- the reduce likelihood of transmission from a patient or fomite to another patient
Describe how to properly dispose of linens:
- fold the corners in towards each other
- hold linen away from body
- take linen to hamper, don't toss
- all linen that touches the floor is immediately considered contaminated
Where do you discard items contaminated with blood or body fluids?
in a biohazard container
When cleaning an item such as a radiographic table, where should you start?
start with the least soiled area and progress to the most soiled area to prevent the cleaner areas from becoming more heavily contaminated.
Name some things you do not do when discarding needles:
- do not recap needle
- do not touch needle
- do not bend or break needle
- do not try to remove needle from syringe (throw away all, needle first)
What should you do in the event of an accidental needle stick?
allow the wound to bleed under cold water and wash it with soap.
Name some aspects of airborne precautions:
- used to prevent diseases like TB and measles
- use particulate respirators (heppa filters)
- negative air flow and special air circulation
- room doors remain closed
Name some aspects of droplet precautions:
- used to prevent diseases such as diptheria, influenza, pneumonia, and meningitis
- surgical masks
- no special air flow
What a droplet precautions patient must be transported, who wears the surgical mask?
Name some aspects of contact precautions:
used to prevent staph infections, skin infections, e coli, capasis sarcoma (specific to AIDS patients)
Describe how an x-ray of an isolation patient should be taken:
- by the two-man approach
- "dirty" radiographer positions patient
- "clean" radiographer manipulates equipment and takes exposure
Describe some aspects of Protective Isolation:
- a.k.a. reverse or neutropenic isolation
- for immunosuppressed patients
- high degree of medical asepsis is practiced
- "clean" radiographer positions patient
- "dirty" radiographer manipulates equipment and takes exposure
- positive air flow pressure is used
the complete removal of all organisms and their spores:
surgical asepsis/ sterilization
When is surgical asepsis practiced?
for all invasive procedures
Name 6 methods of sterilization:
- Dry Heat
- Gas plasma technology
- Autoclaving (steam under pressure)
- Ionizing radiation
Involves the immersion and soaking of clean objects in a bath of germicidal solution followed by a sterile water rinse:
Name three reasons that chemical sterilization is not dependable:
- solution strength
- immersion time
- (all influence effectiveness and are difficult to control)
When an oven is required to sterilize some sharp instruments, certain powders, and greasy substances:
Dry Heat Sterilization
Name some specifics about Dry Heat sterilization:
- 1-6 hours needed
- 329-338 degrees F (165-170 degrees C)
Sterilization with a mixture of freon and ethylene oxide, heated to 135F (57C):
- Conventional Gas Sterilization
- usually used on electrical, plastic, rubber, optical ware, telephones, stethoscopes, blood pressure cuffs, and other isolation room equipment
What is a drawback of using Conventional Gas Sterilization?
The gases are poinonous, so they must be dissipated by means of aeration in a controlled environment (lengthy, too).
When items are cleaned, wrapped, and placed in a compact mobile unit where low-temperature hydrogen peroxide gas plasma diffuses through the wrapped instruments and kills both organisms and spores:
Gas Plasma Sterilization
The most common sterilization method, quickest and most convenient:
Items that identify that a pack has been sterilized:
closed containers that contain different species of nonpathogenic spore-forming bacilli, each resistant to a specific sterilization process:
Biological Indicatiors (BIs)
In ionizing radiation as a sterilization method, what is used to destroy the mocroorganisms and spores?
Cobalt 60 or an electron beam
What three methods of sterilization cause special indicators to change color, signifying that sterilization has been reached?
- ionizing radiation
a microorganism-free area that can recieve sterile supples:
a sterile field
Name some instances when an item may be considered unsterile:
- it is not clean and dry
- it appears to have been previously opened
- the expiration date has passed
- the sterility indicator does not indicate sterilization
How are items sterilized by central supply and by the manufacturer wrapped?
always in a standardized manner, always opened using the same technique
Describe how to extablish a sterile field:
- open the 1st corner away from you
- open the sides by grasping the corner tips
- pull the remaining corner towards you
Name some basic protocol when dealing with a sterile field (4):
- don't pass between the physician and the sterile field
- be aware of the 1" buffer zone around the edge of te field
- never leave your sterile field unattended
- everything below waist-high is considered contaminated
What is the area between the physician and the sterile field?
the sterile corridor
Name some important steps in adding liquid to a sterile field:
- check the label three times
- pour 1st few drops in trash (if poured before)
- hold bottle at least 6" above the bowl
- do not splash liquid
- pour all in one stream
- show the label to the physician
- close the spout
Name some imporant steps in skin preparation:
- hair removal (as needed)
- clean with scrub soap (12" area)
- paint with antiseptic solution
- clean/paint starting in center and work outward in circular motion
- drape prepared area with sterile drape
How do you don a sterile gown?
- first put on cap, mask, lead apron
- wash hands
- grasp gown and remove from table
- step away from table
- hold gown away from body, not touching floor
- open gown and hold by shoulder seams.
- both arms into armholes and wait for assistance
- assistant will pull gown closed and finish with either open or closed glove technique
Describe open gloving technique:
when a sterile gown is pulled on to the wearer until the hands are exposed through the sleeves.
Describe closed gloving technique:
when a sterile gown is pulled on to the wearer, but the cuffs of the gown will be left covering the hands.
Which hand should be gloved first, in sterile gloving?
the dominant hand
Describe donning sterile gloves:
- pick up the first glove at the folded cuff and slide chosen hand into glove (palm up), leaving cuff folded down.
- pick up second glove with your gloved hand, under the fold.
- pull the glove over the bare hand and over the cuff of the gown in one motion.
- place fingers of second hand under the cuff of the first glove and pull it over the cuff of the gown.
- gloves can be adjusted after the cuffs cover the cuffs of the sterile gown.
Name areas of a sterile gown that are automatically considered non-sterile:
- around the neck
- under the arms
- the back
- anywhere below the waist
Upon completion of an isolation procedure in which you are wearing a gown, mask, and gloves, the first step is to:
untie your waistbelt (of the gown)
Describe the steps of changing a dressing:
- never change dressing without a doctor's order
- wash hands
- put on gloves (usually sterile)
- pull dressing away from wound in one fluid motion to prevent cross-contamination
- dispose in biohazard container
- clean wound with sterile water or saline solution.
- pour, don't pat.
- redress wound.
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