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Which percentage of hospital administered patient acquire a nosocomial infection?
25%
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which are the 6 most common nosocomial infections?
Urinary tract, respiratory, wound, skin, soft tissue and septicaemia.
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define preventable nosocomial infection and give examples
- stuff you can control. Medical or nursing or surgical mishaps.
- ex: bad handwashing, leaving stuff inside patient, caughing all over.
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define non-preventable nosocomial infection and give examples
- stuff you can't control
- ex: immunodeficient patient, surgeries where organs are seriously damaged, gunshot / stabbing to GI tract.
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What are the 7 sources of hospital-acquired infections?
Environment, person-2-person (endogenous vs exogenous), food supply, water supply, air supply, fomites, vector.
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Which are the 3 medical activities that can cause problems?
Intravenous access, urinary catheters, surgeries.
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What are the 3 factors that play a role in the transmission of a nosocomial infection?
- 1. Source: location where microorganisms replicate and disseminate.
- 2. Route of infection: way by which microorganisms leave source to get to host (us)
- 3. Host: how susceptible are you? age? immune status? etc...
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What must be done to have control over nosocomials?
Chain of infection (source to host) must be prevented.
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Hospital infection control plans are in place to ... (there are 4)
- 1. render souce non-infectious
- 2. prevent microorganisms from leaving source
- 3. interfere with dissemination routes
- 4. prevent microorganisms to enter host
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Which is the most efficient step in control over nosocomials?
the identification and detection of the source of infection
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Which activities prevent infection?
- good clinical practices (separation of infected/non-infected patients)
- wound and enteric isolation (toilet facilities, basins)
- respiratory isolation (facemasks, SARS)
- strict isolation (enclosed isolation units, air systems)
- protective isolation (patients highly susceptible to infection) typing (serology, phage, molecular)
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Give examples of universal precautions
- Good hygiene habits, such as hand washing and the use of gloves and other barriers
- Correct sharps handling
- Aseptic techniques.
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What other types of precautions are used in addition to universal precautions?
- Prion diseases (e.g., Creutzfeldt-Jakob disease)
- Diseases with air-borne transmission (e.g., tuberculosis)
- Diseases with droplet transmission (e.g., mumps, rubella, influenza, pertussis)
- Transmission by direct or indirect contact with dried skin (e.g., colonisation with MRSA) or contaminated surfaces
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Who are universal precautions recommended for?
not only for doctors, nurses and patients, but for health care support workers such as laundry and housekeeping staff.
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Who is going to ace this exam?
We are, of course :-)
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Give some examples of ways infections can be controlled within communities.
- Social and environmental factors
- Health education
- Food safety
- Vector control
- Immunization (immunoglobulins, vaccination)
- Chemoprophylaxis (e.g., rifampicin/ciprofloxacin for meningococcal contacts)
- Outbreak investigations
- National and international agencies
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What are the 3 physical approches that we use in cleaning, sterilization and desinfection? give examples.
- Heat: dry (150-200oC); moist (pasteurization, boiling, autoclaving, microwaves); incineration (1000oC!)
- Radiation: gamma, ultraviolet
- Filtration
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in order for a disinfectant to be effective, the following must be thought about...
- concentration of germicide?
- what is the target?
- what is the contact time?
- what is the temperature that I should use product at?
- load? Organic? Inorganic?
- miscellaneous factors... (Ph)
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In decreasing order of resistance to desinfectants, list 5 different classes of organisms. give two examples for each.
Spores/cysts --> Mycobacteria --> Fungi -->Vegetative bacteria --> enveloped virus
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What are antiseptics used for?
- used to inactivate and remove flora (transient, resident) from hands prior to surgical procedures and from site of operation
- used for treatment and/or prevention of infection on skin surfaces or mucous membranes
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What are hand rubs used for?
removes transient flora only. Usually contains 60-70% ethanol...plus emollient(s)
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