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Describe the microflora of human hands.
- resident microflora- supposed to be there, maintain normal environment of our skin
- transient microflora- more likely to be pathogenic, easier to remove
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What is the purpose of hand hygiene? (2)
- reduce transient flora
- reduce transfer of transient flora
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A 20% increase in adherence to good hand hygiene showed an effect of...
40% decrease in hospital-associated infections
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What are the key components to hand hygiene success? (3)
- agent
- timing-frequency
- techinque
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How do alcohol-based hand sanitizers work?
denature proteins, kill (not remove) microbes
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How does soap and water work?
- emulsifying (break up oils) and mechanically removing microbes
- strips moisture/oil from the skin
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If there's concern for non-enveloped viruses, clostridial spores, crypto, etc (more resistant organisms), what method of hand hygiene should you use?
- soap and water!
- hand sanitizer is not generally effective against these organisms
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When should you use soap and water? (4)
- visibly soiled
- Clostridium
- Crypto
- Non-enveloped viruses
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What are 5 instances you should wash your hands?
- immediately before and after contact with a patient or environment
- after contact with a patient's body fluids
- after removing gloves
- before eating
- after using the restroom
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What is the proper hand washing technique? (5)
- special attention to fingertips, between fingers, backs of hands, and base of thumbs
- clean a MINIMUM or 15s
- keep nails short
- minimize jewelry
- creams and lotions are ok afterwards
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What are the purposes of PPE? (2)
- reduces contamination of clothing, skin, environment
- protect from colonization/ infection
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What are the principals of wearing gloves?
- wear gloves when cleaning or when you'll be in contact with body fluids, blood, secretions, mucous membranes, wounds, infectious patients
- do NOT touch surfaces that may be touched by people with non-gloved hands
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When is a surgical mask/ goggles imperative? (6)
- dental procedures
- surgery
- wound lavage
- abscesses
- obstetrics
- necropsy
- [splashes/ sprays into eyes/ MMs likely]
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When is respiratory protection important (N95 respirators)?
- masks to filter non-oily particular aerosols
- few indications in clinical practice- tularemia, TB
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You're most likely to contaminate yourself when...
removing PPE.
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2 major concerns for PPE in an outbreak.
exposure potential: respiratory protection, dermal protection
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What are the levels of PPE?
- A: greatest level of skin, respiratory, and eye protection
- B: highest level of respiratory protection; lesser level of skin protection
- C: concentrations an types of airborne substances known; criteria for using air purifying respirators met
- D: minimal protection; "nuisance" contamination only (coveralls, boots, exam gloves, safety glasses)
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