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What are HAIs
Health-care associated infection
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What are the parameters for airborne precautions?
- Use a private room with negative air pressure that has 6 to 12 air changes per hour.
- Keep room door closed.
- N-95 respirator
- People not immunized for measles or varicella should not enter, if they do use a respirator.
- Use a surgical mask during transport.
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What diseases require airborne precautions?
- Tuberculosis (pulmonary) - confirmed or suspected
- Chicken pox (varicella)
- Herpes zoster (varicella-zoster) - disseminated
- Measles
- SARs (severe acute respiratory syndrome)
- Smallpox
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What are the parameters for contact precautions?
- Private room if possible, cohort if needed.
- Wear gloves when entering. Change gloves when in contact with fecal material or wound drainage.
- Wear gown when entering. Remove before leaving.
- C.Diff and Norovirus require soap and water hand washing.
- Minimize contact with environment during transfer.
- Dedicated patient care equipment.
- Thoroughly disinfect common items used before leaving.
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What diseases require contact precautions?
- Methicillin resistant bacteria (MRSA)
- Enteric infections (C.Diff, E.Coli, Hep. a, Norovirus)
- Major, uncontrolled wound drainage.
- Scabies or lice (for 24 hours after treatment)
- Varicella (in addition to airborne precautions)
- Hemorrhagic fever
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What are the parameters for droplet precautions?
- Private room if possible. Cohort with 3-6 feet spatial separation from visitors and other patients.
- Simple isolation mask when entering room.
- Pull curtain in cohort room.
- Surgical mask during transport.
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What diseases require droplet precautions?
- Influenza
- Meningitis
- MRSA in sputum
- Mumps
- Pertussis
- Pneumonia (Neisseria, Meningococcus, Hemophilus influenza)
- Multi-drug resistant Streptococcus pneumonia
- Adenovirus
- Pneumonic plague
- Rubella
- Parvo virus B19
- Epiglottitis
- Diptheria
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What are neutropenia precautions?
Low neutrophil count (WBCs)
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What are the parameters for neutropenia precautions?
- Private room
- No ill visitors/caregivers in room
- Minimize risk of their own flora
- Sign posted on door
- Gloves at all times
- Mask on patient outside of room
- No cut flowers or plants in room
- No fresh fruit, vegetables, or raw eggs in diet
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What are standard precautions?
- Precautions used with every patient.
- Use hand hygiene before entering or leaving room.
- Gloves when in contact with body fluids, non-intact skin (including rashes), mucous membranes, used equipment, linen and trash.
- Change gloves when soiled or when moving from a dirtier area to a cleaner one.
- Use a gown if you may be soiled.
- Use a mask and eye protection if you might be splashed.
- Do not recap sharps or use one-handed method.
- Discard sharps immediately.
- Activate safety sharps immediately.
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What, in infection prevention, is one of the top 10 leading causes of death in the US?
healthcare-associated infections
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What link in the chain of infection can you eliminate?
Mode of transmission
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What are infectious agents?
Germs
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What actions do we take to eliminate germs?
- Sterilizing surgical instruments
- Cleaning reusable equipment
- Safe food handling practices
- Telling sick coworkers to stay home
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What are reservoirs?
- Where the germs live and grow.
- Generally wet.
- Most important are people. (Sick people or healthy people with their flora)
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What are portals of exit?
- The way germs get out of the reservoir.
- Break in the skin, natural orifice, body fluid
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What are modes of transmission?
- Ways we carry germs from one patient to another.
- Hands and things that move from patient to patient.
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What is a portal of entry?
Hole in the body germs can get into.
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What is a susceptible host?
- Someone able to take on germs and get infected.
- Partially eliminated by vaccination and natural disease that causes immunity.
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What is the most important procedure for infection prevention?
Hand hygiene
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When do you wash your hands with soap and water?
- If they are visibly soiled.
- Norovirus or C.Diff
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What is an infection?
Germs are present, invading tissues and causing tissue damage and causing symptoms.
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What is colonization?
Germs are present, not invading tissues and not causing symptoms.
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Endogenous flora
- the patient's own germs they come in with.
- includes normal flora and pathogens
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Exogenous flora
- germs the patient did not come in with
- either exo or endogenous can cause HAIs
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What are blood borne pathogens and what are the main ones?
- Organisms in the blood that can cause disease.
- Hep.B, Hep.C, HIV
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How can bloodborne pathogens be transmitted?
- Needlesticks
- Bodily fluid contact with mucous membranes (such as eyes or mouth) or broken skin
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What goes into a red bag?
Biohazard waste that is dripping.
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How can you tell if a patient has TB?
- Cough that lasts more than 3 weeks
- Unexplained weight loss or loss of apetite
- Night sweats
- Bloody sputum
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How do you diagnose TB?
Microscope examination of sputum
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What are the 4 types of isolation?
- Airborne
- Droplet
- Contact
- Standard
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Disseminated zoster
Recurring chickenpox all over
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PAPR
Powered air purifying respirator
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What are contact enteric precautions?
- Precautions used for C.Diff, norovirus and undiagnosed diarrhea.
- Bleach based disinfectant
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A patient has a cough and weight loss, should they be isolated and what is the possible diagnosis?
Yes, airborne precautions, TB
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A patient has respiratory symptoms, should they be isolated and what could be a possible diagnosis?
Yes, droplet precautions, influenza.
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A patient has a rash, should they be isolated and what could be a possible diagnosis?
Yes, airborne and contact precautions, chicken pox or measles.
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A patient has diarrhea, should they be isolated and what could be a possible diagnosis?
Yes, contact precautions, C.Diff or norovirus
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A patient has a draining wound, should they be isolated?
Yes, contact precautions.
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A patient has dementia, should they be isolated and why?
Yes, because they could wander and touch things, causing spread of infection.
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How many people have ordinary staph aureus?
1/3
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What are the 4 main kinds of HAIs?
- Bloodstream infections
- Surgical site infections
- Pneumonia
- Urinary Tract Infections
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What are natural host defenses?
- Skin
- Mucous membranes
- Cilia
- Cleansing flow
- Normal flora
- Stomach acids
- WBCs
- Antibodies
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