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Elaina: Clin Assess ID > lalala > Flashcards

lalala Flashcards

1
Q

what is the main principle of infection control in the healthcare setting?

A

prevent and reduce rates of nosocomial infection

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2
Q

what are the four major areas of infection control?

A

1) standard precautions (including hand hygiene)
2) isolation precautions
3) environmental cleaning
4) surveillance

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3
Q

what are the indirect consequences of HAIs from a societal perspective?

A

1) indirect costs to family and caretakers
2) decreased level of productivity from disability
3) decreased trust in healthcare system
4) malpractice costs
5) years of productive life lost to death
6) increased bacterial resistance from increased use of antibiotics

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4
Q

what are three major challenges that have presented in infection control?

A

1) antimicrobial resistance
2) advances in medicine have led to prolongation of life in immune-compromised hosts
3) there are agents that appear recent in origin

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5
Q

where is MRSA commonly found?

A

common areas: fitness centers, locker rooms, military living quarters, childcare centers, assisted living facilities, prisons

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6
Q

how does MRSA present?

A

skin and soft tissue infections

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7
Q

what population is at high risk for VRE infection?

A

ABX treatment with penicillin/gentamycin, long hospitalization, weakened immune system, ABDOMINAL surgery, invasive devices

KNOW: lies in GI & female genital tract

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8
Q

how does c. diff present?

A

watery diarrhea, fever, loss of appetite, nausea, abdominal pain/tenderness

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9
Q

complications of c. diff?

A

pseudomembrane colitis, toxic megacolon, perforation of colon, sepsis, death

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10
Q

risks of developing c. diff?

A

1) ABX exposure (fluoroquinolones like cipro)
2) proton pump inhibitors
3) GI surgery
4) long hospitalization
5) immunocompromised state

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11
Q

how to treat c. diff?

A

vancomycin, fecal transplant, metronidazole

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12
Q

what must we keep in mind when trying to protect against c. diff?

A

alcohol hand gels do NOT kill c. diff spores!

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13
Q

group a. streptococcus is a common HAI; what can it cause?

A

cellulitis, impetigo, scarlet fever, strep throat, severe infection (bacteremia, toxic shock, necrotizing fascitis)

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14
Q

where do we pick up hospital acquired infections?

A

1) patient’s own microflora
2) visitor’s microflora
3) hospital environment
4) hospital equipment
5) healthcare workers

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15
Q

what is a surveillance plan?

A

systematic method of collecting, consolidating, and analyzing data concerning the distribution of determinants of given disease or event, followed by dissemination of that information to those who can improve the outcomes

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16
Q

SO what is the purpose of a surveillance plan?

A

1) detect outbreaks (via findings on labs & what not)
2) quantify magnitude of problem (datamining based on algorithms)
3) evaluate prevention measures
4) detect changes in healthcare practice
5) facilitate planning

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17
Q

what is targeted surveillance?

A

looks at a particular type of surgery or procedure or at outcomes related to a particular device

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18
Q

who is responsible for “duty to report” in regards to infectious disease?

A

1) healthcare providers
2) medical laboratories
3) health care facilities
4) administrations
5) veterinarians
6) health officers

disease reporting is 24/7!

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19
Q

why is TB re-emerging? where is it the worst right now?

A

multi-drug resistant strains have emerged!

india has 70-80,000 cases of drug-resistant TB each year

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20
Q

what is MDR-TB? what is XDR-TB?

A

MDR-TB: resistant to at least two first line drug

XDR-TB: also resistance to one of the three second-line drugs

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21
Q

how is ebola transmitted?

A

contact with infected animal then person-to-person through direct contact with secretions, excretions, blood

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22
Q

why is ebola emerging at such a high rate? why is it hard to treat?

A

ebola targets the macrophages, and these are the cells that usually elicit the inflammatory response

the early infection of macrophages helps ebola evade the immune system while subsequently spreading through host

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23
Q

the number of new cases in a specific population in a defined time period is also known as?

A

incidence

24
Q

the total number of current cases in a defined population is known as?

A

prevalence

25
Q

what are the four steps to investigating an outbreak?

A

1) confirm the diagnosis
2) develop a case definition
3) plot the epidemic curve
4) prove that an epidemic exists by showing that the current rates are higher than pre-epidemic rates

26
Q

recommendations for PPE?

A

1) double globe
2) hood
3) face shield and mask
4) knee high impermeable shoe covers
5) standardized suit for consistency in use

obviously whether you wear all this depends on the case

27
Q

when do standard precautions apply?

A

whenever contact with blood, bodily fluids, nonintact skin, mucous membranes, & secretions (except sweat) is likely or possible

28
Q

what do standard precautions entail?

A

1) hand hygiene before and after every patient
2) gloves, gowns, eye protection if body secretions or blood exposure likely
3) safe disposal of sharps
4) soiled linens in impervious bags
5) safe injection practices
6) mask w/ spinal canal puncture
7) respiratory hygiene/cough etiquette

29
Q

when would we use contact precautions? what do they entail?

A

contact (ie. MRSA, C. diff)

1) wash hands w/ soap and water
2) wear gloves & gown when entering room
3) private room preferred

30
Q

when would we use droplet precautions? what do they entail?

A

droplet (ie. pertussis, RSV)

1) weak mask if

31
Q

when would we use airborne precautions? what do they entail?

A

airborne (TB, smallpox, SARS)

1) patient in AIIR (airborne infection isolation room)
2) room exhaust
3) certified respiratory must be worn when entering room of pt with TB
4) transport of patient should be minimized

32
Q

how can we personally prevent spread of HAI in terms of our attire and what we carry with us?

A

1) sterilize your stethoscopes, cell phones, pages (25 percent are contaminated)
2) launder white coat and attire frequently
3) “bare below the elbows”
4) no jewelry, ties, artificial nails

33
Q

how often should we replace peripheral IV lines to prevent HAI?

A

every 3 days

34
Q

what part of our medical care team is critical in protecting against HAI?

A

CNAS and attentive nursing care

repositioning to prevent pressure ulcers, wound care, catheter care, etc.

35
Q

which HAI is disproportionately high in maine compared to the national average?

A

CAUTI!

72 percent more prevalent here than the rest of the country

the only other one is colon surgery (20 percent higher)

36
Q

additional types of HAI?

A

1) central line associated bloodstream infections
2) CAUTIS
3) MRSA
4) surgical site infection
5) VRE
6) ventilator associated pneumonia

37
Q

who should get a hep B vaccine?

A

those traveling to places with 8% or higher rate of endemic hepatitis B (africa, south asia, middle east)

esp if patient will have contact with blood, unprotected sex, or will be using illicit drugs

38
Q

when should vaccination for hep B begin should it be recommended to the traveler?

A

6 months prior to travel

39
Q

who should get the hep A vaccine?

A

people traveling to areas where sanitation is poor and risk of exposure to contaminated food and water is high

40
Q

how and when is the hep A vaccine delivered?

A

single dose administered as SOON as travel is considered

those with chronic disease should also receive immunoglobulin

41
Q

who should get the meningococcal menigitis vaccine?

A

if traveling to nepal, sub-saharan africa, northern india and you are between the ages of 2-55

42
Q

do we give vaccine against the plague? what do we do if someone is at high risk?

A

no! no longer commercially available

consider prophylaxis with doxy

43
Q

what must travelers departing from afghanistan, pakistan, or nigeria provide once entering the US?

A

evidence of 3 series inactivated polio vaccine!

people going to those countries should also recieve!

44
Q

do we use a live attenuated polio vaccine?

A

NO! the risk of side effects much worse than risk of developing polio

45
Q

who gets the rabies vaccine?

A

those planning on partaking in extensive outdoor activities, veterinarians, animal handlers in areas where rabies is common in domestic animals (india, asia, mexico, central/south america, africa)

PEP with vaccine

46
Q

who gets the typhoid vaccine?

A

travelers to developing countries who will have prolonged exposure to contaminated food and water

NOT for children under 6

47
Q

when is the typhoid vaccine given?

A

4 doses 1 week before travel

48
Q

what areas may require vaccine to protect against yellow fever?

A

equatorial africa and parts of central and south america

49
Q

who can you not give the vaccine for yellow fever to?

A

immunosuppressed individuals or history of anaphylaxis to eggs

50
Q

should all travelers to asia be vaccinated with the vax for japanese B encephalitis?

A

NO; risk of infection is low and adverse effects of vax can be serious

51
Q

who should receive vax for japanese B encephalitis?

A

those traveling to endemic areas, who will be staying at least 30 days, are traveling during transmission season, and are traveling to rural area

52
Q

which 3 vaccines should be given to pregnant women?

A

tetanus, diptheria, influenza

remember: influenza can be terrible if someone gets it during pregnancy

53
Q

what type of vaccine must we avoid in immunocompromised, HIV+, or pregnant women?

A

live attenuated vaccines

54
Q

when should we give patients with HIV their vaccines?

A

EARLY in disease before their immune system is shot!

55
Q

when should we give individuals post-stem-cell transplant their vaccines?

A

6-12 months following transplant!

they won’t be able to respond to them any earlier

56
Q

when do we give people eligible for solid organ transplants their vaccines?

A

try your best to get them before transplant!

if not possible, 3-6 months post transplant

Elaina: Clin Assess ID (1 decks)

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