Basic infection control

Question 1

What is the chain of infection?

Answer 1

Infectious agent, reservoirs, portal of exit, means of transmission, portal of entry, susceptible host

Question 2

What are infectious agents?

Answer 2

Bacteria, virus, fungi, parasite/protozoa

Question 3

How can you break the chain at the infectious agent level?

Answer 3

Rapid, accurate ID of organisms

Question 4

What are culture and sensitivity tests?

Answer 4

Blood, sputum, urine for culture and possibly stool to ID an infectious agent

Question 5

What are reservoirs?

Answer 5

People, equipment, solutions

Where something sits/is held

Question 6

How can you break the chain at the reservoir level?

Answer 6

Health assessment

Question 7

What is a portal of exit?

Answer 7

How germs get out of the reservoir
Blood and body fluids
Respiratory secretions
Wound drainage
Skin

Question 8

How can you break the chain at the portal of exit level?

Answer 8

Handwashing, PPE, disposal, containment

Question 9

What is a means of transmission?

Answer 9

How the infectious agent is transmitted
Contact
- Direct/indirect (bacteria falling off onto another surface)
Airborne
Vectorborne
Vehicle

Question 10

How can you break the chain at the means of transmission level?

Answer 10

Handwashing, isolation, decontaination, airflow control, food handling

Question 11

What is a portal of entry?

Answer 11

How the infectious agent enters a host

Skin

Question 12

What is a susceptible host?

Answer 12

Someone who is susceptible to infectious
Immunosuppressed
Poor skin integrity
Invasive devices
Being in a hospital

Question 13

How can you break the chain at the susceptible host level?

Answer 13

Vaccinations, leukopenic precautions, treatment of underlying disease, recognition of high risk patients

Question 14

What are principle risk factors for transmission?

Answer 14

Inadequate education
Failure to recognize infected pt or susceptible host
Absent/inappropriate barriers
Unrestricted infected HCW
Inadequate disinfection/sterilization

Question 15

What are the goals of infection control?

Answer 15

Minimize development of infections in pts and HCWs

Prevent cross-transmission from pt to pt and pt to HCW

Question 16

What is transmission by contact?

Answer 16

Direct route (hands of HCW)
Indirect route (invasive/non-invasive equipment)
Droplet route (meningitis, influenza, RSV)

Question 17

Direct transmission

Answer 17

Hands of HCW
- Respiratory infx
- Enteroviral infx (coxsackie, echo, polio)
- Hep A, E
- Diarrheal diseases
Response
- Avoid pt-pt contact
- Use barrier

Question 18

Indirect/fomite route

Answer 18

Invasive/non-invasive equipment

Organisms can be carried on inanimate objects

Question 19

Aerosol transmission

Answer 19

Falls to floor within 1-3 ft
Most respiratory viruses
- RSV/influenza
- Most childhood exanthemas (rashes)
- Strep
Response
- Single room
- Mask within 3 ft

Question 20

Airborne transmission

Answer 20

Droplet nuclei remain suspended in air
- TB, measles, VZV
Response
- Neg pressure room
- Surgical mask on for pt travel
- Seropositive HCW (have titers)
- Respirator on HCW

Question 21

What follows the transmission-based precautions?

Answer 21

Airborne
Droplet
Contact

Question 22

What follows airborne precautions?

Answer 22

Measles
Chicken pox
Herpes zoster
TB
(My Chicken Hez TB)

Question 23

What is used for airborne precautions?

Answer 23

Private room, negative pressure with 6-12 air exchanges per hour, mark, N95 mask for TB

Question 24

What requires droplet precautions?

Answer 24

S - Sepsis
S - Scarlet fever
S - Streptococcal pharyngitis
P - Parvovirus B19
P - Pertussis
P - Pneumonia
I -  Influenza
D - Diphtheria (Pharyngeal)
E - Epiglottitis
R - Rubella
M - Mumps
M - Meningitis
M - Mycoplasma or meningeal pneumonia
An - Adenovirus

Question 25

What are the precautions for droplet precautions?

Answer 25

Private room, mask

Question 26

What requires contact precautions?

Answer 26

``` M - Multidrug resistant organism R - Respiratory infection - RSV S - Skin infections (see below) W - Wound infections E - Enteric infections - clostridium difficile E - Eye infections ```

Question 27

Skin infections?

Answer 27

``` V - Varicella zoster C - Cutaneous diphtheria H - Herpes simplex I - Impetigo P - Pediculosis S - Scabies, Staphylococcus ```

Question 28

What are the precautions for contact precautions?

Answer 28

Private room, gloves, gown

Question 29

What is the donning PPE sequence?

Answer 29

Gown, mask, goggles gloves

Question 30

What is the doffing PPE sequence?

Answer 30

Gown and gloves, goggles/face shield, mask/respirator, wash hands

Question 31

Age 3-4 months of development

Answer 31

Infants begin to develop eye–hand coordination

Question 32

Age 5-6 months of development

Answer 32

Many children have been introduced to solid foods

Question 33

Age 7-9 months of development

Answer 33

Children can hold a spoon or drink from a cup with help

Question 34

Age 9-12 months of development

Answer 34

Children can pick up finger food and feed themselves/drink from a bottle

Question 35

Age 2-3 years of development

Answer 35

Daytime bowel and bladder control

Question 36

Age 4+ years of development

Answer 36

Nighttime bowel and bladder control

Question 37

What is transmitted by vehicle route?

Answer 37

``` Salmonella Hep A Hep B Hep C HIV ```

Question 38

What is transmitted by vector borne route?

Answer 38

Lyme disease Malaria Rabies Rocky Mt. Spotted Fever