Exam 1: Infection Control/Culture/SDOH

Question 1

What is a Healthcare associated infection (HAI’s)?

Answer 1

nosocomial infection, not reimbursable

Question 2

What are types of HAI’s?

Answer 2

CAUTI (catheter associated UTI)
CLABSI (central line blood stream infection)
SSI (Surgical Site Infection)
VAE (Ventilator Associated Events)
MRSA, VRE, C-diff

Question 3

Describe the Chain of Infection

Answer 3

Infectious Agent
Reservoir -> think hands for worker
Portal of Exit -> mode of coming out to infect other
Mode of Transmission
Portal of Entry (broken skin, invasive device)
Susceptible host -> immunocompromised (ADD PIC FROM SLIDE)

Question 4

What makes a host susceptible to infection?

Answer 4

Breaks in skin (pressure ulcers, wounds)
Invasive devices (Foley)
Statis of body fluids (CHF)
Poor nutrition
Stress/Hyperglycemia
Chronic Conditions (DM, HTN, Cancer)
Drug Therapy (Steroids, chemo)

Question 5

What is the #1 way we prevent the spread of infection?

Answer 5

hand hygiene

Question 6

What is the difference between a local and systemic infection?

Answer 6

Local – Wound on body part or area - (abscess if left axilla)
Systemic – multiple body systems (Sepsis)

Question 7

What is the difference between a chronic and acute infection?

Answer 7

Acute – short term ( < 3 months) *UTI, viral pharyngitis, cellulitis
Chronic – long term ( > 3 months) *Hepatitis C, H. Pylori

Question 8

What is the purpose of antibiotic stewardship?

Answer 8

Creates drug resistant bacteria – hard to treat

Question 9

What are the signs and symptoms of an infection?

Answer 9

Fever
Chills/Shivers/Rigors
Increased pulse, RR
Inflammatory symptoms
Pain
Purulent DrainageEnlarged lymph nodes
GI symptoms
Increased WBC
Erythrocyte sedimentary rate (ESR)
Lactate level (0.3 -2.6)
+ UA with culture and sensitivity
+ Diagnostic imagine (CXR, CT, MRI)

Question 10

What is the treatment for an infection?

Answer 10

Rest
Comfort Measures
Ambulation & Positioning
Respiratory Interventions
Nutrition and Hydration
Immunizations
Antimicrobial Therapy

Question 11

Describe standard precautions.

Answer 11

the minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where health care is delivered

Question 12

What are transmission based precautions?

Answer 12

the second tier of basic infection control and are to be used in addition to Standard Precautions for patients who may be infected or colonized with certain infectious agents for which additional precautions are needed to prevent infection transmission

Question 13

Describe contact precautions

Answer 13

Requires Gown and Gloves
Direct transmission – care and handling of body fluids (foleys, drains)
Indirect transmission – transfer of infection through contaminated objects (hands, pens, stethoscopes, etc.)
Prevents the healthcare worker from being infected
Prevents spread to other patients, family, staff

C. diff, MRSA

Question 14

Describe droplet precautions

Answer 14

-Must wear surgical mask w/in 3 feet
-Disease transported by large droplets
-Example: Influenza A

Question 15

Describe airborne precautions

Answer 15

Private, negative airflow room
N95 Mask
Disease is transported by small droplets over long distances
Example: TB

Question 16

What is the procedure for donning and doffing PPE?

Answer 16

Don:
1. Hand hygiene
2. Gown
3. Mask
4. Eye protection
5. Hand hygiene and gloves

Doff:
1. Gown and gloves
Exit the room
2. Hand hygiene
3. Remove Face shield and mask
4. Hand hygiene

gloves
face shield
gown
mask

Question 17

What is considered contaminated on our ppe?

Answer 17

have or are likely to be in contact with the pt or organisms

Question 18

What is protective isolation?

Answer 18

aims to protect an immunocompromised patient who is at high risk of acquiring micro-organisms from either the environment or from other patients, staff or visitors

surgical masks
own room
no flowers or fruit

Question 19

What are medical asepsis principles we follow in the care setting?

Answer 19

disposable sterile objects within sterile fields

med - clean (hand hyg., clean, gloves, masks)
surg - sterile

Question 20

When do we perform hand hygiene?

Answer 20

After every direct contact w/ patient

Question 21

When should we use soap instead of alcohol based sanitizer?

Answer 21

obviously soiled
toileted
C. diff

Question 22

What are the principles of maintaining a sterile field?

Answer 22

sterile touches sterile, above waist, keep dry, field must remain in sight, edges (1”) are contaminated

Question 23

What do you do if you break sterile technique during a procedure?

Answer 23

start over

Question 24

What is the definition of culture?

Answer 24

the customs, arts, social institutions, and achievements of a particular nation, people, or other social group

Question 25

Why should a nurse be culturally aware?

Answer 25

x

Question 26

What is the difference between illness and disease?

Answer 26

illness - the way that individuals and families react to disease disease - malfunctioning of biological or psychological processes

Question 27

Why is it important that we understand our client's experience with illness?

Answer 27

create an appropriate plan

Question 28

What is the definition of culturally congruent care?

Answer 28

goal is to create a plan of care that fits the person’s life patterns, values, and their system of meaning

Question 29

What are 3 strategies to provide culturally congruent care?

Answer 29

assume role of learner include your own perspective and experience

Question 30

What is the relationship between patient centered care and cultural competency?

Answer 30

x

Question 31

Describe the 5 components of the Campinha-Bacote Model?

Answer 31

1. cultural awareness 2. cultural knowledge 3. cultural skill - assessment 4. cultural encounters 5. cultural desire

Question 32

What are some questions that we can ask to assess a client's culture?

Answer 32

explanatory model what do you call your problem? when did it start?

Question 33

What are the main principles when using a medical interpreter?

Answer 33

introduce direct to patient pace yourself ask for clarification

Question 34

How do social determinants of health lead to health disparities?

Answer 34

acting as barriers

Question 35

What are the 5 social determinants of health?

Answer 35

economic stability education access & quality health care & quality social & community context neighborhood & built environment

Question 36

Goal of economic stability

Answer 36

help people earn steady incomes that allow them to meet their health needs

Question 37

Goal of education access & quality

Answer 37

increase educational opportunities and help children and adolescents do well in school

Question 38

Goal of health care & quality

Answer 38

increase access to comprehensive healthcare, high-quality health care services

Question 39

Goal of social & community context

Answer 39

Increase social and community support

Question 40

Goal of neighborhood & built environment

Answer 40

Create neighborhoods and environments that promote health and safety