How many hospitalized patients in the US acquire 1 or more healthcare associated infections?
5-10% or 2 million people a year
What does HAI stand for?
What are the 4 most prevalent infections?
Urinary tract infections (catheter associated 35%)
Surgical site infections (20%, but 1/3 of the costs)
Bloodstream infections (15%)
Pneumonia (15% and usually ventilator-associated. accounts for 25% of mortality)
What organization makes the rules for ensuring workers have safe working environment?
National Institute for Occupational Safety and Health (NIOSH)
What organization enforces the rules and standards set forth?
Occupational Safety and Health Administration (OSHA)
What is methylmethacrylate?
Glue used in ortho rooms that can cause respiratory and genitourinary problems
What anesthetic vapor was known to cause/increase likelihood of Hepatitis and therefore is no longer used?
What patient population is automatically treated as having a latex allergy?
Spina bifida (congenital birth defect)
What does PPE stand for?
Proper precautions equipment
You should stand at least _____ ft away from radiation to be safe for a 1 time zap IE. chest x-ray in PACU
Name the 4 risks associated with lasers?
What should healthcare personnel always wear in room with lasers?
Proper eye protection and high-efficiency laser mask
What percent of error in anesthesia management is attributed to fatigue?
64% by far the highest
For transmission of infection to occur, what must be present/required
Source Stabile pathogen Adequate numbers Infectivity of agent Appropriate vector Portal of entry
What respiratory infections can be transmitted by aerosolization (coughing sneezing airborne)
What respiratory infections can be transmitted by self inoculation (direct)
Respiratory syncital virus (RSV)
This disease leads to 36 K deaths a year, is very easily transmitted, and pt should be isolated bc disease is shed for 5 days
T OR F: If a patient has measles, mumps, or rubella, they can still have surgery?
FALSE–no surgery for these patients
All about rubeola:
Carries fever and 3 c’s: cough, coryza,and conjunctivitis
All about rubella:
aka german measles
most adults immune
Can cause birth defects and miscarriages in 1st trimester
All about mumps:
transmitted by airborne droplets
swelling of salivary and parotid glands
most often seen in children 5-9 YO
All about respiratory syncytial virus (RSV):
most severe cause of lower respiratory disease in children
transmitted by self-inoculation–Infected children can shed virus for 7 days
viable on skin for 6 hours
can have recurrent asthma for 6 months
What is the common cold called?
What are the 3 types of Herpes virus?
HSV 1 & 2
All about VZV:
aka chicken pox and shingles
transmitted to immuno-compromised patients
communicability 1-2 days before pt will show symptoms and lasts 5-6 days
All about herpes simplex type 1:
severe oral lesions and pt has fever
transmitted by self-inoculation
can lead to encephalitis
All about cytomegalovirus (CMV):
usually in childhood
transmitted by direct contact
can spread to fetus during pregnancy
Which is the “bad guy” of hepatitis?
transmitted by blood/body fluids
All about Hepatitis B:
seroconversion up to 30%
can develop cirrhosis and ESLD
HBV primary prevention strategy
All about hep C:
leading cause of chronic liver disease
What is seroconversion?
Exposure to a disease that will turn into an active disease in the exposed
All about Human immunodeficiency virus (HIV):
increased risk with blood, deep injury, needle sticks
is terminal illness, death within 2 months
All about Tuberculosis (TB)
transmitted through airborne particles Protection: N95 mask detected with skin PPD test Elective surgeries should be postponed until pt no longer infectious non-elective performed at end of day
Is urine considered to be sterile?
Fluids that can be considered infectious?
Blood, bloody fluids
Peritoneal/ synovial fluids
What is the single most important action in prevention of the spread of infection?
What is the recommended minimal amount of time to scrub hands?
If spraying or splashing of fluids is anticipated during surgery, what should be worn?
Mask, eye protection, gowns
What goes in the blue contamination bags?
Needles or other sharps go in what bin?
The reusable gowns go in which container?
For all airborne precautions, you should wear what PPD(device)/PPE(equipment)?
Do not have contact with mumps,measles, or rubella unless immune
What procedure is done to a person who tested positive on a PPD?
Chest x-ray (CXR)
T OR F: All patients are treated as if they have a communicable blood and/or body fluid infection?
removal of foreign material
chemical germicide for use on living tissue
chemical germicide for use on non-living items
completely free of all microorganisms
process that results in probability of microorganism survival on an item is <1:1000000
What are the disinfection levels?
High level- kills fungi, viruses, and vegetative bacteria (no endospores)
Intermediate-level: kills fungi, large viruses, and bacteria (no endospores)
low-level : kills fungi, some viruses and bacteria (exception TB endospores)
T or F: Any item which comes in contact with mucous membranes but does not penetrate body surface must be washed and cleaned with high-level disinfectant
Define simple cleaning:
soap and water
Define antiseptic cleaning:
substance that has antimicrobial activity and that can be applied to living tissue
Define steam sterilization:
autoclaving: kills everything b/c of pressure and temperature
15 min @ 121C
10 min @ 126C
3.5 min @ 134*C
confirmed by indicator strip on inside of tray
What is the most widely used of the chlorine disinfectants and used on tables, floors, and equipment?
What food allergies are also associated with latex allergy?
avocado, kiwi, banana, chestnuts, stone fruit
What past medical history can be associated with latex allergy?
When do you want to schedule surgeries for patients who have latex allergy?
First cases of the day
Betadine allergy patients can also be allergic to?
Which vein carries the lowest risk of catheter related infections?
Describe the best prevention for IV catheter related infections:
full body wraps when placing catheter
transparent, semi-permeable dressings