Healthcare epidemiology and Gram+ and Acid Fast Bacilli Flashcards

1
Q

What is the definition of endemic?

A

occurring at a relatively constant state

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2
Q

What is the definition of epidemic?

A

occurring at a greater than expected frequency; suddenly see numbers clearly in excess of normal expectancy (disease-chronic or infectious, injury, or health related event)

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3
Q

How is incidence rate determined?

A

(# new cases for a time period/ population at risk) x 100

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4
Q

How is prevalence rate determined?

A

(# existing cases for a time period/ population at risk) x 100

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5
Q

How is relevant risk assessed?

A

incidence rate (exposed)/ incidence rate (not exposed)

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6
Q

what are some of the healthcare associated infections?

A

acinetobacter, varicella, C. Diff, MRSA, VISA, norovirus, legionella, VRE, TB, S. Pneumoniae, Group A Strep, CMV, SARS, Rubells, Influenza, Mumps, Hep A, B and C, Aspergillus, CJD, and atypical mycobacter

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7
Q

What are the leading nosocomial epidemics for hospitals?

A

S. Aureus, Resistant B (MRSA, VRE), Legionella, Aspergillus, Bacteremia, Gastroenteritis, and Hepatitis

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8
Q

What are the leading nosocomial epidemics for nursing homes?

A

Influenza, TB, Gastroenteritis, Conjuctivitis, URIs and scabies

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9
Q

How are outbreaks found?

A

surveillance, lab reports, other healthcare institutions, public health officials; in the end most discovered by observant healthcare personnel

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10
Q

Who does surveillance, how is it done, and why?

A

by epidemiologists, provides ideal information since rates are tracked overtime, may not be timely, review labs and chart notes to watch trends of various diseases

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11
Q

What are the steps in an epidemic investigation?

A

establish presence of epidemic, communicate and/or control, analyze outbreak, form hypothesis, test hypothesis and complete investigation

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12
Q

How do you establish the presence of an epidemic?

A

develop case deifinition, look at case findings, look for reporting artifacts, check the denominator, check baseline data, determine nature, location and severity of problem

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13
Q

how is a case definition developed?

A

initial case definition should be narrow enough to focus efforts but broad enough to catch all possible cases; scope depends on pathogen (spread, incubation, etc)

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14
Q

How is an epidemic communicated to others and cotroled? What is the focus?

A

implement emergency control measures (what is potential for spread), look for new cases, inform and minimize fears, prevent surprises

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15
Q

Who are interested parties in an epidemic?

A

patients, other health workers, facility administration, media (can be good or bad) and lawyers

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16
Q

What is the goal when implementing control measures?

A

stop transmission, not necessarily find the source, ok to implement a variety of measures targeting various possibilities based on initial observation (droplet, airbone, etc)

17
Q

How is an outbreak analyzed?

A

line listing of variables, graph- cases vs time, study epidemic curve (primary, secondary, recurring), calculate attack rates, do analyses (analyze ariables, simple statistics), verify diagnosis (update case definition)

18
Q

What are sources of information in a hospital to utilize for line listing of variables? What are you looking for?

A

log books (OR, ER, Nursing unit, ICU), microbio records, employee health records, infection control surveillance data, MR, Op notes, Path reports, Pharm records, Rdiology reports, hospital billing, central-service records, purchasing records; common factors in sick patients but not healthy

19
Q

How is attack rate calculated?

A

(cases exposed to a factor/ total patients exposed to a factor) x 100

20
Q

what goes into forming a hypothesis?

A

look at precipitating events, confounding factors, characterize outbreaks by etiology, sources and transmission, and review literature

21
Q

what is a pseudo-outbreak? causes?

A

situation in wchi there is a rise in positive culture results without evidence of disease; may be surveillance artifact: new definition, new practitioners, new area or pop surveyed, change in culture/test frequency, new medical procedures

22
Q

How is a hypothesis tested?

A

collect more data (cultures, special micro studies), institute control measures and see if epidemic stops, evaluate control measures, causality v. association, case control v cohort study

23
Q

Why use pulse field gel electrophoresis?

A

may be different sources of the same thing, can id which share the same source

24
Q

What must be done to complete an investigation?

A

thorough written report (CDC disseminates to other clinicians to learn from, track, etc.), keep records, keep isolates, educate, communicate continuously

25
Q

what is something important to note about an outbreak investigation?

A

not linear or orderly, multiple steps simultaneously, steps are often repeated several times

26
Q

What is a community source for information for a line list of factors?

A

public health question ill and those exposed to ill