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PPPVN > Hygiene, handwashing and hospital design > Flashcards

Hygiene, handwashing and hospital design Flashcards

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1
Q

Why is regular handwashing needed?

A

Remove bacteria and reduce level of residual bacteria

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2
Q

When do you need to wash your hands?

A

Before aseptic procedures

Before and after touching patients and their surroundings

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3
Q

How should you wash your hands properly?

A

Antimicrobial soap or alcohol based sanitiser

Use WHO handwashing protocol

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4
Q

What are the general requirements for hand hygeine?

A

Bare below elbows
Short clean and bare nails
Cover cuts in water proof dressing

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5
Q

Describe the stages of the WHO handwashing procedure

A 
Wet hands and apply soap
Palm to palm
Palm over back of hand with interlocked fingers (both sides)
Palm to palm with fingers interlocked
Hands clasped around each other with fingers interlocked
Rotational thumb rubbing
Clean fingers on palms
Rinse hands and dry
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6
Q

Why is infection control important?

A

Prevent HAI
Keep staff and patients safe
Maintain public health

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7
Q

How to clean kennels appropriately

A

Remove bedding and wash at 60 degrees
Remove organic material then remove any traces with detergent
Use disinfectant correctly
Wipe top to bottom

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8
Q

Define disinfectant

A

Killing or removal of microorganisms

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9
Q

Define antiseptic

A

Similar to disinfection but on living tissue

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10
Q

Define detergent

A

Solution with cleaning activity to remove organic matter

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11
Q

Define sterilisation

A

Removal of all microorganisms including spores

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12
Q

Define asepsis

A

Complete removal of all microorganisms including spores resulting in complete sterile state

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13
Q

How do bacteria exist in the environment?

A

Spores- dormant

Vegetative- living and replicating

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14
Q

What is the effect of viruses lipid envelope when trying to disinfect?

A

More easily removed as disinfectant removes lipid layer making it vulnerable

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15
Q

What are features of the ideal disinfectant?

A 
Broad spectrum
Non-irritant and non-toxic
Easy to use
Stable and not easily inactivated
Cost effective
Rapid action
Remains on surface for contact time
Not deactivated easily
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16
Q

What needs to be considered when choosing disinfectant?

A

Whats it being used on
Amount of organic matter involved
Contact time
Dilution

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17
Q

How do alcohol disinfectants work, what are they used for and what is an example?

A 
Cause cell membrane damage
Fast acting but no residual activity
Broad spectrum effect except against enveloped viruses and spores
Hand disinfection and patient prep
Surgical spirit
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18
Q

How do aldehyde disinfectants work, why aren’t they used and what is an example?

A

Denatures proteins, broad spectrum
Toxic and possible carcinogenic
Formaldyhyde

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19
Q

How do biguanide disinfectants work, what are they used for and what is an example?

A

Alters cell membrane permeability but inactivated by organic matter, good residual action.
Effective against bacteria, some fungi but not spores
Used for patient prep or surgical scrub
Chlorhexidine

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20
Q

How do halogen disinfectants work, what are they used for and what is an example?

A

Destroys proteins in cells
Broad spectrum
Cleaning surfaces and skin
Bleach

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21
Q

How do QAC disinfectants work, what are they used for and what is an exmaple?

A 
Inactivate enzymes and denature proteins
Some residual activity
Broad spectrum but not against unenveloped viruses or spores
Surface disinfection
Anigene
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22
Q

How to phenol disinfectants work, what are they used for and what is an example?

A

Denature proteins and disrupt cell membranes
Broad spectrum but not against unenveloped viruses or spores
Surface disinfection
Dettol

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23
Q

What is meant by a hospital acquired infection?

A

Infections acquired by patients during hospitalisation of acquired up to 30 days father discharge

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24
Q

What are common HAI?

A

UTIs
Pneumonia
Blood stream infections
Diarrhoea

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25
What are some of the consequences of hospital acquired infections?
Client dissatisfaction Longer hospitalisation Higher morbidity Multidrug resistance
26
What are common routes of infection of HAI?
``` Urinary catheters Surgery IV catheters or blood taking Implants Feeding tubes Contamination between patients ```
27
What are risk factors for HAIs?
``` Elderly Young Immunocompromised Invasive devices Endocrine disease ```
28
How are UTIs acquired in hospitals?
Urinary catheters main cause from repeated placement or poor hygiene
29
What are the signs of UTI?
Pyrexia | Colour or smell change in urine
30
How to correctly insert urinary catheter to prevent UTI?
Wash hands and wear sterile gloves Clean and clip area Used closed system collection bag Avoid repeated placement and remove as soon as possible
31
What is the main cause of blood stream infections?
IV catheter use especially central lines when placed/maintained with poor hygeine
32
How to prevent bloodstream infections from catheterising?
Wash hands Clean and clip area Use sterile equipment Remove catheter as soon as possible and avoid repeated placement
33
How to prevent infectious diarrhoea?
Wash hands and clean accommodation thoroughly between patients Regularly deep clean facilities Limit transport in and out of ward when there is an outbreak
34
What equipment is the main cause of pneumonia in patients?
ET tubes, circuits so need cleaning properly or disposing if cant clean
35
What is the most common type of pneumonia and how is it prevented?
Aspiration, mainly when under GA | Starve patients before anaesthesia, secure airway ASAP and keep head elevated until cuff is inflated
36
How to prevent superficial or systemic surgical infections?
Adequately prepare skin and personnel, use good theatre practice Keep wound covered for 24-48 hours and only change when dirty or damaged
37
What are some ways to prevent HAI?
Initial telephone calls can flag infection Use SOPs between patients Correctly dispose bodily fluids and waste Handwashing Barrier nursing when appropriate Infection control team monitors and makes changes
38
Where should you house those with poor immune status?
In normal wards but reverse barrier nusre
39
What is mean by reverse barrier nursing?
Nursing those with poor immune systems before those with strong immune systems
40
Where should you house those with strong immune systems?
Normal ward
41
Where should you house those with mild infectious disease?
In ward or isolation When in ward use separate area, PPE and own equipment Isolate when with immunocompromised patients
42
Where should you house severely infectious patients?
Isolation with barrier nursing
43
What are the features of isolation facilities?
``` At least 5m away from other patients Dedicated nurse Disposable items where possible Patient has own equipment PPE on entrance Use bedding wash bags to avoid handling Use of SOPs Minimise owner visits ```
44
What is meant by HAIs being opportunistic?
Take advantage when patient is already compromised
45
When should you suspect a resistant infection?
Not responding to antibiotics or is at risk
46
How is resistant infections avoided?
Limit antibiotic use Hand hygiene Education of veterinary team Report incidences to track any issues
47
What is MRSA?
Methicillin resistant staphylococcus areus
48
What issues to MRSA cause and how should you treat it?
Issues- unhealing wounds, sepsis | Treating- strict isolation
49
What are the 5 freedoms that must be provided to patients?
``` Freedom from pain, injury and disease Freedom from hunger and thirst Freedom from discomfort Freedom from fear and distress Freedom to express normal behaviour ```
50
What considerations need to be in place for boarding environments?
Enough space to express normal behaviour Able to disinfect Enrichment and company when approptriate
51
What considerations need to be in place for animals in hospital environments?
Space to express normal behaviour unless needs restricting or being disturbed due to injury or treatment Be able to sterilise Enrichment and company when appropriate
52
What do you need to consider in hospital design regarding different species housing?
Different area for cats, dogs, exotics and isolation
53
What are the key features of different structural materials?
Concrete- appropriate outdoors, time consuming to clean, cheap, reflects temperature of environment Tiles- avoid, hard to clean, slippery and cold Stainless steel- cheap, manufactured to fit, easy to clean, slippery, loud and reflective Fibreglass- hardwearing, easy to clean, hard to ventilate but good for oxygen therapy
54
What are the ventilation requirements in hospitals?
Clean air at least 4-8 changes per hour and more in isolation to reduce likelihood of airborne infections Allows humidity and temperature control
55
What are the different ways of ventilating?
Active- extractor fans, aircon | Passive- windows and doors
56
What temperature should the hospital be at and why?
18-22 degrees | Helps mould and damp prevention and keeps everyone comfortable
57
How can temperature be regulated in hospitals?
``` Underfloor/central heating Aircon heating systems Radiators Heat lamps, pads Fans ```
58
What are the different types of bedding that can be used?
``` Fleece Blankets Towels Covered foam wedges Newspaper Incontinence pads Bean bags ```
59
What are advantages and disadvantages of fleece bedding?
Adv- reusable, absorbent, warm | Dis- expensive, chewable
60
What are advantages and disadvantages of blankets and towels for bedding?
Adv- reusable, washable, warm | Dis- expensive, non- draining
61
What are advantages and disadvantages of covered foam wedges for bedding?
Adv- reusable, support for recumbency | Dis- chewable
62
What are advantages and disadvantages of newspaper bedding?
Adv- some warmth, cheap | Dis- disposable, staples, ink leaking, no padding
63
What are advantages and disadvantages of incontinence pads?
Adv- some warmth, absorbent | Dis- disposable, no padding, expensive
64
What are advantages and disadvantages of bean bags for bedding?
Adv- reusable, insulating, comfortable, support | Dis- only cover is washable
65
What needs considering for patients when putting them in kennels?
Temperament | Disease and injury
66
How is the best way to approach and house animals when unsure on temperament?
Hands free when possible Keep lead not slip attached Keep on flood level Never keep muzzle on
67
How to move patients when in pain?
Slide where possible not lift
68
What needs considering about mobility of patients?
Whether its acute or chronic | Ambulatory/walking or non-ambulatory
69
How to manage recumbent patients?
Thick bedding Incontinence sheets Vet beds to wick away urine Enough space to lift patients
70
What do critical hospitalised patients needs?
Constant monitoring | Rapid access to life support
71
How should infectious patients be hosptalised?
Barrier nursing Isolation Housed at bottom

PPPVN (14 decks)

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