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Flashcards in infection control Deck (31):
1

nosocomial

infection appears more than 48 hours after hospital admission or less than 48 hours after discharge

2

5 categories of nosocomial infection

1. UTIs
2. surgical site infections
3. pneumonia
4. blood stream infections
5. GI infections (C. diff associated Diarrhea- CDAD)

3

interventions that breach barriers

1) Catheter associated UTI
2) surgeries
3) ventilator-associated pneumonia (VAP
4) central-line associated BSI (BLABSI)

4

5 strategies to reduce HAIs

1) hand hygiene
2) source control
3) isolation
4)cleaning/disinfection
5) antimicrobial stewardship

5

contact precautions

antibiotic resistant organisms

avian influenza

chickenpox (VZV)

6

Contact Precautions require

standard precautions PLUS:

1. private room
2. gloves, gown for entry and transport
3. clean hands between tasks
4. dedicated equipment

7

droplet precautions

1. mycoplasma pneumoniae

8

droplet precautions require:

standard PLUS

1. private room
2. mask and eye proteciton within 3 ft
3. mask patient if must leave room
4. clean hands between tasks

9

airborne/aerosol precautions

1. Avian influenza
2. pulmonary TB
3. Measles
4. Chickenpox
5. Smallpox
6. SARS

10

airborne/aerosol precaution requirements:

standard PLUS

1. negative pressure private close room with air exhausted through HEPA filter or outdoors
2. Closed door
3. Respirator Mask (n-95)-- fitted mask, no leaks!!!
4. mask patient out of room
5. controlled entry to visitors/personnel
6. notification

11

positive pressure

protection for NON-infectious, at risk patients (i.e. kidney transplant, burns)

Air pushed out of the room so no infectious agents from outside can get in.

12

Negative Pressure

for people with airborne precautions

provides source isolation for infectious patients. Air sucked into the room so infectious particles don't leak out

13

ethylene oxide

gaseous sterilant-- penetrates VERY well

very toxic, but very effective (you need 24 hours to de-gas after you've gassed)

14

plasma (hydrogen peroxide) gas

gas treated with EM --> free radicals and it is non-toxic (end up with oxygen and water)

non-toxic!

15

Formaldehyde, glutaraldehyde

irritant, smelly, carcinogenic-- so we don't like to use them

16

many disinfectants will not kill what?

spores

17

germicide refers to disinfectant or sterilization?

disinfection

18

high-level disinfection

- kills everything but high spore load, Mycobaterium


- examples:
1. Bleach (HYPOCHLORITE)
2. lower level of chemical sterilant (i.e. ethylene oxide, plasma),
3. less heat
4. aldehydes [GLUTARALDEHYDE, FORMALDEHYDE]
5. O2 based [HYDROGEN PEROXIDE, OZONE, PERACETIC ACID]
6. halogens [POVIDONE IODINE, HYPOCHLORITE]

19

intermediate-level disinfectant

- iodophores
-alcohols [ETHANOL, ISOPROPANOL]
-phenolics [chloroxylenol, hexachlorophene]

will kill vegetative bacteria (non-spore), some viruses, some fungi

20

low-level disinfection

1. quaternary ammonium compound [BENZALKONIUM CHLORIDE]
2. triclosan


- will kill vegetative bacteria, enveloped viruses or larger ones, and some fungi

21

antiseptics are used to disinfect what? and what are 3 examples?

live tissue

1) alcohols [ ethanol, isopropanol] - intermediate
2) Chlorhexidine
3) iodophores - intermediate

22

antiseptics cannot kill what?

spores

23

what antiseptic can kill mycobacterium?

betadine

24

what process can kill coxiella?

pasteruization

25

ultrapasteurization can kill what?

spores (high temp, short time)

26

surfactant MOA

mechanical removal of microbes

27

spaulding scheme

let's us know how clean things need to be.

Critical-- breach barriers i.e. scalpel (sterilization)

semi-critical-- items contact broken skin or mucous membranes (sterilization or high-level)

non-critical i.e . BP cuff-- skin contact only (mid or low level OK)

28

example of what needs to be sterilized

bacterial spores (bacillus atrophaeus) and coccidia (cryptosporidium)

29

examples of what needs high- level disinfectant

mycobaterium (M. TB, M. Terrae)

30

example of what needs intermediate-level disinfectant

nonlipid or small-sized viruses (i.e. Polio, coxsackie, noro)

fungi (aspergillus, Candida)

31

examples of what requires low level disinfectant

vegetative bacteria (s. aureus, P. aerginosa)

Lipid or medium-sized viruses (i.e. HIV, herpes, hep B)