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Patient Care I > Infection Prevention > Flashcards

Infection Prevention Flashcards

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1
Q

In a dental setting what serves as a reservoir for pathogens

A

air water and fomites

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2
Q

Healthcare associated infection (HAI)

A

refers to an infection acquired during the delivery of healthcare in any setting

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3
Q

microorganisms in the mouth and respiratory tract can be transported in ___

A

aerosols, slash/spatter, during dental procedures

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4
Q

Chain of infection (3 elements)

A
  1. a source or reservoir (contaminated air water or fomites
  2. susceptible host (portal of entry receptive to the agent/exposure to an adequate number of sufficiently
    virulent microorganisms)
  3. Mod of transportation (agent from the source to the host)
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5
Q

Infection control strategies intend to do what?

A

break one or more of the links -> preventing disease transmission

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6
Q

Pathogens associated with healthcare are derived from?

A

primarily human sources BUT contaminated objects and environmental sources are also implicated

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7
Q

Who can pass on pathogens

A

someone with an acute infection, in the incubation (subclinical) phase, or is asymptomatic

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8
Q

Factors that affect someone’s susceptibility

A

age
physical conditions
medications
underlying medical conditions
immunizations

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9
Q

consequences of being a susceptible host

A
  1. infected but remain asymptomatic
  2. colonization to symptomatic disease either immediately or after a period of asymptomatic latency
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10
Q

Aerosols

A

a liquid or solid particle less than 50 micrometers in diameter

stay airborne for an extended period before settling on environmental surfaces or enter respiratory tract through inhalation

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11
Q

droplets and droplet nuclei

A

0.5 - 1.0 micrometers in diameter have potential to enter lungs and settle within the pulmonary alveoli (HIGH RISK of infection transmission in the dental office)

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12
Q

Splash and Splatter

A

a mixture of air, water, and/or solid substances larger than 50 micrometers in diameter and are visible to the naked eye (ex. Blood; sneezes)

only airborne briefly - limited penetration to the respiratory system

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13
Q

droplets

A

airborne particles of moisture > 5 unit microns

limited to 3 feet of the source

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14
Q

droplet nuclei

A

residuals of droplets ranging from 1-5 unit microns that dry out while suspended in air.

droplet nuclei may remain in the air indefinitely and travel beyond 3ft from source.

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15
Q

Human hair is how big?

A

60-120 microns wide

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16
Q

percentage of nuclei in the dental office is less than 5 microns in size

A

95%

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17
Q

what size of microns can reach the epiglottis area of the throat?

A

5-10 micron

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18
Q

what size can reach deep down into the bronchi?

A

<5 microns

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19
Q

high speed handpieces ; ultrasonic scalers ; air/water syringes =

A

aerosols

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20
Q

dental plaque is major source of microorganisms, containing how many pathogens?

A

more than 700 known pathogens

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21
Q

how are pathogens transferred

A

direct or indirect contact

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22
Q

direct contact

A

transmission occurs when pathogens are transferred between individuals WITHOUT a contaminated intermediate

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23
Q

what could be a contaminated intermediate?

A

person
object
environmental surface

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24
Q

Indirect contact

A

transmission occurs when pathogens are transferred between individuals VIA a contaminated intermediate person object or surface

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25
Respiratory Transmission
ALSO CALLED airborne transmission may result from inhalation of droplets from inhalation of droplet nuclei
26
Direct Transmission happens through
broken skin mucosal contact
27
Indirect transmission happens through
contaminated instruments surfaces
28
Droplet transmission through
sneezing coughing
29
Virulence is
ability to cause infection and damage easily colonizes grows rapidly produces harmful substances evades / counters body's defenses
30
2 types of resistance
Innate Acquired
31
Innate resistance is
physical (skin, mucous membranes) Mechanical (secretions, cilia) Chemical (stomach acid)
32
Acquired resistance is
cell-mediated (antibodies)
33
Immunity is
a condition of being able to resist a particular disease especially through preventing development of a pathogenic microorganism
34
Requirements for infection
Susceptible host pathogen (sufficient numbers) Portal of entry mode of transportation
35
stages of infection
incubation prodromal acute or period of illness convalescent or decline
36
incubation
the time between exposure and sings and symptoms
37
prodromal
the period between the appearance of initial symptoms and the full development early signs and symptoms - not yet clinically specific or severe
38
acute or period of illness
the signs and symptoms of the disease are most obvious specific and severe
39
convalescent or decline
of pathogens begin to decrease signs and symptoms decline patients may become susceptible to developing secondary infections because their immune systems have been weakened
40
Causes of disease emergence
microbial changes breakdown in public health measures ecological changes changes in human demographics behaviors international travel and commerce
41
sanitization
process of physical cleaning to reduce the quantity of microbes and bioburden
42
process of sanitization
use of disinfectant and paper towel on surfaces use of soap and brush on instruments ultrasonic on instruments *ALL should be done BEFORE sterilization or disinfection
43
Sterilization
Destruction of ALL microbial forms (including spores) term intends absolutely destruction but probability of pathogenic or other organisms can never be reduced to zero
44
kinds of sterilization
heat (most common - used at SOD) filtration radiation chemical
45
In oral healthcare settings the primary sterilizing methods are
steam under pressure dry heat
46
what are used to sterilize heat sensitive instruments
germicides like chemical sterilant and high/intermediate/low level disinfectants
47
Antiseptics
a substance that stops or slows down the growth of microorganisms used on living tissue ex. skin / mucous membranes
48
Alcohol as an antiseptic
alcohol coagulates the protein in bacteria 30% solution with water penetrates bacteria and is more effective than 100%
49
Disinfection
less lethal than sterilization doesn't destroy spores and certain resistance microorganisms applied to inanimate objects and environmental surfaces (our target for cubical preparation)
50
Disinfectants are not used on what?
Skin not used for tissue antisepsis due to it being toxic to skin
51
Liquid chemical disinfectant requirements
surface must be cleared of debris first adequate contact time correct temperature correct pH correct concentration
52
High level disinfectant
kills ALL pathogens but not all bacterial spores extended contact (3-10 hours) use on environmental surfaces is inappropriate AKA chemical sterilant
53
High level disinfectant is used for
heat sensitive critical and semi critical items *Not used in dentistry
54
Intermediate level disinfectant
destroys Mycobacterium TB ; most fungi ; most viruses ; vegetative bacteria does NOT kill bacterial spores labeled as tuberculocidal disinfectants
55
What doe we use to disinfect dental operative surfaces at UMKC
intermediate level disinfectant (cavicide)
56
surface disinfectant categories (2)
dual quaternaries alcohol
57
dual quaternaries
surface disinfectant most types in this category use at UMKC
58
Alcohol
surface disinfectant Unacceptable for instruments and surfaces evaporates rapidly does NOT kill spores does not work in presence of blood and saliva
59
Low level disinfectant
kills most vegetative bacteria and some viruses and fungi used for floors and walls in dental settings
60
what categorization system is used for sharps and instruments
spaulding's classification system *categories by potential risk of infection
61
According to spaulding patient care items can be categorized as
critical semi critical non critical
62
critical items
penetrate soft AND hard tissues confer a high degree of risk for infection if contaminated with pathogens EX. explorers ; scalpels ; burs ; scalers ; needles ; carpules *must be sterilized
63
semi critical items
contact but do not penetrate (non sharp items that enter the oral cavity EX. amalgam condensers ; mirrors ; reusable impression trays ; hand pieces ; suctions *must be sterilized or for heat sensitive high level disinection
64
non critical items
items that do not enter the oral cavity but may be touched come in contact with skin but not mucous membranes EX. bracket table ; counter tops ; chair controls ; light handles ; computer keyboard ; tray ; door knobs *require disinfectant or plastic barrier
65
What happened in response to the HIV epidemic in the mid 1980s
all blood and body fluids contaminated with blood were to be treated as infectious
66
in 1996 the CDC expanded universal precautions into what?
the concept of standard precautions
67
standard precautions
basically treat everyone as infectious
68
Controls to infection prevention (3)
administrative controls engineering controls work practice controls
69
Administrative controls are
policies procedures and enforcement measures targeted at reducing the risk of occupational exposure to infectious persons
70
Engineering controls are
devices that isolate or remove the risk of exposure to bloodborne pathogens in a workplace EX. instrument cassettes ; sharps containers ; needle recapping devices
71
Work practice controls are
procedures that reduce the likelihood of exposure to infectious materials by altering the manner in which a task is performed ex. replacing sharps container when full ; recapping a needle using the one handed scoop technique
72
OSHA: regulated waste
blood or other potentially infectious material in liquid or semi liquid state items caked with dried blood that may release it contaminated sharps pathological / microbiologic waste with blood or other potentially infectious material
73
Regulated medical waste ; UMKC Red biohazard bag
solid waste soaked/saturated with blood or saliva *dripping or squeezable dried on fluid that could flake off contaminated sharp items anesthetic carpules surgically removed hard and soft tissue
74
Ultrasonic cleaners
use high frequency sound waves and cavitation to loosen and remove debris 16x more effective than scrubbing less potential to injure self *visible debris must be removed to not interfere with sterilization and disinfection process
75
Autoclave
steam under pressure most dependable most common standard cycle 250 F ; 15 PSI ; 20min dulls instruments
76
Flash Sterilizers
Steam 273 F ; 20 PSI ; 3-10 min not intended for sole method of sterilization
77
Dry Heat
320 F ; 2 hr 338 ; 1 hr long cycle handpieces wont tolerate poor penetration doesn't dull cutting edge
78
Chemiclave
Steam under pressure with chemical vapor shorter cycle and less corrosive chemical vapor is hazardous
79
Sterilization monitoring is done by
Spore testing weekly spore test results should be maintained for at least 1 year
80
common reason to fail a spore test is
overloading the sterilizer
81
3 types of latex reactions
irritant contact dermatitis allergic contact dermatitis immediate allergic reaction (latex hypersensitivity)
82
what percentage of health care workers have some form of latex allergy
5-10%
83
Irritant Contact dermatitis
not an allergic skin reaction least threatening type due to repeated exposures dry itchy burning irritated areas
84
allergic contact dermatitis
Type IV delayed reaction hypersensitivity may take 23-48 hours to develop from time of exposure may result from allergy to chemicals used in glove manufacturing more severe reaction can spread and lasts longer
85
latex allergy
type 1 (immediate) hypersensitivity to natural rubber latex proteins reactions include nose, eyes, and skin reactions more serious reactions include urticaria bronchospasm/respiratory distress rarely shock or death
86
how to minimize contact dermatitis
dry hands completely before donning gloves only use latex free gloves only use gloves WITHOUT powder

Patient Care I (6 decks)

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