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NPTE > Safety and Protection; Professional Responsibilities; Research > Flashcards

Safety and Protection; Professional Responsibilities; Research Flashcards

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1
Q

Standard precautions

A

for the care of all patients regardless of infection or diagnosis

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2
Q

Transmission based precautions

A

airborne
droplet
contact

These are in addition to standard precautions

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3
Q

Airborne Precautions

A

Private negative pressure room

N95 or higher respirator when entering room. Pt should be wearing surgical mask.

examples: measles, varicella (chickenpox), TB, SARS

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4
Q

Droplet Precautions

A

Requires close contact; infectious agents travel 3-6 feet or less

Private room but door can be open

Pts in the same room need to be 3 ft apart

Pt and healthcare professional need to be wearing a mask especially when going to be 3-6 feet apart

examples: meningitis, pneumonia, sepsis, flu, mumps, strep

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5
Q

Contact Precautions

A

skin-to-skin transmission

Private room

Pts in same room should be 3 ft apart

Gloves and gown

examples: GI, respiratory, skin or wound infections (C-diff, E coli, MRSA)

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6
Q

Donning PPE

A

hand hygiene
gown
mask
goggles
gloves

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7
Q

Doffing PPE

A

gloves
goggles
gown
mask
hand hygiene

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8
Q

Sterile field

A

gowns are only sterile in the front from the waist up, including sleeves

only top of surfaces are sterile

talking, sneezing or coughing will contaminate the sterile field

do not turn your back to a sterile field; constant observation of sterile field is required.

If object on the sterile field becomes contaminated the field is considered non-sterile and should be discarded.

Sterile fields should be prepared as close to the treatment time as possible

Anything that falls below the waist is considered contaminated

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9
Q

Asepsis

A

elimination of microorganisms that cause infection and the creation of sterile field

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10
Q

Nosocomial infection

A

hospital acquired

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11
Q

PT response to allergic reaction

A

First try to remove source.
Then check airway
Then Epipen if have it

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12
Q

PT response to Autonomic Dysreflexia

A

First placed in upright position
identify noxious stimulus
monitor vitals and call for assistance

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13
Q

PT response to a burn

A

Initially remove source
Liquid chemical-dilute with water
Powder chemical- brush off
Thermal burn- under cool tap water
Burn covers a large area- cold water should not be used as it can increase risk for hypothermia.
Electrical burn-HR and RR should be assessed

All clothing or jewelry near burn should be removed unless it is in the burn itself.

Clean towel or dressing over wound to prevent infection.

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14
Q

PT response to fractures

A

peripheral pulses and sensation should be assessed distal to injury

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15
Q

Signs of Ketoacidosis that occurs with hyperglycemia

A

fruity breath
deep, labored breathing
N/V
dry tongue

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16
Q

If there is arterial bleeding…

A

intermittent pressure to artery proximal to site of injury
If blood flow is excessive, then extremity should be elevated above level of heart.
Prolonged pressure with tourniquet should be avoided.
After 10 minutes of steady pressure, call EMS.

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17
Q

After seizure do what with pts head

A

turn to side in case they vomit

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18
Q

Positioning of pt when in shock

A

supine with feet elevated above the level of head

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19
Q

Fowler’s position

A

supine with HOB elevated between 45-60 degrees with knees supported

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20
Q

Semi-fowler’s position

A

supine with HOB elevated 30-45 degrees

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21
Q

Fowler’s positions and its variations are used for

A

cardiac conditions
respiratory conditions
breathing difficulties
those with NG tube

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22
Q

Trendelenburg is used for

A

postural drainage
hypotension
medical emergencies like hypovolemic shock

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23
Q

Workstation recs:
Monitor size
Monitor display direction
Monitor set how far
How many exercise breaks
Space under desk

A

18-20 in

10 degrees below horizontal

at least 20 inches away

30 second breaks every hour

30 in wide
19 in deep
27 in high
2-3 inches between top of thighs and desk

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24
Q

Elbows should be bent to what when working

A

90-120 degrees

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25
Employment provisions for disabilities (Title I) applies to who? Title II, Public accommodations applies to who?
employers of 15 or more all businesses regardless of size
26
ADA does not require employers to make accommodations that pose what
undue hardship (significantly difficult or expensive)
27
Ramps should possess
12 inches of horizontal run for each inch of vertical rize. 8.3% grade
28
Ramp should be how wide? with ..... if rise is greater than 6 inches or horizontal run of greater than 72 inches. Needs a level ..... at the top and bottom. If ramp changes direction, the landing area must be a minimum of what?
36 inches HR landing 5x5
29
Doorways need to be how wide? Deep? Thresholds in doorways need to be less than ___ inch for sliding doors and less than ___ inches for regular doors. Hallway clearance needs... W/c turning radius: width and length
32 inches 24 inches 3/4 1/2 36 inches 60 inches 78 inches
30
Validity
closeness to the truth
31
Impact
size of effect
32
Applicability
usefulness in clinical practice
33
PICO
Patient or problem Intervention Comparison Outcome
34
Levels of Evidence Hierarchy from most reliable to least
systematic reviews and meta-analyses RCTs Cohort studies case control studies cross-sectional studies case series case reports ideas/opinions
35
Cohort study
longitudinal, observational study prospectively or retrospectively from historical records
36
The measure of association between exposure and disease in cohort studies is known as
the relative risk
37
Limitations of cohort studies
excessive length influence of other lifestyle variables
38
Case control study
retrospective, observational study already have a particular disease matched with a comparison group of individuals without the disease
39
Measure of association between exposure and occurrence of disease in case control studies is the
odds ratio (the ratio of odds of exposure in disease subjects to the odds of exposure in non-diseased subjects)
40
Cross-sectional study
observational study where the data or observations are made at only one point in time and all subjects are tested at relatively the same time aims to describe relationships between a disease or condition and factors of interest that exist in a specified population at a given time. These studies cannot distinguish between newly occurring and long-established conditions, nor can they identify causal relationships.
41
Case reports or case series cannot
test hypotheses or establish cause and effect relationsips
42
Exploratory research
examines dimensions of a phenomenon of interest and its relationships to other factors. Examples: cohort studies, case control studies, historical research and methodological studies
43
Descriptive research
recording, analyzing, and interpreting conditions that exist for the purpose of classification and understanding a clinical phenomenon. Examples: developmental research, normative research, qualitative research, case report, case series
44
Experimental research
Comparing 2 or more conditions for the purpose of determining cause and effect relationships between independent or dependent variables. Examples: RCTs, quasi-experimental studies and single-subject designs
45
Assent
childs affirmative agreement to participate in research.
46
A childs failure to object should
not be construed as agreement
47
Belmont Report articulated three ethical principles that guide human subjects' research
respect beneficence justice
48
Continuous data
can assume any value along a continuous scale Examples: ROM, distance, weight, time
49
Discrete data
measured in whole units Examples: HR, those diagnosed with cancer, # of PT visits
50
Dichotomous data
type of discrete data with only two values Examples: pass or fail, smoker or non-smoker
51
Qualitative data
Examples: eye color, blood type and hand dominance
52
Nominal
each object or person can only be assigned to one category. Qualitative Examples: blood type, type of breath sound, type of arthritis
53
Ordinal
ranking Examples: MMT, level of assistance, pain
54
Interval
Intervals between adjacent values are equal but there is no true zero point. Examples: temp, some developmental and functional status tests
55
Ratio
intervals between adjacent values and there is a true zero point. Examples: ROM, distance, time, nerve conduction velocity
56
Reliability
reproducibility or repeatability of measurements
57
Internal consistency
measurement relates to function
58
Intrarater reliability
same person
59
Interrater reliability
more than one person
60
Test-retest reliability
same individual on separate occasions
61
Validity
degree to which a useful or meaningful interpretation can be inferred from a measurement
62
Face validity
tests what its supposed to
63
Content validity
measurement reflects meaningful elements of a construct and items test the interested elements Examples: MPQ has more content validity than a visual analog scale because it assesses location, quality and duration of pain
64
Construct validity
theoretical construct is measured by a test Examples: MMT have this for nerve innervation if there is a relationship between scores and EMG testing
65
Criterion-related validity
established by comparing it to a different measurement that is considered the gold standard
66
Concurrent validity
form of criterion interpretation is justified by comparing measurement to the gold standard at the same time. Examples: HR by palpation and ECG if they are associated
67
Predictive validity
form of criterion if a measurement is considered predictive of future behavior Example: GRE or GPA for admission to predict future academic success
68
Prescriptive validity
form of criterion measurement suggests the form of treatment each person should receive based on successful outcome of treatment. Examples: measurement of asystole on ECG if patients with this arrhythmia are successfully revived with CPR.
69
Sampling error
chance between statistic calculated from a sample and true value of the parameter in population
70
Sampling with replacement
putting those selected for the sample back into population before next unit is drawn. This results in units having an equal chance of being selected Rarely used on human subjects
71
Sampling without replacement
not replacing and results in decreasing size of population
72
Simple random sampling
table of random numbers or random number generator not the most statistically efficient method
73
Systematic sampling
taking every nth subject
74
Stratified random sampling
divided into subgroups (strata) then a simple random sample is done. this helps with representation of key subgroups of population
75
Cluster sampling
clustered together and then random clusters are sampled
76
Non-probability sampling
does not involve random selection
77
Independent variable
intervention or condition
78
Dependent variable
outcome or response
79
Completely randomized design
randomly assigned and each group receives a unique intervention and they are compared at the end.
80
Crossover design
subject receives both treatments in random order with a period of no treatment
81
Factorial design
two or more independent variables investigated
82
Repeated measures design
subjects are tested under all conditions and each person acts as their own control.
83
Sequential clinical trial
data analyzed as they become available so trial can be stopped as soon as evidence is sufficient to show a difference
84
Quasi-experimental design
one without control group, random assignment or both
85
One group pretest and posttest design
time is independent variable, with two levels (pretest and posttest)
86
One way repeated measures design over time
measurements made on one group of subjects at multiple, prescribed time intervals Intervention can be administered once or may be repeated
87
Time series design
multiple measurements made before and after treatment to observe patterns or trends during pre and post treatment periods
88
Internal validity is when there is
confidence that the intervention caused the outcome
89
Double blind
subjects and some of the research team are unaware of hypothesis and group each subject was assigned to
90
Triple blind
subject, some of the research team and data analyzers unaware
91
When an effective treatment is available, it is
unethical to use placebo
92
Matching pairing classical example
identical twins
93
Intention to treat analysis
all subjects randomly assigned to one of the treatments are analyzed together regardless of whether they received or completed treatment
94
External validity
degree to which the results of research can be generalizable to populations or circumstances beyond those in the study
95
Hawthorne effect
untreated subjects experience changes just by participating in study.
96
Alternate hypothesis
differs from null hypothesis.
97
Null hypothesis
statistical hypothesis
98
p-value
probability that a particular statistical result could have happened by chance.
99
When the p-value is smaller than the stated alpha value the null hypothesis
is rejected
100
When p-value is larger than states alpha value, the null hypothesis
is accepted
101
Alpha level
significance level probability of rejecting the null when it is true (chance of committing a type I error) Traditional values= 0.05- 0.01
102
Type I error (alpha error)
wrongly deciding to reject the null hypothesis concluding there is a difference when there isnt. a false positive
103
If the level of significance is set at 0.01 there is a ___% chance of a Type I error.
1
104
Type II error (beta error)
wrongly deciding to not reject the null hypothesis deciding there is no difference when there is a false negative
105
Statistical power
refers to chance that a statistical test will lead to rejection of false null hypothesis
106
Larger the effect size, the more likely it will be
statistically significant
107
Effect size index: <0.1= 0.1-0.3= 0.3-0.5= >0.5=
trivial effect small effect moderate effect large effect
108
Minimal clinically important difference
smallest difference in a patient's conditions that the patient or clinician considers worthwhile
109
Minimal detectable difference
smallest difference or change that would be statistically significant
110
Parameter
greek letters for mean, standard deviation
111
Statistic
english letters used for mean and standard deviation
112
Forest plots are used in
meta-analyses
113
Histogram is a
frequency distribution
114
Line graphs
relationship between two or more quantitative variables variable on y-axis=dependent variable x-axis= independent ideal for showing trends
115
Scatter plot
relationship between two quantitative variables
116
Step and leaf plots
observe entire distribution of data without losing any information
117
Descriptive stats
summarize or describe important characteristics of a population
118
Kurtosis
peakedness of a distribution
119
Within a normal distribution: 68% of all values fall within ___ SD. 95% of all values fall within ___SD. 99% of all values fall within ___SD.
1 2 3
120
Negatively skewed distribution
mean and median are to the left of mode and left tail is elongated
121
Positively skewed distribution
mean and median are to the right of mode and right tail is elongated
122
20th percentile is
value or score below which 20% of scores are found
123
Standard Deviation
measure of the spread or dispersion of data
124
Inferential stats
uses sample data to make inferences about a population test hypotheses parametric or nonparametric
125
ANOVA
test the equality of means between two or more populations
126
One way ANOVA
one independent variable is examined
127
Two way ANOVA
two or more independent variables examined
128
Regression analysis
predicts change in one or more independent variables affecting dependent variables
129
Confidence interval
range of values used to estimate a population parameter
130
Confidence level
probability that the confidence interval actually contains the unknown population parameter.
131
Pearson product moment correlation (r)
-1.0- +1.0 Positive sign= two variables increase or decrease together Negative sign= increase in one variable is associated with decrease in other 0= no relationship
132
t-test
estimates a population mean or compares two means when the population is normally distributed and variance is unknown
133
paired t-test
samples are matched pairs
134
independent t-test
differences between male and females for example because cannot be in both groups
135
z-test
estimating the mean or comparing two means
136
Nonparametric
do not assume that samples come from populations that are normally distributed and do not assume homogeneity of variance usually applied to nominal, ordinal, interval or ratio data are not normal
137
Kruskal-Wallis test
equivalent to one way ANOVA
138
Mann-Whitney test
alternative to independent t-test
139
Spearman rank correlation coefficient
equivalent to Pearson product
140
Wilcoxon Signed Rank test
alternative to dependent or paired t-test
141
Sensitivity
test positive for those that have the disease
142
Specificity
test negative for those that do not have the disease
143
SpPin
test with high specificity= positive diagnostic test rules in the diagnosis.
144
SnNout
test with high sensitivity=negative diagnostic test rules out the diagnosis
145
Relative risk of 1.0= greater than 1.0= less than 1.0= aka
event is equally probable in both groups exposure increases risk exposure decreases risk risk ratio
146
Odds ratio of 1.0= >1.0= <1.0= aka
exposure probably does not increase risk of developing disease exposure may increase risk of getting disease may reduce risk relative odds
147
Number needed to treat
of patients that need to be treated to prevent one bad outcome or result in one good additional outcome. ideal number=1 higher the number the less effective the treatment
148

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