Infection Prevention & Control (IPC) Questions and Complete Solutions Graded A+

Infection Prevention & Control (IPC) Questions and Complete Solutions Graded A+ Purpose of IPC - Answer: Prevent healthcare associated infections (HAI) HAI (Healthcare Associated Infection) - Answer: An infection acquired as a consequence of a healthcare intervention (e.g. infection acquired during surgical procedure). Can occur in any health care setting. Any microorganism can be the source of an HAI. The risk of HAI can be reduced by understanding and following IPC practices Chain of Infection - Answer: 1. Infectious agent (the bug) 2. Reservoir or source. Mostly people are the source 3. Portal of exit. How bug gets out of the host (usually through an opening in body; orifice) 4. Transmission. How bugs get to site 5. Portal of entry. How bugs get into the host 6. Susceptible host. E.g. If someone with chicken pox encounters someone who hasn't had chicken pox, that person is a susceptible host Have to have all steps in order to get an infection. Interrupt the chain of infection to protect the patient and prevent spread b/w people Types of Transmission - Answer: 1) Contact 2) Droplet 3) Airborne Contact Transmission - Answer: Includes: i) Direct -Direct transfer of organisms b/w people through non-intact skin, splash into eye ii) Indirect contact -Hands, patient care equipment, environmental surfaces -Happens all the time iii) Droplet -Coughing, sneezing, talking Droplet Transmission - Answer: Coughing, sneezing, talking Airborne Transmission - Answer: Dissemination of very small infectious agents. Remain viable and float over long distances when suspended in the air. Have to actually inhale the bug (not spread by contact or droplet). TB and chickenpox most common Transmission Based Precautions - Answer: When know how microorganism is spread, know how to prevent transmission. Helps guide routine practices Routine Practices - Answer: What healthcare workers are expected to do when interacting w/ patient. Are basic IPC measure which: -Assume all patients are carrying microorganisms that can be transmitted and are potentially pathogenic -Prevent exposure to blood, body fluids, secretions, excretions, contaminated surfaces, equipment -Are used for all patients at all times in all clinical settings -Provide protection of self, other staff, patients, vicitores Elements of Routine Practices - Answer: -Patient screening, assessment and patient placement -PCRA -Hand hygiene -Respiratory etiquette -PPE (personal protective equipment) -Environment and equipment cleaning Point of Care Risk Assessment (PCRA) - Answer: All about thinking ahead and what is going to happen with the patient. For each patient interaction, perform a point of care risk assessment to determine: -Degree of patient contact anticipated -Tasks to be performed -Potential for contamination with bloody/body fluids, non-intact skin or infectious agents Select PPE based on PCRA. Identify strategies to decrease exposure risk and prevent transmission of microorganisms Hand Hygiene - Answer: Single most important practice to reduce transmission of infectious agents. Clean hands with alcohol based hand rubs (ABHR) unless visibly soiled. AHS policy (ABHR is #1 choice, no artificial nails/chipped polish, minimal jewelry). AHS approved moisturizer is encouraged 4 Moments of Hand Hygiene - Answer: Thinking about the patient and their whole environment. *Environment is anything patient or you encounter* 1. Before initial patient/patient environment contact 2. Before aseptic procedure 3. After body fluid exposure risk 4. After patient/patient environment contact How to Use ABHR - Answer: 1) Apply product to palm of one hand. Get enough product on hands to keep them wet for at least 15s 2) Rub all surfaces of your hands and wrists 3) Include fingertips and thumbs 4) Rub until hands are completely dry Personal Protective Equipment (PPE) - Answer: -Gloves -Gowns -Masks/N95 respirators -Eye protection/face shields *The PPE you choose are based on your assessment of the patient, environment, care you will provide.* Gloves, gowns, masks, eye protection are contaminated if you have been in treatment room Gloves - Answer: Reduce amount of bioburden exposure. Are not required for every interaction. Gloves do not replace hand hygiene (clean hands before and after Gowns - Answer: Protect clothing from contamination Surgical/Procedure Mask - Answer: Protect nose and mouth from splashes and sprays Face Shields/Eye Protection - Answer: Protect eyes from splashes and sprays. If need a mask, need eye protection N95 Respiratory - Answer: Prevents airborne particles from being inhaled into lungs. Fit-testing is required every 2 years MRSA (Methicillen-Resistant Staphylococcus aureus) - Answer: Type of staph bacteria that is resistant to cloxacillin. Often carried on skin. Can cause serious infections in hospital and community. Contact precautions required. Screen inpatients for MRSA as outlined in the Admission Screening Form. 3 -ive screens off antibiotics to discontinue precautions in consultation with IPC VRE (Vancomycin Resistant Enterococcus) - Answer: Type of gastrointestinal bacteria resistant to vancomycin. Very hardy (can survive in environment for months). Contact precautions required. 3 -ive screens off antibiotics to discontinue precautions in consultation with IPC CDI (Clostridium difficile Infection) - Answer: Bacteria that causes diarrhea. Risk factors include age, immunosuppression, antibiotic use. Symptoms include watery diarrhea, fever, loss of appetite, nausea, abdominal pain/tenderness. Contact precautions required. Precautions can be discontinued after 48 hours of normal stool in consultation with IPC Shingles - Answer: A reactivation of the virus (VZV) that causes chicken pox. A patient can only present with shingles if they haven't had chicken pox in the past. More likely to reactive in people with severely compromised immune systems. If have not had chicken pox in past, can get chicken pox from having contact with someone with shingles. If have had chicken pox, you are immune to VZV and will not develop chicken pox or shingles Contact Precautions - Answer: Wear gown and gloves. Single room recommended w/ dedicated equipment Contact & Droplet Precautions - Answer: Wear mask, eye protection (gown and glove only if assisting with care). Single room recommended w/ dedicated equipment Airborne & Contact Precautions - Answer: Wear N95 respirator (gown and gloves only if assisting with care). Single room with negative air pressure, door closed, dedicated equipment Airborne Precautions - Answer: Wear N95 respirator. Single room w/ negative air pressure and door closed Why will routine practices be used in CancerControl Alberta ambulatory care areas for patients who are colonized with an ARO (MRSA, VRA, ESBL, CPO)? - Answer: -Promote a consistent patient experience -Align with current IPC Guidelines which recommend use of routine practices for patients who are colonized with an ARO -Focusing prevention strategies on symptomatic patients at higher risk of transmission will support safe care for patients and staff -Routine practices used for all patients will prevent transmission of AROs and other microorganisms spread by the contact route Screening and Risk Assessment - Answer: Assess patients for active infection before and/or at every patient risk (be more proactive). Remind patients to let staff know if they develop new signs and symptoms of infection during treatment time. Patients may be asked to contact facility if signs and symptoms of infection develop Respiratory Etiquette - Answer: Cough and sneeze into a tissue and discard tissue promptly. Clean hands after coughing, sneezing, blowing nose. Masks, tissues, hand sanitizer available for patients and staff Classification of Medical Devices - Answer: Non-Critical Semi-Critical Critical Non-Critical - Answer: Contact with only intact skin. Cleaning to remove bioburden, visible and invisible Semi-Critical - Answer: Contact with mucous membranes/non intact skin. Cleaning followed by high-level disinfection Critical - Answer: Enter sterile tissue or vascular system. Cleaning followed by sterilization Medical Devices and Equipment - Answer: Medical devices and equipment become contaminated during use. All reusable equipment must be adequately reprocessed after each use. Ensure clean/sterile supplies are stored separately from dirty/contaminated supplies to prevent cross-contamination Contaminated Surfaces - Answer: Environmental surfaces have same bugs as patient. Bacteria can survive for DAYS on surfaces. Think about what is clean and what is dirty and keep the two separate Priorities to Prevent HAIs - Answer: Routine practices for every patient, every time -PCRA -Hand hygiene -Assess patients for symptoms of infection -PPE -Respiratory etiquette -Clean equipment and environment -Keep clean and dirty separate