Chapter 2: Prevention and Risk Management Strategies

risk management

identification, assessment, and application of resources to minimize, monitor, and control the probability and impact of unfortunate events

standard precautions

minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where health care is delivered

communicable disease

condition or illness that can be spread from one person or species to another

infectious disease

medical condition caused by the growth and spread of small, harmful organisms within the body

pathogen

an agent that causes infection or disease, especially a microorganism, such as bacterium, virus, or fungus

host

organism that harbors a pathogen, providing nourishment and shelter

microbes

relating to a microorganism (e.g. bacterium) causing disease

antimicrobial

agent that kills microorganisms or stops their growth

antibiotic

drug that kills or stops the growth of bacteria; examples include penicillin and ciprofloxacin

vaccine

a substance used to stimulate the production of antibodies and provide immunity against one or several diseases; usually an agent resembling a disease-causing microorganism or a weakened or dead form of a microbe

latent infection

a hidden or dormant infection that is asymptomatic but capable of manifesting symptoms under particular circumstances or if activated

active infection

a virus or bacterium that is actively replicating and potentially causing symptoms; opposite of a latent infection

transmission

passing a pathogen-causing communicable disease from an infected host to an individual to cause infection

fomite

any nonliving object or substance capable of carrying infectious organisms and hence transferring them from one person to another

nosocomial

of or pertaining to a hospital, especially infections acquired in the hospital setting

colonized

when a disease-causing organism is present in or on the body but is not casing illness; a HCP can be colonized and become a carrier and spread infection to other health care workers and patients

hand hygiene

cleaning hands by using handwashing (washing hands with soap and water), antiseptic hand wash, antiseptic hand rub (alcohol-based hand sanitizer including foam or gel), or surgical hand antisepsis

health care-associated infection (HAI)

infection from receiving medical treatment in a health care facility—a major, yet preventable, threat to patient safety

bacteremia

presence of bacteria in the blood, which is usually a sterile environment

sepsis

potentially life-threatening complication of an infection in which chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body

carbapenems

antibiotics used for the treatment of infections known or suspected to be caused by multidrug-resistance (MDR) bacteria, primarily used for people who are hospitalized

catheters

flexible tube inserted through a narrow opening into a body cavity for removing fluid, particularly the bladder

immunity

ability of an organism to resist infection by the action of specific antibodies or sensitized white blood cells

gastroenteritis

inflammation of the lining of the stomach and intestines, causing an acute onset of severe vomiting and diarrhea

antibiotic resistance

ability of bacteria to resist the effects of an antibiotic, the bacteria are not killed, and their growth is not stopped; resistant bacteria survive exposure to antibiotics and continue to multiply in the body, potentially causing more harm and spreading to other animals or people

multidrug-resistant organisms (MDROs)

microorganism with resistance to multiple antibiotics that pose a serious threat for hospitalized patients

methicillin

an antibiotic that is a beta-lactam and semisynthetic derivative of penicillin, formerly used in the treatment of bacterial infections caused by Staphylococcus bacteria, which have becomes resistant to commonly used penicillin-related antibiotics (e.g. methicillin-resistant S. aureus, or MRSA)

beta-lactams

class of broad spectrum antibiotics, consisting of all antibiotic agents that contain a beta-lactam ring in their molecular structures, including penicillin derivatives (penams), cephalosporins (cephems), monobactams, and carbapenems

vancomycin

antimicrobial drug often used to treat infections caused by enterococci

occupational exposure

reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials (OPIM) that may result from the performance of the employee's duties

parenteral route

delivery of medications outside the gastrointestinal system, usually through injection or insertion of an indwelling catheter

other potentially infectious materials (OPIM)

any body fluid that is visibly contaminated with blood and all body fluids in situations where is it difficult or impossible to differentiate between body fluids

exposure control plan (ECP)

required by the standard precautions ensuring that procedures are in place to protect health care providers from exposures to blood and other body fluids

aseptic technique

preparation of equipment or anatomic site prior to an administration of medication or procedure, in a manner to avoid contamination of the equipment and site in an effort to reduce chances of infection caused by the procedure or medication deliver; procedure performed under sterile conditions

percutaneous exposure incident

also called needlestick injury, the penetration of skin by a needle or other sharp object, which was in contact with blood, tissue, or other body fluid before the exposure

reprocessing

sterilization, disinfection, or cleaning of a reusable medical device

germicide

a substance that kills germs or other microorganisms; an antiseptic

antiseptics

substance applied to living tissue or skin to reduce the possibility of infection

sterilization

process that eliminated, removes, kills, or deactivates all forms of life and other microbial agents (bacteria, viruses) present in a specified region, such as a surface, a volume of fluid, or medication

biohazardous materials

waste contaminated with potentially infectious agents (e.g. blood, body fluids, and human cell lines), or other materials considered a threat to public health or the environment

sharps

medical devices with sharp points or edges that can puncture or cut skin (e.g. needles, scalpels)

Good Samaritan laws

legal protection for someone who voluntarily renders aid to an injured person during an emergency; the law grants immunity, if an error is made while rendering emergency medical care, there can be no legal liability for damages in court

Protected health information (PHI)

any information about health status, provision of health care, or payment for health care that can be linked to a specific person

Health Insurance Portability and Accountability Act (HIPAA)

U.S. Federal law that sets the standard for protecting sensitive patient data and protected health information

Privacy Rule

national standard for protection of individuals' medical records and other personal health information and applies to health plans, health care facilities, and health care providers that conduct health care transactions electronically

covered entity

a provider of health care services and any other person or organization that furnishes, bills, or is paid for health care in the normal course of business; health care providers (e.g. physicians, hospitals, and clinics) are covered entities if they transmit health information in electronic form in connection with a transaction for which a HIPAA standard has been adopted

notice of privacy practices

pamphlet or brochure that focuses on privacy issues and concerns, prompting people to have discussion with their health care providers and exercise their rights

electronic health record (EHR)

a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting; EHRs typically contain information such as the patient's demographics, contact information, vital signs, allergies, medical history, current and past medications, immunizations, radiology reports, and laboratory data

willful neglect

conscious, intentional failure or reckless indifference to the obligation to comply with the administrative simplification provision violated

unsecured PHI

an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information

Family Educational Rights and Privacy Act (FERPA)

federal law that protects the privacy of student education records and applies to all public schools

electronic medical records (EMRs)

digital version of the traditional paper-based medical record; the EMR represents a medical record within a single facility, such as a doctor's office or a clinic

health informatics

acquiring, storing, retrieving, and using health care information to foster better collaboration among a patient's various HCPs

patient/prehospital care report (PCR)

document of all patient care and pertinent patient information that serves as a method for data collection

against medical advice (AMA)

also called discharge against medical device (DAMA), a term used when a patient leaves a health care facility or refuses treatment against the advice of the health care provider; widespread ethical and legal consensus is that competent patients (or their authorized surrogates) are entitled to decline recommended treatment