Infection control Flashcards and Podcast

Community-onset infection

An infection acquired outside a healthcare setting.

Healthcare-associated infection (HAI)

An infection acquired after exposure to a healthcare environment.

Hospital-acquired or nosocomial infection

The older term commonly replaced by healthcare-associated infection.

Sources of HAIs

Hospitals, clinics, nursing homes, long-term care facilities, and other healthcare environments.

Typical onset of HAIs

Usually begins at least about 24 hours after admission or healthcare contact.

Importance of HAIs for hospitals

They worsen outcomes, increase length of stay, and increase healthcare costs.

Impact of HAIs on financial performance

Longer stays and complications can reduce financial performance.

Pathogen associated with healthcare settings

Pseudomonas aeruginosa.

Resistant organism associated with HAI

MRSA.

Prevalence of HAIs in hospitalized patients

About 1 in 31.

Most important infection-control measure

Hand hygiene.

Methods for hand hygiene

Handwashing with soap and water or alcohol-based hand rubbing.

Hand rubbing

Using alcohol-based gel or foam sanitizer.

Three elements for transmission of infection

A source of pathogens, a route of transmission, and a susceptible host.

First required element in infection transmission

A source of pathogens.

Common human sources of pathogens

Blood, secretions, body fluids, skin, and other contaminated materials.

Second required element in infection transmission

A route of transmission.

Third required element in infection transmission

A susceptible host.

Patients especially susceptible to infection

Immunocompromised patients.

Susceptibility of oncology patients to infection

Their immune systems may be suppressed.

Major transmission routes emphasized in healthcare

Contact, droplet, and airborne.

Most frequent mode of transmission in the healthcare environment

Indirect contact.

Direct-contact transmission

Transfer of pathogens through direct skin-to-skin or person-to-person contact.

Examples of direct-contact transmission

Skin contact, kissing, sexual contact, or direct contact with contaminated soil or vegetation.

Organisms/diseases associated with direct contact

Hepatitis A, HIV, and Staphylococcus aureus.

Indirect-contact transmission

Transfer of an infectious agent through an intermediate object, particle, or vector.

Common healthcare example of indirect transmission

Using a contaminated stethoscope on another patient.

Cleaning reusable equipment between patients

It can act as a vehicle for indirect transmission.

Pathogens associated with indirect transmission

Pseudomonas and hepatitis B.

Vehicle in infection transmission

An inanimate medium that carries an infectious agent.

Examples of vehicles

Food, water, biological products, and fomites.

Fomite

An inanimate object that can transmit pathogens.

Common examples of fomites

Doorknobs, stethoscopes, phones, and other contaminated objects.

Damp object as a vehicle

Warm, moist conditions may encourage microbial growth.

Vector

A living organism that carries an infectious agent.

Common examples of vectors

Mosquitoes, fleas, and ticks.

Vector transmitting malaria

Mosquitoes.

Vector associated with Lyme disease

Ticks.

Droplet transmission

Transmission by relatively large, short-range respiratory particles.

Particle size associated with droplets

Greater than 5 micrometers.

Activities that produce respiratory droplets

Coughing, sneezing, talking, and singing.

Droplet spread classified as direct transmission

The droplets must directly contact a susceptible person’s mucous membranes.

Mucous membranes receiving infectious droplets

Eyes, nose, and mouth.

Infections associated with droplet transmission

Diphtheria, pertussis, and influenza.

Distance traveled by large respiratory droplets

About 3–5 feet.

Why droplets travel only short distances

They are relatively large and heavy and fall out of suspension.

Airborne transmission

Transmission by very small infectious particles that remain suspended in the air.

Particle size associated with airborne transmission

Less than 5 micrometers.

Airborne particles remaining suspended

They are small and stable enough to remain in the air.

Difference between airborne and droplet transmission

Airborne particles remain suspended longer and can travel farther.

Classic airborne disease example

Tuberculosis.

Another airborne disease example

Measles.

Settled infectious dust becoming airborne hazard

It can be resuspended into the air.

Obligate airborne transmission

A disease naturally transmitted only by the airborne route.

Example of obligate airborne transmission

Tuberculosis.

Preferential airborne transmission

A disease that can spread by multiple routes but is transmitted predominantly through the air.

Example of preferential airborne transmission

Measles.

Opportunistic airborne transmission

A disease usually spread by another route that can become airborne under certain conditions.

Example of opportunistic airborne transmission

COVID-19.

Procedures creating airborne particles

Aerosol-generating procedures.

Aerosol-generating respiratory procedures

Intubation and bronchoscopy.

Increased risk for respiratory therapists during procedures

They can produce small infectious particles that remain airborne.

Major infection-control strategy in hospitals

Creating a culture of safety.

Culture of safety involves

Shared commitment to protecting patients and healthcare workers.

Empowering healthcare workers in a safety culture

Speak up when they observe unsafe infection-control practices.

Another major infection-control strategy

Maintaining a healthy workforce.

Avoiding sick healthcare workers caring for vulnerable patients

They can become a source of infection.

Maintaining a healthy healthcare workforce

Vaccinations, infection-prevention practices, and appropriate postexposure care.

Chemoprophylaxis definition

Medication given to prevent infection after a potential exposure.

When healthcare worker may require chemoprophylaxis

After a needlestick or exposure to potentially infectious blood or body fluids.

Exposure that may require chemoprophylaxis

HIV exposure.

Where to report occupational exposure

Employee health or the appropriate occupational-health service.

Environmental strategy to eliminate pathogen sources

Cleaning, disinfecting, and sterilizing equipment and spaces.

Importance of environmental services in infection prevention

They help maintain clean, disinfected healthcare environments.

Who requires a protective environment

Immunocompromised patients.

Patients commonly requiring protective environments

Oncology and transplant patients.

Major goal of a protective environment

Minimize fungal spores and other environmental pathogens.

Filtration used in protective environments

HEPA filtration.

What HEPA filtration helps remove

Airborne particles, including fungal spores.

What OSHA stands for

Occupational Safety and Health Administration.

OSHA’s role in infection control

Establishing and enforcing workplace safety requirements.

Employee vaccinations mentioned for infection prevention

Hepatitis A, hepatitis B, varicella, rubella, measles, and annual influenza vaccination.

Organizations influencing infection-control standards

EPA, FDA, CDC, Joint Commission, and OSHA.

Three equipment classifications based on infection risk

Critical, semicritical, and noncritical.

Critical equipment definition

Equipment that enters sterile tissue, the bloodstream, or normally sterile areas.

Level of processing required for critical equipment

Sterilization.

What sterilization must destroy

All microorganisms, including bacterial spores.

Examples of critical equipment

Surgical instruments, intravascular catheters, implants, dialysis components, and bronchoscopes.

Semicritical equipment definition

Equipment that contacts mucous membranes but does not enter sterile tissue.

Level of processing generally required for semicritical equipment

High-level disinfection.

Respiratory equipment identified as semicritical

Ventilator circuits, humidifiers, and airway-related equipment.

Noncritical equipment definition

Equipment that touches only intact skin.

Level of processing generally appropriate for noncritical equipment

Cleaning with low- to intermediate-level disinfection as needed.

Examples of noncritical equipment

Pulse oximeter probes, blood pressure cuffs, face masks, and the exterior of ventilators.

Cleaning definition

Removal of foreign material, soil, and organic matter.

First step in reducing microbes on equipment

Cleaning.

Disinfection definition

Inactivation of most pathogenic microorganisms, generally excluding bacterial spores.

Low-level disinfection definition

Inactivation of most bacteria and some viruses and fungi, but not TB organisms or bacterial spores.

Intermediate-level disinfection definition

Inactivation of vegetative bacteria, most viruses and fungi, and TB organisms, but not bacterial spores.

High-level disinfection definition

Inactivation of essentially all microorganisms except some bacterial spores.