PMLS LEC-2

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Measles

is a viral infection that starts in the respiratory system which causes a red, blotchy rash that usually appears first on the face and behind the ears, then spreads downward to the chest and back and finally to the feet.

T

T/F

Dengvaxia posed risk to individuals vaccinated without having a prior dengue infection.

hazards

Safety begins with the recognition of ___, is achieved through the application of knowledge, and maintained through vigilant awareness.

Universal Precautions (UP)

Mandates that personnel should treat all blood and blood-contaminated samples as potentially infectious.

F

T/F

Universal Precautions treat other bodily fluids that are not visibly contaminated with blood as potentially infectious.

Standard Precautions (SP)

are the 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.

F

T/F

The Standard Precaution is a set of infection control work practices designed to reduce the risk of transmission between patient to patient interactions.

T

T/F

The Standard Precaution must be practiced
in the treatment and care of all patients regardless of their infectious status.

F

T/F

Infection can be controlled mainly through the

prevention of the chain of infection.

T

T/F

the first priority of infection control is containing the source of any infection: the patient.

INFECTIOUS AGENT

which link will break?

eliminating or inactivating the agent, preventing the agent from exiting the reservoir, sterilizing surgical instruments

RESERVOIR

which link will break?

treating infectious individuals, vaccination, handling and disposing of body fluids appropriately,

PORTAL OF ENTRY

which link will break?

performing appropriate hand hygiene, using aseptic technique when required, applying best practice techniques with wound and catheter care

MODE OF TRANSMISSION

which link will break?

ensuring transmission between objects or people does not occur; use appropriate barriers, safe practices, spatial separation, engineering controls, hand hygiene, environmental sanitation, and equipment disinfection/sterilization.

PORTAL OF EXIT

which link will break?

implementing safe practices such as covering coughs and sneezes, handling body fluids with gloves, performing appropriate hand hygiene, and containing draining wounds.

SUSCEPTIBLE HUMAN HOST

which link will break?

including measures such as immunizations, good nutrition, recognition and treatment of high risk patients

Influenza

Patient X

Patient’s respiratory tract

Airborne transmission

Mucous membranes

Watchers, the healthcare worker

\

A patient X is admitted to the infectious ward for a severe respiratory disease called Influenza. The patient is isolated from other patients but then began coughing in an airconditioned room, and guidelines in the infectious ward enforce a strict policy in the use of personal protective equipment of healthcare workers.

\
Infectious Agent – ?

Reservoir- ?

Portal of Exit – ?

Mode of Transmission - ?

Portal of Entry – ?

Susceptible Host – ?

\

Occupational safety

is a foundation of knowledge that must be ingrained in every professional’s mindset and general work habits allows them to function seamlessly while reducing the risk of inflicting harm onto themselves or to others.

Occupational Safety and Health
Administration

is a governing body founded in the United States responsible for ensuring and monitoring the implementation of work standards in all fields, including the medical field.

OSH Act

is a set of standards providing employees,
including clinical laboratory personnel, a safe work environment.

Occupational Safety and Health Standards

1989

RA 11058

198-18

One of the standards stemming from the OSH Act is the _____ in 1978 formulated by the Department of Labor and Employment. It was amended in ____,__ and follows another revision through the passage of ____.__ Department Order _____ implements the rules and regulations set by this law

“hierarchy of controls”

Occupational safety and health professionals use a framework called the ___________ to select ways of dealing with workplace hazards.

1. Engineering controls

2. Administrative controls

3. Work practices

4. Personal protective equipment (PPE)

what is the order of “hierarchy of controls”

1-4

Engineering controls

These types of controls are preferred over all others because they make permanent changes that reduce exposure to hazards and do not rely on worker behavior.

Engineering controls

Examples include:
▪ Chemical Fume Hoods
▪ Biological Safety Cabinets (BSCs)

Administrative controls

are those that modify workers’ work schedules and tasks in ways that minimize their exposure to workplace hazards.

Administrative controls

Examples include:
▪ Developing a Chemical Hygiene Plan
▪ Developing Standard Operating Procedures for chemical handling

Work practices

are procedures for safe and proper work that are used to reduce the duration, frequency or intensity of exposure to a hazard.

Work practices

Examples include:
▪ No mouth pipetting
▪ Chemical substitution where feasible (e.g., selecting a less hazardous
chemical for a specific procedure)

F

T/F

When defining safe work practice controls, it is a good idea for the employer to ask the supervisors for their suggestions, since they have firsthand experience with the tasks as actually performed.

Personal Protective Equipment (PPE)

is protective gear needed to keep workers safe while performing their jobs.

T/F

In general, control measures are usually directed against the segment in the infection chain that is most susceptible to intervention, unless practical issues dictate otherwise.

controlling or eliminating

For some diseases, the most appropriate intervention may be directed at __________the agent at its source.

soil

In the community, ____may be decontaminated or covered to prevent escape of the agent.

isolation

Interruption of direct transmission may be accomplished by _____ of someone with infection,

elimination or decontamination

Vehicle-borne transmission may be interrupted by _________ of the vehicle.

promoting handwashing.

To prevent fecal-oral transmission, efforts often focus on rearranging the environment to reduce the risk of contamination in the future and on changing behaviors, such as ____

ventilation; filtering or treating

For airborne diseases, strategies may be directed at modifying __ __or__ air pressure, and ______ the air.

vector population

To interrupt vector-borne transmission, measures may be directed toward controlling the _____

protect portals of entry

what chain of infection protects this?

bed nets are used to protect sleeping persons from being bitten by mosquitoes that may transmit malaria.

protect portals of entry

what chain of infection protects this?

Wearing of long pants and sleeves and use
of insect repellent are recommended to reduce the risk of Lyme disease and West Nile virus infection,

Vaccinations

_____ promote development of specific antibodies that protect against infection.

T

T/F

prophylactic use of antimalarial drugs, recommended for visitors to malaria-endemic areas, does not prevent exposure through mosquito bites, but does prevent infection from taking root.

increase a host’s defenses.

Vaccinations and prophylactic drugs are interventions that aims to?

herd immunity

The concept of _____ suggests that if a high enough proportion of individuals in a population are resistant to an agent, then those few who are susceptible will be protected by the resistant majority, since the pathogen will be unlikely to “find” those few susceptible individuals.

phlebotomy

has the potential to expose health workers and patients to blood from other people, putting them at risk from bloodborne pathogens.

malaria and syphilis

Diseases such as ___and____may also be transmitted via contaminated blood, and poor infection control practices may lead to bacterial infection where the needle is inserted and contamination of specimens.

F

T/F

Serious adverse events linked with phlebotomy are common and may include loss of consciousness with seizures.

blood transfusion services

The best documented adverse events are in _________, where poor venipuncture practice or anatomical abnormality has resulted in bruising, hematoma and injury to anatomical structures in the vicinity of the needle entry.

T

T/F

Injuries from sharps commonly occur between the use and disposal of a needle or similar device.

F

T/F

One way to reduce accidental injury and blood exposure among health workers is to always perform proper handwashing techniques.

T

T/F

Safety devices can avoid up to 75% of percutaneous injuries; however, if they are disassembled or manually recapped, or if the needle safety feature is not activated, exposure to blood becomes more likely.

F

T/F

Needle recapping and immediately disposing of the sharp into a puncture-resistant sharps container markedly reduces needle-stick injuries

washing hands before and after working

after removing

One of OSHA's primary requirements for phlebotomists is _______ with patients, ____ personal protection equipment such as gloves, and anytime they are exposed to blood or anything else that may carry infection.

red; bio-hazardous

OSHA regulations require containers to be sealable, resistant to punctures, leak-proof and easily accessible. The container must be color-coded___ and labeled __"______."

employee

Acc. to OSHA, Personal protective equipment protects the _____ from contact with blood or other infectious materials.

F; must be properly disinfected to remove any possible infection.

T/F

Reusable materials that are exposed to blood or other infectious matter must be disposed in a container immediately.

Oxacillin

Resistance to this antibiotic is dangerous as treatment becomes more difficult.

F; years of careless prescription for antibiotics.

T/F

The existence of S. aureus bacteria resistant to this antibiotic is due to years of wrong bacterial culture methods

Methicillin-resistant

all the patients who were originally in the pediatric ward immediately begin treatment for MRSA, or _______ Staphylococcus aureus.

T

T/F

Infection control is important due to increasing incidence of healthcare-associated infections caused by antibiotic-resistant organisms

F

T/F

A Healthy lifestyle is important due to more susceptible patients are admitted in healthcare facilities, such as very old or young patients, immunosuppressed individuals, patients undergoing invasive diagnostic procedures, and patients suffering from chronic diseases

T

T/F

Infection control is important due to the emergence of highly transmissible life-threatening infections

Philippine Hospital Infection Control Society (PHICS); 1992

was founded on ______ to develop, implement and sustain effective strategies in preventing and controlling healthcare-associated infections.

2004

on ______, SARS outbreak leads to talks in developing standards in collaboration of DOH and NGO professional societies (PHICS, PHICNA, and PSMID) after the SARS outbreak.

2012

On _____, Creation of the National Center for Health Facility Development Technical Working Group for the development of the National Policy on Infection Prevention and Control

2016

when was the sign and release of the National Policy on Infection Prevention and Control

National Policy on Infection Prevention and Control

is the standards used in the development of infection control procedures in healthcare facilities such as hospitals and clinics.

Office of the Chief of Hospital.

In the National Policy on Infection Prevention and Control, the standard requires an Infection Control Committee under the ______

Infection Control Committee

formulates the policies, guidelines, and procedures followed by the hospital, ensures their implementations, and ensures the availability of resources for these policies.

F; Infection Control Committee

T/F

The OSHA is also responsible for disseminating necessary information and coordinates with medical, nursing, administration, and other hospital committees.

Physician, Nurse, and

Representatives from:
a. Microbiology laboratory
b. Nursing Service
c. Special and High Risk Units
d. And other departments

As a multidisciplinary committee, the members of the ICC are made up of the following:

1\.

2\.

3\.

c

which does not belong in the Basic Infection Control:

a. Protection of healthcare workers

b. Isolation Precaution

c. Urinary catheter care

d. Decontamination, Disinfection, Sterilization;

\
\
\
\

a & d

which does not belong in the procedures on prevention of healthcare-associated infection:

a. Special Areas and High Risk Units

b. In-dwelling Intravascular Device Care

c. Respiratory care

d. Regular rooms/ wards

a and c

which does not belong to the policies on Housekeeping procedures:

a. Wound care

b. Outpatient department

c. Burn Unit, Trauma ward

d. Isolation rooms

b, c, e

which does not belong to the procedures for Specific Patient Care areas:

a. Dental Clinic

b. Radiology

c. Patient transport facilities

d. Emergency Room

e. Special Areas and High Risk Units

a,b,d,e

which belongs to the procedures for Hospital Auxiliary Service Departments/Units:

a. Sterile Supply Service

b. Mortuary care and management

c. Environmental Care and Healthcare Waste Management

d. Pharmacy

e. Clinical Laboratory

healthcare-associated infection

can be defined as “an infection occurring in a patient during the process of care in a hospital or other healthcare facility, which was not present or incubating at the time of admission.”

Nosocomial infections,

is an infection that is acquired in a hospital or other health care facility.

T

T/F

Nosocomial infections, also known as hospital-acquired infections,

T

T/F

Nosocomial infections are often caused by improperly sterilized or unsterilized healthcare
equipment.

Candida albicans yeast infections

________can occur from improperly sterilized gynecological equipment,

pneumonia

____ can occur from improperly sterilized ventilators or air conditions.

Methicillin-resistant Staphylococcus aureus (MRSA)

is a bacterium responsible for several difficult-to-treat infections in humans.

T

T/F

The development of such resistance does not cause the organism to be more intrinsically virulent
than strains of Staphylococcus aureus that have no antibiotic resistance, but resistance does make
MRSA infection more difficult to treat with standard types of antibiotics, and thus more dangerous.

48-72

Nosocomial pneumonia, refers to any pneumonia contracted by a patient in a hospital at least ___ hours after being admitted.

Hospital-acquired pneumonia (HAP)

15-20%

is the second most common nosocomial infection and accounts for ______of the total. It is the most common cause of death among nosocomial infections, and is the primary cause of death in intensive care units.

T

T/F

Nosocomial infections do not occur only with patients, but also with healthcare workers that are continuously exposed to such biological hazards.

number of infected individuals

type and number

Important factors that influence the overall risk for occupational exposures to bloodborne pathogens include the ___ in the patient population and the _______ of blood contacts.

• The pathogen involved

• The type of exposure

• The amount of blood involved in the exposure

• The amount of virus in the patient's blood at the time of exposure

Following a specific exposure to sharps, the risk of infection may vary with factors such as these:

F

T/F

Pathogens such as HBV, HBC and HIV may be transmitted in the presence of visible blood contamination.

malaria; blood transfusion

Vector-borne diseases such as __ can also be transmitted through blood, but require large volumes, such as are found in a _______.

b

which of these statements is true?

a) patient’s hands are the most common vehicle of microorganisms causing HAI.

b) The transmission of these pathogens to the patient, the HCW, and the environment can be prevented through hand hygiene best practices.

T

T/F

Hand hygiene has long since been recognized as one of the most effective intervention to control the transmission of infections in a hospital

F

T/F

Soap and alcohol-based handrub should be used concomitantly.

T

T/F

In handwashing, the most commonly neglected areas are the tips of the fingers, palm of the hand, and the thumb.

Respiratory Tract.

which portal of exit breaks this link?

• Do not talk directly into patient’s face

• Wear a mask

Gastrointestinal Tract

which portal of exit breaks this link?

• Handle and dispose of body secretions properly

• Perform good housekeeping

Skin

which portal of exit breaks this link?

• Dispose of wound dressings properly

• Perform good hand hygiene