Chp 4 Egan’s Notes: Principle of Infection Prevention and Control (Pgs. 60-79)

Vocabulary flashcards covering key terms and definitions from the notes on infection prevention and control for respiratory therapy.

Health Care-Associated Infections (HAIs)

Infections patients acquire during medical treatment in a hospital/healthcare facility (e.g., pneumonia, surgical site infections, bloodstream infections); about 4% of hospitalized patients develop at least one.

Weak immune systems

States such as elderly or infant patients or those with immunosuppression/immunodeficiency, representing extremes of age as higher risk groups.

Source (reservoir) of pathogens

Where infectious agents live and multiply (patients, staff, visitors, contaminated equipment, water, or food).

Susceptible host

Person at risk of infection, often with a weak immune system.

Route of transmission

How a pathogen moves from source to host (e.g., droplet, contact, airborne).

Fomites

Inanimate objects that can transfer pathogens between people (e.g., stethoscope, bed rails).

Direct contact transmission

Pathogen passes directly from one person to another through touch.

Indirect contact transmission

Transmission via contaminated surfaces or objects; most frequent form in healthcare.

Droplet transmission

Transmission via large respiratory droplets (>5 µm) that travel short distances (≤3 ft, sometimes 6–10 ft); examples include influenza and Neisseria meningitidis.

Airborne transmission

Transmission via droplet nuclei (<5 µm) that remain suspended and travel longer distances; examples include Mycobacterium tuberculosis, varicella-zoster, and rubeola; requires NIOSH-approved respirators and AIIR.

NIOSH

National Institute for Occupational Safety and Health; approves respirators (e.g., N95) and PPE.

AIIR (Airborne Infection Isolation Room)

Room designed to prevent airborne pathogen spread; used for airborne precautions.

Spaulding Classification

System classifying equipment as Critical, Semicritical, or Noncritical based on contact with sterile tissues or mucous membranes.

Critical items

Enter normally sterile tissues or the vascular system; must be sterile; examples: surgical instruments, intravascular catheters, implants, needles.

Semicritical items

Contact mucous membranes or non-intact skin; require high-level disinfection (HLD); examples: bronchosopes, ET tubes, ventilator circuits, humidifiers, nebulizers, resuscitation bags, laryngoscope blades.

Noncritical items

Contact only intact skin; require low- to intermediate-level disinfection; examples: BP cuffs, stethoscopes, bed rails, ventilator exteriors.

High-Level Disinfection (HLD)

Destroys all organisms except high numbers of bacterial spores; used for semicritical items.

Disinfection

Destroys most pathogenic organisms, but not all spores; levels include low-, intermediate-, and high-level.

Sterilization

Destroys all microbial life, including spores; required for critical items.

Steam sterilization (autoclaving)

Uses pressurized steam (e.g., 121°C/250°F for 15–30 min; 134°C shorter times); inexpensive and reliable but not for heat-sensitive items.

Glutaraldehyde (2.4%)

HLD chemical disinfectant; contact time 20–45 minutes; 10 hours for sterilization; requires test strips; can irritate eyes/skin.

Ortho-phthalaldehyde (OPA, 0.55%)

HLD chemical disinfectant; similar efficacy to glutaraldehyde but less irritating; contact time ~12 minutes; more expensive.

Hydrogen peroxide (7.5%)

Disinfectant effective against spores, bacteria, viruses, fungi; contact time ~30 minutes; environmentally friendly.

Peracetic acid (0.2%)

Strong oxidizer; fast-acting; contact time ~10–12 minutes; good for automated reprocessors.

Chlorine compounds (bleach)

Effective and inexpensive disinfectants; corrosive to some metals/plastics; short shelf life; more for surfaces than semicritical equipment.

Quaternary ammonium compounds

Disinfectants suitable for noncritical items only; not effective for semicritical devices.

Pre-cleaning

First step: remove gross debris, use neutral detergent, brush channels, rinse, and dry surfaces before disinfection.

High-Level Disinfection steps

Immerse equipment, fill all channels, maintain required contact time, and monitor concentration with test strips.

Rinsing & Drying

Rinse with sterile/filtered water, flush channels, and dry completely to prevent residue and microbial growth.

Reassembly & Storage

Reassemble only when dry; use clean gloves; store in a clean, dry, closed cabinet; label with date/time; reprocess unused items per policy.

VAP prevention

Ventilator-associated pneumonia prevention includes oral care with chlorhexidine, daily sedation breaks, head-of-bed elevation >30°, and proper circuit care with HLD.

Surveillance

Continuous, systematic tracking of infections to detect HAIs, identify outbreaks, and assess prevention measures.

Infection Prevention & Control Team

Team (infection preventionists, RTs, epidemiologists) under physician oversight; collects/validates data using standardized definitions (CDC/NHSN) and reports results.

Standard precautions

Basic infection-control practices for all patients, including PPE, hand hygiene, eye protection, equipment handling, and patient placement.

Transmission-based precautions

Additional precautions specific to suspected/confirmed infections (droplet, airborne, contact) beyond standard precautions.

NHSN

National Healthcare Safety Network; CDC program for reporting infection data to hospitals and public health authorities.

VAE (ventilator-associated events)

A broader category used to identify and track events related to ventilated patients beyond pneumonia alone.

VAP bundle

Set of measures to prevent VAP, including oral care with chlorhexidine, sedation breaks, head-of-bed elevation, and suctioning practices.

CAUTI/CLABSI/SSI

CAUTI: catheter-associated urinary tract infection; CLABSI: central line-associated bloodstream infection; SSI: surgical site infection.

Head-of-bed elevation (>30 degrees)

Positioning strategy to reduce risk of VAP in mechanically ventilated patients.

Single-use devices

Devices that must not be disinfected and reused; discard after use.

Aseptic technique

Procedures used to prevent contamination of sterile sites and equipment.

PPE

Personal protective equipment (gloves, gowns, masks, eye protection) used to reduce exposure to pathogens.