Infection control study guide

Infection control
Comprehensive, systematic program that, when applied, prevents the transmission of infectious agents among persons who are in direct/indirect contact with the healthcare environment.
Standard precautions
A set of infection-control precautions that when used consistently ensure the safe delivery of oral healthcare. Healthcare personnel follow the same infection-control protocols for all clients regardless of infectious status or health history.
Standard of care
The level of care that a reasonably prudent practitioner would exercise.
Pathogen
Any disease-producing agent (especially a virus or bacterium or other microorganism)
Portal of entry
A pathway by which the caustive agent enters the host
Direct contact
exposure or transmission of a communicable disease from one person to another by physical contact
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Indirect contact
results from touching something contaminated by the infected person, such as a tissue or clothes.
Virulence
degree of pathogenicity
Reservoir
anything (a person or animal or plant or substance) in which an infectious agent normally lives and multiplies
Susceptible host
person likely to get an infection or disease ually because body defenses are weak
Cross contamination
the transfer of oral fluids and debris from a client to surfaces, equipment, materials, workers’ hands, or another person.
PPE
Personal protective equipment including gloves, masks, protective eyewear, protective gowns.
HCP
Health care personnel
Engineering controls
Devices or equipment that reduce or eliminate a hazard: Devices that contain or remove sharp items, anesthetic syringes that contain shielding or encapsulating mechanisms, anesthetic needles that contain shielding mechanisms, disposable scalpels that do not require removal of a used blade, scalpel handles with retractable blades.
Work practice controls
Reduce or eliminate a hazard by changing the way in which workers perform a task.
Critical instruments
Instruments that penetrate soft tissue or bone. Must be sterilized between each use or discarded if disposable.
Semicritical instruments
Instruments not intended to penetrate soft tissue or bone but contact oral fluids. These instruments should be heat sterilized between use.
Noncritical instruments and devices
Items that come into contact only with intact skin. Disinfect these items with EPA-registered low- to intermediate-level disinfectant.
Autoclave
The most common method of heat sterilization in the dental office, uses steam in a pressurized chamber to sterilize heat-stable instruments and devices.
Chemical vapor sterilization
Uses a process similar to the autoclave; however, in place of steam, a chemical vapor enters the pressurized sterilization chamber.
Dry-heat sterilization
Uses high heat for a specific amount of time to achieve sterile results.
Droplets
transmitted by direct exposure released from the mouth or nose ex. coughing, sneezing, talking
airborne
a type of vehicle transmission of diseases through aerosols, sneezing, coughing, sweeping, air conditioning, dust (Stapphylococcus, Streptococcus, hantavirus), or dried droplets (measles virus, tuberculosis bacilli, fungal spore)
Biologic indicator
BI’s use nonpathogenic spores that are especially resistant to the sterilization process embedded on a strip or in a solution that is places in the sterilizer with a load of instruments. Incubation of the spore test confirms the destruction of the spores by the sterilization process, which indicates a successful sterilization process.
Chemical indicator
Allows the operator to determine the presence of certain necessary parameters such as heat or steam. These indicators often appear as arrows or color-change indicators on pouches used to package instruments during sterilization.
What body fluids do standard precautions include?
Blood; other bodily fluids, secretions, and excretions except sweat regardless of whether or not they contain visible blood; nonintact skin; mucous membranes.
Explain what is meant by “scrutinizing each individual health history will not determine the degree of risk for disease transmission.”
Not all individuals are completely honest about their health history.
Identify two U.S. government agencies that play key roles in infection control. Specify the role each play.
Center for disease control and prevention (CDC) develops guidelines and recommendations for infections control for health care settings.
Occupational Safety and Health Administration (OSHA) enforces workplace safety regulations including those for infection control in healthcare settings.
How are the U.S. FDA and the U.S. EPA involved in infection control?
The U.S. Food and drug administration also provides regulatory oversight in the area of products used in the application of infection-control procedures. The EPA regulates medical and chemical waste and registers chemical germicides used for healthcare.
Explain the four principles of infection control
1. Take action and stay healthy
2. Avoid contact with blood and other infectious body substances
3. Make client care items safe for use
4. Limit the spread of blood and other infectious body substances
If a person does not develop detectable antibodies to hepatitis B surface antigen after six doses of the vaccine, what should be done and why?
They should be considered nonresponders and tested for hepatitis B surface antigen which indicates active infection or carrier status.
Give several examples of work practice controls to prevent exposures
Proper client positioning that allows a 14- to 18-inch focal distance, use of a high-speed evacuator while spraying a clients’ mouth with air and water to reduce the amount of droplet splash, using an ultrasonic cleaner, washer, or disinfector to decontaminate used dental instruments before sterilization
What is the OSHA requirement concerning protective clothing?
Glasses, mask, overgarment.
What is the best way to manage environmental surfaces in the clinical environment to prevent cross contamination?
Disinfect or barrier-protect clinical contact surfaces. Protect housekeeping surface by covering them with fluid-impervious barriers.
Give examples of housekeeping surfaces and clinical contact surfaces.
Housekeeping surface: switches, knobs, hoses, brackets.
Clinical contact surfaces: dental chair, operator chair, dental unit, dental light handle, x-ray unit, countertops, air and water syringe handle and tubing, pencils, pens, face, mirror for client education
Identify the microorganisms used to biologic indicators for the autoclave, chemical, and dry heat.
Geobacillus stearothermophilus is a standard organisms for testing steam and chemical vapor sterilization.
Bacillus pumilus spores are the organisms most resistant to dry heat sterilization.
How frequently should spore testing done?
Weekly
What is meant postexposure management?
When an injury occurs, the goal is to contain the injury soon as possible to reduce risk of transmission.
List and the steps involved in postexposure management.
1. Perform immediate first aid
2. Report the incident to a designated individual
3. A designated individual should discuss the incident with the source patient
4. Initiate immediate referral to a QHCP capable of treating an exposed individual
5. Begin medical evaluation and follow-up in accordance with the most recent USPHS guidelines.
Identify what is evaluated in determining the risk of infection after exposure.
Amount of blood, the titer of virus in the patient, and the depth of the injury with the contaminate device or instrument.
What is the time, temperature, and pressure required for moist heat steam under pressure?
Time: 15-30 minutes
Temperature: 250-270 degrees F
Pressure: 15 psi
What is the time, temperature, and required for dry heat?
Time: 120 minutes
Temperature: 320 degrees F
What is the time, temperature, and pressure required for unsaturated chemical vapor?
Time: 20 Minutes
Temperature: 270 degrees F
Pressure: 20-40 psi
What is the time, temperature, required for Ethylene oxide gas?
Time: 10-16 minutes
Temperature: 270 degrees F
Identify 4 modes of transmission of potential pathogens
Direct contact with blood or body fluids, indirect contact with a contaminated instrument or surface, contact of mucosa of the eyes, nose, or mouth with droplets or spatter, inhalation of airborne microorganisms
Explain the “Chain of Infection Control”
Pathogen to source to mode to entry to susceptible host.
Give 3 examples of bloodborne pathogens.
HBV, HIV, HCV
Describe the average risk of bloodborne virus transmission after a needle stick for HBV, HCV, and HIV.
HBV: 1%-6%
HCV: 1.8%
HIV: 0.3%
Explain the risk of contracting HCV in the dental setting.
Prevalence of HCV infection among dentists similar to that of general population (~ 1%-2%). No reports of HCV transmission from infected DHCP to patients or from patient to patient
Identify three routes of exposures for bloodborne pathogens.
Patient to DHCP
DHCP to patient
Patient to patient
If the dental waterlines are not self-contained, how long should the waterlines be discharged at the beginning of each clinic session between patients?
Flush for 2 minutes at beginning of day/30 seconds after each patient.
Describe the correct method to recap a needle from the syringe, and dispose of the used needle?
Never recap needles by hand. Never disengage needles from a reusable syringe. Use disposable needle systems. Dispose of needles and sharps in appropriate sharps disposal containers.
What is the difference between medical waste and regulated medical waste?
Medical Waste: Not considered infectious, thus can be discarded in regular trash.
Regulated Medical Waste: Poses a potential risk of infection during handling and disposal.
Identify the TB testing requiremet for you while you are a student in the SIUC DH program.
Sophomores: initial two-step test required
Juniors: no testing unless an active case is reported
Seniors: testing required due to rotation site requirements

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