Chapter 4 Principles of Infection Prevention and Control
What term refers to infections that develop in a patient during the course of medical treatment?
healthcare associated infection (HAI)
In order to protect health care workers _________ and _______ are used.
immunization and chemoprophylaxis
Vector-borne transmission of infectious diseases happens through?
insects, rats and other vermin occurs but is of less significance in U.S. health care facilities.
3 feet or less as the minimum threshold to wear a _____ has been _____ in preventing transmission.
mask / effective
indirect contact transmission
most frequent mode of transmission in health care transfer of pathogen through contaminated intermediate object or person
Infections that develop outside the hospital are called?
Community Onset
The Occupational Safety and Health Administration (OSHA) mandates that employers offer the __________ vaccination.
Hepatits B
Contact Transmission
Most common means of transmitting infection
An unhealthy health care worker is?
a source of infection to vulnerable patients
Common vehicle transmission occurs via exposure to pathogens in?
contaminated food, water, or medications Ex. heparin solution
How can respiratory droplets be generated?
coughing, sneezing, talking, suctioning, bronchoscopy, cough induction
A vaccinated population decreases the risk of?
presenteeism - healthcare workers being at work while sick
Droplet Transmission
transmission via airborne droplets that are propelled ≤3 feet into the air and are deposited in another person's mouth or nose.
direct contact transmission
when a pathogen is transferred directly from one person to another less common than indirect contact but is more efficient
sources of infectious agents
-Humans are primary source -Inanimate objects (e.g., contaminated medical equipment) can spread infection
What three elements must be present for transmission of infection within a health care setting?
1. a source (or reservoir) of pathogens 2. a susceptible host, 3. a route of transmission for the pathogen
About what percentage of hospitalized patients in the United States develop a health care-associated infection?
4%
Experimental studies suggest that droplets from infected patients are rarely able to reach a person __ feet away.
6
Healthcare Infection Control Practices Advisory Committee (HICPAC) guidelines state it may be prudent to don a mask when within __ to ___ feet of a patient or on entry into the room of a patient who is on droplet isolation.
6 to 10
Efforts to decrease hospital-acquired infection and HAIs are commonly organized and coordinated by what hospital program?
Infection Prevention (IP)
Infections that develop in the hospital are called?
Hospital onset or nosocomial infections
Health care personnel especially those working with young infants and children should have what vaccine?
adult acellular pertussis
Health care personnel without medical contraindications should receive?
annual influenza vaccination
Health care workers are recommended to take ________ in addition to _________
antibiotics in addition to standard and transmission- based precautions and vaccination, to prevent disease. Examples of these situations include postexposure prophylaxis after close contact with a patient with meningococcal meningitis or exposure to blood or body fluid of a patient with HIV.
How does a hospital's Infection Prevention program break the chain of events leading to HAIs?
by providing guidance to their organizations
Nonmodifiable host factors
cannot be readily modified in an acute setting Ex. Extreme Age, Chemotherapy, Diabetes Mellitus, HIV, acquired or iatrogenic immunodeficiency, Surgical incisions and Radiation therapy.
What is the first step to decreasing the risk for HAIs?
creating a culture of safety with shared commitment to patient and healthcare worker safety
airborne transmission
occurs via the spread of airborne droplet nuclei (evaporated droplets containing infectious microorganisms that remain in the air for long periods of time) microorganisms can be inhaled over longer distances than droplet transmission due to small size ex: Rubeola (Measles) and Varicella (Chickenpox)
How can we prevent airborne transmission?
placing patients in airborne infection isolation rooms, wearing National Institute for Occupational Safety and Health (NIOSH) approved N-95 or higher respirators (A surgical mask, used for droplet precautions, is insufficient)
Health care worker influenza vaccination is the single most effective way of?
preventing healthcare associated influenza
Modifiable host factors
the risk of infection associated with it can be modified through appropriate techniques of insertion maintenance and removal Ex. Medical devices such as catheters and endotracheal tubing
What vaccines are strongly encouraged for health care personnel?
varicella, measles, and rubella