IPC Flashcards

Question

antimicrobial stewardship intervention bundle ?

Answer 1

- Daily review of prescriptions - Clear documentation of indication, dose, duration, and review date for all prescriptions - Adherence to local guidelines - Regular de-escalation - Stop Abx when appropriate

Answer 2

- Risk assessment and screening of high-risk pt - Active surveillance in high-risk settings - Isolation/ cohorting if confirmed - Strict contact precautions - Enhanced environmental cleaning and decontamination

Answer 3

- Hand hygiene before insertion and manipulation - Maximal sterile technique - Chlorhexidine - Optimal Site selection - Daily review for ongoing need

Answer 4

Single room with an en-suite

Answer 5

- Clean with detergent and water - Followed by hypochlorite at 1000 ppm daily (or combined detergent hypochlorite product) - Communal facilities eg: baths and showers should be cleaned and decontaminated between all patients - s, linen and waste must be handled as hazardous

Answer 6

- Erradication therapy : penicillin V- amox or clinda x10 d - Clearance screens : take swabs 24 h after completing treatment, and again at 1, 3, 6, and 12 weeks

Answer 7

1-Strict hand hygiene protocols 2-Contact precautions 3-Environmental cleaning and disinfection 4-Antibiotic stewardship to reduce selection pressure 5-Active surveillance in high-risk units

Answer 8

avoid undercooked meat, contaminated soil, and cat litter, and practice good hygiene

Answer 9

Eliminates many or all pathogenic microorganisms, except bacterial spores

Answer 10

- Can kill most vegetative bacteria, some fungi, and some viruses. - It is appropriate for non-critical items

Answer 11

- Inactivates mycobacteria, vegetative bacteria, most viruses/ fungi - No effect in spores - Alcohols and chlorine compounds

Answer 12

- Inactivates all microorganisms except high numbers of bacterial spores. - Use Chemical germicides or pasteurisation 1- Hydrogen peroxide 7.5% 2- OPA 0.55% 3- Glutaraldehyde 2% - Required for semi-critical items like endoscopes.

Answer 13

Concentration Contact time pH Temperature Organic load Water hardness

Answer 14

- Hydrogen peroxide vapour/aerosol systems - Ultraviolet (UV-C) light devices - Automated endoscope reprocessors (AERs)

Answer 15

- HTM 01-06, published by the Department of Health and Social Care - British Society of Gastroenterology (BSG) Guidelines 2020 - UK Medical Devices Regulations 2002 -

Answer 16

- Pre-clean or bedside cleaning - Trasfer to the endoscopy unit (<3h) - Leak test - Manual clean - Complete immersion in enzymatic detergent - Automated Endoscope Reprocessing AREs - drying and storage -

Answer 17

- Peracetic acid - Chlorine dioxide

Answer 18

- Occluded lumen or pump failure With failure of the alarm system - Wrong connection - Wrong program selected - Insufficient pump pressure - Incomplete cycle

Answer 19

- AER-integrated drying cycles - Flushing channels with filtered air or medical-grade alcohol, followed by air - Dedicated drying cabinets

Answer 20

- Dedicated drying cabinets with HEPA-filtered air circulation (preferred) - Hanging in designated, clean, dry cabinets

Answer 21

- 72 hours in validated drying cabinets - 3 hours in conventional storage

Answer 22

Check final rinse water

Answer 23

- Total viable count (TVC): Weekly testing - Environmental Mycobacteria: Quarterly - Pseudomonas aeruginosa: Quarterly - Endotoxin levels: if major water supply problems

Answer 24

Bronchoscopes Cystoscopes Ureteroscopes Duodenoscopes used for ERCP

Answer 25

Gastroscopes Colonoscopes ENT scopes

Answer 26

Developing, implementing, and maintaining a Water Safety Plan (WSP) To ensure the safety of water systems

Answer 27

- Core members : 1- Microbiologest 2- IPC 3- Authorising engeneer (water) 4- Estate and property management - Non-core members : 1- Specialist Water Users (e.g renal unit , aquatic therapy ) 2-Housekeeping & Support Services 3- sterile service departments SSD 4- nursing 5-Augmented care

Answer 28

Dysphagia screening and management Oral hygiene protocols Early mobilisation Chest physiotherapy when indicated Hand hygiene compliance Enhanced cleaning of the hospital environment Isolation of patients with MDR pathogens Antibiotic stewardship programmes

Answer 29

Head of bed elevation (30-45°) Endotracheal tubes with subglottic drainage Maintaining endotracheal cuff pressure at 20-30 cmH₂O Daily sedation interruption assessment for extubation Early mobilisation when possible Peptic ulcer prophylaxis Deep vein thrombosis prophylaxis Daily oral care with chlorhexidine

Answer 30

1- Patient-Related Risk Factors - Advanced age - Male sex - Preexisting illnesses ( COPD, diabetes, heart failure, or kidney disease) - Immunosuppression - Low GCS - Burns - Smoking - Multiple-organ failure

Answer 31

2- Treatment- related: - Prior antibiotic therapy . - Corticosteroid treatment - Prolonged duration of intubation and mechanical ventilation. - Reintubation - Cuffed endotracheal tubes - Lack of subglottic secretion drainage - Supine position

Answer 32

- FFP3 respirator- fit tested to the wearer - single-use fluid-repellent gown - single-use gloves - eye protection e.g. goggles or full face visor - linens should be bagged and managed as “infectious laundry” - hypochlorite solution (1000ppm available chlorine).

Answer 33

"BIOLOGICAL SUBSTANCE, CATEGORY B"

Answer 34

- UN2814 Infectious substance, affecting humans; or - UN2900 Infectious substance, affecting animals

Answer 35

UN3373 Diagnostic specimens/ Clinical specimensdosnt meet the criteria of category A

Answer 36

- Surgical teams - Laboratory personnel - Pharmacy staff - Cleaning staff - Pathology

Answer 37

- Filter Grade: EPA E10 - Efficiency: 85%

Answer 38

Answer - air change rate (Ach)

Answer 39

measure the pressure difference before and after the filter

Answer 40

- Conventional - Laminar flow

Answer 41

- The specification of the air-handling unit - What are the air change rates? - Airflow direction - Pressure - microbiological air sampling - for conventional theatre

Answer 42

- Sufficient air volume. - Air velocity under the canopy. - appropriate fitting of the HEPA filter - ensuring the airflow under the canopy can prevent any ingress of contamination.

Answer 43

- The Food Safety Act 1990 - The Food Hygiene (England) Regulations 2006 - Regulation (EC) No. 852/2004 on the hygiene of foodstuffs - The Food Safety (Temperature Controls) Regulations 1995). EC 852/853 - HACCP (Hazard Analysis of Critical Control Points) 2004

Answer 44

HACCP (Hazard Analysis of Critical Control Points) 2004

Answer 45

- Leakproof primary pack - Leakproof secondary pack - If liquid contents , an absorbent material in sufficient quantity placed between the primary & secondary packaging - A rigid outer packaging - The smallest external dimension not less than 100 mm.

Answer 46

packing instruction P650.

Answer 47

Contact precautions isolation in a single room, use of personal protective equipment (PPE) (most commonly plastic apron and gloves), meticulous hand

Answer 48

- Same as SSTI Plus: - Wear PPE, including face and eye protection (e.g. surgical mask with integral eye protection) - if high risk exposure to confirmed case with no PPE , need screening b/w 3-7days post exposure

Answer 49

- should not work until the acute infection has resolved and 48 hours of a five day decolonization - assess for PVL-SA-related disease in close contacts and can be treated simultaneously - Follow up screens- three screens one week apart - should stop working if a further skin lesion develops.

Answer 50

- Chlorhexidine 4% bodywash /shampoo or Triclosan 2% use once a day for 5 d - also as a shampoo on day 1,3,5 - Mupirocin (Bactroban Nasal) (use three times a day for 5 days

Answer 51

- tenofovir disproxil 245mg OD - emtricitabine 200 mg OD - raltegravir 1200mg OD - Duration: 28 D

Answer 52

- Known resistance from index pt - Pregnant – reduce raltegravir dose to 400mg BD (from 1200mg OD) - Renal failure – can substitute TDF for TAF

Answer 53

- 4th generation HIV test (HIV-1 Ag/Ab) - Hepatitis B surface antigen (HepBsAg) - Hepatitis C antibody (Hep C Ab)) Note : if high risk hep C (PWID) then a hepatitis C PCR (HCV PCR) or hepatitis C antigen (HCV Ag) can be done instead of Hep C Ab.

Answer 54

Tenofovir alafenamide fumarate/Emtricitabine (FTC/TAF)

Answer 55

Emtricitabine and Tenofovir Disoproxil (FTC/TD)

Answer 56

- Resample the water system immediately - Conduct an immediate review of control measures - Risk assessment to identify necessary remedial actions - Consider disinfection of the entire water system - Arrange an alternative water supply

Answer 57

= TP / (TP + FN)

Answer 58

- TN/(TN+FP)

Answer 59

1. Hazard analysis 2. Determine Critical Control Points (CCPs) 3. Establish critical limits 4. Monitoring procedures 5. Establish corrective actions 6. Verification procedures, and 7. Establish record-keeping and documentation procedures

Answer 60

Hazard Analysis Critical Control Point

Answer 61

ppl at increased risk of transmitting to ‘vulnerable’ individuals in ‘group 1’ if they have pertussis, who have not received a pertussis-containing vaccine more than one week and less than 5 years ago: A. Pregnant women who have reached 32 weeks’ gestation. B. HCWs who provide close personal care to infants (as defined in Group 1 above) and pregnant women. C. People whose work involves regular, close and prolonged contact with infants as defined in Group 1 D. People who share a household with an infant as defined in infants in Group 1

Answer 62

Exception if household or other close contact who falls into priority Group 1 for public health action or is a pregnant woman, then can commene Abx within 21 days of onset of cough

Answer 63

pregnant erythromycin 500 mg po 6h for 7 days then Azithro then clary for neonate <1 month Clarythromycin BD for 7 days 7.5mg/kg

Answer 64

F Exclusion for contacts is not required just chemoprophylaxis for high risk group if exposure with in 14 days of symptoms

Answer 65

- The temperature should be at least 55°C within one minute of turning on the tap. - The temperature should be below 20°C within two minutes of turning on the tap

Answer 66

- Avoid TMT/TMV Maintain temperature at recommended range (above 55-60°C or below 20°C) - Regular flashing or unusual outlets - Avoid dead legs

Answer 67

- The Health and Safety at Work etc. Act 1974 - The Control of Substances Hazardous to Health Regulations 2002 (COSHH) - Health Technical Memorandum (HTM) 04-01: Safe water in healthcare premises - The Health and Safety Executive's Approved Code of Practice L8 - The Control of Legionella Bacteria in Water Systems

Answer 68

- Resample the water system immediately - Conduct an immediate review of control measures - Perform a risk assessment to identify necessary remedial actions - Consider disinfection of the entire water system - Arrange for an alternative water supply - Risk assessment and review of the patients

Answer 69

- Isolate the patient in a single occupancy room, preferably a respiratory isolation room and ideally under negative pressure - Minimise contact with staff - If a patient has to come out of the isolation room, should wear a surgical mask. - Full PPE: correctly fitted FFP3 respirator, gown, gloves and eye protection - Inform local lab and All samples must be handled at containment level 3 - Samples should be sent by Category B transport.

Answer 70

Disposable coveralls or fluid-resistant gowns Gloves (disposable, preferably nitrile) Respiratory protection (N95 respirator or equivalent) Eye protection (goggles or face shield) Disposable boot covers or rubber boots that can be disinfected

Answer 71

- Enhanced environmental and clinical surveillance - A targeted inactivated polio vaccine (IPV) booster campaign for children aged 1-9 years in affected areas. - Communication with healthcare professionals about the importance of polio vaccination.

Answer 72

- Circulating VDPV (cVDPV) - Immunodeficiency-associated VDPV (iVDPV) - Ambiguous VDPVs (aVDPVs)

Answer 73

ACH= Air Supply Rate/ Room Volume

Answer 74

- Measuring Airflow Velocities, - Distribution - Confirming Air Change Rates. You can also mention: - Checking HEPA Filter Integrity. - Validating Pressure Differentials

Answer 75

Nicotinic Acetylcholine Receptor (nAChR)

Answer 76

high efficiency particulate air

Answer 77

- Satisfactory air velocity in the ultraclean zone - HEPA filter is effective and sealed correctly (leakage test - particle check) - Ultraclean air can prevent any ingress from outside (UVC Canopy entainment test)

Answer 78

- Avoid stagnation of water (deadlegs ) - Avoid Under-use of taps - Ensure appropriate water tempreture (avoid 20-45) - Water treatment (e.g chlorination )

Answer 79

- HTM 01-06, published by the Department of Health and Social Care - British Society of Gastroenterology Guidelines 2020 - UK Medical Devices Regulations 2002 - Care Quality Commission (CQC)

Answer 80

- Filtered water (0.2 μm filters) - Reverse osmosis (RO) water - Sterile water for specific applications

Answer 81

- Bedside cleaningy - Trasfer to the endoscopy unit - Leak test - Manual clean (enzymatic detergent solution) - Automated Endoscope Reprocessing - ARE - Drying and storage

Answer 82

Detergent phase Rinse phase Disinfection phase ( peracetic acid or chlorine dioxide) Final rinse phase(s) Optional drying phase

Answer 83

peracetic acid or chlorine dioxide

Answer 84

- Alarm failure in case of occluded lumen or pump failure - Wrong connection or wrong program selected. - Insufficient pump pressure - Incomplete cycle

Answer 85

- Total viable count (TVC): Weekly testing - Environmental Mycobacteria: Quarterly testing - Pseudomonas aeruginosa: Quarterly testing - Endotoxin levels: if major water supply problems identified

Answer 86

Bronchoscopes Cystoscopes Ureteroscopes Duodenoscopes used for ERCP

Answer 87

- Unsatisfactory results - Do not reprocess until acceptable results obtained

Answer 88

Unacceptable results Stop all reprocessing, recall and reprocess all unused endoscopes

Answer 89

- Check the final filter between incoming water and the EWD chamber - EWD rinse self disinfection - Replace all non-metallic water contacts between the filter and the chamber - Use an extra filter between the final filter and the chamber (polishing filter).

Answer 90

Is to creat , implement , and manitain a Water Safety Plan (WSP)

Answer 91

Authorising Engineer (Water), Estates/Facilities Management, Infection Control, Medical Microbiology, nursing staff, and potentially other clinical or operational departments like Housekeeping or sterile services.

IPC Flashcards

(117 cards)