Free a-IPC Exam Flashcards

Colonization means an organism is present and multiplying without host injury or symptoms. Infection means the organism is causing tissue damage and a clinical response. Pseudo-infection is a false positive created by contamination during collection or processing. Only true infections belong in surveillance counts.

Prophylactic therapy prevents infection before it happens, such as a preoperative dose. Empiric therapy treats a suspected infection before cultures return, guided by likely pathogens and the antibiogram. Therapeutic (definitive) therapy targets an identified organism using susceptibility results, which allows de-escalation to a narrower agent.

Give the dose within 60 minutes before incision so tissue levels peak at cut time. Vancomycin and fluoroquinolones get a 120-minute window because they must infuse slowly. Redose during long or high-blood-loss procedures. CDC advises no additional doses after wound closure in clean and clean-contaminated surgery.

Fever, leukocytosis with a left shift, rising CRP or procalcitonin, purulent drainage, and localized heat, redness, and pain suggest infection. Post-surgical inflammation, drug fever, transfusion reaction, and venous thrombosis mimic the same signs. Confirm with cultures, imaging, and the surveillance definition before counting a case.

Collect before antimicrobials start, from the true site of infection, using aseptic technique with the correct container and volume. Label at the bedside, transport promptly at the temperature the laboratory specifies, and use the required biohazard packaging. Poor collection yields contamination, pseudo-infections, and unnecessary treatment.

Assess travel and exposure history, vaccination status, age, and immunocompromising conditions such as neutropenia, transplant, chemotherapy, or chronic corticosteroids. Indwelling devices, recent surgery, and prior antimicrobial exposure add risk. These factors drive isolation decisions, test selection, and whether a case is plausible during an outbreak.

A culture reporting MRSA, VRE, CRE, or Candida auris triggers precautions, notification, and possible contact tracing. Read the susceptibility panel, not just the organism name. Provider notes and imaging determine whether the result reflects true infection or colonization, which changes whether the case is reportable.

Monitor the CDC Health Alert Network, WHO Disease Outbreak News, and state or local health department advisories. Early awareness lets a facility update screening questions, isolation triggers, testing algorithms, and PPE supply planning before a novel or reemerging pathogen reaches the local population.

Incidence counts new cases arising in a population during a defined period, divided by the population at risk. Prevalence counts all existing cases, new and old, at a point in time. Incidence measures the risk of acquiring infection; prevalence measures burden and is inflated by long-lasting infections.

Rate equals the number of device-associated infections divided by the number of device-days, multiplied by 1,000. Device-days are the total days the device was in place summed across all patients. The result reads as infections per 1,000 device-days, which lets units with different device use be compared.

SIR equals observed infections divided by predicted infections, where NHSN predicts the count from a national baseline adjusted for facility and patient risk factors. An SIR below 1.0 means fewer infections than predicted. NHSN does not calculate an SIR when fewer than 1.0 infections are predicted.

Attack rate equals the number of people who became ill divided by the number of people at risk, multiplied by 100. It is used over a defined outbreak period. Comparing attack rates in exposed and unexposed groups points toward the likely source, such as a shared meal, procedure, or room.

A point-source curve rises and falls in one peak within a single incubation period, indicating one common exposure. A continuous common-source curve plateaus while the exposure persists. A propagated curve shows successive peaks roughly one incubation period apart, indicating person-to-person transmission.

Confirm the diagnosis and verify a true outbreak against baseline rates. Notify stakeholders, write a case definition, and conduct case finding. Describe cases by time, place, and person, then form a hypothesis on source and mode. Implement control measures immediately, test the hypothesis, evaluate, and report.

Clinical or laboratory criteria plus explicit limits on time, place, and person, applied uniformly to everyone screened. Tiers such as confirmed, probable, and suspect allow graded certainty. Write it before case finding begins, and never modify it to include or exclude a particular individual.

A laboratory-confirmed bloodstream infection counts as a CLABSI when a central line has been in place more than two consecutive calendar days, counting the day of insertion as day 1, and was in place on the date of event or the day before. The infection must not be secondary to another site.

Most operative procedures are followed for 30 days after surgery. A defined list, largely implant-related procedures such as cardiac, breast, craniotomy, spinal fusion, and hip or knee arthroplasty, carries a 90-day window. Superficial incisional SSI is always a 30-day event regardless of procedure.

Compare only against data built on the same definitions, denominators, and risk adjustment, such as NHSN pooled means. Validate first by re-reviewing a sample of records to confirm cases were classified correctly. Unvalidated data that beats a benchmark usually reflects under-detection rather than better care.

Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. Breaking any single link interrupts transmission. Hand hygiene breaks the transmission link, vaccination reduces host susceptibility, and device reprocessing eliminates the reservoir on shared equipment.

They apply to every patient regardless of diagnosis, because infection status is often unknown. Components are hand hygiene, PPE chosen by anticipated exposure, respiratory hygiene and cough etiquette, safe injection practices, safe handling of contaminated equipment and surfaces, and safe sharps handling and disposal.

Contact precautions add gown and gloves for organisms spread by touch. Droplet precautions add a surgical mask for large respiratory particles, with the patient in a single room or separated by at least 3 feet. Airborne precautions require a fit-tested respirator and an isolation room. All layer onto Standard Precautions.

The room is negative to the corridor by at least 0.01 inch water gauge (2.5 pascals), with at least 12 air changes per hour in new construction and 6 in existing rooms. Air is exhausted outdoors or HEPA-filtered before recirculation. The door stays closed and pressure is monitored daily while in use.

It shields severely immunocompromised patients such as allogeneic stem cell transplant recipients. It is positive pressure relative to the corridor, with HEPA-filtered supply air, at least 12 air changes per hour, and sealed surfaces. It protects the patient from the environment, the opposite of an isolation room.

Alcohol-based hand rub is the default because it acts faster and is less damaging to skin. Switch to soap and water when hands are visibly soiled, after restroom use, and after caring for patients with Clostridioides difficile or norovirus, because alcohol does not kill spores and is unreliable against norovirus.

Clean hands before touching a patient, before a clean or aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching the patient's surroundings. Moments 1 and 2 protect the patient; moments 3, 4, and 5 protect the healthcare worker and the care environment from the patient's organisms.

One needle, one syringe, one time. Never reuse a syringe to re-enter a vial, even with a fresh needle. Prepare medications in a clean area away from contaminated equipment, dedicate single-dose vials to one patient, and disinfect the vial septum with alcohol before every entry.

29 CFR 1910.1030 requires a written exposure control plan reviewed annually, hepatitis B vaccination offered free within 10 working days of assignment to at-risk duties, engineering and work-practice controls, employer-provided PPE, a sharps injury log, training, and confidential post-exposure evaluation and follow-up.

Hepatitis B carries up to about 30 percent risk of clinical hepatitis when the source is HBeAg-positive, HIV about 0.3 percent, and hepatitis C about 0.2 percent under CDC's 2020 guidance (older texts cite 1.8 percent). Hepatitis B is both the highest risk and the only one of the three prevented by a vaccine.

Wash the site, report immediately, and evaluate both the source patient and the exposed worker. Start HIV post-exposure prophylaxis within hours when indicated and continue 28 days. Give hepatitis B immune globulin and vaccine according to vaccination and response status. No prophylaxis exists for hepatitis C, so test and treat early.

OSHA requires medical evaluation, training, and fit testing before first use, then repeat fit testing at least annually for each respirator make, model, style, and size. A user seal check is done at every donning. Facial hair crossing the seal invalidates the fit; loose-fitting PAPRs need no fit test.

Plan the change and predict the result, Do it as a small test, Study the data against the prediction, and Act by adopting, adapting, or abandoning it. Small rapid cycles limit risk and build local evidence before any facility-wide rollout.

A fishbone (Ishikawa) diagram groups possible causes into categories such as people, process, equipment, and environment. A Pareto chart ranks causes to isolate the vital few. A SWOT analysis weighs strengths, weaknesses, opportunities, and threats. A gap analysis compares current practice against the required standard.

Reportable condition lists, timeframes, and recipients are set by state or local health authorities rather than by CDC, and some conditions require notification within 24 hours. Know the facility organizational chart, escalate findings through it, and route media inquiries to communications leadership rather than answering directly.

A written risk assessment reviewing geography, patient population, services provided, prior surveillance data, and regulatory or accreditation requirements. Risks are ranked by probability and potential impact, and that ranked list sets the year's surveillance priorities, goals, and resource requests. Progress is evaluated at year end.

Adults learn best when content is job-relevant, builds on experience, and can be applied immediately. Match the format: hands-on return demonstration for donning and doffing, brief unit huddles for staff reminders, and plain-language teach-back for patients and families.

Attendance and satisfaction scores do not prove learning. Measure process outcomes such as observed hand hygiene compliance or correct PPE sequence, then track outcome measures such as infection rates. Direct observation and return demonstration are the strongest evidence that behavior actually changed.

Correct it immediately, privately, and without blame, explaining the specific risk to the patient. Delayed feedback loses the teachable moment. Log the lapse type so aggregated data can drive system fixes, such as relocating PPE or redesigning workflow, instead of repeated individual coaching.

Systematic reviews and meta-analyses of randomized trials rank highest, followed by individual randomized trials, cohort studies, case-control studies, case series and reports, and expert opinion. Prefer peer-reviewed sources and current national guidelines, and always check the publication date before applying a recommendation.

It pairs the type of construction activity with the risk group of nearby patients to set the required precautions. Higher combinations demand sealed rigid barriers, negative pressure inside the work zone, HEPA-filtered exhaust, dedicated worker routes, and daily monitoring. The assessment is completed before work begins.

Construction and demolition aerosolize Aspergillus and other mold spores from dust and ceiling voids, causing invasive disease in neutropenic and transplant patients. Mitigation includes rigid dust barriers, negative pressure in the work area, tacky mats, HEPA filtration, and relocating high-risk patients away from the zone.

Legionella multiplies where water temperature, stagnation, biofilm, or scale allow growth. ASHRAE Standard 188 and CMS require a written water management program with defined control points, monitoring limits, and corrective actions. Investigate every possible healthcare-associated case, since one case can signal a system-wide problem.

Cleaning physically removes soil and organic material; disinfection kills the organisms that remain. Disinfectants are inactivated by soil and cannot penetrate it, so cleaning always comes first. Then honor the label's wet contact time, keeping the surface visibly wet for the full period and re-applying if it dries early.

Alcohol and quaternary ammonium products do not kill spores. Use an EPA List K sporicidal product, such as diluted sodium hypochlorite, for Clostridioides difficile rooms, and an EPA List P product for Candida auris. Contact times for these products are often longer than for routine disinfectants.

Only items that would release blood or other potentially infectious material if compressed or that are caked with dried blood, plus sharps, pathological, and microbiological laboratory waste. Most patient-room trash is not regulated. Handle soiled linen with minimal agitation and bag it at the point of use.

Critical items enter sterile tissue or the vascular system and require sterilization. Semicritical items contact mucous membranes or non-intact skin and require high-level disinfection at minimum. Noncritical items touch only intact skin and require low-level disinfection. Intended use, not the device name, sets the required level.

High-level disinfection kills all microorganisms except large numbers of bacterial spores. Intermediate-level kills mycobacteria, vegetative bacteria, most viruses and fungi, and carries a tuberculocidal claim. Low-level kills vegetative bacteria, some fungi, and enveloped viruses. Sterilization destroys all microbial life, including spores.

Point-of-use treatment to keep soil moist, closed-container transport, then cleaning, rinsing, and drying, followed by inspection and either disinfection or packaging and sterilization, then controlled storage. Cleaning is the step everything else depends on, because residual soil and biofilm defeat sterilization.

Gravity-displacement cycles commonly run 121 degrees Celsius for about 30 minutes; dynamic-air-removal (prevacuum) cycles commonly run 132 to 135 degrees Celsius for about 4 minutes. Sterilization needs the right combination of time, temperature, saturated steam, and direct steam contact after air is removed.

A biological indicator is the only monitor that proves the cycle killed highly resistant spores. Steam and vaporized hydrogen peroxide cycles use Geobacillus stearothermophilus; dry heat and ethylene oxide use Bacillus atrophaeus. Run one at least weekly, preferably daily, and in every load containing an implant.

A chemical indicator shows only that a package was exposed to the process, never that the contents are sterile. Place an internal indicator in every package and an external one where the internal cannot be seen. Run a Bowie-Dick air-removal test each day the sterilizer is used, in an empty dynamic-air-removal chamber before the first processed load.