o bjectives (39 q uestions ) develop and review infection prevention and control policies and...
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OBJECTIVES (39 QUESTIONS)
Develop and review infection prevention and control policies and procedures
Collaborate with public health agencies in planning community responses to biological agents (eg, anthrax, influenza)
Identify and implement infection prevention and control strategies
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PART I
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POLICIES & PROCEDURES
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POLICY REVIEW
IP is responsible for development and review of IPC guidelines and policies
Purpose is to protect the patient and healthcare workers in a cost efficient environment
Use national references such at APIC, SHEA, CDC, HICPAC, AORN
CMS requires using nationally recognized guidelines for policy development National Guideline Clearinghouse
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BIOLOGICAL AGENTS
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PREPAREDNESS FOR BIOLOGICAL EVENTS
Assess hazards and vulnerabilitiesDevelop plansIncorporate syndromic
surveillanceEducate all involvedPractice the plan
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MITIGATION/INFECTION PREVENTION PROCEDURES
Follow the principles of an outbreak investigation
Report unusual infectionsTriage quicklyQuarantineProphylaxis, vaccination,
treatmentDecontaminationPost mortem care
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POTENTIAL BIOTERRORISM AGENTS
Category AAnthraxBotulismPlaqueSmallpoxTularemiaViral hemorrhagic fevers
Category B have moderate morbidity and low mortality
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HAND HYGIENE
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HAND HYGIENE
Standardized definition of hand hygiene
Product standardization, dispenser location, indication for hand hygiene, and technique
Surgical hand antisepsis requires persistent activity (CHG and alcohol is best)
Develop monitoring programs to comply with accreditation
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CLEANING, DISINFECTION & STERILIZATION
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DEFINITIONS
Cleaning Removal of visible soil
Sanitizing Reduction in microbial population to a safe or
relatively safe level Decontamination
Rendering the object safe for handling Disinfection
Elimination of many or all pathogenic organisms, except bacterial spores
Sterilization Complete elimination, destruction of all microbial
life
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SPAULDING CLASSIFICATION
CriticalEnters sterile tissue or vascular
systemSemi-critical
Touches mucous membranes or non-intact skin
Non-criticalTouches intact skin
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CLEANING
Goal is to render item safe for handling
Follow manufacturer’s instructions for use
Enzymatic cleaner (dilution)UltrasonicWasher (quality monitoring)
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STERILIZATION
SteamGravityPre-vacuum
Ethylene OxideLow-temperature hydrogen
peroxide gas plasmaOzoneDry-heatLiquid sterilant (peracetic acid)
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MONITORING OF STERILIZATION SYSTEMS
Mechanical indicators: recording charts Chemical indicators: impregnated
paper or strips. The Bowie Dick checks to see if the air has been removed from the chamber and the efficiency of the vacuum pump
Biological indicators: use first load of every day but at least once a week and with all implantables
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HIGH LEVEL DISINFECTION
Pasteurization (time + heat) Glutaraldyde Stabilized hydrogen peroxide Peracetic acid Ortho-phthalaldehyde (OPA)
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HIGH LEVEL DISINFECTION
Assure that the solutions and strips are marked with expiration date after opening
Assure that the temperature of the solution is monitored for each soaking
Assure that the QC for the strips and the solution are documented
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LOW LEVEL DISINFECTION
Quaternary Ammonia productsQUATs (4th generation)Most common in hospitals
Phenolics Never use in nurseries due to
associated neurotoxicity to infants Chlorine-releasing agents Accelerated hydrogen peroxide
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RECALLS
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CONTAMINATED EQUIPMENT/SUPPLIES
Intrinsic Contaminated during production
Extrinsic Contaminated during use
Notify the FDA and CDC if a contaminated or defective product, device, or medication us suspected as the cause of an outbreak
Immediately remove from use Initiate an outbreak investigation