Term
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Definition
| Local/systemic conditions resulting from ADVERSE REACTION to the presence of INFECTIOUS AGENT or its toxins with NO EVIDENCE that it was incubating/present at time of admission to acute care setting. |
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Term
| What is the most common HAI? |
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Definition
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Term
| What is the most deadly HAI? |
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Definition
| Blood Stream Infections (from MANY different infections including UTI's, pneumonia, etc) |
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Term
| What are the steps in the Chain of Infection? |
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Definition
1. Pathogens (Prions, Fungi, Parasites, bac, virus)
2. Reservoirs (animate/inanimate)
3. Portal of Exit (mouth, butt, skin, et)
4. Mode of transmission (vehicle born)
5. Portal of entry
6. Suscpetable host |
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Term
| What are the elements of the ventilator associated pneumonia (VAP)? |
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Definition
• Elevation of head of the bed 30-45 degrees
• Daily “sedation vacations” and assessment of readiness to extubate
• Peptic ulcer disease prophylaxis
• Venous thromboembolism prophylaxis |
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Term
| What are the sources and modes of transmission for HAI? |
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Definition
Endogenous: skin, nose, mouth, GI tract, vagina--all sites normally inhabited by mirco-organisms
Exogenous sources: those external to the patient, patient care personnel, visitors, equipment, devices, health care environment |
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Term
| How do you prevent a catheter associated UTI? |
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Definition
Insertion Techniques
- Hand Hygeine
- trained professionals
- Sterile techniques (DRAPES)
- Proper securement
- Smallest bore catheter
Maintenance
- Maintain closed drainage system (if it breaks have to change it)
- Maintain unobstructed urine flow
- Standard precautions
- No need to change routinely, unless indications of infection/obstruction/system compromise
- Routine Hygein EVERY DAY
- NO Routine irrigation |
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Term
| How do you prevent Surgical Site Infection? |
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Definition
- Hair removal
- OR Skin prep
- antimicrobial prophylaxis
- Sterile Drapes
- Dressing changes every 24-48 hours |
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Term
| What are the Criteria 1 for CLABSI? |
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Definition
| - Has one + blood culture of a recognized pathogen NOT from another infection site |
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Term
| What are Criteria 2 for CLABSI? |
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Definition
| Patient has at least one of the following s/sx: FEVER (>38C), CHILLS, or HYPOTENSION that are NOT related to another infection AND 2 or more + blood cultures from a COMMON SKIN CONTAMINANT. |
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Term
| What are the criteria for CLABSI 3? |
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Definition
Pt is <1 yo and has EITHER
1. Fever 38C by RECTAL OR
2. HypoTHERMIA OR
3. Apnea OR
4. Bradycardia -- NOT related to another infection
and two + blood cultures from a common skin contaminant
OR 1 + blood culture from a pt with an intravascular line and the doctor gave them antimicrobial tx |
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Term
| What is the 48 hour rule? |
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Definition
A patient must have had a central line placed within the 48 hour pd before developing a BSI ...AND...
- If the BSI dev in a pt w/in 48 hrs of discharge from a location the bsi is accountable to the discharging location
- htere is NO min pd of time that the central line must be in place in order for the BSI to be considered Central line associated. |
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Term
| What are the risk factors for HAI? |
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Definition
- prolonged hsp PRIOR to catheterization
- Prolonged duration of catheter
- Heavy microbial colonization at insertion site
- Heavy microbial colonization of CATH HUB
- Cath placed at INTERNAL JUGULAR site
- Neutropenia (immune suppressed)
- Premature babies
- Has TPN
- Excessive manipulation of cath |
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Term
| What are the sources of CLA contamination? |
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Definition
1. HUB
2. Insertion
3. Contaminated FLUIDS
4. Hands of medical professionals
5. Patient's skin flora
6. Hemologenous spread (blood stream?) |
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Term
| What is the RN's role in reducing CLABSI? |
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Definition
- Know policies and procedures!
- Advocate for your patient!
- Educate pt/family
- Care for the life of the line |
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Term
| What is the Central Venous Catheter Bundle? |
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Definition
- Hand Hygeine
- Barriers upon Insertion
- Chlorhexidine Skin Antisepsis
- Optimal site selection (NOT Femoral vein for adults!)
- Daily review of necessity of the line and prompt removal. |
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Term
| What are the 4 CLMB components? |
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Definition
1. DAILY review of line necessity
2. Cath access (Hub/Cap and Tube care)
3. Cath insertion site maintenance (sterile!)
4. NO ROUTINE replacement |
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Term
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Definition
| A bacterial film, if you DRAW from a CVC flush twice! Flush it per shift! |
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