The chain of infection describes the process of disease transmission. It’s represented by a series of 6 linked events, places, and organisms, all of which play a role in the contraction of infection.
The chain of infection describes the process of disease transmission. It’s represented by a series of 6 linked events, places, and organisms, all of which play a role in the contraction of infection. These 6 “links” are the infectious microorganism, the reservoir or location where the microorganism lives, the port of exit from the reservoir, the mode of transmission from the reservoir to the host, the portal of entry into the person or host, and the host themselves. When the chain of infection is completed from infectious agent to host, the host will become infected. But if the chain of infection is broken or interrupted, infection will not occur.
Handwashing is a vital step in breaking the chain of infection. It helps prevent the movement of disease from one place to another through direct and indirect contact. It helps a sick person from contaminating surfaces with their body fluids, and it helps a potential host from inhaling or ingesting diseases.
When a healthcare professional performs hand hygiene, which of the following links could they interrupt? Select all that apply.
Preventing a reservoir from developing
Ensuring there are no susceptible hosts exposed to the disease
Keeping agents from a portal of entry
Stopping the mode of transmission
Question 2
The chain of infection can occur in all types of contexts, well beyond medical facilities. And while the types of “links” are consistent across situations, the specific incidents and individuals involved will change. The mode of transmission is one element that is likely to shift depending on the circumstances.
Airborne transmission occurs through the respiratory tract, and contact and vector transmission occur through contact, often via the skin. With vector transmission, an organism transmits to the disease the host, and with contact transmission, the host comes into direct or indirect contact with the infected organism or contaminated area.
Imagine a healthcare worker is working in a clinic in Brazil. She is exposed to mosquitos and patients with malaria every day. Because malaria is not contagious, how is it transmitted?
Indirect contact transmission
Vector transmission
Airborne transmission
Direct contact transmission
Question 3
The 6 “links” in the chain of infection are the infectious microorganism, the reservoir or location where the microorganism lives, the port of exit from the reservoir, the mode of transmission from the reservoir to the host, the portal of entry into the person or host, and the host themselves. In medical facilities, it’s vital that everyone works to interrupt the chain of infection by applying infection prevention and control, or IPAC, practices. These are procedures that can prevent disease transmission and eliminate sources of infection.
Because patients in medical facilities are typically already compromised with sickness or injury, they’re especially susceptible and vulnerable to other infections. But that also means the inverse is true—because medical facilities serve sick and infected people, there are many more infectious agents, reservoirs, modes of transmission, and susceptible hosts in these facilities. In general, there are more opportunities for everyone to contract a disease.
When IPAC practices are applied rigorously and correctly, they can reduce the number of healthcare-associated infections (HAIs), also known as nosocomial infections, in healthcare facilities. For patients, these are infections that occur in any healthcare setting due to contact with a pathogen that was not present at the time the infected person was admitted to the facility.
Which of the following could be an example of using an IPAC practice to prevent a nosocomial infection? Select all that apply.
A healthcare worker asks a coughing patient to wear a surgical mask.
A healthcare worker prescribes an antibiotic to a patient who might not have a bacterial infection.
A healthcare worker uses the same gloves after examining a healthy patient.
A healthcare worker properly cleans an exam room before seeing a new patient.
Question 4
At its most fundamental level, asepsis is about stopping the spread of disease. While medical asepsis refers to the absence of disease-causing microorganisms, surgical asepsis refers to the absence of all microorganisms. While medical asepsis is about being clean (which is above being sanitary), surgical asepsis is about being as close to sterile as possible. These methods are applied to a variety of situations, and there are specific aseptic techniques applied in each case.
You’re a medical assistant on the job. Which of the following would likely require medical asepsis? Select all that apply.
Preparing an exam room
Giving a patient a bath
Preparing an OR
Arranging instruments for a cesarean section
Question 5
Asepsis is defined as not septic. In other words, asepsis is the absence of pathogens and disease-causing organisms. There are two types of asepsis: medical asepsis and surgical asepsis. Medical asepsis is less comprehensive, aiming to eliminate all pathogenic microbes. Surgical asepsis covers more ground—it requires the elimination of all microbes, both pathogens and non-pathogens.
Surgical asepsis is most often practices in operating rooms, delivery rooms, and other special diagnostic or treatment areas. It may also be applied when a sterile, somewhat invasive procedure is being performed at a patient’s bedside, such as inserting devices into sterile areas of the body or cavities.
When would you apply surgical asepsis? Select all that apply.
When you’re inserting a catheter
When you’re inserting a chest tube
When you’re emptying a urinary catheter drainage bag
When you’re removing excess water and toxins from the blood through dialysis
Question 6
In healthcare settings, germs are found everywhere. People—from patients, to healthcare workers, to visitors and family members—are a major source of germs. They can leave them on a variety of surfaces, and other people can pick them up. This, at its most basic level, is one possible route of the chain of infection. But because these people and places can be the reservoir or the mode of transmission, it suggests that each of the 6 “links” in the chain of infection can change slightly or switch depending on the circumstances. Mode of transmission is how the infection or disease is passed on, and the reservoir is where the pathogen lives.
This requires that healthcare professionals consider the appropriate approach for the variety of infections that can be contracted in their workplace. Which of the following techniques could break the chain of infection at the reservoir link? Select all that apply.
Removal of catheters and tubes
Sterilization
Disinfection
Infection prevention policies
Question 7
Performing hand hygiene is a critical step in maintaining antiseptic healthcare facilities. But handwashing as a medical professional is not the same as handwashing as a layperson in your regular life. It’s methodical and systematic, and it requires very specific steps and procedures. There are also several types of handwashes, which can be applied to different situations depending on the level of asepsis required.
The objective of a regular handwash is to clean off organic material that is visibly present on hands. An alcohol-based rub, on the other hand, is a quicker and easier approach when the hands are not soiled, and a surgical or aseptic handwash requires the use of antimicrobial soap and a very specific technique.
You’re a medical assistant on the job, and you’re running late for a birth in the delivery room. You’ve just washed your hands with soap and water. What do you do next?
Administer an alcohol rub before putting on gloves. This strikes the right balance and doesn’t take too much more time.
Put on gloves and go into the delivery room. You don’t want to be late.
Perform a surgical handwash and then do an alcohol rub before putting on gloves. This takes the longest, but it seems like the most thorough approach.
Perform a surgical handwash before putting on gloves. This takes longer, but it feels like the right approach.
Question 8
A surgical hand scrub, or an antiseptic handwash, is done before an operation, surgery, or another type of invasive procedure. It’s a handwashing technique that is used for surgical asepsis. Because the goal of surgical asepsis, and therefore surgical handwashing, is to eliminate all microorganisms, the process of performing a surgical handwash has many steps. It requires diligence, attentiveness, and attention to detail. It also requires that you move your hands in specific ways and directions and perform actions and activities in a particular order. Time also plays a role.
When performing a surgical handwash, which of the following is important? Select all that apply.
Using antimicrobial soap for several minutes
Removing jewelry
Scrubbing one hand first and then doing the other
Keeping your hands above the elbows
Question 9
Compound microscopes have many parts and pieces, and they each play a specific role. Typically, when using a compound microscope, you will first turn the revolving nose piece so that the lowest power objective lens (e.g., 4x) is in position. You will then place the microscope slide on the stage and ensure it is fastened with stage clips. You’ll then look at the objective lens and the stage from the side, and then you’ll turn the focus knob so the stage moves up toward the lens. You can move it up as far as possible without letting the objective lens touch the coverslip of the slide. Then, look through the eyepiece and move the focus knob until the image comes into focus.
Which of the above parts is most responsible for magnifying the slide?
Objective lens
Focus knob
Revolving nose piece
Stage
Question 10
Contamination, typically, is used to refer to contact with a microorganism. It doesn’t need to be a pathogenic microorganism, and sterile items and clean or medically aseptic items might be considered contaminated in different ways. A clean item is contaminated with it comes in contact with pathogens; sterile items become contaminated when they touch any item that is not sterile.
You’re a medical professional, and you’re working with sterile instruments for a surgery. You also have a clean device that you keep away from the sterile instruments. In this case, what are you adhering to?
Rules of contamination
Medical asepsis
Rules of decontamination
Surgical asepsis
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