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Infection Prevention
Quiz by Diane Donaldson
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Infection prevention and controlPN Infection Prevention and Control (Fundamentals)7.012 Employee Health The Center provides a safe working environment for all employees through a collaborative effort with them and the organization’s infection control program to identify infectious conditions that may put staff, patients and visitors at risk. Health evaluations, immunity testing for measles, mumps rubella and chickenpox, tuberculosis screening and immunity testing for hepatitis B and if not immune either signs declination form or accepts 3 dose vaccine series. (Rrefer to the Employee and Occupational Health Section policy Chapter 3.21) It is the center’s policy to monitor Health Care Associated Infections (HAI) in patients and personnel working in the Center as part of its ongoing program in Infection Prevention and Control. Staff should be encouraged to stay home when they have signs and symptoms of an infectious disease. If a staff develops signs and symptoms while at work, the person of other personnel and patients who may have been exposed to a staff member with a communicable disease should be taken into consideration. Patients and personnel can be told that they were exposed to a certain disease without disclosing the index case’s identity. In addition we work together to provide an annual influenza vaccination program that includes all staff who have patient contact, and licensed independent practitioners. Environmental Rounds - Environmental rounds are performed daily by assigned staff members, ie. “safety officer”. Feedback on opportunities for improvement is given to the Infection Control Coordinator and QAPI committee and then reported to the board Education – Employee education includes: General information about infections Techniques for prevention, surveillance, investigation and control Review of policies and procedures related to infection control: (See attachment B, policy and procedure reference list) Employee health practices; refer to Administration 3.16 Orientation and Training Offer of Hepatitis B vaccination & post exposure evaluations Annual TB skin testing Provides access to influenza vaccinations. Educates staff and licensed independent practitioners about influenza vaccination; non-vaccine infection control measures (such as the use of Droplet Precautions); and diagnosis, transmission, and potential impact of influenza. Annually evaluates vaccination participation and non-participation in the influenza immunization program and reports to Department of Health. 7.018 Safe Injection Practices (Refer to 7.07 Safe Injection Policy) Environment of Care: Active participation with all identified projects to assess compliance with infection control standards. . Surveillance, Control, and Reporting includes: Baseline information about the frequency and type of nosocomial infections. Identification of patients and/or staff with communicable or potentially communicable infections. Patients identified with a communicable disease will be isolated from other patients in the facility or, if this is not possible, they will be transferred to a local hospital for care or rescheduled. Identification of clusters of microorganisms or significant deviations from endemic level. Reporting to committees and outside agencies, when required. Investigation of infections as needed. Immediate implementation of corrective and preventive measures that result in improvements. The Infection Control nurse or designated staff member will perform facility audits and report results to the QI committee and Board of Managers. EVALUATION Evaluation and improvement of the infection prevention and control activities are important steps in the Center’s efforts to control and prevent infection. Infection prevention and control practices should become a routine part of the care, treatment, or services the center provides to patients. Patients expect and deserve hygienic and safe care even if their contact with the Center does not extend beyond a single visit. Continuous review of the goals, activities, and outcomes of the Center’s initiative are therefore followed by improvement activities that are realistic in expectation and, above all, effective. Evaluation of the plan shall include but not be limited to: Evaluation of the infection prevention and control activities annually and whenever risks significantly change. The evaluation includes a review of the following: The infection prevention and control prioritized risks The infection prevention and control goals. Implementation of infection prevention and control Outcomes of infection prevention and control activities. Findings from the evaluation are communicated at least annually to the Quality Management Committee References: http://oneandonlycampaign.org/content/what-are-they-why-follow-them. Centers for Disease Control and Prevention (CDC). (2004). Guidance for the Selection and Use of Personal Protective Equipment (PPE) in Healthcare Settings. Retrieved January 29, 2015 from www.cdc.gov/niosh/topics/bbp/sharps.html. Centers for Disease Control and Prevention (CDC). (2003). Guidelines for Environmental Infection Control in Health-Care Facilities 52(RR10);1-42. Retrieved January 29, 2015 from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm. Centers for Disease Control and Prevention (CDC). (2002). Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR. 51(RR-16). Retrieved January 29, 2015 from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm. Centers for Disease Control and Prevention (CDC). (2008). Sharps Safety Workbook. Retrieved April 24 2014 from http://www.cdc.gov/sharpssafety/pdf/workbookcomplete.pdf. Guideline for Infection Control in Healthcare Personnnel available at: Guideline for Infection Control in Healthcare Personnel available at: http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf Immunization of HealthCare Personnel, guidance available at: http://www.cdc.gov/vaccines/spec-grps/hcw.htm Occupational Safety & Health Administration (OSHA) Bloodborne Pathogens and Needlestick Prevention Standards available at: http://www.osha.gov/SLTC/bloodbornepathogens/index.html Sax H, et al. (2007). My five moments for hand hygiene: A user-centered design approach to understand, train, monitor and report hand hygiene. For the World Health Organization. J Hosp Infect 67(1):9–21. World Health Organization (WHO). (2005). World Alliance for Patient Safety. WHO Guidelines on Hand Hygiene in Health Care. Retrieved January 29 , 2015 from http://www.who.int/patientsafety/events/05/HH_en.pdf.Oral Manifestations of Viral Infections Viral infections can lead to a variety of oral manifestations, which may vary depending on the type of virus involved. Below are the key viral infections and their associated oral symptoms. --- 1. Herpes Simplex Virus (HSV) Infections Type: HSV-1 and HSV-2 Common Oral Manifestations: Primary Herpetic Gingivostomatitis: In children, presents as painful swelling and redness of the gums, with vesicular lesions on the lips, tongue, and hard palate. Recurrent Herpes Simplex: Cold sores (herpes labialis) often appear on the lips or around the mouth, and are painful and fluid-filled. Herpetic Whitlow: Infection of the fingers, often seen in healthcare workers. Clinical Features: Vesicular lesions that break to form ulcers Painful and burning sensations in affected areas Swollen lymph nodes Fever (during primary infection) Diagnosis: Direct immunofluorescence, PCR, or viral culture. --- 2. Varicella-Zoster Virus (VZV) Infections Type: Varicella (chickenpox) and Herpes Zoster (shingles) Common Oral Manifestations: Varicella: Enanthem (oral lesions) such as vesicular lesions on the hard palate, tongue, and lips, in conjunction with the characteristic skin rash. Herpes Zoster (Shingles): Unilateral painful oral lesions, often involving the hard and soft palate, and can extend to the tongue or buccal mucosa along the distribution of the trigeminal nerve. Clinical Features: Vesicular lesions that ulcerate Pain and discomfort in affected areas Fever, malaise, and headache (for chickenpox) Diagnosis: PCR, direct fluorescence antibody test, and clinical signs. --- 3. Human Papillomavirus (HPV) Infections Type: Multiple strains, including HPV types 16 and 18 Common Oral Manifestations: Oral Warts: Benign, non-painful growths typically found on the lips, palate, tongue, and floor of the mouth. Condyloma Acuminatum: Wart-like lesions in the mouth, often associated with genital HPV. Oropharyngeal Cancer: Certain high-risk HPV strains (e.g., HPV-16) are linked to cancers of the oropharynx, including tonsils and base of tongue. Clinical Features: Raised, fleshy, or cauliflower-like growths Rarely associated with pain or discomfort Diagnosis: Biopsy and PCR testing for HPV. --- 4. Coxsackievirus Infections Type: Hand, Foot, and Mouth Disease (HFMD) Common Oral Manifestations: Oral Ulcers: Painful, shallow ulcers typically seen on the soft palate, tonsils, tongue, and buccal mucosa. Vesicular Lesions: Small vesicles that ulcerate to form painful sores. Clinical Features: Red spots or vesicles that turn into ulcers Fever, sore throat, and malaise Rash and lesions on hands and feet Diagnosis: Clinical presentation and PCR. --- 5. Measles (Rubeola) Type: Paramyxovirus Common Oral Manifestations: Koplik Spots: Small, white or bluish-white spots seen on the buccal mucosa opposite the molars before the rash appears. Generalized Oral Ulceration: Following the appearance of Koplik spots, mucosal lesions may develop. Clinical Features: High fever, cough, and rash (starts on the face and spreads) Conjunctivitis Koplik spots as early indicators Diagnosis: Clinical signs and serology for measles antibodies. --- 6. HIV/AIDS Type: Human Immunodeficiency Virus Common Oral Manifestations: Oral Candidiasis: Fungal overgrowth in the mouth due to immunosuppression. Kaposi's Sarcoma: A form of cancer that appears as purple or brown lesions in the mouth, especially in the palate or gingiva. Oral Hairy Leukoplakia: White, hairy lesions on the lateral borders of the tongue, often associated with Epstein-Barr virus. Herpes Simplex and Zoster: Recurrent infections in the oral cavity. Clinical Features: Candidiasis: White plaques that can be scraped off Kaposi’s Sarcoma: Purple, macular lesions Hairy Leukoplakia: White, corrugated patches on the tongue Recurrent infections and oral ulcers Diagnosis: HIV testing, biopsy for Kaposi's sarcoma, and culture for candidiasis. --- 7. Influenza Virus Type: Influenza A and B Common Oral Manifestations: Pharyngitis: Sore throat and erythema of the oropharyngeal mucosa. Dry Mouth: Often secondary to fever and dehydration. Mucosal Erosions: Rare, but may occur in severe cases. Clinical Features: Fever, cough, sore throat, muscle aches, and headache Red or swollen tonsils and oral mucosa Diagnosis: Rapid influenza tests and PCR. --- 8. Epstein-Barr Virus (EBV) Type: Epstein-Barr virus Common Oral Manifestations: Oral Hairy Leukoplakia: White, asymptomatic, corrugated patches on the lateral borders of the tongue. Pharyngitis: Sore throat with swelling of tonsils. Oral Ulcers: Occasionally seen in association with infectious mononucleosis. Clinical Features: Fever, sore throat, and swollen lymph nodes (mononucleosis) Fatigue and malaise Diagnosis: EBV serology and PCR. --- 9. Rabies Virus Type: Rabies virus Common Oral Manifestations: Hydrophobia: Difficulty swallowing and fear of water. Increased Salivation: Resulting from dysfunction in the throat and jaw muscles. Clinical Features: Progressive neurological symptoms Paroxysms of pain or spasms in the throat and mouth Diagnosis: Clinical signs, rabies testing (saliva, CSF, or tissue biopsy). --- 10. Human Immunodeficiency Virus (HIV) Common Oral Manifestations: Oral Candidiasis: White, creamy lesions in the mouth, especially in immunocompromised individuals. Kaposi’s Sarcoma: Purple or red lesions on the palate and gingiva. Herpes Simplex: Recurrent oral lesions. Oral Hairy Leukoplakia: A condition linked with Epstein-Barr virus, presenting as white patches on the lateral borders of the tongue. --- Conclusion Oral manifestations of viral infections are varied and can provide valuable clues for diagnosing systemic viral diseases. Clinicians must consider the specific features and patterns of lesions in combination with other clinical signs for an accurate diagnosis. Some infections may also have long-term oral health implications, requiring management and prevention strategies.Preventing infection - fill in the blankPreventing infectionPreventing infection - multiple choice