Difference between revisions of "AY Honors/Home Nursing/Answer Key"

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A '''heating pad''' is a pad used for warming of parts of the body in order to manage [[Pain and nociception|pain]]. Localized application of heat causes the blood vessels in that area to [[vasodilator|dilate]], enhancing [[perfusion]] to the targeted tissue. Types of heating pads include [[electric|electrical]], [[chemical]] and [[hot water bottle]]s.
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'''Infection control and health care epidemiology'''
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is the discipline concerned with preventing the spread of infections within the health-care setting.
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As such, it is a practical (rather than an academic) sub-discipline of [[epidemiology]].
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It is an essential (though often underrecognized and undersupported) part of the infrastructure of health care.
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Infection control and hospital epidemiology are akin to [[public health]] practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.
  
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==Types==
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Infection control concerns itself both with prevention (hand hygiene/hand washing, cleaning/disinfection/sterilization, vaccination, surveillance) and with investigation and management of demonstrated or suspected spread of infection within a particular health-care setting (e.g. outbreak investigation).
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===Electrical===
 
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Electric pads usually operate from household current and must have protections against overheating.
 
  
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A '''moist heating pad''' is used dry on the users skin. These pads register temperatures from 170 to 180 degrees Fahrenheit (76 to 82 °C) and are intended for deep tissue treatment and can be dangerous if left turned on unattended. Moist heating pads are used mainly by physical therapists but can be found for home use.  A moist cloth can be added with a stupe cover to add more moisture to the treatment.
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==Infection control in healthcare facilities==
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===Hand hygiene===
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Independent studies by [[Ignaz Semmelweis]] in [[1847]] in [[Vienna]] and [[Oliver Wendell Holmes, Sr.|Oliver Wendell Holmes]] in [[1843]] in [[Boston]] established a link between the hands of health care workers and the spread of [[Nosocomial infection|hospital-acquired]] disease.<ref>[http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm CDC Guideline for Hand Hygiene in Health-Care Settings]</ref> The [[Centers for Disease Control and Prevention|Centers for Disease Control and Prevention (CDC)]] has stated that “It is well-documented that the most important measure for preventing the spread of of pathogens is effective handwashing.” <ref>[http://www.cdc.gov/nceh/vsp/cruiselines/hand_hygiene_general.htm CDC General information on Hand Hygiene]</ref> [[Hand washing#Medical hand washing|Hand washing]] is a mandatory requirement in most health care settings and required by many different state and local regulations as well as good sense.  
  
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===Chemical===
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[[Occupational Safety and Health Administration|Occupational Safety and Health Administration (OSHA)]] standards<ref>[http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051 OSHA Bloodborne Pathogens Regulations 1910.1030]</ref> require that employers must provide readily accessible hand washing facilities, and must ensure that employees wash hands and any other skin with soap and water or flush mucous membranes with water as soon as feasible after contact with blood or other potentially infectious materials (OPIM).
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Chemical pads employ a chemical heat reservoir or a one-time chemical reaction such as [[catalyst|catalyzed]] [[rusting]] of [[iron]].
 
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[[image:Hand warmer.jpg|right|thumb|A sodium acetate heat pad]]
 
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A '''sodium acetate heat pad''' contains a [[supersaturated]] solution of [[sodium acetate]] (CH<sub>3</sub>COONa) that heats when the [[crystallization]] process is started by pressing a piece of metal that is embedded in the liquid.
 
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Because the liquid is [[supersaturated]], pressing the metal makes the solution crystallize suddenly, thereby releasing the energy of the crystal lattice.  See [[sodium acetate]] for a more technical discussion.
 
  
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The heat is released on solidification, which is triggered by flexing a (patented <ref>[http://www.sfu.ca/physics/ugrad/courses/teaching_resources/demoindex/thermal/th4c/patentheatpack.html Physics course on thermal heat packs]</ref>) small flat disc of notched [[ferrous]] metal which releases very tiny adhered crystals of sodium acetate<ref>[http://www3.interscience.wiley.com/cgi-bin/abstract/108065684/ABSTRACT Article on sodium acetate]</ref> into the solution which then act as [[nucleation]] sites for the recrystallization of the remainder of the salt solution.
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===Cleaning, disinfection and sterilization===
  
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The pad can be reused by placing it in boiling water for 10-15 minutes, which redissolves the sodium acetate in the contained water and recreates a supersaturated solution. Once the pad has returned to room temperature it can be triggered again. Triggering the pad before it has reached room temperature results in the pad reaching a lower peak temperature, as compared to waiting until it had completely cooled.
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Cleaning, [[disinfection]] and [[sterilization (microbiology)|sterilization]]...
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{{sect-stub}}
  
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==High specific-heat capacity materials==
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===Personal protective equipment)===
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Heating packs can also be made by filling a container with a material that has a high [[specific heat capacity]], which then gradually releases the heat over time.  A hot water bottle is the most familiar example of this type of heating pad.
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[[Image:Disp-med-ppe.jpg|thumb|120px|Disposable PPE]]
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[[Personal protective equipment|Personal protective equipment (PPE)]] is specialized clothing or equipment worn by a worker for protection against a hazard. The hazard in a health care setting is exposure to blood, saliva, or other bodily fluids or aerosols that may carry infectious materials such as [[Hepatitis C]], [[HIV]], or other blood borne or bodily fluid [[pathogen]]. PPE prevents contact with a potentially infectious material by creating a physical barrier between the potential infectious material and the healthcare worker.  
  
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A '''microwavable heating pad''' is a heating pad that is warmed by placing it in a [[microwave oven]] before use.  Microwavable heating pads are typically made out of a thick insulative fabric such as flannel and filled with grains such as [[buckwheat]] or [[flax seed]]. Due to their relative simplicity to make, they are frequently sewn by hand, often with a custom shape to fit the intended area of use. These types of pads have been known to ignite during or after the microwave process and cause fires.
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The [[Occupational Safety and Health Administration|Occupational Safety and Health Administration (OSHA)]] requires the use of [[Personal protective equipment|Personal protective equipment (PPE)]] by workers to guard against blood borne pathogens if there is a reasonably anticipated exposure to blood or other potentially infectious materials. <ref>[http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051#1910.1030(d)(2)(i) OSHA Bloodborne Pathogens Regulations 1910.1030(d)(2)(i)]</ref> 
  
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Often, [[aroma compound|aromatic compound]]s will also be added to the filler mixture to create a pleasant or soothing smell when heated.  The source of these can vary significantly, ranging from adding [[essential oil]]s to ground up [[spices]] such as [[clove]]s and [[nutmeg]], or even dried [[rose]] petals.
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Components of [[Personal protective equipment|Personal protective equipment (PPE)]] include [[Medical gloves|gloves]], [[Hospital gown|gowns]], bonnets, shoe covers, [[Face shield|face shields]], [[CPR mask|CPR masks]], [[Goggles|goggles]], [[Surgical mask|surgical masks]], and respirators. How many components are used and how the components are used is often determined by regulations or the infection control protocol of the facility in question. Many or most of these items are [[Disposable|disposable]] to avoid carrying infectious materials from one patient to another patient and to avoid difficult or costly [[Disinfection|disinfection]]. [[Occupational Safety and Health Administration|OSHA]] requires the immediate removal and disinfection or disposal of worker's PPE prior to leaving the work area.<ref>[http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051#1910.1030(d)(3)(vii) OSHA 1910.1030(d)(3)(vii)]</ref>
  
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== Function ==
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===Vaccination of health care workers===
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Many episodes of pain come from [[muscle]] exertion or strain, which creates tension in the muscles and [[soft tissue]]s.  This tension can constrict [[circulatory system|circulation]], sending pain signals to the [[brain]]. Heat application eases pain by:
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Certain diseases have [[Vaccine|vaccines]] that give [[Vaccine#Efficacy of vaccines|some protection]] to workers in a healthcare setting. Depending on regulation, recommendation, the specific work function, or personal preference, healthcare workers or first responders may receive vaccinations for [[Hepatitis_B#Prevention|hepatitis B]]; [[Flu vaccine| influenza]]; [[MMR vaccine|measles, mumps and rubella]]; [[TDaP|Tetanus, diphtheria, pertussis]]; [[Neisseria_meningitidis#Vaccines|N. meningitidis]]; and [[Varicella vaccine|varicella]]. In general, [[Vaccine|vaccines]] do not guarantee complete protection from disease, and there is [[Vaccine#Potential_for_adverse_side_effects_in_general|potential]] for adverse effects from receiving the vaccine. <ref>[http://www.cdc.gov/node.do/id/0900f3ec8005df1f CDC Vaccine Site]</ref>
  
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* dilating the [[blood vessel]]s surrounding the painful area.  Increased [[blood]] flow provides additional [[oxygen]] and nutrients to help heal the damaged muscle tissue.
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===Surveillance for emerging infections===
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Surveillance is the act of infection investigation using the CDC definitions.  Determining an infection reqires an ICP to review a patient's chart and see if the patient had the signs and symptom of an infection.  Surveillance definition cover infections of the bloodstream, Urinary tract, pneumonia, and sugical sites.
  
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* stimulating sensation in the [[skin]] and therefore decreasing the pain signals being transmitted to the brain
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==Outbreak investigation==
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Antibiotics are a common treatment when an outbreak occurs. However, if the infection has built a resistance to a particular antibiotic, then that antibiotic would be ineffective. Resistances are 'bred' into an organism as a result of consistent exposure to an antibiotic. Overuse of antibiotics is therefore to be avoided in the interest of public health.
  
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* increasing the flexibility (and decreasing painful stiffness) of soft tissues surrounding the injured area, including muscles and [[connective tissue]].
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==Training in infection control and health care epidemiology==
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Practitioners can come from several different educational streams. Many begin as nurses, some as medical technologists (particularly in clinical microbiology), and some as physicians (typically infectious disease specialists). Specialized training in infection control and health care epidemiology are offered by the professional organizations described below. Physicians who desire to become infection control practitioners often are trained in the context of an infectious disease fellowship.
  
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As many heating pads are portable, heat may be applied as needed at home, at work, or while traveling. Some physicians recommend alternating heat and [[ice]] for [[pain management|pain relief]]. ''As with any pain treatment, a physician should be consulted prior to beginning treatment.''
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[http://www.cbic.org Certification Board of Infection Control and Epidemiology] is an organization that certifies infection control practitioners based on their educational background and professional experience, in conjunction with testing their knowledge base with standardized exams. The credential awarded is CIC, Certification in Infection Control and Epidemiology.
  
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==See also==
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A [http://www.shea-online.org/about/shea_courses.cfm course] in hospital epidemiology (infection control in the hospital setting) is offered jointly each year by the Centers for Disease Control and Prevention (CDC) and the Society for Healthcare Epidemiology of America.
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*[[Hand warmer]]
 
  
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== References ==
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== Footnotes ==
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* [http://www.spine-health.com/topics/conserv/heat_therapy/heat_therapy01.html Benefits of heat therapy for lower back pain]
 
 
<references/>
 
<references/>
  
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[[Category:Medical treatments]]
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==Professional organizations==
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[[Category:Medical equipment]]
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[http://www.apic.org Association of Professionals in Infection Control and Epidemiology] is primarily composed of infection  prevention and control professionals with nursing or medical technology backgrounds
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[[Category:Heat]]
 
  
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[http://shea-online.org The Society for Healthcare Epidemiology of America] is more heavily weighted towards practitioners who are physicians or doctoral-level epidemiologists.
  
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[[de:Wärmekissen]]
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[[Category:Epidemiology]]
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[[nl:Natriumacetaat-verwarmertje]]
 

Revision as of 01:18, 1 April 2007

Infection control and health care epidemiology is the discipline concerned with preventing the spread of infections within the health-care setting. As such, it is a practical (rather than an academic) sub-discipline of epidemiology. It is an essential (though often underrecognized and undersupported) part of the infrastructure of health care. Infection control and hospital epidemiology are akin to public health practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.

Infection control concerns itself both with prevention (hand hygiene/hand washing, cleaning/disinfection/sterilization, vaccination, surveillance) and with investigation and management of demonstrated or suspected spread of infection within a particular health-care setting (e.g. outbreak investigation).

Infection control in healthcare facilities

Hand hygiene

Independent studies by Ignaz Semmelweis in 1847 in Vienna and Oliver Wendell Holmes in 1843 in Boston established a link between the hands of health care workers and the spread of hospital-acquired disease.& The Centers for Disease Control and Prevention (CDC) has stated that “It is well-documented that the most important measure for preventing the spread of of pathogens is effective handwashing.” & Hand washing is a mandatory requirement in most health care settings and required by many different state and local regulations as well as good sense.

Occupational Safety and Health Administration (OSHA) standards& require that employers must provide readily accessible hand washing facilities, and must ensure that employees wash hands and any other skin with soap and water or flush mucous membranes with water as soon as feasible after contact with blood or other potentially infectious materials (OPIM).

Cleaning, disinfection and sterilization

Cleaning, disinfection and sterilization... Template:Sect-stub

Personal protective equipment)

Disposable PPE

Personal protective equipment (PPE) is specialized clothing or equipment worn by a worker for protection against a hazard. The hazard in a health care setting is exposure to blood, saliva, or other bodily fluids or aerosols that may carry infectious materials such as Hepatitis C, HIV, or other blood borne or bodily fluid pathogen. PPE prevents contact with a potentially infectious material by creating a physical barrier between the potential infectious material and the healthcare worker.

The Occupational Safety and Health Administration (OSHA) requires the use of Personal protective equipment (PPE) by workers to guard against blood borne pathogens if there is a reasonably anticipated exposure to blood or other potentially infectious materials. &

Components of Personal protective equipment (PPE) include gloves, gowns, bonnets, shoe covers, face shields, CPR masks, goggles, surgical masks, and respirators. How many components are used and how the components are used is often determined by regulations or the infection control protocol of the facility in question. Many or most of these items are disposable to avoid carrying infectious materials from one patient to another patient and to avoid difficult or costly disinfection. OSHA requires the immediate removal and disinfection or disposal of worker's PPE prior to leaving the work area.&

Vaccination of health care workers

Certain diseases have vaccines that give some protection to workers in a healthcare setting. Depending on regulation, recommendation, the specific work function, or personal preference, healthcare workers or first responders may receive vaccinations for hepatitis B; influenza; measles, mumps and rubella; Tetanus, diphtheria, pertussis; N. meningitidis; and varicella. In general, vaccines do not guarantee complete protection from disease, and there is potential for adverse effects from receiving the vaccine. &

Surveillance for emerging infections

Surveillance is the act of infection investigation using the CDC definitions. Determining an infection reqires an ICP to review a patient's chart and see if the patient had the signs and symptom of an infection. Surveillance definition cover infections of the bloodstream, Urinary tract, pneumonia, and sugical sites.

Outbreak investigation

Antibiotics are a common treatment when an outbreak occurs. However, if the infection has built a resistance to a particular antibiotic, then that antibiotic would be ineffective. Resistances are 'bred' into an organism as a result of consistent exposure to an antibiotic. Overuse of antibiotics is therefore to be avoided in the interest of public health.

Training in infection control and health care epidemiology

Practitioners can come from several different educational streams. Many begin as nurses, some as medical technologists (particularly in clinical microbiology), and some as physicians (typically infectious disease specialists). Specialized training in infection control and health care epidemiology are offered by the professional organizations described below. Physicians who desire to become infection control practitioners often are trained in the context of an infectious disease fellowship.

Certification Board of Infection Control and Epidemiology is an organization that certifies infection control practitioners based on their educational background and professional experience, in conjunction with testing their knowledge base with standardized exams. The credential awarded is CIC, Certification in Infection Control and Epidemiology.

A course in hospital epidemiology (infection control in the hospital setting) is offered jointly each year by the Centers for Disease Control and Prevention (CDC) and the Society for Healthcare Epidemiology of America.

Footnotes

  1. ↑ CDC Guideline for Hand Hygiene in Health-Care Settings
  2. ↑ CDC General information on Hand Hygiene
  3. ↑ OSHA Bloodborne Pathogens Regulations 1910.1030
  4. ↑ OSHA Bloodborne Pathogens Regulations 1910.1030(d)(2)(i)
  5. ↑ OSHA 1910.1030(d)(3)(vii)
  6. ↑ CDC Vaccine Site

Professional organizations

Association of Professionals in Infection Control and Epidemiology is primarily composed of infection prevention and control professionals with nursing or medical technology backgrounds

The Society for Healthcare Epidemiology of America is more heavily weighted towards practitioners who are physicians or doctoral-level epidemiologists.

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