Kawalan Jangkitan dan Keselamatan Pesakit: pek ulang kaji kilat

Lembaran formula, langkah kaedah utama untuk setiap topik dan 6 soalan latihan, dengan penyelesaian penuh di bahagian belakang.

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1Formula dan kaedah

Kawalan jangkitan & keselamatan pesakit

Kaedah

  1. Mulakan dengan langkah berjaga-jaga standard untuk setiap pesakit: kebersihan tangan, PPE untuk pendedahan yang dijangka, benda tajam yang selamat.
  2. Tambah langkah berjaga-jaga mengikut laluan: sentuhan (gaun, sarung tangan), titisan (pelitup muka pembedahan), bawaan udara (N95, bilik tekanan negatif).
  3. Pastikan item steril kekal steril: jika ragu-ragu, ia tidak steril; gantikan, jangan sekali-kali dilap.
  4. Cegah bahaya dalam persekitaran: langkah pencegahan jatuh, sekatan hanya sebagai pilihan terakhir, RACE dan PASS untuk kebakaran.
  5. Semak hak pemberian ubat, dua pengenalpastian dan perlindungan tambahan untuk ubat berisiko tinggi; laporkan kesilapan dan hampir-hampir terlepas.

2Soalan latihan

1.Kawalan jangkitan & keselamatan pesakitSederhana

A family member tells the nurse, “My father is not himself. Something is wrong.” The hospital has a family-activated rapid response system. What is correct?

  1. AOnly doctors may call the rapid response team
  2. BThe family must wait for the next scheduled ward round to raise the concern with a doctor
  3. CThe family can call the rapid response team if they are worried and staff have not responded
  4. DThe family should call emergency services from outside the hospital
2.Kawalan jangkitan & keselamatan pesakitSukar

A patient dies after a wrong-drug error, and the hospital carries out a root cause analysis. What is its main focus?

  1. AFinding the system and process weaknesses that allowed the error
  2. BDeciding whether to tell the family about the error
  3. CIdentifying which staff member made the error and should be disciplined
  4. DEstimating the legal costs for the hospital
3.Asas kejururawatanSederhana

A patient has just finished a glass of iced water. How should this affect taking an oral temperature?

  1. AAdd half a degree to the reading to correct for the drink
  2. BTake it straight away, as cold drinks do not affect the mouth
  3. CUse the reading but only if the patient says they feel warm
  4. DWait about 15–30 minutes, as the reading may be falsely low
4.Asas kejururawatanSukar

A patient with heart failure weighs 2 kg more than yesterday on the same scales. What does this most likely show?

  1. AAbout 2 litres of fluid has been retained
  2. BThe patient has gained 2 kg of body fat
  3. CThe patient is becoming dehydrated
  4. DThe scales must have been faulty
5.MikrobiologiSederhana

MRSA rintang terhadap metisilin kerana ia mempunyai:

  1. APam efluks untuk setiap antibiotik
  2. BTiada dinding sel langsung
  3. CProtein pengikat penisilin (PBP2a) yang berubah
  4. DKapsul polisakarida yang menyekat kemasukan semua beta-laktam
6.MikrobiologiSukar

Pada tahun 1840-an Ignaz Semmelweis mengurangkan kematian akibat demam nifas di sebuah klinik bersalin di Vienna. Apakah yang diperkenalkannya?

  1. AMengekalkan ibu dalam bilik pengasingan yang berasingan selepas bersalin
  2. BMencuci tangan dengan kapur berklorin sebelum memeriksa wanita
  3. CMerawat ibu dengan penisilin
  4. DVaksinasi semua ibu sebelum bersalin

3Larutan

1.Kawalan jangkitan & keselamatan pesakit

Jawapan: C · The family can call the rapid response team if they are worried and staff have not responded

Mengapa ini jawapannya

Family-activated rapid response systems allow patients and families to call for help directly when they notice a worrying change. The nurse should also take the concern seriously and assess the patient.

Jawapan

C · The family can call the rapid response team if they are worried and staff have not responded
2.Kawalan jangkitan & keselamatan pesakit

Jawapan: A · Finding the system and process weaknesses that allowed the error

Mengapa ini jawapannya

A root cause analysis looks beyond the individual to the system factors, such as storage, labeling, staffing or workflow, that allowed the error. The aim is to change the system so the error cannot happen again.

Jawapan

A · Finding the system and process weaknesses that allowed the error
3.Asas kejururawatan

Jawapan: D · Wait about 15–30 minutes, as the reading may be falsely low

Mengapa ini jawapannya

Hot or cold drinks, eating and smoking change the temperature in the mouth for a while. The nurse waits 15–30 minutes or uses another site.

Jawapan

D · Wait about 15–30 minutes, as the reading may be falsely low
4.Asas kejururawatan

Jawapan: A · About 2 litres of fluid has been retained

Mengapa ini jawapannya

A rapid weight change over a day reflects fluid, not fat; 1 kg is roughly 1 litre. Daily weights taken at the same time on the same scales are a sensitive measure of fluid retention.

Jawapan

A · About 2 litres of fluid has been retained
5.Mikrobiologi

Jawapan: C · Protein pengikat penisilin (PBP2a) yang berubah

Mengapa ini jawapannya

Gen mecA mengekod PBP2a, yang mempunyai afiniti rendah terhadap beta-laktam, maka bakteria boleh terus membina dinding selnya walaupun terdapat metisilin.

Jawapan

C · Protein pengikat penisilin (PBP2a) yang berubah
6.Mikrobiologi

Jawapan: B · Mencuci tangan dengan kapur berklorin sebelum memeriksa wanita

Mengapa ini jawapannya

Semmelweis perasan kematian lebih tinggi di wad yang dikendalikan oleh doktor yang juga melakukan bedah siasat. Pembasmian kuman tangan dengan kapur berklorin mengurangkan kematian dengan ketara, lama sebelum teori kuman diterima.

Jawapan

B · Mencuci tangan dengan kapur berklorin sebelum memeriksa wanita

ExamProblems · examproblems.com/courses/infection-control-and-patient-safety