1: Infection prevention and control

Question 1

Describe the impact of Health care-associated infections (HAI)

Answer 1

• most common complication affecting patients in hospitals
• those in healthcare are often more susceptible due to being immune-compromised.
• cost Vic gov +80 million a year
• the longer a patient lives in. a healthcare system, the more procedures they have, the more chance of a HAI

Question 2

List some effects of HAI

Answer 2

• financial stress on the hospital as they aren’t moving people in and out
• increased risk of adverse outcomes
• patients get sicker and can die
• patient finance
• fewer hospital beds available
• risk of multi-resistance microorganisms
• Hospital resourced drained
  delayed movement of patients throughout hospitals

Question 3

List some vulnerable populations who are susceptible to HAI’s

Answer 3

• Oncology patients- chemo=immunocompromised
• Burns patients- broken skin allowing for pathogen entry
  ICU- critically ill with lots of interventions and external objects in their body (urinary catheter, IV)
• Children- an immune system not a developed
• Pregnant women- immune system stretched
• Surgical patients- internal environment exposed to the external environment

Question 4

Define an infection

Answer 4

disease state where the is invasion and multiplication of pathogens in tissue or bodily fluids causing cellular damage

• maybe asymptomatic or symptomatic

Question 5

Define a pathogen

Answer 5

Disease-causing microorganisms. (e.g. bacteria, virus, fungi, parastie)

Question 6

Define a Hospital or Nosocomial acquired infection

Answer 6

Infection where signs and symptoms occur at least 2 days after administration

Question 7

Iatrogenic infections

Answer 7

infections which result from treatment or diagnostic procedure

Question 8

Define an endogenous HAI

Answer 8

an infection resulting from patient’s own normal body flora multiplies and moves into another body site.

Question 9

Define Exogenous HAI

Answer 9

an infection from an organism external to the person’s own normal flora.

Question 10

Define a non hospital health care-acquired infection

Answer 10

infection from other form of health care which presents at the hospital.

e.g. dentist causing mouth infection

Question 11

up to 50% of all HAI are associated with what 5 patient care practices

Answer 11

1- hand hygiene and standard precautions
2- use and care of indwelling urinary catheters
3- use and care of vascular access devices
4- Therapy and support for pulmonary functions
4- experience with surgical procedures

Question 12

Does the presence of a microorganism (colonisation) on/in the body mean infection.

Answer 12

No

Question 13

What must occur for an infectious microorganism to develop

Answer 13

• colonise (grow and multiply)
• move from one source to another
• Overcome a hosts defence system
• Damage cells, tissues and body systems

Question 14

Describe residential flora

and what is required to clean them from the skin?

Answer 14

microorganisms that are always present on or in the host, usually without altering the health of the host.

friction and antimicrobial wash are necessary to remove them from the skin.

resident= lives there/on the body

Question 15

Describe transient flora

and what is required to remove them from the skin?

Answer 15

microorganism that are episodic and usually don’t continually live on or in the host

MAIN CAUSE OF HAI

soap and water or alcohol are usually enough to remove them from the skin.

usually acquired from direct contact with microorganisms on environmental surfaces or patients.

Quickly travel from patient- cloths- nurse- wash staff

Question 16

What are the four stages of infection

Answer 16

1- Incubation
2- Prodromal
3- Illness
4- Convalescence

Question 17

Name and describe the first stage of infection

Answer 17

1- Incubation

- time between entry of an infectious organism to the host and onset of symptoms

Question 18

Name and describe the second stage of infection

Answer 18

2- Prodromal

- time between nonspecific symptoms (fever) and specific symptoms manifestation (puss/discharge from a wound)\

Question 19

Name and describe the third stage of infection

Answer 19

3- Illness

- When a patient begins manifesting specific symptoms of an infection

Question 20

Name and describe the fourth stage of infection

Answer 20

4- Concalenscence

- time between the disappearance of symptoms until the person returns to their pre-illness state

Question 21

Define Multi resistance

Answer 21

is antimicrobial resistance shown by a species of microorganism to multiple antimicrobial drugs.

Question 22

List the components of the chain of infection

Answer 22

• Infectious agent
• Reservoir
• portal of exit
• method of transmission
• portal of entry
• susceptible host

Question 23

Describe the components of the chain of infection and the method for eradication- Infectious agent

Answer 23

A disease-producing organism
e.g. bacteria, ebola, e.coli

method for eradication 
- clean environment
- disinfectant 
sterilisation 
- eradication of environmental factors

Question 24

Describe the components of the chain of infection and the method for eradication- Reservoir

Answer 24

where growth occurs in an organism
- pH 5-8 ideal for pathogens to thrive

pH changes through parts of the body.

the acidity of a person varies and effects suceotablity to pathogens

e.g. human host- blood, human tissue

method of eradication
- antiviral/bacterial/fungal

Question 25

Describe the components of the chain of infection and the method for eradication- Portal or exit

Answer 25

escape route and how it enters the world

e.g. urinary gastrointestinal tracts and integumentary system (skin)

method of eradication
- fecal matter, vomit= all of these resivours can be contained also WASH YOUR HANDS AND ENVIRONEMNT

Question 26

Describe the components of the chain of infection and the method for eradication- method of transmission

Answer 26

How the pathogen gets into the body.

e.g. via blood, feces, urine, spit, semen, vagina secretion, breast milk

method of eradication

• hand washing
• PPE

Question 27

Describe the components of the chain of infection and the method for eradication- Portal of entry

Answer 27

How the pathogen exits the body.

e.g. via blood, feces, urine, spit, semen, vagina secretion, breast milk

method of eradication

• hand washing
• ensuring cracked skin is covered
• masks
• wounds covered

Question 28

Describe the components of the chain of infection and the method for eradication- Susceptible host

Answer 28

those who immune systems are less able to cope and fight a pathogen.

e.g. diabetes, emphasema, cancer, peripheral VD, burns, smoking (all immunocompromised)

method of erradication

• education
• promote healthy life style

Question 29

What is the promaru method of infection transmission in hospitals?

Answer 29

via hands of health care professionals

Question 30

What is the primary role of nures/midwifes in prevention of HAI’s?

Answer 30

Control infection and break linkages in the chain of infection by implementing methods of erradication via standard and additional precautions

• get immunised, speak up if poor hand hygiene is occurring
• achieved through STANDARD PRECAUTIONS

Question 31

List some examples of non-pharmacological factors increasing HAI susceptibility

Answer 31

cancer- immunosuppression from chemotherapy
PVD- reduced blood flow to injured tissue and delayed wound healing
Down syndrome- decreased lymphocytes and reduced response to a communication
Smoking- increased risk of respiratory, vaginal, gastric and surgical infections

Question 32

List some examples of pharmacological factors increasing HAI susceptibility

Answer 32

Radiotherapy- suppresses bone marrow function and damages the first line of defense
Immunosuppressants- reduced lymphocyte responsiveness to foreign matter
cytotoxins- depressed bone marrow, decreased production of white blood cells and lymphocytes

Question 33

Define a standard precaution

Answer 33

minimum requirements for the basic level of infection control.

• hand hygiene before and after every episode of patient contact (5 moments )
• use of PPE

Question 34

What are the five moments of hand hygiene

Answer 34

1- before touching a patient
2- before performing a procedure
3- after a procedure/exposure to bodily fluid
4- after touching a client
5- After touching environment of a client

Question 35

Define and give examples of a standard precaution

Answer 35

= are the minimum requirements for a basic level of infection control

• hand hygiene- before every episode of patient contact
• PPE
• routein environment cleaning
• Safe sharps disposal
• Cough etiquette
• Antiseptic non-touch technique
• waste management
• appropriate handling of linen
• Reprocessing of reusable medical equipment and instruments

Question 36

Define and give examples of additional precautions

Answer 36

• required when a patient has a highly transmissible infection not contained by standard precautions

can include;

• combination of SP
• appropriate use of PPE
• Patient dedicated equipment - Single rooms/cohorting patients
• appropriate air handling
• enhanced cleaning and disinfection of the patient environment
• restricted transfer of patients within and between facilities

Question 37

Are nurses and midwives at risk of acquiring HAI’s also?

Answer 37

Yes