5. HAIs Flashcards
What are healthcare infections?
Infections arising as a consequence of providing healthcare:
- in hospital patients - neither present nor incubating at time of admission, i.e. onset >48hrs after admission
- infections in hospital visitors and healthcare workers
What is the prevalence of HAIs?
8% of in-patients
What is the prevalence of different types of HAIs?
- GI: 21%
- UTI: 20%
- pneumonia: 14%
- surgical wound infections: 14%
- other: 14%
- skin and soft tissue: 10%
- primary bloodstream: 7%
At which stages of the infection model can infection prevention interventions occur?
- prevent pathogen presence
- prevent pathogen and patient contact and infection
- prevent pathogen virulence
Give examples of HAI pathogens (viruses, bacteria, fungi and parasites).
Viruses
- blood borne viruses (hepB and C, HIV)
- norovirus
- influenza
- chickenpox
Bacteria
- S. aureus, inc. MRSA
- C. difficile
- E. coli
- P. aeruginosa
- M. tuberculosis
Fungi
- C. albicans
- Aspergillus sp.
Parasites
- Malaria
Which patient characteristics predispose to HAIs?
- age extremes
- obesity/malnourishment (poor wound healing in very thin)
- diabetes (esp. if poor glycaemic control)
- cancer or immunosuppression
- smoking (lung infections -pneumonia, poor vascularisation and O2 supply - surgical wound infections)
- surgical patients
- emergency admission
What are the 4 Ps of infection prevention and control?
- Pathogen
- virulence factors
- ecological interactions
other bacteria
antibiotics/disinfectants - Patient
- general and specific risk factors
- interactions with: other patients, healthcare workers, visitors - Practice
- general and specific activities of healthcare workers, e.g. hand hygiene, sharps disposal, surgical technique
- policies and their implementation
- organisational structure and engagement
- regional and national political initiatives
- leadership at all levels from government to the ward - Place - healthcare environment
- fixed features (e.g. design of wards, carpets…)
- variable features
Name types of patient interventions for the prevention of HAIs.
General:
- optimise patient’s condition, e.g. smoking, nutrition, diabetes
- antimicrobial prophylaxis (conc. that will last for duration of surgery)
- skin preparation
- hand hygiene
Specific
- MRSA screens
- mupirocin nasal ointment
- disinfectant body wash
Halting patient-to-patient transmission via physical barriers
- isolation of infected patients, e.g. single rooms with high pressure antechamber
- protection of susceptible patients, e.g. sterile positive pressure rooms for bone marrow transplant patients
Name types of healthcare worker interventions for the prevention of HAIs.
Healthy
- disease-free
- vaccinated
Good practice
- good clinical techniques (e.g. sterile non-touch)
- hand hygiene
- personal protective equipment (PPE), e.g. plastic aprons, gloves, masks, respiratory protection
- antimicrobial prescribing
Name types of environmental interventions for the prevention of HAIs.
Control of water, food, air and surfaces
- built environment
- e.g. space/layout, toilets, wash hand basins
- furniture and furnishings - Cleaning
- disinfectants
- steam cleaning
- hydrogen peroxide vapour (toxic) - medical devices
- single use equipment
- sterilisation
- decontamination - food prep
- appropriate kitchen and ward food facilities
- good food hygiene practice
What does “I-fiving” patients mean?
- Identify HAI risk factors:
- abroad
- blood borne infections
- colonised
- diarrhoea/vomiting
- expectorating
- funny looking rash
so. ..
2. Isolate
3. Investigate
4. Inform
5. Initiate
