5. Healthcare-Associated Infection (HAI) Flashcards
What is the definition of Healthcare-Associated Infections (HAI’s)?
- Infections that were not present, or in the pre-symptomatic phase, at the time of admission to hospital
- Infections which arise more than 48 hours after admission or within 48 hours of discharge
How prevalent are Healthcare-Associated Infections (HAI’s)?
4.9% patients in Scotland in 2011
What are the possible outcomes of Healthcare-Associated Infections (HAI’s)?
- Extended length of stay, pain, discomfort, permanent disability, death
- Increased cost
- Litigation
- Loss of public confidence and decreased staff morale
What are the most common sites of Healthcare-Associated Infections (HAI’s)?
- Urinary Tract Infections (UTI’s) - 22.6% (catheterisation)
- Surgical Site Infection - 18.6%
- Respiratory Tract Infection - 17.5% (intubation = 1/4)
- Bloodstream Infections - 10.8% (Central Venous Catheter)
- Gastrointestinal Infection - 6.8%
- Skin and Soft Tissue Infection - 4.0%
What is natures 1st Line defence mechanisms against infections?
- Intact Skin
- Normal Bacterial Flora (Skin and G.I. Tract)
- Body Secretions (Coughing)
- Gastric Acid
- Flushing (Urination)
What is natures 2nd Line defence mechanisms against infections?
The immune system:
1. Innate immune system
2. Adaptive immune system
What, in the hospital setting, harbours mircrobes?
Everyone and Everything:
Patients in hosptial are more vulnerable to microbial colonization and infection
What is the difference between Colonisation and Infection, in relation to Staph Aureus?
Colonisation: Approx. 30% of the populous are colonised with Staph Aureus (most with Meticillin-Sensitive S.A.)
Infection: The same strain of Staph Aureus that is colonising can also cause infection through:
1. Breaks in the Skin (Surgical Site Infection)
2. Vasculature Device (PVC/CVC)
3. Catheter Associated UTI
4. Ventilator Associated Pneumonia (VAP)
What is the cause of most Healthcare-Associated Infections (HAI’s)?
Disturbance in the Bacterial-Host equilibrium
What Microbial factors tip the balance point towards infection?
- Increased Resistance
- Increased Virulence
- Increased Transmissability
- Increased Survival Ability
- Ability to Evade Host Defence’s
What Host factors tip the balance point towards infection?
- Invasive Devices (PVC, CVC, Urinary Catheter, Ventillation)
- Antibiotics
- Break in the Skin Surface
- Foreign Body (Silk Suture)
- Immunosuppression
- Gastric Acid Suppression
- Age Extremes
- Overcrowding
- Increased opportunity for transmission (e.g. interventions, hand hygiene)
What are the 3 phases of the Chain of Infection?
- Source of Microbe (Endogenous or Exogenous)
- Transmission
- Host
What are the means of Transmission for Healthcare-Associated Infections (HAI’s)?
- Direct Contact (Staph. Aureus, Coliforms)
- Respiratory / Droplet (N. Meningitidis, M. TB)
- Faecal - Oral (C. Diff, Salmonella sp.)
- Penetrating Injury (Group A Strep. BBV)
What ways are there to break the chain of infection?
- Risk Awareness
- Standard Infection Prevention and Control Precautions
- Hand Hygiene
- Appropriate PPE
- Vaccination
- Post-Exposure Prophylaxis
- Environment
What is the definition of cleaning?
Physical removal of organic material and decrease in microbial load