5- Nosocomial Infections

Question 1

The word “nosocomial” used to mean “hospital acquired infections”, but now what does it mean?

Answer 1

healthcare ASSOCIATED infections (HAI)

Question 2

This is a nosocomial infection from the pts body.

Answer 2

Endogenous infection

Question 3

What is a nosocomial infection from sources external to the pt (personnel, equipment, visitors, hospital environment)?

Answer 3

Exogenous infection

Question 4

Who defined an HAI as a localized or systemic condition resulting from an adverse rxn to the presence of an infectious agents or its toxins?

Answer 4

CDC

Question 5

Who was the dude in 1847 who washed his hands when delivering babies, which decreased infections and mortality, and thus became the first standards of infection control?

Answer 5

Ignaz Semmelweis

Question 6

Who was the dude that used carbolic acid to chemically sterilize surgical equipment and bandages?

Answer 6

Joseph Lister

Question 7

How many nosocomial infections occur per year?

Answer 7

1.7 million

Question 8

How many people die per year from nosocomial infections?

Answer 8

99,000

240deaths/day

Question 9

How much $ does nosocomial infections cost us per year?

Answer 9

$30 billion

Question 10

What is the most common HAI?

Answer 10

UTI’s (32%)

Question 11

What is the most common reason that UTI’s are the most common HAI?

Answer 11

Catheters

Question 12

To reduce the incidence of HAI’s causing UTI’s, what is the recommendation?

Answer 12

Shorten the duration of use

Question 13

What % of HAI’s are surgical site infections (SSI)?

Answer 13

22%

Question 14

What % of HAI are PNA?

Answer 14

15%

Question 15

What % of HAI are bloodstream infections (bacteremia)?

Answer 15

14%

Question 16

Why are SSI, PNA, and bacteremia important HAI’s?

Answer 16

They cause the most serious illness and death

Question 17

Which pts are at the highest infection rates?

Answer 17

ICU pts

Question 18

What are the 3 most common G+ microbes for HAI?

Answer 18

S. aureus
CoNS (inc S. epi)
Enterococci

Question 19

What are the 4 most common G- microbes for HAI?

Answer 19

E. coli
Pseudomonas aeruginosa
Enterobacter sp.
Klebsiella pneumoniae

Question 20

This is a G+ spore and toxin former that infect hospitalized pts on antibiotics and pts that are typically > 65 y/o.

Answer 20

Clostridium difficile (C diff)

If you’ve never smelled a C. diff pt’s poop, you’re in for a surprise. When I worked in the ICU it wasnt uncommon where I had to clean up pt’s with C. diff and their mucoidal, green, gelatinous poop gave off a very retched, distinctive, gagging smell. It wakes you up!

Question 21

What % of the population are asymptomatic carriers of C diff?

Answer 21

3%

Question 22

What are the Sx of C diff infetions after antibiotics kill of normal flora?

Answer 22

Diarrhea and pseudomembranous colitis

Question 23

What is the estimated annual cost of C diff infections?

Answer 23

$3.2 billion

Question 24

What is the essential care of any pt with C diff infections?

Answer 24

WASH YOUR HANDS

hand sanitizers dont work!!

Question 25

Which yeast is a major HAI?

Answer 25

Candida albicans

Question 26

The consistent use of disinfectants, antiseptics, and antimicrobials causes what change in bacteria to cause more HAI's?

Answer 26

antimicrobial resistance

Question 27

What are the 3 major antibiotic resistant bacteria to cause HAI?

Answer 27

VRE, MRSA, and P. aeruginosa

Question 28

TO improve infection control, in addition to better surveillance and reporting and antibiotic control programs, what 2 things can u tell healthcare workers to do to reduce HAI's?

Answer 28

Require vaccinations | hand hygiene

Question 29

What is the most common mode of transmission of pathogens?

Answer 29

Hands

Question 30

What are the 2 compoents of handwashing?

Answer 30

Soap and water

Question 31

In additon to soap and water, what can u add to the handwash to help fight bugs?

Answer 31

Antiseptic agent

Question 32

What 2 things can surgical personnel do to limit HAI before operations?

Answer 32

handwashing or... | use an alcohol-based handrub

Question 33

Generally, why are hospitilized pts more vulnerable to infection?

Answer 33

immunocompromised/suppressed

Question 34

What is the thing that the CDC esablished in 2005 that reports nosocomial infections from over 3000 US hospitals and organizes data into 4 categories?

Answer 34

National Healthcare Safety Network (NHSN)

Question 35

What are the 4 categories of the NHSN?

Answer 35

1. Patient safety 2. healthcare presonnel safety 3. Biovigilance 4. Research and development

Question 36

True or False: medicare will not pay for the treatment of healthcare associated conditions that could reasonably have been prevented.

Answer 36

True

Question 37

What are "condtiions that could reasonably have been prevented?"

Answer 37

bedsores, pressure ulcers, Vascular catheter assocaited infections Catheter associated UTIs

Question 38

So if medicare doesnt pay for preventable conditions (HAI's), is the pt responsible for it?

Answer 38

No

Question 39

According to the American Recovery and Reinvestment Act of 2009, how much $ was authorized to support states in the prevention and reduction of HAI's?

Answer 39

$50 million