(7b) Infection, Prevention and Control Flashcards
What is the prevalence of healthcare-associated infection (HCAI) and how much does it cost?
7.6% in 2006
5,000 UK HCAI deaths per annum
£2,917 per HAI
Annual cost to NHS = £930.6 million
What are the stages in the chain of infection?
- pathogenic organism
- reservoir
- exit
- transmission
- entry
- susceptible host (non-immune)
What must a pathogenic organism have in order to cause disease?
It must be of sufficient virulence and be in adequate numbers to cause disease
What does the ‘reservoir’ stage in the chain of infection mean?
Reservoir or source that allows the organism to survive and multiply
What is infection prevention and control (IPC)
Activities undertaken with the aim of breaking the chain of infection
- eliminate pathogenic organism
- remove source/reservoir
- minimise transmission
- eliminate exit and entry
- reduce susceptibility to infection
In what ways can the pathogenic organism be eliminated (part of IPC)?
- environmental cleaning and decontamination
- equipment decontamination
- antisepsis
- antibiotic prophylaxis
Environmental cleaning and decontamination helps to eliminate the pathogenic organism. Give examples of this
- H2O2 room decontamination
- spillage management
- laundry
Equipment decontamination can help to eliminate the pathogenic organism. Give examples of this
- sterilisation
- disinfection
Antisepsis can help to eliminate the pathogenic organism. Give examples of this
- surgical skin prep
- MRSA decolonisation
Antibiotic prophylaxis can help to eliminate the pathogenic organism. Give examples of this
- perioperative
- post-exposure
What is involved in removing the source/reservoir (part of IPC)?
- hand hygiene
- environmental cleaning and decontamination
What can be done to minimise transmission (part of IPC)?
- hand hygiene
- personal protective equipment (PPE - aprons, gloves, masks)
- equipment decontamination (surgical instruments, stethoscopes etc)
- source and protective isolation
- use of disposable equipment (syringes, needles etc)
What can be done to eliminate entry (and exit) -part of IPC?
- antisepsis (surgical skin prep)
- asepsis (insertion and management of invasive devices)
- air handling
- sharps management
- patient management (minimise use and duration of invasive devices)
Air handling can help to eliminate entry of micro-organism as part of IPC. What is involved in this?
- air filtration and laminar flow
- positive pressure ventilated lobby (PPVL) rooms
What can be done to reduce susceptibility to infection? (part of IPC)
- antibiotic stewardship “start smart - then focus” (reduce susceptibility to C. diff infection, reduce chance of colonisation with multi-resistant organisms)
- immunisation
What is surveillance?
Process of gathering information to ensure that disease outbreaks are pre-empted or identified early?
- alert organisms (organisms with the propensity to cause outbreaks)
- alert conditions (conditions caused by such organisms)
The IPC team in hospitals is involved in both passive and active surveillance. What is involved in passive surveillance?
Clinical reporting and laboratory records
The IPC team in hospitals is involved in both passive and active surveillance. What is involved in active surveillance?
Seeking out trouble eg. surgical site infection surveillance (SSIS) programmes
How is the community involved in surveillance?
Legislation of reportable/notifiable diseases
What are sterilisation, disinfection and antisepsis?
Decontamination methods used with the aim of reducing the burden of potentially pathogenic organisms from medical equipment and human tissue
What stages of the chain of infection to sterilisation, disinfection and antisepsis interrupt?
- eliminate pathogenic organism
- remove source/reservoir
- minimise transmission
- eliminate exit and entry
What is sterilisation?
Complete killing or removal of all types of microorganisms
- bacteria (vegetative, spores)
- viruses
- fungi
- mycobacteria
Give some sterilisation methods
- heat (moist, dry)
- chemical (gas, liquid)
- filtration
- ionising radiation (used for single use disposable equipment)
Sterilisation by heat can be moist heat or dry heat. How is moist heat sterilisation achieved?
Autoclave
- delivery of steam under high pressure
- specific pressure and temperature cycles
