8. Approach to Infection Prevention and Control Flashcards
What 5 main patient care practices are health care associated infections (HAI’s) assocaited with?
Give some G+ and G- bacteria that can cause HAI’s.
Use and care of urinary catheters, use and care of vascular access line (e.g. cellulitis around site), therapy and support of pulmonary function (e.g. ventilator assisted pneumonia), survelliance of surgical procedure, hand hygiene and standard precautions. Key to reducing HAI = prevention + control
G+: MRSA 20% carry it harmlessly, can live on skin, if gets in blood can metastasise to heart valves - endocarditis, or bones - osteomyelitis. Tx: IV therapy for 2w or more), MSSA, C. diff
G-: E.coli, pseudomonas, enterobacteriaceae
Does alcohol hand gel work on C. diff?
What can C.diff cause?
How is C.diff infection treated? (3 drugs)
Why is the general use of carbapenems discouraged for E.coli?
No.
Can produce spores and possess toxins. Causes diarrhoea and C.diff pseudomembranous colitis. Colonises gut in 2.5% of pop (so abx use may promote C.diff gut growth)
Metronidazole (1st line, oral/NG for mild/moderate), vancomycin (for severe), fidaxomicin (expensive, for severe)
Increasing rate of carbapenem resistant Enterobacteriaceae (CRE) e.g. carbapenemase producing E.coli and Klebsiella spp. V difficult to treat
What are the different categories of TB resistance?
How does norovirus spread? Does alcohol gel kill it?
Whats the main differences between washing with soap + water vs alcohol gel?
Resistant TB, MDR TB (to rifampicin and isoniazid), XDR TB (also to amikacin and fluoroquinolone)
Vomit/stool. No.
Soap + water: for pts with active diarrhoea/C.diff/norovirus
Alcohol gel: destroys 99% of microorganisms including viruses BUT NOT norovirus and C.diff
When does MRSA screening take place for elective admissions?
What if a patient is MRSA positive?
Give 2 IPC (infection prevention and control) measures to prevent MRSA bloodstream infection.
Within 3 month period prior to surgery.
5 days MRSA decolonising protocol, then 2 days off protocol and rescreen. If negative, repeat screening at 7 and 14d. If positive give 2nd MRSA protocol, 2 days off and repeat screen
- ANTT (aseptic non-touch technique)
- Remove peripheral line after 72hrs and/or when no longer needed
