Chapter 12 Flashcards
healthcare epidemiology
- study of occurrence, determinants, and distribution of heath and disease in healthcare
- primary focus on infection control an prevention of HAI
- includes activities to study and improve pt care outcomes
2 categories of infectious diseases
1) HAI - acquired in healthcare facility or erupts within 14 days of discharge
2) community acquired infections - acquired outside healthcare
frequency of HAIs
5% of pts acquire HAIs
most common gram + cocci HAI
- staphylococcus aureus
- coagulase-negative staphylococci
- enterococcus spp
most common gram - bacilli HAI
- escherichia coli
- pseudomonas aeruginosa
- enterobacter spp
- klebsiella spp
% of HAI involving drug resistant bacteria
70%
4 most common types of HAIs
- UTI
- surgical site infection
- lower respiratory tract infections (pneumonia)
- bloodstream infections (specticemia)
- other: C difficile
pts most likely to develop HAIs (8)
- elderly
- labour & delivery
- infants & newborns
- surgical and burn
- diabetic, cancer, transplant pts
- steroid treatment, anticancer drugs, antilymphocyte serum, and radiation
- immunosuppressed
- paralyzed or undergoing renal dialysis or catheterization
3 major factors of HAIs
- increasing number of drug resistant pathogens
- failure of HCP to follow infection control
- increase of immunosuppressed pts
additional HAI factors (7)
- overcrowding and employee shortage
- indiscriminate use of antimicrobial agents
- false security about antimicrobial agents
- lengthy and more complicated surgeries
- increase use of less trained HCP
- increased use of anti-inflammatory and immunosuppressants
- over and improper use of indwelling devices
ways to reduce HAIs (7)
- compliance with infection control guidelines
- hanwashing
- disinfection/sterilization
- air filtration
- UV lights
- isolation
- PPE
infection control
- measures taken to prevent infections from occurring in healthcare
2 types of asepsis
1) medical
2) surgical
medical asepsis
- clean technique
- measure to prevent direct transfer of pathogens person to person and indirect transfer of pathogens through air or fomites
- exclude all pathogens
surgical asepsis
- sterile technique
- used in ORs, labour and delivery, and during invasive procedures
- exclude all microbes
standard precautions
- applied to all pts in all healthcare settings
- provide infection control guidelines
- primary strategy for prevention of HAI transmission between HCP and pt
transmission based precautions
- used for pts who are known or suspected to be infected with highly transmissible or epidemiologically important pathogens
- additional safety precautions are required to interrupt transmission
3 types of transmission based precautions
1) contact precaution
2) droplet precaution
3) airborne precaution
2 types of contact precaution
1) direct contact (body surface to body surface)
2) indirect contact (through contaminated objects)
- most important and frequent mode of HAI transmission
contact precaution pathogens
- ebola
- chickenpox
- smallpox
- wounds or burns
droplet precaution
- droplets produced by sneezing, coughing, talking
- used for particles larger than 5um
droplet precaution pathogens
- influenza
- meningitis
- mumps
- whooping cough
airborne precaution
- small particles of evaporated droplets that remain suspended in air
- used for particles smaller than 5um
airborne precaution pathogens
- SARS
- measles
- monkeypox
- pulmonary or laryngeal TB
