CP3-4 infection prevention and control Flashcards
What was the prevalence of health care associated infections in 2011?
6.4%
What is involved in the chain of infection?
pathogenic organisms (of sufficient number and virulence) at a source that allows them to survive and multiply, exit. A mode of transmission from the source to a host which has a portal of entry. If th whist is susceptible, the infection manifests.
What is the mode of transmission of MRSA?
Direct contact with infected sites of indirect contact with formites of hands of healthcare workers
How can we protect again MRSA?
Eliminate the pathogenic organisms
Remove the source
Minimise transmission e.g. by washing hands
Eliminate exit and entry
Reduce susceptible of host to the infection
How can it be identified whether the same organisms are causing a disease in a MRSA scenario?
MRSA typing
What is an outbreak of a disease?
Two or more linked cases if the same illness
What are common causes of outbreaks in a hospital?
Viruses (e.g. flu, norovirus, covid-19)
Bacteria (e.g. clostridium difficile, MRSA)
Fungi (e.g. aspergillus)
What are patients screened for pre-operatively?
Screened for MRSA
How can infection risk be reduced perioperatively?
Perioperative antibiotics (if MRSA positive patient)
Surgical skin prep
Scrub technique
Hand hygiene
Ventilation of operative theatre
Correct disposal of clinical waste
Environmental cleaning and decontamination
Sterilisation of equipment
What is cleaning?
Removal of dirt, dust or any organic matter using water and detergent
What is disinfection?
Reduction of micro organisms to a level at which they are not harmful by heat or chemical disinfection
What is sterilisation?
ALL microorganisms are completely destroyed including spotted by heat, chemical, filtration or ionising radiation.
When should you use sterilisation?
When items will enter sterile body areas or break skin
When should you use disinfection?
When items or devices will come into contact with mucus membranes or that will be contaminated with bodily fluids
When should you use cleaning?
When items/devices will only come into contact with intact skin
How should a central venous catheter be decontaminated?
Chemical disinfection
How should surgical equipment be decontaminated?
By moist heat sterilisation
How can infection be prevented postoperatively?
Wound care
Hand hygiene
Use of PPE (aprons and gloves)
Place patients with MRSA in a single room with en-suite
Correctly dispose of infected clinical waste separately
Decontaminate metal equipment (e.g. stethoscopes, blood pressure monitors etc..)
Clean and decontaminate the environment
Do laundry
What are the two subtypes of bacteria carried on our hands?
Resident -deep seated and difficult to remove
Transient- easily picked up and transferred causing HCAI, easily removed
When should you wash your hands at the point of care?
before patient contact
Before aseptic tasks
After bodily fluid exposure risk
After patient contact
After contact with patient surroundings
When should you wash your hands and when is alcohol gel okay?
Wash hands on entry and exit to the ward, for visibility soiled hands and for contact with particular infection like c. Difficile and viral gastroenteritis
Hand gel is fine for most other activities on the ward
What is passive immunity?
When a person is given antibodies to a disease rather than producing them through their own immune system e.g. vertical transmission (lasts around a year) or immunoglobulin (from donors) injection into patient who needs antibodies/in blood transfusion (doesn’t last long)
What is active immunity?
Exposure to a disease causes the immune system to produce antibodies to that disease e.g. by natural infection or vaccination - tends to be long lasting or lifelong
What are the 4 main types of vaccine?
Live attenuated pathogen e.g. MMR
Inactivated organisms e.g. typhoid
Components of an organism e.g. influenza
Inactivated toxins e.g. diphtheria and tetanus
What are advantages of live vaccines?
Single dose tends to be long lasting
Evokes strong immune response producing localised and supystemic immunity
What are disadvantages of live vaccines?
Potential to cause disease rather than prevent
Contraindicated in immunosuppressed
Potential for contamination
Interference by viruses or vaccines and passive antibodies
Poor stability
What are advantages of inactivated/killed vaccines?
Stable
Constituents are clearly defined
Unable to cause the infection
