CP3-4 infection prevention and control

Question 1

What was the prevalence of health care associated infections in 2011?

Answer 1

6.4%

Question 2

What is involved in the chain of infection?

Answer 2

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.

Question 3

What is the mode of transmission of MRSA?

Answer 3

Direct contact with infected sites of indirect contact with formites of hands of healthcare workers

Question 4

How can we protect again MRSA?

Answer 4

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

Question 5

How can it be identified whether the same organisms are causing a disease in a MRSA scenario?

Answer 5

MRSA typing

Question 6

What is an outbreak of a disease?

Answer 6

Two or more linked cases if the same illness

Question 7

What are common causes of outbreaks in a hospital?

Answer 7

Viruses (e.g. flu, norovirus, covid-19)
Bacteria (e.g. clostridium difficile, MRSA)
Fungi (e.g. aspergillus)

Question 8

What are patients screened for pre-operatively?

Answer 8

Screened for MRSA

Question 9

How can infection risk be reduced perioperatively?

Answer 9

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

Question 10

What is cleaning?

Answer 10

Removal of dirt, dust or any organic matter using water and detergent

Question 11

What is disinfection?

Answer 11

Reduction of micro organisms to a level at which they are not harmful by heat or chemical disinfection

Question 12

What is sterilisation?

Answer 12

ALL microorganisms are completely destroyed including spotted by heat, chemical, filtration or ionising radiation.

Question 13

When should you use sterilisation?

Answer 13

When items will enter sterile body areas or break skin

Question 14

When should you use disinfection?

Answer 14

When items or devices will come into contact with mucus membranes or that will be contaminated with bodily fluids

Question 15

When should you use cleaning?

Answer 15

When items/devices will only come into contact with intact skin

Question 16

How should a central venous catheter be decontaminated?

Answer 16

Chemical disinfection

Question 17

How should surgical equipment be decontaminated?

Answer 17

By moist heat sterilisation

Question 18

How can infection be prevented postoperatively?

Answer 18

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

Question 19

What are the two subtypes of bacteria carried on our hands?

Answer 19

Resident -deep seated and difficult to remove
Transient- easily picked up and transferred causing HCAI, easily removed

Question 20

When should you wash your hands at the point of care?

Answer 20

before patient contact
Before aseptic tasks
After bodily fluid exposure risk
After patient contact
After contact with patient surroundings

Question 21

When should you wash your hands and when is alcohol gel okay?

Answer 21

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

Question 22

What is passive immunity?

Answer 22

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)

Question 23

What is active immunity?

Answer 23

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

Question 24

What are the 4 main types of vaccine?

Answer 24

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

Question 25

What are advantages of live vaccines?

Answer 25

Single dose tends to be long lasting
Evokes strong immune response producing localised and supystemic immunity

Question 26

What are disadvantages of live vaccines?

Answer 26

Potential to cause disease rather than prevent
Contraindicated in immunosuppressed
Potential for contamination
Interference by viruses or vaccines and passive antibodies
Poor stability

Question 27

What are advantages of inactivated/killed vaccines?

Answer 27

Stable
Constituents are clearly defined
Unable to cause the infection