HAIs and IPC Flashcards
Which conditions are NOT HAIs?
- Already present on admission
- Transplacental infections <48h after birth
- Reactivation of latent infection
- Colonisation
- Inflammation
What is the Date of Event (DOE) for Surgical Site Infections (SSIs)?
Date when the 1st element used to meet SSI infection criterion occurs for 1st time during SSI surveillance period
What are the criteria for a BSI to be determined to be secondary to an SSI?
- > 1 organism from the specimen matches an organism from the site used to meet SSI criterion AND blood specimen is collected during the secondary BSI attribution period
OR - Organism identified in the blood is an element used to meet the organ/space SSI site-specific infection criterion AND is collected during timeframe for SSI elements
What is the secondary BSI attribution period
17d period including SSI DOE, 3 days prior and 13 days after
What are the criteria for a superficial incisional SSI?
- DOE within 30d following operation
AND - Involves only skin and subcutaneous tissue of infection
AND - Patient has at least 1 of the following
- purulent drainage from incision
- organism from aseptic specimen from incision
- superficial incision is opened by surgeon/physician AND patient has localised pain, swelling, erythema, or heat
- diagnosis by a physician
What are the 2 specific types of superficial incisional SSIs?
- Superficial incisional primary (SIP)
- Superficial incisional secondary (SIS)
Define a superficial incisional primary SSI
Superficial incisional SSI that is identified in primary incision in patient with one or more incisions
Define a superficial incisional secondary SSI
Superficial incisional SSI that is identified in secondary incision in patient with >1 incision
Which conditions do not qualify to meet the criteria of superficial incisional SSI?
- Cellulitis diagnosis
- Stitch abscess alone
- Localised stab wound or pin site infection
Is a laparoscopic trocar site considered a surgical incision or a stab wound?
Surgical incision
What are the criteria for a deep incisional SSI?
- DOE within 30d following operation
AND - Involves deep soft tissues of incision
AND - Patient has at least 1:
- purulent drainage
- deep incision deliberately opened by surgeon/physician with organism identified and patient has fever or localised pain
- abscess or other evidence of infection
What are the criteria for an organ/space SSI?
- DOE within 30 or 90d following operation
AND - Involves deep soft tissues
AND - Patient has at least 1:
- purulent drainage
- organism identified
- abscess or evidence of infection
AND - Meets are least 1 criterion for a specific organ/space infection
What are the criteria for Lab Confirmed BSI 1?
- Not on commensal list
- Identified by blood culture
- Identified by NCT (not collected within 2d before or 1d after)
- Organism not related to another site infection
What are the criteria for Lab Confirmed BSI 2?
- Symptoms
- Not related to another site infection
- Commensal identified from >1 blood specimen on separate occasions
What are the criteria for VAP?
- Continuous assisted ventilation through tracheostomy or ETT
- Infection 48h after intubation or within 48h post removal
- Diagnosis of pneumonia based on clinical and radiological features
What is the Infection Window Period (IWP)?
7d period where all site specific criterion must be met including
- date of 1st positive test
- 3d before
- 3d after
What are the criteria for symptomatic UTI (SUTI) 1a?
Catheter in place + SS + culture
- Catheter >2d on DOE
- Catheter present on DOE OR removed 1d before DOE
- Patient symptomatic
- Urine culture with maximum 2 organisms and > 10*5 CFU
What are the criteria for SUTI 1b?
No catheter + SS + culture
- No catheter or <2d DOE
- Symptomatic
- Urine culture with maximum 2 organisms with > 10*5 CFU
What are the components of the SSI bundle?
- Appropriate prophylaxis
- Appropriate hair removal
- Post-op glucose control (major cardiac)
- Post-op normothermia (open abdomen)
Which is better to prevent CLRBSIs, chlorhexidine skin prep or povidone-iodine?
Chlorhexidine
How often should you replace gauze dressings on short-term CVC sites?
2d
How often should you replace transparent dressings on short-term CVC sites?
7d
What are the components of the VAP bundle?
- Elevation of head of bed to 30-45 degrees
- Oral care w/ 0.12% chlorhexidine solution every 4h daily
- Daily sedation vacation
- PUD prophylaxis
- DVT prophylaxis
Name appropriate indications for indwelling catheter use
- Acute urinary retention or bladder outlet obstruction
- Protection of SSIs
- Stage 3/4 sacral or perineal wounds in incontinent patients
- To improve comfort in palliative care
