Health Care Associated Infections

Question 1

How do we stop HCAIs?

Answer 1

• Measure the problem - survielence
• Understand the problem - epideimiology
• Manage the problem - education
• Prevent the problem - interrupt transmission

Question 2

HAI =

Answer 2

hospital acquired infection

is one that was not prsent on admission and occured >48hrs after admission

Question 3

HCAI =

Answer 3

healthcare associated infextion

Question 4

Why is HCAI an issue?

Answer 4

• chronic disease
• invasive medical devices
• elderly population
• immunosuprresion
• complex procedures
• antibiotic resistance

Question 5

How can doctors take measures to prevent HCAI?

Answer 5

• recognition of risk factors of pateints
• behaviour and practice
• hand hygiene
• dress
• PPE
• use isolation facilities correctly

Question 6

What are potential infectious agents?

Answer 6

• Bacteria
• Fungi
• Parasites
• Prions

Question 7

What are potential resevoirs for potentially infectious agents?

Answer 7

• people
• water
• food

Question 8

What are the main portals of exit?

Answer 8

• blood
• secretions
• excretions
• skin

Question 9

What are the main modes of transmission? And examples of infectious agents included in each category

Answer 9

• Direct or indirect contact via fomites and ingestion
  
  • blood borne viruses, Diarrhoea, MRSA, C.diff, Strep A, gonorrhoea
• Droplet transmission
  
  • meningitis, norovirus, diptheria, pertussis, pneumonia plague
• Aerosol (airbone) transmission
  
  • TB, chicken pox, flu, haemorrhagic fever, measles

Question 10

What are the main portals of entry?

Answer 10

• mucousmembrane
• respiratory system
• digestive system
• broken skin

Question 11

When are contact precuations put in place?

Answer 11

for patients infected/colonised with organisms transmitted by direct or indirect contact

Question 12

What are the main droplet precautions?

Answer 12

• single room if possible
• glovves
• aprons
• disposable masks/eye protection

Question 13

Examples of organisms included in contact precuations

Answer 13

• Syndrome
  
  • gastroenteritis
  • fever in patients returning from the tropics
• Specific organism
  
  • C. diff
  • MRSA
  • S. pyogenes

Question 14

When are droplet precautions put in place?

Answer 14

for organisms transmitted in droplets - these only travel short distances

Question 15

What are the droplet precautions?

Answer 15

• single room if possible
• wear surgical mask when within touching distance os patient or cough inducing procedure

Question 16

What do droplet precautions apply to?

Answer 16

• Syndrome
  
  • meningism
  • fever with cough or rash
  • vomitting
• Organism
  
  • N.meningitis
  • mumps
  • rubella

Question 17

When are airborne precautions put in place?

Answer 17

when particles can be widely dispersed

e.g. TB, measles, viral haemorrhagic fever, influenza

Question 18

What are the precautions used for airborne transmission?

Answer 18

Wear FFP3 mask for all aerosol generating procedures

Question 19

Examples of invasive medical devices

Answer 19

• CVC
• PCV
• urinary catheter
• dialysis lines

Question 20

Examples of indwelling prosthetic devices

Answer 20

• heart valves
• joints
• pacemaker

Question 21

Name the gram negative enterobacteriaceae that are antibiotic resistant

Answer 21

• extended spectrum - lactamase producong enterobacteriaceae (ESBL producer)
• Carbapenem resistant enterobacteriaceae (CRE)
• Carbapenem producing pseudomonas

Question 22

Name the gram positive organisms that are antibitoic resistant

Answer 22

• MRSA
• Vancomycin resistant enterococcus (VRE)

Question 23

When shoul you wash your hands?

Answer 23

• After 4 uses of hand gel
• before touching patient
• before procedure
• after body fluid exposure
• after touching patient
• after touching paitent surroundings