Healthcare Acquired Infection

Question 1

What is the impact of HAI’s on the NHS?

Answer 1

More strain on resources
Increased cost
Bad perception

Question 2

What is the impact of HAI on staff?

Answer 2

Stress
Increased workload
Changes in decision making: focussed on trying to discharge patients quickly overlook small problems
Feelings of demotivation

Question 3

What is the impact of HAIs on the patient?

Answer 3

Frustration
Worried
Longer stay
Further complications leading to more worrying illness
Confusion
May be reluctant to return to hospital
Stress from commitments they are missing e.g. work and caring for a loved one

Question 4

What is the impact of HAIs on other visitors?

Answer 4

Need for infection control
Increased fear of infection
May not be able to visit loved ones

Question 5

What are the mechanisms of spread of infection in hospital?

Answer 5

Direct patient contact e.g. poor hand hygiene
Airborne
Spread between medical staff treating multiple patients
Invasive devices e.g. catheters, IV lines

Question 6

What are the 5 moments of hand hygiene?

Answer 6

Before touching a patient 
Before clean/aseptic procedure 
After body fluid exposure risk
After touching patient
After touching patient surroundings

Question 7

What does sensitivities mean?

Answer 7

Which antibiotic will the bacteria be sensitive too

Question 8

What is CRP?

Answer 8

C-reactive protein test

Measure of inflammation

Question 9

What is RR?

Answer 9

Respiratory rate

Indication of septic shock

Question 10

What is stats?

Answer 10

Oxygen saturation

Question 11

What does pyrexial mean?

Answer 11

Fever

Question 12

Why would a doctor choose IV delivery of antibiotics?

Answer 12

Faster delivery

Infection already having systemic effects

Question 13

What is MCS?

Answer 13

Microscopy, culture screening

Question 14

What is CSU?

Answer 14

Catheter specific urine

Question 15

Give some common mechanisms of resistance to antibiotics

Answer 15

Altered target sites 
Increasing amount of substrate produced
Altered metabolism 
Decreased accumulation 
Increase efflux of antibiotics
Natural selection
Excess use of antibiotics 
Not finishing a course

Question 16

How has co-amoxiclav overcome one method of penicillin resistance ?

Answer 16

Produces clavionic acid which inhibits beta-lactamase

Question 17

Name some bacterial defence strategies?

Answer 17

Restrict access
Get rid of antibiotic
Change/destroy antibiotic
Bypass the effects of the antibiotic
Change antibiotic targets

Question 18

How can healthcare professional help prevent resistance?

Answer 18

Follow clinical prescribing guidelines
Shorten duration of therapy to minimum effective duration
Educate patients and families
Perform hand hygiene and follow infection prevention measures

Question 19

What are the components of the chain of infection?

Answer 19

Organism
Reservoir
Portal of exit
Transmission
Portal of entry
Vulnerable hosts

Question 20

What is HAP?

Answer 20

Hospital acquired pneumonia

Acquired after at least 48 hours of admission

Question 21

Give an example of how someone can acquire c diff diarrhoea?

Answer 21

Developed post-op urinary retention
Catheterised, likely transmission of gut commensals
Developed E. coli urinary sepsis
Treated with Co-amoxiclav (broad spec)
Disruption of gut microbiome
Activation of toxinogenic C.difficile
Positive for C. difficile diarrhoea