Healthcare Acquired Infection Flashcards
What is the impact of HAI’s on the NHS?
More strain on resources
Increased cost
Bad perception
What is the impact of HAI on the hospital?
Longer hospital stays
Bed-blocking has knock on effects e.g. surgeries cannot go ahead and people are waiting in A&E for hours
New people cannot get into A&E
What is the impact of HAI on staff?
Stress
Increased workload
Changes in decision making: focussed on trying to discharge patients quickly overlook small problems
Feelings of demotivation
What is the impact of HAIs on the patient?
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
What is the impact of HAIs on the patients family?
Dissatisfaction
Worry
Confusion
Might leave a vulnerable family member without a carer
Disruption to family and increased cost to NHS
Increased distrust
What is the impact of HAIs on other visitors?
Need for infection control
Increased fear of infection
May not be able to visit loved ones
What are the mechanisms of spread of infection in hospital?
Direct patient contact e.g. poor hand hygiene
Airborne
Spread between medical staff treating multiple patients
Invasive devices e.g. catheters, IV lines
What are the 5 moments of hand hygiene?
Before touching a patient Before clean/aseptic procedure After body fluid exposure risk After touching patient After touching patient surroundings
Why is hygiene important for Mr. Ratchet?
Examined his hip
He’s been catheterised, environment, equipment and personnel should be aseptic
Hand hygiene important before and after catheterisation as it may involve contact with fluids
If he is to be discharged/ leave room for procedure the room should be cleaned
Bed used for transport cleaned
What does sensitivities mean?
Which antibiotic will the bacteria be sensitive too
What is CRP?
C-reactive protein test
Measure of inflammation
What is RR?
Respiratory rate
Indication of septic shock
What is stats?
Oxygen saturation
What does pyrexial mean?
Fever
Why would a doctor choose IV delivery of antibiotics?
Faster delivery
Infection already having systemic effects
What is MCS?
Microscopy, culture screening
What is CSU?
Catheter specific urine
Why may Mr Ratchett be resistant to amoxicillin?
The bacteria might be producing beta-lactamases which render the antibiotic ineffective?
Give some common mechanisms of resistance to antibiotics
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
How has co-amoxiclav overcome one method of penicillin resistance ?
Produces clavionic acid which inhibits beta-lactamase
What events lead to Mr. Ratchetts diarrhoea?
Admitted for elective hip replacement Goes for operation Has urine retention Catheter administers likely transmission of gut commensals Contracts E. Coli infection We give IV antibiotics (co-amoxiclav) C. difficile activates due to broad spectrum antibiotics Becomes toxinogenic leads to diarrhoea
What is candour?
Honesty
Owning up to mistakes
What is empathy?
Ability to understand and share another persons feelings and perspective
Name some bacterial defence strategies?
Restrict access Get rid of antibiotic Change/destroy antibiotic Bypass the effects of the antibiotic Change antibiotic targets
How can healthcare professional help prevent resistance?
Follow clinical prescribing guidelines
Shorten duration of therapy to minimum effective duration
Educate patients and families
Perform hand hygiene and follow infection prevention measures
What are the components of the chain of infection?
Organism Reservoir Portal of exit Transmission Portal of entry Vulnerable hosts
What is the sequence of events that led to Mr Ratchett’s diarrhoea?
Admitted for elective hip replacement 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
What is important when explaining HAI’s to patients?
Empathy and Candour
