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CSI > Healthcare Acquired Infection > Flashcards

Healthcare Acquired Infection Flashcards

1
Q

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

A

More strain on resources
Increased cost
Bad perception

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2
Q

What is the impact of HAI on the hospital?

A

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

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3
Q

What is the impact of HAI on staff?

A

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

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4
Q

What is the impact of HAIs on the patient?

A

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

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5
Q

What is the impact of HAIs on the patients family?

A

Dissatisfaction
Worry
Confusion
Might leave a vulnerable family member without a carer
Disruption to family and increased cost to NHS
Increased distrust

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6
Q

What is the impact of HAIs on other visitors?

A

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

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7
Q

What are the mechanisms of spread of infection in hospital?

A

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

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8
Q

What are the 5 moments of hand hygiene?

A 
Before touching a patient 
Before clean/aseptic procedure 
After body fluid exposure risk
After touching patient
After touching patient surroundings
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9
Q

Why is hygiene important for Mr. Ratchet?

A

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

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10
Q

What does sensitivities mean?

A

Which antibiotic will the bacteria be sensitive too

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11
Q

What is CRP?

A

C-reactive protein test

Measure of inflammation

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12
Q

What is RR?

A

Respiratory rate

Indication of septic shock

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13
Q

What is stats?

A

Oxygen saturation

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14
Q

What does pyrexial mean?

A

Fever

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15
Q

Why would a doctor choose IV delivery of antibiotics?

A

Faster delivery

Infection already having systemic effects

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16
Q

What is MCS?

A

Microscopy, culture screening

17
Q

What is CSU?

A

Catheter specific urine

18
Q

Why may Mr Ratchett be resistant to amoxicillin?

A

The bacteria might be producing beta-lactamases which render the antibiotic ineffective?

19
Q

Give some common mechanisms of resistance to antibiotics

A 
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
20
Q

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

A

Produces clavionic acid which inhibits beta-lactamase

21
Q

What events lead to Mr. Ratchetts diarrhoea?

A 
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
22
Q

What is candour?

A

Honesty

Owning up to mistakes

23
Q

What is empathy?

A

Ability to understand and share another persons feelings and perspective

24
Q

Name some bacterial defence strategies?

A 
Restrict access
Get rid of antibiotic
Change/destroy antibiotic
Bypass the effects of the antibiotic
Change antibiotic targets
25
Q

How can healthcare professional help prevent resistance?

A

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

26
Q

What are the components of the chain of infection?

A 
Organism
Reservoir
Portal of exit
Transmission
Portal of entry
Vulnerable hosts
27
Q

What is the sequence of events that led to Mr Ratchett’s diarrhoea?

A 
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
28
Q

What is important when explaining HAI’s to patients?

A

Empathy and Candour

CSI (17 decks)

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