Healthcare Associated Infections Flashcards
Healthcare Associated Infections Outline
Infections that appear within 30 days of recieving healthcare (eg hospitals, GPs, ect)
Exogenous HAIs Types
enviorment/equipment acquired, patient-patient acquired and staff-patient acquired
Endogenous HAIs Types
Acquired from patients own flora (contamination from different regions of body). Harder to prevent then exogenous
HCAIs Considerations Outline
morbidity increase , mortality increase, increased patient and hospital costs, increased public awareness and antimicrobial resistance
How preventable are HAIs and association between HAIs and antibiotic resistance
50% of HAIs are preventable. 71% of HAIs
Most common type of HCAI
Pneumonia (31%), urinary tract (20%), bloodstream (13%) and surgical site (12%)
Least common types of HCAIs
Skin/soft tissue (4%), systemic (5%) and GIT (9%)
HCAI Risk Factor
Environmental (overcrowding, shared facilities and equipment upkeep), microorganisms (virulence) and patients (immunosuppression, invasive devices, age and previous antibiotic use)
Most common pathogen to cause HCAIs
Coagulase negative streptococci (15%), streptococcus aureus (15%), enterococcus spp (12%) and candida spp (11%)
2 types of surgical site infection
Superficial (red and hot to touch) and deep (can be implant associated, infection settles in foreign body)
Surgical Site Infection Pre-operation risk factors
Skin flora (MRSA colonisation) and comorbidities (eg diabetes, obesity, malnutrition)
Intra-operaion Surgical Site Infection Risk factors
Contaminated procedure (perforated bowel), foreign body implantation, contaminated hands/instruments/dressings and airborne contamination
Post-operation surgical site infection risk
Poor wound care and contamination from drains/catheters
Most common SSIs pathogens
Staph aureus (including methicillin resistant), beta-haemolytic streptococci Group A, anaerobes (eg bacteroides spp), gram negative bacilli (eg E Coli) and enterococci. Anaerobes, gram negative bacilli and enterococci enter via abdominal wounds
Hospital Acquired Pneumonia predisposing factors
Post-operative state: compromised breathing, disrupted normal flora. Incubation: substances bypassing upper respiratory defences and aspiration risks: drowsiness or poor swallow due to neurological disease (eg stroke)
Hospital Acquired Pneumonia Outline
P aeruginosa and other gram negative bacilli
Ventilated Associated Pneumonia Outline
Pseudomonas Arigenousa forms a biofilm in taps/vents (moist areas). If taps/ vents aren’t cleared routinely species can infect anything it’s sprayed onto.
UTIs Outline
Mainly caused by E Coli. Can be spread by catheters (intralumenal = break in drainage system/contamination by urine bag and extraluminal = insertion). Infections within the same patients is a result of wiping
Pathogens for central line blood stream infections
Staph aureus, coagulase-negative streptococci, enterococci and candida albicans (in immunocompromised individuals)
Why are there so many HCAIs in the ICU
Hands on care, indwelling devices, patient overcrowding, antibiotic ressistance (MRSA, VRE)
Device Related Infection Examples
Ventilator associated pneumonia, catheter associated UTIs, central venous catheter BSIs, Prosthetic joint infections
HCAI Prevention
Hand hygiene, CDC guidelines, infection control training, PPE and vaccination
HCAI Precautions
Hand hygiene preformed before and after every patient contact, PPE (prevent body fluid exposure), use and dispose equipment correctly, environmental cleaning, clean shared patient equipment and aseptic technique
Transient Organisms Def
Organisms that colonise superficial layers of skin, picked up from enviorment. Easily transfered from hands to patients
Resident Organisms Def
Organisms deep in skin layers resistant to removal. Part of bodies normal flora
Cleaning Def
Removal of dirt without removing contaminating organisms. Done by simple detergents
Disinfection Def
Reduction of viable microbes without destroying spores/prions. Done by physical (heat) and chemical means
Sterilisation Def
Removal of any type of microorganism including spores but excluding prions. Can be done many ways eg; autoclaves, hot air ovens, ethylene oxide, sporicidal chemicals and irridation
2 types of hand cleaning
alcohol gel and hand washing
Standard Precautions For Uniform
No ties, no wrist watches, no rings, no fake nails, short sleeves, use apron and gloves (change after every patient) and hand hygiene must be preformed every time gloves come off.
Contact Precautions Before Entering Room
Clean hands, put apron on, put gloves on
Contact precautions when exiting room
dispose of gloves, dispose of apron and wash hands
Droplet and Contact Precautions when entering room
Wash hands, put apron on, surgical mask on, gloves on
Droplet and Contact Precaustions when leaving room
Dispose of gloves, dispose of apron, dispose of surgical mask and clean hands
Airborne Precautions When entering room
Clean hands, put on apron, put on PPF2 mask, gloves on
Airborne Precautions When Exiting Room
Dispose gloves, dispose apron, dispose PPF2 mask and clean hands
What room is used for patients with airborne concerns
Negative pressure isolation room. Whenever door opens air only moves into room not out
Contact Plus Precaustions When Entering Room
Clean hands, put on long sleeved apron and put on gloves
Reasons to monitor HCAIs
Improve practice, anticipate problems, classification of microbes and outbreak protocols
Outbreak Def
2+ linked cases of same illness. Observed cases exceed expected number
