Healthcare Associated Infections

Question 1

Define health care associated infection

Answer 1

Infections that were not present or in the pre-symptomatic phase at the time of admission to hospital or which arise more than 48 hours after admission or within 48 hours of discharge

Question 2

State the percentage of patients who get health care associated infections

Answer 2

4.9%

Question 3

State the possible outcomes of health care associated infections

Answer 3

Extended length of stay, pain, discomfort, permanent disability, death.
Increased cost and loss of public confidence and decreased staff morale

Question 4

State the most common sites for health care associated infections

Answer 4

UTI, surgical site, RTI, Blood stream infections, GI infection, Skin and soft tissue infections

Question 5

State the number of bacteria in adult human

Answer 5

10 to the power of 14

Question 6

`State the body’s first line of defence against infecion

Answer 6

Intact skin, normal flora, body secretions, gastric acid, fluishing

Question 7

State the percentage of the population colonised with staphylococcus aureus in their nose - that includes patients, staff and relatives

Answer 7

30%

Question 8

How can a bacteria which is colonising a human cause and infection

Answer 8

Break in the skin (surgical site), vascular device, catheter associated, ventilator

Question 9

State the microbial factors which can cause infection

Answer 9

Increased resistance, increased virulence, increased transmissability, increased survival ability, ability to evade host defences

Question 10

State the bacteria which can be spread through direct contact

Answer 10

Staphylococcus aureus and coliforms

Question 11

State the bacteria which can be spread via respiratory or droplet method

Answer 11

Neisseria meningitidis, mycobacteria tuberculosis

Question 12

State the faecal-oral bacteria which can be spread

Answer 12

Clostridium Difficile, Salmonella

Question 13

State the bacteria which can be spread through penetrating injury

Answer 13

Group A strep, bloodborne viruses

Question 14

State the different ways in which the chain of infection can be broken

Answer 14

Risk awareness, standard infection prevention and control precautions, hand hygiene, appropriate PPE, vaccination, post exposure prophylaxis, environment

Question 15

Define cleaning

Answer 15

Physical removal of organic material and decrease in microbial load

Question 16

Define disinfection

Answer 16

Large reduction in microbe numbers

Question 17

Define sterilisation

Answer 17

Removal and destruction of all microbes and spores

Question 18

State low risk equiptment and how it should be cleaned

Answer 18

Stethoscopes, cots, mattresses should be cleaned according to manufactures instructions

Question 19

State the medium risk equipment and how it should be cleaned

Answer 19

Bedpans, vaginal specula and endoscopes should be disinfected or sterilised as appropriate

Question 20

State the high risk equipment and how it should be cleaned

Answer 20

Surgical instruments and these should always be sterilised

Question 21

State the different methods of sterilisation

Answer 21

Steam under pressure (autoclave), hot air oven, gas (ethylene dioxide) or ionising radiation

Question 22

Define local surveillance

Answer 22

Lab detects an organism and notifies IPCT and clinicians

Question 23

State the advantages of local surveillance

Answer 23

Know what organism is and specific recommendations made

Question 24

State the disadvantages of local surveillance

Answer 24

Depends on samples being sent, time taken to detect organism, tests not 100% accurate

Question 25

Define clinical area based local surveillance

Answer 25

Notify infection prevention and control team

Question 26

State the advantages of clinical area based local surveillance

Answer 26

Detect potential problem sooner and can ensure the correct samples are sent to the lab

Question 27

State the disadvantages of clinical area based local surveillance

Answer 27

The causative microbe is not known and PC measures need to be more general

Question 28

Define outbreak

Answer 28

An outbreak of an infection is defined as 2 or more cases of an infection linked in both time and place

Question 29

How can an outbreak be identified

Answer 29

Act on suspicion, typing is necessary to determine if the same strain is present ie an outbreak

Question 30

State the different typing methods

Answer 30

Antiobiogram, phage typing, pyocin typing, serotyping, molecular typing

Question 31

State the control measures which can be used to prevent an outbreak

Answer 31

Single room isolation, cohorting of cases, clinical area/ward closure, staff exclusion, staff decolonisation

Question 32

State the clinical characteristics of C.Difff

Answer 32

Diarrhoea, faeces have a characteristic odour, abdominal pain, pyrexia and raised white cell count

Question 33

State the risk factors for C.Diff infection

Answer 33

Imbalance in gut flora, endogenous or exogenous source, variable in severity, elderly more susceptible

Question 34

State the treatment of C.Diff

Answer 34

Oral metronidazole, oral vancomycin if severe or failure to improve on metronidazole, oral fidaxomicin if 2nd episode