Healthcare-Associated Infections

Question 1

How do we stop HCAI

Answer 1

◼ Measure the problem -Surveillance
◼ Understand the problem -epidemiology (where, when, who, how big, cost)
◼ Manage the problem -Education
-Knowledge
-Management tools for the problem ie audit, bundles
◼ Prevent the problem
-Interrupting transmission (Standard infection control precautions, Hand
hygiene, vascular access devices) -Prevention strategies
-Vaccines

Question 2

HAI

Answer 2

Hospital Acquired Infection

one that was not present on admission but occurred >48hours after admission

Question 3

HCAI

Answer 3

Healthcare Associated Infection

Question 4

Why is HCAI an issue?

Answer 4

◼ Chronic disease
◼ Invasive medical devices
◼ Elderly population
◼ Immunosuppression
◼ More complex procedures
◼ Quality measure – LDP targets (Scotland) 
◼ Antibiotic use

Question 5

quality of your care reports

Answer 5

◼ The Francis Report is leading to a paradigm shift is clinical care
◼ Health Improvement Scotland (HIS)

Question 6

How can doctors take measures to prevent HCAI?

Answer 6

◼ Recognition of risk factors in patients 
◼ Behaviour & practice
◼ Hand hygiene
◼ Dress
◼ Personal protective equipment 
◼ Use isolation facilities correctly

Question 7

How are organisms spread?

Answer 7

infectious agent 
reservoir 
portal of exit 
mode of transmission
portal of entry 
susceptible host

Question 8

Mode of transmission

Answer 8

◼ Direct or indirect Contact via fomites or ingestion

Question 9

diseases that are transferred by direct or indirect contact

Answer 9

-Blood born viruses, diarrhoea, MRSA C. difficile, Group A Streptococcus, N. gonorrhoea, COVID-19

Question 10

diseases transmitted via droplet transmission

Answer 10

-N. meningitis, Norovirus, Diphtheria, Pertussis, Pneumonic

plague, COVID-19

Question 11

aerosol transmission diseases

Answer 11

-Tb, chicken pox, influenza, viral haemorrhagic fever, measles

Question 12

For pts infected/colonised with organisms transmitted by direct or indirect contact that precautions would you take

CONTACT PRECAUTIONS

• Syndrome: gastroenteritis, fever in patient returned from the tropics
• Specific organisms : C. difficile, MRSA, S. pyogenes, COVID-19

Answer 12

◼ Single room if possible
◼ Gloves
◼ Aprons
◼ Disposable masks/eye protection if at risk of exposure to body fluid

Question 13

Droplet Precautions

◼ For organisms transmitted in droplets (>0.5 microns) These travel only short distances

-Syndrome: Meningism , fever with cough, fever with rash, vomiting
-Specific organisms: N. meningitis, mumps, rubella,
COVID-19

Answer 13

◼ Single room if possible
◼ Wear surgical mask when within touching distance (1 metre) of patient or cough inducing procedure
◼ Wear eye protection (goggles or visor)

Question 14

Airborne Precautions
◼ Particles <5microns. Can be widely dispersed ie TB, chickenpox, measles, Flu. Wear FFP3 mask for all aerosol generating procedures (AGP)

• Syndrome: influenza like illness
• Specific organisms: TB, measles, Viral Haemorrhagic Fevers

Answer 14

◼ Single room
◼ Apron
◼ Gloves
◼ High efficiency filter mask

Question 15

◼ Precautions for confirmed or suspected COVID patients

Answer 15

• Droplet precautions
• Contact precautions if having direct contact with patient
• Hand hygiene
• Single room when undertaking anaerosol generating procedure (AGP)
• Airborne precautions when entering a room where AGP is performed ie some forms of supplementary oxygenation

Question 16

Hand decontamination

Answer 16

◼ Alcohol gel can be used if hands sociably clean
◼ MUST use soap and water after examination of a patient with diarrhoea and after removing gloves
◼ Know how the 7 steps to hand decontamination

Question 17

◼ Invasive medical devices

Answer 17

Maybe long
term or short term. All break the skin or
mucous membrane barrier
-CVC, PVC, urinary catheters, dialysis lines…. etc

Question 18

◼ Indwelling prosthetic devices:

Answer 18

Usually
long term devices which are buried into
tissue under the skin
-Heart valves, joints, pacing units…etc