Healthcare Associated Infections

Question 1

How do we stop HCAI?

Answer 1

• measure the problem (surveillance)
• understand the problem (epidemiology)
• manage the problem
• prevent the problem (vaccines)

Question 2

Definition of HAI

Answer 2

• hospital acquired infection

- wasn’t present prior to patient coming in/48hrs of admission

Question 3

Definition of HCAI

Answer 3

• healthcare associated infection

- may have been acquired outside hospital but is related to healthcare facilities

Question 4

Why is HCAI an issue?

Answer 4

• chronic disease
• invasive medical devices
• elderly population
• immunosuppression
• more complex procedures
• quality measure
• antibiotic use

Question 5

What measures can doctors take to prevent HCAI?

Answer 5

• recognition of risk factors in patients
• behaviour and practice
• hand hygiene
• dress
• PPE
• use isolation facilities appropriately

Question 6

Describe the chain of infection

Answer 6

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

Question 7

Examples of infections that spread by contact

Answer 7

• blood borne viruses
• diarrhoea
• MRSA
• C. difficile
• group A strep
• gonorrhoea

Question 8

Examples of infections that spread by droplets

Answer 8

• n. meningitis
• norovirus
• diptheria
• pertussis
• pneumonic plague
• COVID-19

Question 9

Examples of infections that spread by aerosol

Answer 9

• TB
• chicken pox
• influenza
• viral haemorrhagic fever
• measles

Question 10

What are the precautions to target transmission of infection?

Answer 10

• standard infection control precautions (cleaning procedures, staff immunisation)
• standard precautions ( hand hygiene, PPE)
• transmission based procedures

Question 11

Contact precautions

Answer 11

• single room
• gloves and aprons
• disposable masks/eye protection if exposure to body fluid

Question 12

Droplet precautions

Answer 12

• single room
• wear surgical mask if within touching distance of patient or coughing inducing procedure
• eye protection

Question 13

Airborne precautions

Answer 13

• single room
• apron and gloves
• high efficiency filter mask

Question 14

What are invasive medical devices?

Answer 14

• long term/short term
• all break skin/mucous membrane barrier
• CVC, PVC, catheters
• causes infection

Question 15

What are the indwelling prosthetic devices?

Answer 15

• long term
• buried into tissue under skin
• heart valves/joints/pacers
• usually not source of infection

Question 16

Why is HCAIs a big problem?

Answer 16

• effects a lot of patients
• costs NHS a lot of money
• increases length of stay
• increases morbidity and mortality