Healthcare Infections Flashcards
What are healthcare infection?
Infections that arise as a consequence of providing healthcare.
In hospital patients:
- Neither present nor incubating at the time of admission.
- For practical purposes, this means that onset is at least 48hrs after admission.
Also includes infections in hospital visitors and healthcare workers.
Why are healthcare infections important?
Frequent - Prevalence = 8% of in-patients at any one time.
Impact in health
Impact in healthcare organisations - on avg, every patient says in hospital a day longer. Also used drugs and time ect..
Preventable.
What types of HCAI are prevalent?
UTI = 20% (uses antibiotics so use resources and contribute to antibiotic resistance)
Pneumonia = 14%
Surgical wound infections = 14% (takes wounds longer to heal)
Skin and soft tissue = 10% (flobitis)
Primary bloodstream = 7%
Gastro-intestinal = 21% (Diarrhoea. C. Dif or Viral -norovirus)
Other = 14% (depends on types of wards in hospital)
Where can you intervene to prevent infection?
Getting wrid of pathogen in first place
Stop pathogen patient interaction becoming an infection
Stop infected patient infecting other people
What are some healthcare acquired viruses?
Norovirus (In winter time)
Blood borne viruses (Hep B,C, HIV)
Influenza
Chickenpox
What are some examples of bacteria that cause healthcare infections?
Staph aureus including MRSA
Clostridium difficile (Travel as spores - in anaerobic)
Escherichia coli (Gram negative rods - Can cause UTI or in gall bladder as a result of Colangitis)
Klebsiella pneumoniae
Pseudomonas aeruginosa (Resistant to wide range of antibiotics and likes wam, moist environments -designed for hospitals - causes ventilator associated pneumonia)
Mycobacterium tuberculosis (Cough so not always though of as TB, slow infection so takes months to get wrid of infection).
What are some examples of fungi that cause healthcare infections?
Candida albicans - Can cause blood stream infections in ICU patients.
Aspergillus species - Organ transplants as immunosuppression.
What parasite can cause a healthcare infection?
Malaria - Infected someone in a hospital in Nottingham years ago. -Although parasites are not normally a problem in the UK.
What patient factors can make them more susceptible to healthcare infections?
- Extremes of age
- Obesity / Malnourished
- Diabetes
- Immunosuppression
- Cancer
- Smoker - pneumonia and wound infections (even stopping for a week before improves outcome)
- Surgical patient
- Emergency admission
What are the four Ps of infection prevention and control?
Patient - General and specific patient risk factors for infections,
Interactions with other patients, healthcare workers and visitors.
Pathogen - Virulence factions, Ecological interactions such as other bacteria and antibiotics / disinfections.
Practice - General and specific activities of healthcare workers, Policies and their implementation, Organisational structure and engagement, Regional and national political initiatives, Leadershp at all levels from government to the ward
Place - Healthcare environments e.g fixed features (like toilets) and variable features.
Patient intervention to reduce risk of infection?
General
- Optimise patients’s condition (smoking, nutritions and diabetes.
- Antimicrobial prophylaxis (antibiotics before surgery)
- Skin preparation
- Hand hygiene
Specific
- MRSA screens
- Mupirocin nasal ointment (used to kill bacteria inc. MRSA)
- Disinfectant body wash
How can you halt patient to patient transmission?
Physical barriers:
Isolation of infected patient - Higher pressure in growing lobby to patients room and outside so bacteria goes where door opens. This stops viru’s going into wrong place.
-Protection of susceptible patients - Air pressure differences.
Healthcare workers interventions?
Healthy
- Disease free
- Vaccinated (inc. flu vaccine)
Good practise
- Good clinical techniques e.g. steril non-touch techniques)
- Hand hygiene
- PPE
- Good antimicrobial prescribing.
Environmental interventions?
- Built environment
- Space / Layout
- Toilets
- Wash hand Basins
- Furniture and furnishings.
- Cleaning
- Disinfectants
- Steam cleaning
- Hydrogen peroxide vapour
- Medical devices
- Single use equipment
- Sterilisation
- Decontamination - need to use chemicals and the WASH chemicals off as also toxic to us.
- Appropriate kitchen and ward food facilities
- Good food hygiene practise
- Theatres
- Positive / Negative pressure rooms
- Immunosuppressed patients
What are the 5 Is?
- Identify (A-F)
- Abroad
- Blood borne infection
- Colonised
- Diarrhoea / Vomiting
- Expectorating
- Funny looking rash
- Isolate
- Investigate
- Inform
- Initiate
