Hospital acquired infection

Question 1

Common HAIs - bugs

Answer 1

MRSA - skin and soft tissue, IV device, HAP
C diff - abx associated diarrhoea
Multidrug resistant gm -ve organism - pseudomonas, E coli, Klebsiella
Norovirus - D+V
TB
VZV - pregnancy, neonates, immunocompromised
Legionella

Question 2

DoH high impact interventions

Answer 2

1. Central venous catheter care
2. Peripheral IV cannula care
3. Renal dialysis catheter care
4. Prevention of surgical site infection
5. Care for ventilated patients
6. Urinary catheter care
7. Reduce risk of C diff
8. Cleaning and decontamination of clinical equipment

Question 3

10 compliance criteria for hospitals

Answer 3

1. Effective management systems
2. Clean and appropriate environment
3. Provide suitable accurate information on infection - patients and relatives
4. Provide suitable accurate information on infection - staff
5. Identification and appropriate treatment of those who have an infection
6. All staff in all settings involved in infection prevention and control
7. Adequate isolation facilities
8. Adequate access to lab support
9. Appropriate policies and protocols for prevention and control of HAI
10. Workers protected from exposure to communicable disease as far as is reasonably practical, and educated in HAI

Question 4

Source isolation

Answer 4

To stop a nasty bug the patient has getting out
3 standards:
• Standard
• Respiratory
• Strict

Question 5

Standard source isolation

Answer 5

Single room, preferably own toilet and basin
Hands cleaned following all procedures, after removing PPE, before leaving room
PPE donned before entering and before leaving

Question 6

Respiratory source isolation

Answer 6

Single room, own toilet, preferably negative pressure
If masks required, donned before entering and after leaving
Patient should wear surgical mask if leaving room
Hands should be cleaned after all procedures, after removing PPE, after entering room

Question 7

Strict source isolation

Answer 7

Single room + anteroom
Extract ventilation
Staff entry to room kept to a minimum
Transferred to RVI

Question 8

Protective isolation

Answer 8

Single room, preferably own toilet
Handwashing:
• Entering room, prior to patient contact
• Following all procedures
• Before leaving
• After removing PPE (outside room)
Aprons should be worn
Drinking water should be boiled

Question 9

Hierarchy of isolation (highest to lowest)

Answer 9

Viral haemorrhagic fever
Smallpox
MDR-TB
SARS
Swine flu
Measles
Chicken pox
Viral encephalitis
Bacterial meningitis
Norovirus
C diff
MRSA