Hospital acquired infections Flashcards
what are HAIs?
Infection arising as a consequence of providing healthcare
definition in terms of the patient
o Neither present nor incubating at time of admission
o For practical purposes- this means onset at least 48 hours after admission
HAIs also include
includes infections in hospital visitors and healthcare workers
why are HAIs important
- Very common= 8% of in-patients
- Impact on health
- Impact on healthcare organisations
- Preventable
- Economic cost
historical background of HAIs
Ignaz Semmelweis
Ignaz Semmelweis
o Ideas preceded Pasteur’s germ theory and Listers use of antiseptic surgery
o Found that hand washing reduced the number of cases of puerperal fever
most common HAIs
UTI, pneumonia, GI and surgical wound infections
infection prevention can be used at
many stages of the infection model
Patient factors which increase likelihood of HCAI
- Extremes of age
- Obesity/ malnourished
- Diabetes
- Cancer
- Immunosuppression
- Smoker
- Surgical patient
- Emergency admission
viruses that are common HAIs
blood born viruses (hepatitis B, C + HIV)
norovirus
influenza
chickenpox
bacteria that are common HAIs
MRSA C. diff E.coli Klebsiella pneumoniae Pseudomonas aeruginosa M. tuberculosis
fungi that are common HAIs
Candida albicans
Aspergillus species
parasites that are common HAIs
malaria
The 4 Ps of infection prevention and control
patient
pathogen
practice
place
patient infection prevention and control
o General and specific patient risk factors for infection
o Interactions with: other patient, healthcare workers, visitors
general patient interventions
- Optimise patients conditions o Stop them smoking o Improve condition o Diabetes - Antimicrobial prophylaxis - Skin preparation - Hand hygiene
specific patient interventions
- MRSA screens
- Mupirocin nasal ointment
- Disinfectant body wash
Mupirocin nasal ointment
is used to kill bacteria which can live in your nose, and which can spread to other people when you breathe
pathogen prevention and control
o Virulence factors
o Ecological interactions (other bacteria/ antibiotics/ disinfectants)
practice prevention and control
o General and specific activities of healthcare workers e.g. handwashing
o Policies and their implementation
o Organisational structure and engagement
o Regional and national political initiatives
o Leadership at all levels from government to the ward
place prevention and control
o Healthcare environment
Fixed features
Variable features
halting patient to patient transmission- physical barriers
o Isolation of infected patients e.g. isolation chambers (air pressure in the lobby)
Positive pressure lobby
Negative pressure room
o Protection of susceptible patients
E.g. patients about to have a bone marrow transplant
Positive pressure rooms
To prevent patients from airborne pathogens
healthcare worker interventions: healthy
o Disease free
o Vaccinated
healthcare worker interventions: good practice
o Good clinical techniques (e.g. sterile non-touch)
o Hand hygiene
o PPE- personal protective equipment
o Antimicrobial prescribing
environmental interventions can include
- Built environment
- Furniture and furnishings
- Cleaning
- Medical devices
- Appropriate kitchen and ward food facilities
- Theatres
- Positive/negative pressure rooms
- Immunosuppressed patients
2 with a cross through it means
single use
built environment
o Space/layout
o Toilets
o Wash hand basins
cleaning
o Disinfectants
o Steam cleaning
o Hydrogen peroxide vapour
medical devices
o Single use equipment
o Sterilisation
o decontamination
Have you I-fived your patients today?
- Identify (patients at high risk of transmitting)
Does the patient have an A-F??
- Isolate
- Investigate
- Inform
- Initiate
Identify checklist: A–> F
- Abroad
- Blood borne infections
- Colonised with multidrug resistant organisms
- Diarrhoea/ vomiting
- Expectorating (cough)
- Funny looking rash
