Infection: Hospital acquired infections Flashcards
What are healthcare infections?
Infections arising as a consequence of providing healthcare.
For pts this means onset of infection at least 48 hours after admission
Also includes infections in staff and hospital visitors
Why are healthcare infections important?
They are frequent - affect 8% of in-patients and affect their health, can be severe and fatal.
They are costly - cost of prolonged stay and investigations and treatments
A lof of them are preventable
Which patients are at high risk of hospital acquired infections?
- Extremes of age: neonates have delicate skin that easily breaks down
- malnourished or obese
- diabetics
- pts with cancer and other immunosupression
- smokers (paralysed cilia, increased risk of wound infection)
- emergency admissions (usually less healthy and less prepared than routine pts)
What are the 4 Ps of infection prevention?
Patient - risk factors, and interactions with other people
Pathogen - virulence factors and interactions with other bacteria and antibiotics
Practice - policies, funding, hand hygiene
Place - the healthcare environment such as bed spacing, cleanliness
What are some patient interventions to prevent infections?
Generally optimise patients condition - smoking, nutrition, control diabetes
Antimicrobial prophylaxis, hand hygiene
Specific: MRSA screens, disinfectant body wash
Immunity - vaccinations
Isolating infected pts to reduce transmission
What are some place interventions to prevent infections?
Layout - increase space between beds, have lots of wash hand basins
Make sure furniture and furnishings are cleanable
Good kitchen and food facilities
What are some practice interventions to prevent infections?
Use personal protective equipment eg masks, aprons, gloves
Behavioural changes in pts eg STIs, safer sex
What is the A–>F of patient posing a risk of infection?
Abroad - esp if hospitalised abroad Blood bourne infections Colonised - multi drug resistant Diarrhoea or vomiting Expectorating (coughing) Funny looking rash - chicken pox, scabies, measles
Define: Endemic Outbreak Epidemic Pandemic
Endemic: the usual background rate
Outbreak: 2 or more cases linked in time and place (eg 2 cases of norovirus in a ward in a week)
Epidemic: rate of infection greater than usual
Pandemic: very high rate infection spreading across many regions and countries eg swine flu 2009
What are the causes of outbreaks on infection?
The 4 Ps
Pathogen - new resistance, new strain, new virulence factors
Patient - new patients that have not had the infection before so no immunity
Practice - historically the intro of surgery and use of central lines, increase in IVDU increased Hep C
Place - migration carries new strains to new places
What are some pathogen interventions to prevent infections?
Reduction or eradication of the pathogen
Clean using disinfectants, steam and hydrogen peroxide vapour
Sterilise and decontaminate medical devices (eg endoscopes cant be sterilised)
Reduce or eradicate vector eg mosquito breeding sites
