Infection prevention and control

Question 1

what is ccdc?

Answer 1

Consultants in
Communicable Disease Control

Question 2

HCAI?

Answer 2

Healthcare associated infection
(HCAI) is defined as any
infection acquired in relation to
the delivery of healthcare in its
widest sense. This includes care
in hospitals and in the
community via General
Practitioners and health centres

Question 3

incidence?

Answer 3

The number of NEW cases occurring in a population at risk over
a defined period of time
Presented as the percentage or proportion of those “at risk” that
go on to develop the outcome
Requires patients without the outcome e.g. HAI to be followed
over time to determine whether they develop the outcome

Question 4

Prevelence?

Answer 4

Number of affected individuals present in a population at a
specific point in time
Presented as a proportion or percentage of all individuals in
the population at that point in time
Example
Prevalence of HAI
• Survey population= 100
• For each patient- does the patient currently have an HAI?
• If 5 patients have an HAI at the time of survey, prevalence= 5/100= 5%

Question 5

top 5 hai?

Answer 5

UTI 80 (No. HAI) 20.9 (% of HAI) 0.9 (prevelnce)
SSI 75 19.6 0.8
GI infection 44 11.5 0.5
Pneumonia 42 11.0 0.5
BSI 34 8.9 0.4

Question 6

5 key clinical syndromes?

Answer 6

Catheter Associated Blood Stream Infections (CABSI)
– 14% of all HCAI
– Almost 1/3rd of all HCAI related deaths.
• Ventilator Associated Pneumonia
– 1 – 10 cases per 1000 ventilator days
– Attributable mortality 10%
• Catheter associated Urinary Tract Infections (CAUTI)
– 32% of all HCAI
– Attributable mortality rate as high as 13% in cases of HCAI
complicated by blood stream infections.
• Surgical Site Infection
– Approx. 2% of all surgical procedures.
– 20% of all cases of HCAI
• Clostridium difficile infection

Question 7

medical devie use

Answer 7

PVC
CVC
UC
Intubated

Question 8

devices and speciality?

Answer 8

Question 9

story to remember

Answer 9

23 Year old female admitted with acute heart failure
related to congenital heart disease
• Develops a Staphylococcus aureus (MSSA)blood
stream infection following infection of her peripheral
vascular cannula.
• Infective Endocarditis of the congenitally abnormal
heart valve forces emergency cardiac surgery
• Increasing the patients’ LOS, morbidity and risk of
death.

Question 10

indiivudal responsiblities?

Answer 10

Hand Hygiene
• Appropriate use of gloves and aprons
– To protect the patient
– To protect yourself
• Appropriate and timely use of antibiotics
• Aseptic technique and good practice when conducting
invasive procedures
– Urinary catheterisation
– Insertion of peripheral cannulae
– Insertion of central lines
• Review of medical devices e.g. peripheral cannulae
– ? Needed
• Awareness of risks of infection
– Appropriate isolation and management of patients
• Immunisation

Question 11

aims of improvmenet programme?

Answer 11

Reducing Waste
– Unnecessary placement of urinary catheters and peripheral vascular
cannulae
• Reducing Harm
– Infectious and other complications of medical devices
– Eliminating preventable Healthcare Associated Infections in Wales
• Reducing Variation
– Ensuring the same evidence based standard of care is put into practice
for all patients wherever they are treated in Wales

Question 12

risks in the UHW?

Answer 12

Insufficient isolation facilities
• Old plumbing systems
– Legionella risks
– Pseudomonas risks
• Ventilation systems
• Risks of New build
–Aspergillus