Infection Prevention and Control

Question 1

What are HAI’s?

Answer 1

Health Care Associated Infections

• most common serious complication of hospitalization
• 1 in 9 patients admitted in Canada acquire an infection from hospital stay
• 220 000 incidents a year, 8000 deaths
• equivalent to deaths from breast cancer and motor vehicle accidents / year
• 4th leading cause of death after cancer, heart disease, and stroke

Question 2

What are the factors affecting infection risk?

Answer 2

Age, nutrition, stress, chronic disease, medical therapies/immunosuppressants

Question 3

What is immune response?

Answer 3

Protection of the body by neutralizing pathogen and repairing damaged body cells

Question 4

What are specific protection methods against pathogens?

Answer 4

Antibodies

Question 5

What are non-specific protection methods against pathogens?

Answer 5

Normal flora, body system defences (e.g. skin, saliva, respiratory cilia, gastric acid), inflammation (vascular reaction delivers fluid, blood products, and nutrients to injured tissue)

Question 6

What are the elements of the chain of transmission?

Answer 6

Infectious Agent
Reservoirs
Portals of Exit
Modes of Transmission
Portals of Entry
Susceptible Host

Question 7

Infectious Agents

Answer 7

Bacteria, fungi, viruses, parasites, prions

Breaking the chain:
antimicrobial therapy, disinfection, sterilization

Question 8

Reservoirs

Answer 8

People, water, food

Breaking the chain:
engineering controls, environmental cleaning/disinfection, proper food storage, water treatment

Question 9

Portals of Exit

Answer 9

Blood, secretions, excretions, skin

Breaking the chain:
hand hygiene, disposal of waste and contaminated linen, control of excretions and secretions

Question 10

Modes of Transmissions

Answer 10

Contact, droplet, airborne

Breaking the chain:
spatial separation, engineering controls, hand hygiene, environmental sanitation, equipment disinfection/sterilization, PPE

Question 11

Portals of Entry

Answer 11

Mucous membrane, respiratory, GI, broken skin

Breaking the chain:
Hand hygiene, aseptic technique, wound care, catheter care, PPE

Question 12

Susceptible Hosts

Answer 12

Immunosuppression, diabetes, burns, surgery, age

Breaking the chain:
immunization, nutrition, recognition of high-risk patients, treatment

Question 13

What are routine practices?

Answer 13

• practices designed to care for all patients in any setting
• applies for (potential) exposure to blood, bodily fluids (excretions, secretions except sweat), non-intact skin, or mucous membranes
• first tier of isolation guidelines, second tier is transmission-based precautions

Question 14

Types of routine practices

Answer 14

Hand hygiene, mask and eye protection, gown, gloves, environment and equipment, linen and waste, sharps injury prevention, patient placement

Question 15

Hand Hygiene and Glove Use

Answer 15

• Less than 40% of health care professionals practice proper hand hygiene
• Gloves do not replace hand washing
• Wear gloves only when indicated, otherwise they become a major risk of transmission of organisms

Question 16

How to Clean Hands

Answer 16

Method #1
- alcohol-based hand rub is preferred method when hands are not visibly soiled
Method #2
- hand washing with soap and running water when hands are visibly soiled

Question 17

When should hand hygiene be performed?

Answer 17

• Before preparing, handling, serving or eating food
• After personal body functions
• Before putting on and taking off gloves
• whenever there is doubt in doing so

Question 18

Four Moments for Hand Hygiene

Answer 18

• before initial patient/patient environment contact
• before aseptic procedure
• after bodily fluid exposure risk
• after patient/patient environment contact