intro to HAI Flashcards
( intro not rly important) glossary:
—– : the process of inserting an endotracheal tube into the airway
—— : a machine that takes over the work of breathing
intubation
ventilation
( intro not rly important)
glossary ( continued) - surgery types:
1- —- surgery which has no breach of tract as —–
2- —– which has break of breach of GI/ GU/ Respiratory
3- —– surgery operating in a contaminated field as —-
clean surgery as:excision of a
skin lump
Clean- contaminated surgery
Contaminated surgery as post GI perforation
infections acquired by patients
during their stay in a hospital or
another healthcare setting, which
were not present or incubating at
the point of admission defined by WHO is known as:
—– is an infection that is acquired after contact with the healthcare services. This is most frequently after treatment in a hospital, but can also happen after treatment in outpatient clinics, nursing
homes and other healthcare settings. ( another definition by health protection )
HAI healthcare associated infection
microbes that cause HCAI come from —- and —-
1- exogenous which can be acquired from environment parents or staff which are all potentially preventable
2- endogenous: acquired from the patients own flora which is more difficult to prevent
importance of HCAIS:
1- increased —-
2- increased —-
3- increased —- which includes :
4- increased —-
5- associated w —-
- Increased mortality: 25% of S. aureus BSI patients die
- Increased morbidity: patients with post-operative surgical wound
infection spend longer in hospital & suffer - Increased costs which includes :
a) Hospital/healthcare, e.g. antibiotics, X-rays
b) Patient, e.g. delayed return to work
c) Society, e.g. disability allowances, reduced income tax - Increased awareness by public & authorities
- Associated with antimicrobial resistance
why do HCAI occur:
1- the – adapts which leads to:
- antimicrobial —-
- —- production
- —– production
2- host —- such as:
3- the —- :
1- microbes adapts leading to :
- antimicrobial resistance
- biofilm production
- spore production
2- host vulnerability as:
- immunosuppression
- underlying illness
- extreme age
- devices as: iv lines , urinary catheters , ventilators
- wounds
3- the environment which can be from:
- humans: other patients or staff
- inanimate as: equipment , infrastructure ( multi-bedded bays)
types of HCAI :
1- Respiratory
o Pneumonia
o Viral RTI, e.g. influenza, COVID-19, RSV
2- Gastrointestinal
o Clostridioides difficile
o Viral, e.g. norovirus, rotavirus
3- Skin/soft tissue
o Peripheral/central IV catheter infections
4- Surgical site infections
5- Device-associated infections
o Cardiac implantable electronic devices, dialysis catheters,
ventriculoperitoneal shunts, drains, VAP
6- Urinary tract
o Catheter-associated UTI
respiratory tract infection in healthcare associated infection as —- which is predisposed by risk factors as:
1- recent — which leads to compromised — and altered — due to —
2- decreased level of —-
3- —- and —- which can bypass the upper respiratory —- , —- . example:
peneimnia (HAP )
surgery
breathing ( abdominal )
flora
antibiotics
consciousness
intubation and ventilation
defences
coughing
as:ventilation-associated pneumonia (VAP)
( info: NB Aetiology different to community-acquired pneumonia where S. pneumoniae is the commonest)
causes of HAP and VAP:
- Gram negative bacilli (GNB): including multidrug resistant ones
* E. coli
* Klebsiella spp.
* Enterobacter spp.
* Pseudomonas spp. - Staphylococcus aureus: including MRSA
- Legionella pneumophila (most cases though are community-acquired and not healthcare)
- Viruses: COVID-19, influenza, RSV
surgical site ( wound) infections aka SSI predisposed by risk factors as:
1- — factor which is —- ex:
2- —- factors which is via —- or – and is partly prevented by —-
3- —-: during dressing applications /
changes from air, hands, etc. (exogenous) –prevented by good practice, e.g. —-
patient
endogenously
perforated viscus
operating theatre
air from environment or staff which is exogenous
controlled air
post operatively
hand hygiene
classification of SSI are:
pathogens include:
1- superficial
2- deep/incisional
3- organ/space
pathogens include:
* Staph. aureus (most common irrespective of type of surgery)
* Beta-haemolytic streptococci
* GNB (mostly only seen post-clean-contaminated or contaminated surgery)
* Anaerobes (post-clean-contaminated or contaminated
surgery)
* Coagulase-negative staphylococci (if prosthetic material)
urinary tract infection:
1- predisposed by :
2- commonly caused by:
3- prevention by:
– Catheterisation / surgical intervention /instrumentation
– Stasis, e.g. tumour
– Dehydration
caused by:
1. E. coli, Proteus, Ps. aeruginosa
2. Enterococci
prevention:
- Standard precautions including hand hygiene
- Transmission based precautions
- Decontamination
elements of standard precautions:
- Hand hygiene
- Respiratory hygiene and cough etiquette
- Safe patient placement
- Use of appropriate PPE: gloves, gowns, face & eye protection
- Cleaning and decontamination of reusable medical devices
- Environmental hygiene
- Safe injection practices
- Disposal of waste
- Correct use and disposal of sharps
- Management of occupational blood / body fluid exposure (OBE) including sharps injury
- Management of blood and body fluid spills
- Management of linen
what’s on our hands:
1- —– : organisms that are picked up easily from the environment or during patient contact. Can then be easily transferred from your hands on to others
2- —- : organisms
that live naturally within the skin normal flora. That are not easily
transferred.
transient organisms
resident organisms
- Healthcare-associated pathogens are most often transmitted from patient to patient on the —- of healthcare workers
- —— before and after patient contact is one of the most important measures for preventing the spread of microorganisms in
healthcare settings
hands
cleaning your hands
you should clean it when:
1- before touching patient
2- before clean/aspetic procedure
3- after body fluid exposure risk
4- after touching patient surroundings
