L9 - healthcare infections Flashcards
What is a healthcare infection?
An infection arising as a consequence of providing healthcare
Give an example of the impacts healthcare infections have on healthcare organisations
prolongs length of stay/more staff time needed so more staff pay/ money on investiagtion and treatments for each patient
Give two examples of common hosptial acquired infections (note - the only difference with hospital as opposed to healthcare is that it is just to do with hospitals, healthcare also includes things like primary care)
UTI’s/pneumonia/surgical wound infections/Gastro-intestinal such as c. dif/MRSA by staph aureus
What are the 4P’s of infection control, expand on each
Patient
- General patient specific risk factros for infection
- Interactions with other patients/healthcare workers/visitors
Pathogen
- Virulence factors
- Ecological interactions - with other bacteria and resistance to antibiotics
Practice
- Activities of healthcare workers
- Policies and their implementation
- Organisational structure and engagement
- Regional and national political initiatives
- Leadership at all levels
Place
- Fixed features e.g. beds/ward distances
- Variable features
List some risk factors for healthcare infections
Immunosuppression/malnourishment or obesity/diabetes/v old or v young/ cancer/ smoker/ surgical patient - emergency surgery patients are more at risk
List some general and some specific interventions we can make with regard to patients to prevent hospital acquired infections
general - optimise patient condition before admission/antibicrobial prohylaxis before surgery/ disinfectants on skin/ hand hygiene
specific - MRSA screens of at risk patients/ disinfectant bodywash/ decolonisation agents in nose etc.
What are some physical barriers we can put in place to halt patient to patient transmission of healthcare infections if they occur?
Isolate infected patients/protect susceptible patients e.g. filtering air into rooms in severely immunocompromised patients
positive/negative pressure rooms
What interventions can we put in place to stop spread to and from healthcare workers
Ensure if they are at work they are healthy/ vaccinations/ good clinical practice e.g. sterile non touch/ hand hygiene/ PPE/ antimicrobial screening
Give some environmental interventions we can put in place to prevent spread of healthcare infections
Layout e.g. beds not in close proximity/ toilets lots of in separate areas/ bays etc./ hand basins/ placement of furniture and furnishings/ disinfectants/ use of single use equipment where possible/ sterilisation of equipment/ good food hygeine practice/ positive/negative pressure rooms
I-fiving patients is a good way of identifying patients who have healthcare infections and could be at risk of transmitting them. What is this?
- Identify (Abroad? Blood borne infections? Colonised? Diarrhoea/vomiting? Expectorating? Funny looking rash?)
- Isolate them
- Investiage what’s causing it
- Inform others in the team so precautions can be made
- Initiate treatment
Norovirus is a non-enveloped ssRNA virus that is gotten via the foecal-oral route. How do you treat?
Supportive treatments particularly fluids beause it can cause severe dehydration and malnutrition through vomiting
Clostridium difficile is a gram positive obligate anaerobe which is spore forming. It is most commonly a problem associated with antibiotics as they wipe out normal flora.
What are the exotoxins that c dif has?
What is the treatment for c. dif
Toxin A - enterotoxin causing excessive fluid secretion AND INFLAMMATION
Toxin B - disrupts protein synthesis AND CYTOSKELETON
Treatment - fluids, discontinue current antibiotic, orlal vancomycin
What are the symptoms of someone with MRSA?
Commonly in hospital, abcesses, red swollen skin, infected wounds, malaise
How do we treat MRSA after confirming from a throat swab?
Drain any abcesses/isolate patient/prescribe a decolonisation agent/vancomycin IV
what class of drug is vancomycin?
glycopeptide (B-lactam)
