Lecture 13 - Hospital Acquired Infection

Question 1

What are Healthcare infections?

Answer 1

Infections arising as a consequence of providing healthcare

Question 2

What classifies as a Healthcare infection?

Answer 2

The infection must not be present or incubating at the time of hospital admission

Onset = At least 48 hours after admission

Question 3

What are some Viral healthcare infections?

Answer 3

-Blood Borne viruses (Hep B, C and HIV)
-Norovirus
-Influenza
-Chicken pox (Varicella Zoster Virus)

Question 4

What are some examples of Bacterial Healthcare infections?

Answer 4

Staphylococcus Aureus (Including MRSA)
C.difficult
Escherichia coli, Klebsiella pneumoniae
Pseudomonas aeruginosa
Mycobacterium tuberculosis

Question 5

What are some examples of Fungal Healthcare infections?

Answer 5

Candida albicans
Aspergillus species

Question 6

What is an example of a parasitic healthcare infection?

Answer 6

Malaria

Question 7

What are some patient factors which affect the likely head of developing a healthcare infection?

Answer 7

Age
Obesity/malnourished
Diabetes
Cancer
Immunosuppression
Smoker
Surgical patient
Emergency admission

Question 8

What are the 4 Ps of infection prevention and control in healthcare?

Answer 8

Patient
Pathogen
Practice
Place

Question 9

Generally what are patient factors influencing likelihood of getting infections in healthcare?

Answer 9

Interactions with other patients, healthcare workers and visitors

Question 10

What Pathogen factors affect likelihood of developing a healthcare infection?

Answer 10

Virulence factors
Ecological interactions - with other bacteria, antibiotics or disinfectants

Question 11

What Practice factors affect likelihood of developing a healthcare infection? (Everything healthcare workers can do)

Answer 11

General/specific activities of healthcare workers
Policies and their implementation
Organisational structure and engagement
Regional and national political initiatives
Leadership at all levels from government to the ward

Question 12

What Place factors affect likelihood of developing a healthcare infection?

Answer 12

Healthcare environment:
Fixed features (number of beds in a bay) and variable features

Question 13

What General interventions can be done to a patient to prevent acquiring a hospital-acquired infection?

Answer 13

General:
-Optimise patients condition
-Smoking
-Nutrition
-Control diabetes
-Antimicrobial prophylaxis
-Hand hygiene
-Skin preparation before invasive procedure

Question 14

What specific intervention can be done to a patient to prevent acquiring a hospital-acquired infection?

Answer 14

MRSA Screening system
Mupirocin (antibiotic) nasal ointment
Disinfectant body wash

Question 15

What interventions can be done to prevent patient to patient transmission?

Answer 15

Physical barriers:
-Isolating infected patients
-Protecting susceptible patients

Question 16

How can transmission from healthcare workers to patients be reduced?

Answer 16

Ensure Health care workers are healthy:
-Disease free
-Vaccinated
Good practice/good clinical techniques:
-Sterile non touch
-Hand hygiene
-PPE
-Antimicrobial prescribing (can increase risk if certain infections)

Question 17

Using Cefuroxime can increase the risk of what infections?

Answer 17

Clostridium difficile

Question 18

What environmental interventions need to be considered too prevent infections?

Answer 18

-Built environment (space layout, toilets, wash hand basins)
-Cleaning
-Medical devices
-Good kitchen and ward food facilities
-Positive and negative pressure rooms (important in operating theatres)

Question 19

How can the risk of infections from medical devices be reduced?

Answer 19

Single use equipment
Sterilisation
Decontamination

Question 20

What does “Have you I-Fived your patients” mean?

Answer 20

Identify patients
Isolate
Investigate
Inform
Intiate

Question 21

How can you identify a patient at risk?

Answer 21

Travelled abroad
Blood borne infection
Diarrhoaea/vomiting
Funny looking rash
Expectorating (coughing up sputum)