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X PPPVN > Nosocomial Infections > Flashcards

Nosocomial Infections Flashcards

1
Q

what are nosocmial infections also known as?

A

healthcare associated infections or hospital acquired infections

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2
Q

what are hospital acquired infections?

A

infections which are acquired by patients during hospitalisation

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3
Q

when should an infection be considered hospital acquired?

A

within 48 hours of hospitalisation or within 30 days of discharge

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4
Q

what are common hospital acquired infections?

A 
UTI
pneumonia
bloodstream infection
SSIs 
infectious diarrhoea
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5
Q

how many infections has it been suggested that are preventable through infection control measures?

A

10-70%

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6
Q

what are 5 costs of hospital acquired infection?

A 
client dissatisfaction
longer hospitalisation (possibly at cost to practice)
Higher morbidity rates
Multidrug resistance
transmission to humans
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7
Q

what are 6 potential routes of infection?

A 
urinary catheters
surgery
IV catheters
indwelling implants/devices
feeding tubes
contaminated kennels and equipment
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8
Q

what are the 2 types of urinary catheter?

A

indwelling or repeat placement

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9
Q

what is an example of an indwelling device/implant?

A

drains

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10
Q

What patients are more at risk of hospital acquired infection?

A 
elderly
young
immunocompromised 
those with endocrine conditions (diabetes/cushings)
those with multiple indwelling devices
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11
Q

what are UTIs gained from?

A

use of urinary catheters either repeated placement for samples or emptying the bladder.
Poor hygiene when placing/managing an indwelling urinary catheter

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12
Q

what must always done before any procedure involving urinary catheter?

A

hand wash

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13
Q

should sterile gloves be used for placing a catheter?

A

yes for both indwelling and temporary

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14
Q

why should the vulva/prepuce be cleaned with dilute iodine prior to catheter placement?

A

mucous membranes so very sensitive but must be clean before catheter can be placed

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15
Q

what system should be used if an indwelling catheter is used?

A

closed - collection bag attached to the catheter at all times

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16
Q

to avoid UTI, what should be avoided where possible?

A

catheterisation or repeated catheterisation

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17
Q

when should antibiotics only be given to patients with a catheter?

A

if they are showing outward signs of of UTI - to reduce antibiotic resistance

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18
Q

what are the signs of a UTI?

A

pyrexia, change in urine colour, blood in urine

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19
Q

why is pneumonia less common in animals than in humans?

A

lesser use of mechanical ventilation and less totally recumbent patients

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20
Q

what can animals get pneumonia from?

A

endotracheal tubes or anesthetic circuits

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21
Q

what can be done to reduce the risk of pneumonia from endotracheal tubes or anesthetic circuits?

A

SOP for cleaning of ET tubes must be followed

heavily soiled ET tubes and circuits should be disposed of

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22
Q

in what type of animal is aspiration pneumonia a problem?

A

small animals

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23
Q

what causes aspiration pneumonia?

A

contents of regurgitation/vomit are inhaled

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24
Q

how can aspiration pneumonia be avoided?

A

starve patients before procedures requiring sedation or GA

secure airway ASAP once patient is under GA

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25
Q

how can a patient be managed during GA induction if they are at high risk for aspiration pneumonia?

A

head is kept raised until ET tube is correctly placed with cuff inflated

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26
Q

what are bloodstream infections associated with?

A

IV catheters, either peripheral or central

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27
Q

what are bloodstream infections mainly due to?

A

poor skin prep, lack of hand hygiene and contamination of products used

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28
Q

when should hands be washed during an IV placement?

A

before and after placement

29
Q

how can bloodstream infections be avoided?

A

use sterile equipment
take care when using refillable skin prep bottles
avoid repeated IV catheter changes

30
Q

when should an IV catheter be removed?

A

as soon as is practical

31
Q

what should happen if an infection is suspected at IV site?

A

send catheter tip to the lab for culture

32
Q

what should happen to the IV catheter sight after removal of IV?

A

covered

33
Q

what can surgical sight infections range from?

A

superficial to affecting whole organs

34
Q

how can surgical site infections be avoided?

A 
adequate skin preparation techniques
adequate preparation of personnel
good theatre practice
covering of surgical wounds as soon as possible post operatively
identification of at risk patients
35
Q

for how long after surgery should the wound remain covered ideally?

A

24-48 hours

36
Q

what must be considered when preparing skin for a surgical procedure?

A

should be clipped once patient is under GA

correct dilation of disinfectant should be used

37
Q

when may a patient be clipped prior to GA?

A

when the length of GA is more dangerous to health than the infection risk of clipping prior to surgery

38
Q

how can infectious diarrhoea be prevented?

A

hand hygiene
thorough disinfection and cleaning of accommodation/equipment between cases
regular deep cleaning of facilities

39
Q

what should be limited on the ward if there is an outbreak?

A

limit transport in and out of the ward until cases have ceased (48 hours post last symptoms seen)

40
Q

define infection control

A

the use of procedures and techniques in the surveillance, investigation and compilation of statistical data in order to reduce the spread of infection, particularly nosocomial infections

41
Q

what are the main methods of reducing infection?

A

questions and information gained during the initial telephone conversation
thorough cleaning of accommodation an equipment in between patients using correct disinfectants at correct dilutions
correct disposal of bodily fluids and wastes
handwashing
barrier nursing where appropriate
infection control team with one person in charge
monitoring of any infections
education of the veterinary team

42
Q

if the patient has a suspected infection what measures should be taken before they arrive at practice?

A

attempt to keep the animal outside to avoid spending any time in the waiting room and potential infection of others

43
Q

what is the single most effective line of defence against HAIs?

A

handwashing

44
Q

what handwashing technique is the most effective?

A

WHO 6 steps

45
Q

what are the 5 moments for hand hygiene?

A 
before touching a patient
after touching a patient
after contact with patients surroundings
if hands become visibly soiled
before carrying out an aseptic technique
46
Q

can alcohol hand rubs be used?

A

yes

47
Q

can alcohol hand rubs be used if hands are soiled?

A

no, hands must be washed with hand soap

48
Q

where should animals be housed if they have poor immune status, are very young, very old or unvaccinated?

A

usual ward area but nurse before other patients (reverse barrier nursing)

49
Q

where should animals be housed if they are vaccinated and systemically well?

A

on normal wards

50
Q

what is reverse barrier nursing?

A

nursing to protect the compromised patient from others rather than protecting others from that patient. This animal is always nursed first rather than last

51
Q

where should animals be housed if they have mild infectious disease, prolonged antibiotic use or draining wounds?

A

either within wards or isolation. If housed on wards then tape off a section in front of the kennel and nurse patients last wearing appropriate PPE.

52
Q

what extra needs do animals have if they have mild infectious disease, prolonged antibiotic use or draining wounds?

A

own equipment and clinical waste bin

53
Q

Where should patients with mild infectious disease, prolonged antibiotic use or draining wounds be housed if there is an immunosuppressed patient on the ward?

A

they should be isolated rather than risking the immunosuppressed patient

54
Q

where should animals be housed if they have severe infections or are highly contagious?

A

isolation with a dedicated nurse

55
Q

how far away from other patients should isolation facilities be?

A

at least 5 metres

56
Q

what should be used to avoid movement of contaminated equipment?

A

disposable items wherever possible

57
Q

where should the PPE be located in the isolation area?

A

at the entrance so ward doesn’t have to be crossed without PPE on

58
Q

what is the main characteristic of many pathogens implicated in HAIs?

A

opportunistic - exist normally within the animal but only become problematic when animal is below par

59
Q

when should multi resistant infection be suspected?

A

if patient is not responding to antibiotics or if they have significant risk factors

60
Q

what should be done to determine what bacteria are present so they can be treated appropriately?

A

culture and sensitivity tests

61
Q

how can multi resistant infections be avoided?

A 
careful antibiotic use (not an alternative to good hygiene)
hand hygiene
education of veterinary team
clinical audits
reporting of incidences
62
Q

what is MRSA?

A

methicillin resistant Staphylococcus aureus

63
Q

what does MRSA infection result in?

A

non- healing wounds and skin lesions. Can lead to sepsis and death

64
Q

what is diagnosis of MRSA based on?

A

swabs/tissue samples

65
Q

how should suspected MRSA patients be treated?

A

as diagnosed: strict barrier nursing in isolation facility with limited hospital movement (moved on a trolley if movement required)

66
Q

how should diagnosed MRSA patients be treated?

A

strict barrier nursing in isolation facility with limited hospital movement (moved on a trolley if movement required)

67
Q

which staff members should not nurse MRSA patients?

A

those with immunosuppression and skin lesions

68
Q

what happens during infection surveillance?

A

one staff member assigned
monitoring incidences of infections
investigation of trends
implementation of changes (and review of these changes)

69
Q

what can be done to increase infection control compliance?

A

plenty of hand-washing facilities
hand-washing literature (where and how)
regular audits of SOPs and staff compliance
bare below the elbows policy

X PPPVN (27 decks)

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