outbreak - optional Flashcards
what is a healthcare associated infection
infection you might catch when receiving healthcare in hospitals, care homes, GP surgery, health centres or receiving care at home
most common types of infections in hospitals are urine infections, post-op infections, skin infections, sickness and diarrhoea
hospital acquired infections
infection acquired after being in hospital for >48hrs
for some organisms this will vary depending on the incubation period of the organism
types of HAIs
UTI - most common of all HAIs, mainly related to catheterisation
surgical site infection
RTI - intubation accounts for ~25%
bloodstream infections - many central venous catheter related
GI infection
skin and soft tissue infections
define outbreak of infection
≥2 cases of an infection linked in place and time
role of IPCT and surveillance in outbreak
1st purpose of IPCT is to prevent individual infections and outbreaks
purpose of surveillance is to detect and identify a possible outbreak at the earliest opportunity
chain of infection
infectious agent reservoir portal of exit mode of transmission portal of entry susceptible host
(cycle continues)
4 types of infectious agents
bacteria
virus
fungi
prion
5 examples of reservoirs
humans equipment environment food animals
3 examples of portal of exit
blood and body fluids
skin scales/wound
coughing and sneezing
3 examples of mode of transmission
direct or indirect
inhalation
ingestion of contaminated food
5 examples of portal of entry
skin/surgical wounds eyes or mouth resp tract GI tract tubes
4 examples of susceptible host
underdeveloped immune system
decreasing immune system
drugs or diseases
tubes
ways to break the chain of infection at the point of infectious agent
diagnosis and treatment
antimicrobial stewardship
ways to break the chain of infection at the point of reservoir
cleaning, disinfection, sterilisation
infection prevention policies
pest control
ways to break the chain of infection at the point of portal of exit
hand hygiene PPE control of aerosols and splatter respiratory etiquette waste disposal
ways to break the chain of infection at the point of mode of transmission
hand hygiene PPE food safety cleaning, disinfection, sterilisation isolation
ways to break the chain of infection at the point of portal of entry
hand hygiene PPE personal hygiene first aid removal of catheters and tubes
ways to break the chain of infection at the point of susceptible host
immunisations
treatment of underlying disease
health insurance
patient education
5 moments for hand hygiene
before touching a patient before clean/aseptic procedure after body fluid exposure risk after touching a patient after touching patient surroundings
prevalence of SSI
0.8% in acute adult inpatients
accounts for 15% of all HAI
patients w/ SSI
49.4% F, 50.6% M
median age 63y/o
28.7% had life limiting or end of life prognosis
majority on surgical wards
characteristics of SSI
- 7% of SSI were present on admission to hospital
52. 8% of SSI were in deep tissue or organ space
most common causative organisms of SSI
S. aureus - 23.9%
E. coli - 14.1%
unspecified anaerobes - 8.5%
other - 53.5%
antimicrobials for SSI
3.2% of all antimicrobials were prescribed to treat SSI
most commonly prescribed antimicrobials for SSI treatment - flucloxacillin, vancomycin
most commonly prescribed antimicrobials for SSI prevention - gentamicin, cefuroxime, co-amoxiclav
trasmission based precautions (TBPs) for isolated patient
contact
gloves
apron
contact precautions for isolated patient
decontaminate hands before entering room
disposable apron and gloves
keep door closed unless otherwise told to keep open
decontaminate equipment prior to leaving room, discard gloves and apron, decontaminate hands
transmission based precautions for isolated patient - airborne precautions
droplet
gloves
aprons
masks
eye protection
airborne precautions for isolated patient
decontaminate hands before entering room
disposable apron, FFP3 respiratory, eye/facial protection and gloves
keep door closed
decontaminate equipment prior to leaving room, discard gloves and apron and eye/facial protection, decontaminate hands
after leaving remove respirator and discard, clean hands
what is a droplet
> 5µm
spread assumed to be ~1m
drop to the ground
what’s an aerosol
<5µm
much more widespread
remain suspended in air
why is the difference between droplet and aerosol important
airborne spread infections are more highly transmissible and therefore require different precautions
40µm is limit of visibility to human eye
define cleaning
physical removal of organic material and decrease in microbial load
define disinfection
large reduction in microbe numbers - spores may remain
define sterilisation
removal/destruction of ALL microbes and spores
when is cleaning along used
low risk - intact skin contact e.g. stethoscopes, cots, mattresses
cleaning compatible w/ manufacturer’s instructions
when is disinfection or sterilisation as appropriate used
medium risk - mucous membrane contact e.g. bedpans, vaginal specula, endoscopes
when is sterilisation used
high risk - surgical instruments
cleaning process
manufacturer’s instructions
detergent and water
drying is an important part of the process
cleaning essential prior to disinfection and sterilisation if these are required
2 methods of disinfection
heat
chemical
disinfection by heat
pasteurisation - bedpans, linen, dishwashers
boiling - vaginal specula, ear syringes
chemical disinfection
chemicals vary in their organism activity range
needs to be equipment compatible
e.g. alcohol, chlorhexidine, hypochlorites, hydrogen peroxide
4 methods of sterilisation
steam under pressure - autoclave
hot air oven
gas - ethylene dioxide
ionising radiation
surveillance
local - lab based, ward/clinic area based
national surveillance
all healthcare workers
