Perioperative Prevention and Control of Infection Flashcards
What are the common types of hospital acquired infections?
Catheter-associated UTIs
Surgical site infections
Pneumonia
Clostridium difficile
Septicaemia
How do catheter associated UTIs occur?
Skin where catheter was placed is dirty
Organisms from environment travel along the tubes into the bladder. Organisms can also arrive from hand or glove touching the catheter.
How common are surgical site infections?
In Aus, infection of surgical site occurs in ~3% of surgical procedures.
How long after surgeries do infections arise?
Infections occur up to 30 - 90 days after surgery and affecting either the incision or deep tissue at the operation site.
What are the signs of surgical site infections?
Signs of systemic and local inflammation.
What is hospital acquired pneumonia caused by? What are the issues caused by it?
Common nosocomial bacterial infection that is common in medical and surgical ICUs and significantly adds to the cost of hospital care and to the length of hospital stay.
What causes clostridium difficile infection?
Disruption of normal microbiome due to antibiotics causing the pathogenic bacteria to increase in numbers.
C. difficile can also be transmitted from person to person.
What are the symptoms of C. Difficile infection?
Diarrhoea
Stomach pain
Fever
Can be fatal
What causes septicaemia?
Bacterial infection elsewhere in the body such as lungs or skin enters the blood stream and so gets spread to the entire body,
What are the adverse outcomes of septicaemia
Septicaemia can quickly become life threatening
What is the chain of infection?
Infection agent -> Reservoir -> Exit -> transmission -> Entry -> Susceptible host -> Infection agent
What intervention can be done at the infectious agent stage of the chain of infection?
Rapid, accurate identification of organisms. (bacteria, fungi, viruses, ricketssiae, and protozoa)
What intervention can be done at the reservoir stage of the chain of infection?
Employee health programs
Environmental sanitation
Disinfection/sterilization
What are the common reservoirs of infection?
People
Equipment
Water
What are the portals of exit?
Excretions
Secretions
Skin
Droplets
How can we intervene with the exit stage of the chain of infection?
- Proper attire
- Handwashing
• Control of excretions and
secretions
• Trash and waste disposal
What are the means of transmission of infection?
Direct contact
Formites
Ingestion
Airborne
What are the interventions that can be done at the transmission stage of the chain of infection?
Isolation
Food handling
Air flow control
What are the portals of entry of infection?
Mucous membrane
Gastrointestinal tract
Respiratory tract
Broken skin
What are the interventions that can be put in place to control infection at the entry stage of the chain of infection?
Aseptic technique
Catheter care
Wound care
What are the factors that make a host susceptible?
Immunosuppression
Diabetes
Surgery
Burns
Cardiopulmonary
What interventions can be done at the susceptible host stage of the chain of infection?
Treatment of underlying
diseases
Recognition of high-risk
patients
What kinds of infections are caused by staph aureus?
Abscesses
Wounds
UTIs
Septicaemia
What kinds of infections are caused by E. Coli?
UTIs
Wound infections
What kinds of infections are caused by neisseria meningitidis?
Meningitis
Septicaemia
WhIch bacteria that can cause infection are commonly located in the GI tract?
E. coli
C. difficile
WhIch bacteria that can cause infection are commonly located in the nasopharynx?
Staph aureus
Neisseria meningitidis
How can Infection be prevented and controlled?
Personal protective equipment (PPE)
Hand washing
Surgical scrub
Skin preparation of patient
Maintaining sterile field
Safe operating practice
How can skin be prepared for surgery?
Antiseptics (eg chlorhexidine or povidone-iodine applied to surgical site prior to incision)
How is waste managed?
Clinical waste is segregated from household wasted to ensure its correct handling, transportation and disposal, to protect staff, patients, the public and the environment
What are the risks associated with handling sharps?
Sharps include needles, bone fragments, blades, sutures
Risk of sharps injury during invasive and surgical procedures
Risk of transmission of blood borne pathogen following a
sharps injury in unimmunized healthcare worker
- Hepatitis B 1:3
- Hepatitis C 1:30
- HIV 1: 300
What considerations must be taken with prophylactic use of antibiotics?
Timing and dose
Choice of AB
Carriage of resistant organsims and prophylaxis
Prophylaxis for immunosuppressed patients
What is the aim of prophylactic antibiotics?
AB prophylaxis aims to prevent infection by achieving high concentrations of antibiotic during surgery.
How is antibiotic chosen?
Must cover likely pathogen
Single dose must be enough to cover likely pathogens
What should be done if the patient has multi-resistant bacteria or immunocompromised?
The antibiotic choice may need to be modified and expert advice should be sought
