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Year 3 - Clinical Science and Professionalism > Preventing Hospital Infections > Flashcards

Preventing Hospital Infections Flashcards

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1
Q

What is the definition of infection control and prevention

A
  • Infection control and prevention: it’s a scientific approach and a practical solution to try and prevent harm caused by infection to patients and healthcare workers
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2
Q

what are the main concerns about infections

A
  • Severity of disease
  • Effectiveness and availability of treatment
  • Speed of spread
  • Preventability
  • Many spreads by hands
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3
Q

How does the chain of infection happen

A
  • Microorganisms – bacteria, virus, parasite
  • Reservoir – may be the environment, humans or other animals
  • Path from reservoir – vector
  • Mode of transmission – blood Bourne, respiratory transmission
  • Path of entry
  • Susceptible hosts e.g. a human
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4
Q

infection prevention and control seeks to….

A

Infection prevention and control seeks to identify weak links in the chain to break the spread of infection

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5
Q

How do you break the chain of infection

A
  • Hand washing
  • PPE – masks
  • Cleaning materials
  • Sharps bins to get rid of needles that have blood Bourne viruses
  • Vaccination
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6
Q

what 4 components can reduce infection rates by up to 32%

A
  • Appropriate emphases on surveillance activities and vigorous control efforts
  • At least one full time infection control practitioner per 250 beds
  • A trained hospital epidemiologist
  • For surgical wound infections feedback of wound infection rates to practicing surgeons
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7
Q

What does SENIC study mean

A
  • Study on the Efficacy of Nosocomial Infection Control
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8
Q

What are the two essential methods fo hand washing

A
  • Soap and water

- Alcohol hand rub

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9
Q

What is the main difference between soap and water and alcohol rub

A

alcohol hand rub is not effective in destroying norovirus and Cdiff toxin, what this means that after seeing any patient with infectious diarrhoea you must be careful to wash your hands with soap and water

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10
Q

When do you use soap and water to wash your hands

A

Perform for 20 seconds- hand hygiene technique is crucial
• When hand are visibly clean
• Patients with active diarrhoea/Cdiff/Norovirus
• Body fluids
• After cleaning medical items

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11
Q

When do you use alcohol rub to wash your hands

A
  • Takes 30 seconds to dry- contact time is crucial
  • When hands are visibly clean
  • Before aseptic procedure (note: wash hands first)
  • Effective in destroying 99.9 % of micro organisms including viruses when used correctly. Not effective for Norovirus and Cdiff toxin
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12
Q

what is alcohol rib not effective for killing

A

Not effective for Norovirus and Cdiff toxin

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13
Q

what are the WHO 5 moments when you wash your hand

A
  1. Before patient contact
  2. Before aseptic task
  3. After body fluid exposure risk
  4. After contact with patient
  5. After contact with patient surroundings
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14
Q

what is the dress code policy within the NHS

A
  • Bare to mid forearm
  • Short nails
  • No ring with stones
  • No watches
  • No artificial nails
  • No nail varnish
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15
Q

What is the key to reducing the incidence of healthcare associated infections

A

prevention and control

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16
Q

what 5 main patient care practises is healthcare associated infections associated with

A
  1. Use and care of urinary catheter
  2. Use and care of vascular access line
  3. Therapy and support of pulmonary function
  4. Surveillance of surgical procedure
  5. Hand hygiene and standard precautions
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17
Q

name some gram positive bacteria that can cause healthcare associated infections

A

MRSA /MSSA
• Methicillin Resistant Staphylococcus Aureus (MRSA)
• Methicillin Sensitive Staphylococcus Aureus (MSSA)
- Clostridium difficile

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18
Q

name some gram negative bacteria that can cause healthcare associated infections

A
  • E.Coli
  • Pseudomonas
  • Enterobacteriaceae
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19
Q

what is MRSA

A
  • Gram positive pathogenic bacteria that leads to a wide variety of health care association infection
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20
Q

what factors increase the virulence in MRSA

A
  • Various factors increase the virulence such as TSST, PVL, Protein A
21
Q

how does transmission occur in MRSA

A
  • Transmission occurs via skin contact, blood dependent
22
Q

what can MRSA infections cause

A
  • Can cause a variety of infections in the skin, respiraotry, heart and eye
23
Q

What is MRSA used for as a measure

A
  • MRSA is used to measure and compare various trusts on the infection and control preventions
24
Q

what is MRSA bacteraemia

A
  • This is the isolation of MRSA in the blood cultures from a patient
  • Can happen due to community strains of MRSA causing infections in patients
  • More interested in hospital strains
25
Q

what are the antibiotics for MRSA bacteraemia

A
  • First line antibiotics such as fluxocicin are at no use therefore you have to use either 2nd line or 3rd line anitbiotics
26
Q

who is screened for MRSA

A
  • Patient who has been previously identified as having MRSA should be screened
  • All other patients including elective, emergency or transfers from other hospital must be screened for MRSA
27
Q

How do they screen you for MRSA when you are an elective admission

A
  • All patients should be screened prior their procedure
  • Take place 3 month period prior to surgery
  • Ward and department that the patient is to be admitted to must be aware of the result in order so that suitable accommodation can be found on admission to the hospital
  • Results are valid for 3 months from the screening date, after this the screen must be repeated
28
Q

describe what happens if you test MRSA positive

A

MRSA positive

  • 5 days MRSA decolonisation protocol
  • 2 days off protocol
  • screen patient

IF MRSA positive

  • give 2nd MRSA protocol
  • 2 days off protocol
  • repeat screen

or

IF MRSA negative

  • repeat screening at 7 days
  • MRSA negative
  • Repeat screening at 14 days
29
Q

What are the good things to do to prevent MRSA bloodstream infection

A
  • Hand hygiene
  • Good line care
  • Remove peripheral line after 72 hours and or when it is no longer needed
30
Q

what other measures prevent other bloodstream infections such as E.col, bacteraemia/MSSA

A
  • CVC care bundle
  • Care bundle for ventilated patients
  • Peripheral intravenous cannula care bundle
  • Renal haemodialysis care bundle
  • Urinary catheter care bundle
31
Q

describe C diff

A
  • Gram positive anaerobic bacilli can produce spores and can possess toxins
  • Can colonise the gut, proliferate use of antibiotics and other factors, can promote C, diff growth in the gut
  • Can remain in spore form in the environment for weeks
  • 5% carry this as gut commensals
32
Q

How does transmission of C diff happen

A
  • Contact with spores on surfaces, diarrhoea
33
Q

what can C diff cause

A
  • causes diarrhoea

- in severe cases C.diff can cause you to have a colectomy

34
Q

what should you use to wash your hands in case of a C diff exposure

A

use soap and water to wash your hands as C.diff can remain in the environment for weeks

35
Q

What is the treatment for C diff

A
  • Metronidazole – no longer first line treatment – now an adjuvant therapy or used if IV therapy is needed
  • Vancomycin – preferred first line treatment, poor absorption so remain in the gut where they will have all there bactercidial activity directed
  • Fidaxomicin – refractory C diff colitis
  • Oral ingestion is preferred to get it to the gut
36
Q

What is the first line treatment of C diff

A
  • Vancomycin – preferred first line treatment, poor absorption so remain in the gut where they will have all there bactercidial activity directed
37
Q

what is the definition of antimicrobial stewardship

A
  • The term ‘antimicrobial stewardship’ is defined as ‘an organisational or healthcare-system-wide approach to promoting and monitoring judicious use of antimicrobials to preserve their future effectiveness’.
38
Q

what is the definition of antimicrobial resistance

A
  • The term ‘antimicrobial resistance’ is defined as the ‘loss of effectiveness of any anti-infective medicine, including antiviral, antifungal, antibacterial and antiparasitic medicines’.
39
Q

what is the goals of antibiotic stewardship programmes

A
  1. Reduce antibiotic consumption and inappropriate use
  2. Improve patient outcomes and decrease morbidity and mortality
  3. Increase adherence/utilization of treatment guidelines
  4. Reduce adverse drug events
  5. Decrease or limit antibiotic resistance
  6. Reduce healthcare costs
40
Q

what bacteria are priority 1: critical resistance

A
  • Acinetobacer baumannii - carbapenem- resistance
  • Pseudomonas aeruginosa - carbapenem resistance
  • enterobacteriaceae - carbapenem resistance, 3rd generation cephalosporin resistance
41
Q

what bacteria are priority 2: high resistance

A
  • enterococcus faecium - vancomycin resistant
  • staphylococcus aureus - methicillin resistant, vancomycin intermediate and resistant
  • Helicobacter pylori - clarithromycin resistant
  • Campylobacter - fluoroquinolone resistant
  • salmonella app - fluoroquinolone resistant
  • Neisseria gonorrhoea - 3rd generation cephalosporins resistant, fluoroquinolone resistant
42
Q

what bacteria are priority 3: medium resistance

A
  • streptococcus pneumonia - penicillin non susceptible
  • haemophilus influenza - ampicillin resistant
  • shigella spp - fluoroquinolone resistant.
43
Q

what are the types of Mycobacterium tuberculosis

A
  • Resistant TB
  • MDR TB
  • XDR TB
44
Q

what is the cost of antimicrobial resistance

A
  • Costs can cause 66 trillion pounds

- 10 million extra deaths by 2050

45
Q

how is noravirus spread

A
  • Spreads very quickly thorough vomit/stool
  • Not killed by alcohol
  • Causes massive hospital disruption
46
Q

how is influenza spread

A
  • Flu is common infectious viral illness spread by coughs and sneezes
47
Q

what does the infection prevention and control team do

A
  • Comprises of Infection prevention and control doctor and nurses
  • Responsible for the day-to-day running of the of the IPC programme
  • Responsible for setting priorities, applying evidence-based practice and advising hospital administrators on issues relating to infection prevention and control
  • Assists the healthcare facility IPC committee in drawing up annual plans and policies.
  • Provides specialist input in surveillance, Audit, prevention, monitoring and control of HAI’s and assisting with Post Infection Reviews (PIR)..
  • Provides specialist training on IPC to all levels of HCW
48
Q

What does the health and social care act say about infection and prevention

A
  • The Code of Practice (Part 2) sets out the 10 criteria against which the Care Quality Commission (CQC) will judge a registered provider on how it complies with the infection prevention requirements.
  • Good infection prevention (including cleanliness)1 is essential to ensure that people who use health and social care services receive safe and effective care.
  • Effective prevention and control of infection must be part of everyday practice and be applied consistently by everyone.

Year 3 - Clinical Science and Professionalism (32 decks)

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