Prevention of Health Care Associated Infections Flashcards
HCI?
- growing
- most serious complications of hospitalization
- 5-10% of patients acquire it
- 4th leading cause of death in Canada
- 20yrs ago, they where 11th leading cause (growing)
- large proportion are preventable
- a-lot are UTI’s and pneumonia
4 classes of surgical wounds?
- clean (1-5% rate of infection)
- clean contaminated (3-11% rate of infection)
- contaminated (10-17% rate of infection)
- dirty (over 25% rate of infection)
Host susceptibility for HAI?
- age
- diabetes
- immune system
- obesity
- malnutrition
- duration fo surgery
- emergency surgery
- crowding
- pre-op length of stay
- remote infections
Pre-op prevention strategies?
- showers
- hair removal
- skin antiseptic
- drapes
- prophylactic antibiotics
Intra-operative prevention strategies?
- keep doors close din operating room
- duration of procedure
- insertion of drains, catheters and IV’s
Prevention strategies: attire?
- surgical scrub
- masks
- gowns
- gloves
- caps
- shoe covers
Prevention strategies: personnel?
- staying healthy
- no casual visitors
- traffic flow
Environmental Control?
- clean air rooms
- laminar air flow rooms
- traffic flow
- sterilize equipment
Daily, weekly, monthly cleaning?
Daily= floor, lights walls Weekly= shelves, external vents Monthly= hallways, storage areas
Intravascular infection based on…?
- site
- prep
- aseptic procure
- daily observation
- preparation of IV solutions
- duration of IV left insitu
Prevention of Urinary Tract Infections?
-primary risk is instrumentation and catheter care
-#1 HAI
-not a high cost to health care unless there is complications
-sterile
-use of catheters should be minimized
-peri-care
-maintain medical aseptic procedure
catheter bag below patients hips (reduce back flow)
Nosocomial Pneumonia?
10-20% of nosocomial infections
- highest morbidity rate
- not present within 48-72 hours
- due to bacteria, virus, fungi
- spread by aspiration, inhalation, hematogenous spread
- fungi and unusual bacteria= primary risk to immunosuppressed
- transplant cases
Associated risks with pneumonia?
- abdominal operations
- age (extremes)
- aspirate
- decreased ability to cough
- invasive procedures
- COPD, cystic fibrosis
- impaired immune systems
Pneumonia prevention?
-immunizations
-aseptic procedures
antiseptic mouth wash
patient positioning
pre/post OP teaching
-disinfection practices
Antiseptics? disinfectants? sterilizations?
AS- used on living tissue
DI- reduces microorganisms and can eliminate some
Sterilization- kills microbes including spores
How to eliminate micro-organisms?
-sanitization, decontamination, disinfection, sterilization
Critical items?
-come in contact with sterile body cavity/ sterile tissue
-require sterilization
ex= surgical equipment
Semi-critical devices?
-only come in contact with mucous membranes or non-intact skin
-high level of disinfection
ex= endoscopes, anaesthetic equipment
Non-Critical medical devices?
- items that come in contact with intact skin
- require sanitization
Decontamination Process?
- removes blood, body fluids and tissue to ensure sterilization process
- makes items safe to handle
Disinfection?
-thermal or chemical
used on inanimate objects
-eliminates most pathogenic micro-organisms with he exception of bacterial spores
Low level of disinfection?
-kill most bacteria, some viruses and some fungi
cleaning general patient care, bedside, IV poles
inactivates mycobacterium TB, vegetative bacteria and most viruses
High level disinfection?
- destroys all micro-organisms and some spores
- disinfect flexible scopes and small items
- requires special ventilation, PPE
- new technology= UV light
Sterilization?
-destroys all micro-organism and all spores
Types of sterilization?
- steam under pressure
- dry heat
- ethylene oxide gas
- chemical sterilants
- thermal disinfection (water at 93 degrees for 10 min)
- hydrogen peroxide weapon
- hydrogen peroxide gas plasma
- per acetic acid
- ozone
Pasteurization?
reduces number of micro-organisms by mechanical means sing thermal disinfection (hot water 75-82 degrees)
-used with resp. equipment
Disposable?
Single use?
Single patient use?
D- use once then discard
SU- use only once
SPU- repeated use by same patient, discarded on patient discharge
Issues?
- antibiotic resistant organisms (MRSA, VRE, ESBL
- cleaning new complex instruments
- reprocessing single use devices
- impact of construction (ventilation, dust, water)
