Session 5 - Lecture 1 - Hospital Acquired Infections Flashcards
1 - Who is involved in managing healthcare infections?
Healthcare infections
Get to work with lots of people around the hosp – all sorts of healthcare workers – managers – everybody has a big contribution to play in terms of preventing healthcare infections.
2 - Objectives
- Introduce healthcare infections and their importance
- Use the infection model as a basis for understanding pathogen and patient factors leading to healthcare infections
- Introduce the 4Ps of infection prevention
- Look at ways of preventing infections
3 - What are healthcare infections?
• Infections arising as a consequence of providing healthcare
• In hospital patients:
– Neither present nor incubating at time of admission
– For practical purposes, this means onset is at least 48 hours after admission
• Also includes infections in hospital visitors and healthcare workers
{2. healthcare-acquired infections (HAI) – infections that come on during treatment of pts in hospital – but how do you know if infection is HAQ or whether they came in with it?
2a. sometimes infection process already started but no symptoms so
2b. if someone has +ve blood culture as 12 hrs categorise as community onset infection – but if blood culture >48 hrs after pt is in hosp, if pt didn’t hav any features of infection before then HAI – (cases where specimens not taken at right time – if taken to lab late then could be incorrectly labelled as HAI)
Also if it’s after they d/c then it’s also HAI bc of conditions in hosp.
3. Also ppl carry out tests on tissues, blood samples, urine samples, labs which take Post mortem examinations – so also infection prevention in staff and visitors}
4 - Why are healthcare infections important?
- Frequent - prevalence = 8% of in-patients
- Impact on health
- Impact on healthcare organisations
- Preventable
{1. snapshot surveys occur – so on a certain day of a certain week – once every 2-3 yrs – look at pts of hosp in UK – assess whether pt has HAI or not – report published – figs of 8-10% of inpatients any one time – in practice means more than 8-10% get infection – may not have at time of survey - some pts get several infections.
- significant cause of prolonged length of stay – paper said about 10 days. If 10% get HCI then every pt stays on average 1 day longer & in a situation where we don’t have the beds available are avoidable drains on HC resources – use up resources such as beds, operating theatre times, lab time, drug and treatment time
- At least 30%, if not 50% or more}
5 - Types of HCAI
The types of HCAI in the 2006 prevalence survey
- gastrointestinal 21%
- urinary tract infections 20%
- pneumonia 14%
- surgical wound infections 14%
- other 14%
- skin and soft tissue 10%
- primary bloodstream 7%
{slide from 2006 but reflects present as well
- diarrhoea – c. diff bacterial infection; or viral, predominantly norovirus – extremely contagious – occurs out in community as well as hosp - key characteristic of outbreak is rapid spread of D&V not only to other pts but also to staff
- 1 in 5 pts. Can be trivial - e.g. just a degree of discomfort, does not result in prolonged length of stay BUT treatment may lead to antibiotics which contributes to emergence of antibiotic resistance, as well as using costly healthcare resources. Prevent need for antibiotics by preventing infections.
- can also be mild.
- can be disastrous e.g. wound infections following cardiac surgery – cut through midline / sternum - pts in the past (when resistant staph. aureus [MRSA] was a big problem) led to infectious wounds that wouldn’t close – literally see heart beating through wound – one pt took 3 yrs for it to heal.
- depends on dpt – neurosurgical dpt, might see post-op meningitis – diff infections for gynae, for ex. Wide range of infections which are relatively small numbers compared to the rest.
- phlebitis (inflammation of a vein) – venton? to give someone fluid or drugs – phlebitis can go into bloodstream and go through body – potentially life-threatening.
- }
6
6
7
7
8
8
9
9
10
10
11
11
12
12
13
13
14
14
15
15
