Toni and Dave Hutchinson

Question 1

Definition of a healthcare associated infection

Answer 1

Infections occurring during a stay in
hospital that were neither present nor
incubating at the time of hospital
admission

Mostly HCAIs appear in patients
hospitalised for 48 hrs or longer (usual
criterion for surveillance)

Question 2

Susceptible people for HAI;s

Answer 2

1. Age
2. Immuno-compromised
3. Underlying disease - diabetes, renal
   failure
4. Medical interventions – invasive devices,
   surgery, drug treatments
5. Poor physical / psychological well being

Question 3

Agencies involved in infection control

Answer 3

Environmental Health Departments

Health Protection Agency (Currently PHE):

Consultants in Communicable Disease Control
(CCDC)

Communicable Disease Surveillance Centre

Specialist & Reference Laboratories

DH (Department of Health)

Health & Safety Executive

Question 4

What kind of things does the consultant in communicable disease control

Answer 4

Outbreaks

Food poisoning

TB

Meningitis

Vaccinations

Emergency planning

(inc Bioterrorism)

Education of GPs,
public

Question 5

What is the definition of infection surveillance

Answer 5

‘A routine continuous process which
monitors the frequency and distribution
of communicable diseases within the
population, analyses that information
and disseminates it to those who need
to know.’ eg. measles

Question 6

Source of surveillance data

Answer 6

Death Certs

Notifiable diseases - GPs & Hosp doctors

Lab reports (eg salmonellas..)

Hospital discharge data

Spotter practices; Computerised GP
records

NHS Direct calls

Question 7

Layers of the notification pyramid

Answer 7

1. Get disease
2. Go to GP
3. hAVE DIAGNOSTIC TEST
4. Test yields result

Question 8

Which diseases are actively under surveillance

Answer 8

1. Heptatits A
2. TB
3. Meningococcal disease

Question 9

Methods to rpevent infection

Answer 9

Social:

1. Clean water
2. Avoid overcrowding
3. Behavioural change
4. Clean kitchens and abbatoirs
5. Vaccination
6. Control outbreaks

Question 10

Pathway for an outbreak

Answer 10

1. Person with disease
2. GP
3. Microlab
4. Legal notification to the CCDC and communicable disease centre
5. Notification to the ONS
6. CCDC informs EHO who initiates the public health action

Question 11

Practical aspects of an outbreak investigation

Answer 11

1. Really a problem? (‘pseudo-outbreaks’)
   - outbreak means the increase of cases in a specific place and time above
   those expected (above baseline)
2. Review the nature and extent of the incident
   - What kind of illness – how many people involved?
3. Confirm the diagnosis
   - What is the agent causing the disease?
4. Outbreak Control Team - if appropriate
   - CCDC
   - EHO (Environmental Health Officer)
   - Microbiologist, ID physician
   - Experts from CDSC, DoH, etc
   - Various other hangers-on! - as appropriate
5. What are you trying to achieve?
   - Identify those already ill
   - ensure that they receive care & diagnosis
   - Identify those at risk:
   - Identify risk factors - prevent illness if possible
   - Attempt to identify source:(food history, site visit, test food, water, etc)
   - Control source & stop spread

Question 12

How to communicate with a patient with ID

Answer 12

1) Arrange for ample time
2) Smile ☺ when greeting the patient
3) Communicate with the person withthe ID first and involve him/her aS much as possible
4) Maintain eye contact as much as possible
5) Use simple language so that the individual understands you or use A communication aid (i.e. picture books, symbols, etc)
6) Explain what the consultation will entail and demontrate any examination before you perform it
7) If the person is very anxious ask him/her how they relax themselves
8) Explain the outcome of the consultation to the person with ID and the carer, and ask if it’s understood
9) Follow-up visits.
10) Double check the person’s understanding.
11) Involve people with ID in decisions, and understand the law around capacity and consent.

Question 13

How to communicate clearly?

Answer 13

1. Short sentences and break between sentences
2. Use everyday words
3. Literal language/direct
4. Talk slow and givve time to respond
5. Double check understanding
6. Gestures and facial expressions
7. Pictures/symbols and objects
8. Reduce distractions

Question 14

How to support people with visual impairment

Answer 14

1. Use a dark felt tip pen to make handwriting more legible and
   write neatly using thicker strokes
2. Show the person where the toilet, call button, etc., are rather
   than giving directions
3. Encourage people to bring in their usual aids