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Flashcards in 5. HAIs Deck (11)
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1
Q

What are healthcare infections?

A

Infections arising as a consequence of providing healthcare:

  1. in hospital patients - neither present nor incubating at time of admission, i.e. onset >48hrs after admission
  2. infections in hospital visitors and healthcare workers
2
Q

What is the prevalence of HAIs?

A

8% of in-patients

3
Q

What is the prevalence of different types of HAIs?

A
  • GI: 21%
  • UTI: 20%
  • pneumonia: 14%
  • surgical wound infections: 14%
  • other: 14%
  • skin and soft tissue: 10%
  • primary bloodstream: 7%
4
Q

At which stages of the infection model can infection prevention interventions occur?

A
  1. prevent pathogen presence
  2. prevent pathogen and patient contact and infection
  3. prevent pathogen virulence
5
Q

Give examples of HAI pathogens (viruses, bacteria, fungi and parasites).

A

Viruses

  • blood borne viruses (hepB and C, HIV)
  • norovirus
  • influenza
  • chickenpox

Bacteria

  • S. aureus, inc. MRSA
  • C. difficile
  • E. coli
  • P. aeruginosa
  • M. tuberculosis

Fungi

  • C. albicans
  • Aspergillus sp.

Parasites
- Malaria

6
Q

Which patient characteristics predispose to HAIs?

A
  1. age extremes
  2. obesity/malnourishment (poor wound healing in very thin)
  3. diabetes (esp. if poor glycaemic control)
  4. cancer or immunosuppression
  5. smoking (lung infections -pneumonia, poor vascularisation and O2 supply - surgical wound infections)
  6. surgical patients
  7. emergency admission
7
Q

What are the 4 Ps of infection prevention and control?

A
  1. Pathogen
    - virulence factors
    - ecological interactions
    other bacteria
    antibiotics/disinfectants
  2. Patient
    - general and specific risk factors
    - interactions with: other patients, healthcare workers, visitors
  3. Practice
    - general and specific activities of healthcare workers, e.g. hand hygiene, sharps disposal, surgical technique
    - policies and their implementation
    - organisational structure and engagement
    - regional and national political initiatives
    - leadership at all levels from government to the ward
  4. Place - healthcare environment
    - fixed features (e.g. design of wards, carpets…)
    - variable features
8
Q

Name types of patient interventions for the prevention of HAIs.

A

General:

  1. optimise patient’s condition, e.g. smoking, nutrition, diabetes
  2. antimicrobial prophylaxis (conc. that will last for duration of surgery)
  3. skin preparation
  4. hand hygiene

Specific

  1. MRSA screens
  2. mupirocin nasal ointment
  3. disinfectant body wash

Halting patient-to-patient transmission via physical barriers

  1. isolation of infected patients, e.g. single rooms with high pressure antechamber
  2. protection of susceptible patients, e.g. sterile positive pressure rooms for bone marrow transplant patients
9
Q

Name types of healthcare worker interventions for the prevention of HAIs.

A

Healthy

  1. disease-free
  2. vaccinated

Good practice

  1. good clinical techniques (e.g. sterile non-touch)
  2. hand hygiene
  3. personal protective equipment (PPE), e.g. plastic aprons, gloves, masks, respiratory protection
  4. antimicrobial prescribing
10
Q

Name types of environmental interventions for the prevention of HAIs.

A

Control of water, food, air and surfaces

  1. built environment
    - e.g. space/layout, toilets, wash hand basins
    - furniture and furnishings
  2. Cleaning
    - disinfectants
    - steam cleaning
    - hydrogen peroxide vapour (toxic)
  3. medical devices
    - single use equipment
    - sterilisation
    - decontamination
  4. food prep
    - appropriate kitchen and ward food facilities
    - good food hygiene practice
11
Q

What does “I-fiving” patients mean?

A
  1. Identify HAI risk factors:
    - abroad
    - blood borne infections
    - colonised
    - diarrhoea/vomiting
    - expectorating
    - funny looking rash

so. ..
2. Isolate
3. Investigate
4. Inform
5. Initiate