Infection Prevention And Control Flashcards
What are the 10 principles of infection prevention?
- patient placement/assessment for infection risk
- hand hygiene
- respiratory and cough hygiene
- PPE
- safe management of care equipment
- safe management of care environment
- safe management of linen
- safe management of blood and body fluid spillages
- safe disposal of waste (including sharps)
- occupational safety: prevention and exposure management
What are transmission based precautions?
- additional precautions for when standard control measures may not be enough to prevent transmission of specific infectious agents
- it covers the placement of patients, PPE required for staff/visitors, management of equipment + care environment and safe handling of the deceased
What is the most common route of cross-infection transmission?
contact (direct from patient or indirectly from the care environment + equipment of the patient)
What are the contact precautions for isolated patients?
- decontamination of hands before entering the room
- PPE: wear disposable apron and gloves before entering room
- keep door closed (unless risk assessed that it is safe to do so)
- before leaving : decontaminate equipment, discard gloves and apron in correct bin and decontaminate hands
What are the droplet precautions for isolated patients?
- decontaminate hands before entering room
- PPE: wear disposable apron, resistant surgical mask, eye/facial protection and gloves before entering room
- keep door closed (unless risk assessed to be safe to keep open)
- before leaving: decontaminate equipment, discard gloves, apron, eye/facial protection + fluid resistant mask in correct bin, decontaminate hands
Describe droplet transmission
- infection spread over short distances (at least 1 metre) by particles from the respiratory tract of one individual directly onto the mucosal surface/conjunctivae of another individual
- droplets penetrate the respiratory system to above the alveolar level
Describe airborne transmission
- infections spread without having close contact with patient by aerosols from the respiratory tract of one patient onto the mucosal surface/conjunctivae of another individual
- aerosols penetrate the respiratory system to the alveolar level
What are the airborne precautions for isolated patients?
- decontaminate hands before entering room
- PPE: wear disposable apron/gown, FFP3 respirator, eye/facial protection and gloves before entering room
- keep door closed at all times
- before leaving: decontaminate equipment, discard gloves, apron/gown and eye/facial protection in correct bin and decontaminate hands
- after leaving: remove respirator and put in correct bin and decontaminate hands again
Describe positive vs negative pressure rooms
- positive pressure rooms allow airflow from the room into the corridor. Necessary when we need to protect patients from infection eg. Neutropenic patients
- negative pressure rooms keeps airflow into the room to keep any infective pathogens contained. Necessary when we want to protect other patients from an infected individual
What is the most common cause of hospital acquired S. aureus infection (explain how)?
- IV devices (particular PVC)
- this is because it breaches the natural defence barrier of the skin allowing the patient’s own flora to become invasive
How is infection prevented when inserting a PVC?
Ensure:
- it is clinically indicated
- hand hygiene is performed before insertion
- single-use skin antiseptic containing 70% isopropyl alcohol is used to cleanse skin + left to dry before insertion
- aseptic technique is maintained throughout insertion
- sterile transparent, semi-permeable dressing is used to cover site
How is infection prevented when maintaining an inserted PVC in a patient?
Ensure:
- it is clinically indicated (reviewed on daily basis)
- the need for IV therapy reviewed daily (is possible to switch to oral therapy)
- hand hygiene is performed before accessing line/site
- removal of PVCs are considered if >72hrs
- PVC assessed (+ removed if phlebitis/inflammation)
- PVC dressings are intact
- single-use antiseptic containing 70% isopropyl alcohol is used to clean the access hub before accessing site
How is hospital acquired S. aureus bacteraemia managed?
- clinical review to identify source of infection and remove if possible
- prescribe treatment
- continue IV therapy for minimum of 2 weeks to prevent relapse
- echocardiography
- blood cultures repeated after 48-96hrs of effective antibiotic therapy
What are some complications of C. Difficile?
- pseudomembranous colitis
- toxic megacolon
- recurrent infection
- death
What is the symptoms of C. Difficile infection?
- watery dairrhoea
- nausea
- fever
- abdominal pain
