Hospital acquired infections

Question 1

What are healthcare infections?

Answer 1

Infections arising as a consequence of providing care

not present or incubating at time of admission

Question 2

Why are healthcare infections important?

Answer 2

Prevalent
Impact largely on health
Impact on organisations (cost)
Preventable

Question 3

Types of healthcare infections?

Answer 3

UTI
Pneumonia
Gastrointestinal
Surgical wound infections

Question 4

Viruses pathogens in healthcare

Answer 4

Blood bourne viruses (Hep C, B and HIV)
Norovirus (Gastoenteritis)
Influenza
Chicken Pox

Question 5

Bacteria in healthcare

Answer 5

Staph Aureus (MRSA)
Clostridium difficile
E-coli (gram negative)
Mycobacterium tuberculosis

Question 6

Fungi in healthcare

Answer 6

Candida albicans
Aspergillus species

(usually in immunosuppressed)

Question 7

Risk factors associated with hospital acquired infections

Answer 7

Extremes of age
obesity
diabetes
immunosuppressed
smoker
surgical patient
emergency admission

Question 8

What are the 4 P’s of infection control?

Answer 8

Patient
Pathogen
Practice
Place

Question 9

Pathogen aspect of infection control

Answer 9

Virulence factors
Ecological interactions (with other bacteria and antibiotics/disinfectants)

Question 10

Patient aspect of infection control

Answer 10

Risk factors?

Interactions with other patients, healthcare workers and visitors

Question 11

Practice aspect of infection control

Answer 11

General and specific activities of workers
Polices and if they are implemented
Organisation structure/engagement
Political initiatives (regional and national)
Leadership (ward to government)

Question 12

Place aspect of infection control

Answer 12

Fixed features and variable features

Question 13

General patient interventions

Answer 13

Optimise patient health (smoking, diabetes, nutrition)
Antimicrobial Prophylaxis
Skin Prep
Hand hygiene

Question 14

Specific patient interventions

Answer 14

MRSA screening
Disinfectant body wash
Mupirocin nasal ointment

Question 15

How can we halt patient to patient transmission?

Answer 15

Physical barriers (isolation of infected and protection of vulnerable)
Positive pressure ventilation lobby

Question 16

Healthcare worker interventions

Answer 16

Healthy (disease free and vaccinated)
Good practice (PPE, hand hygiene, sterile non touch, good antimicrobial prescribing)

Question 17

Environmental interventions

Answer 17

Well designed spacious
Furniture must tolerate cleaning
Good food hygiene in staff kitchens

Question 18

Ways of cleaning environment

Answer 18

Disinfectants
Steam cleaning
Hydrogen peroxide vapour

Question 19

How are medical devices infection controlled?

Answer 19

Some single use (cross through 2 sign)
Sterilisation
Decontamination

Question 20

Have you I-fived your patient today? (5 I’s)

Answer 20

Identify
Isolate
Investigate
Inform
Initiate

Question 21

Patients to identify (I5)

A-F

Answer 21

Abroad
Blood borne virus
Colonised
Diarrhoea/vomitting
Expectorating (cough)
Funny looking rash

Question 22

Investigations to carry out

Answer 22

Rectal swabs (gram -ve GI?)
FBC
Throat/nasal swabs (MRSA)
Stool sample
Sputum sample
Vesicle fluids (rash?)