HCAI Flashcards
what is HCAI?
what is HAI?
what is CAI?
HCAI= infections acquired in hospital or other health care setting
HAI= (hospital acquired infection) not present on admission, but present more than 48hrs after
CAI= (community acquired infections) infections contracted outside of a healthcare setting or an infection present on admission
what are HCAI costs in Scotland?
how much does it increase the length of stay (LOS)?
how many deaths does HAI cause a year in the UK?
What % of HCAI is preventable?
HCAI cost in Scotland is ~£76.5m or 1.1% of the NHS budget in Scotland
HCAI results in average increase in LOS (length of stay) of 7.8 days
3000 deaths in hospital directly related to HAI In the UK
15-30% of HCAI are preventable
what are 4 common HAI types?
4 common HAI types:
1) Urinary tract infection
2) Blood stream infection
3) Lower respiratory tract infection
4) Gastrointestinal infection
what are 7 reasons why HCAI is an issue?
7 reasons why HCAI is an issue:
1) Chronic disease
2) Invasive medical devices
3) Elderly population
4) Immunosuppression
5) More complex procedures
6) Antibiotic use
7) Failure by HCW to see it as a problem
what is the Francis report leading to?
what are 2 ways we measure quality of care?
the Francis report is leading to paradigm shift in clinical care
how can can measure quality of care:
- health improvement Scotland (HIS)
- rates of HAI
what are 6 ways doctors can take measures to prevent HCAI?
6 ways doctors can take measures to prevent HCAI:
1) Recognition of risk factors in patients
2) Behaviour & practice
3) Hand hygiene
4) Dress
5) Personal protective equipment
6) Use isolation facilities correctly
what are SICP’s?
what are standard precautions?
what are TBP’s?
Standard Infection Control Precautions (SICP) – Measures necessary to reduce the spread of microorganism from both known and unknown sources of infection e.g ventilation, bed spacing, vaccination
Standard precautions – Precautions we take for any patient e.g hand washing
Transmission Based Precautions (TBPs) – A set of measures used when a patient Is either suspected or known to be infected with a specific infection e.g diarrhoea – we don’t know if it is caused by an infectious agent, or has an inflammatory cause
What are the 3 main modes of transmission?
What does the ability to aerolise depend on?
What medical procedures needed to be used for airborne transmission?
3 main modes of transmission:
1) Contact transmission - can be direct or indirect
2) Droplet transmission
* When we breath out, droplets travel a short distance before falling on surfaces
3) Airborne (aerosol) transmission
* Droplets that are less than 5 microns, which can travel a much longer distance than larger droplets
* Droplets this small can also enter alveoli and cause infection there
* Ability to aerosolise depends on the pathogen
* Medical procedures i.e. ventilation technique or specific medical procedures need to be used
When are contact precautions used?
What 3 syndromes require contact precautions?
Contact precautions are used for patients infected/colonised with organisms transmitted by direct or indirect contact
3 syndromes that require contact precautions:
1) Gastroenteritis
2) Fever in patient returned from the tropics
3) Patients with open wounds
what are contact disease precautions?
4 things contact precaution involves:
1) Disposable gloves
2) Disposal apron
3) Single room if possible
4) Disposable masks/eye protection if at risk of exposure to body fluid
What 4 specific organisms require contact precautions?
4 specific organisms require contact precautions:
1) Clostridium difficile
2) MRSA (methicillin resistant staphylococcus aureus)
3) Streptococcus pyogenes
4) COVID-19
what are 5 droplet precautions?
- single room if possible
- disposable apron and gloves
- wear a fluid resistant surgical mask
- wear eye protection
When are airborne precautions used?
What 1 syndrome requires airborne precautions?
What 3 specific organisms require airborne precautions?
What 5 things does airborne precaution involve?
Airborne precautions are for particles that are <5 microns
They can be widely dispersed
FFP3 mask for all aerosol generating procedures (AGP) - medical procedures that can result in the release of aerosols from the respiratory tract e.g bronchoscopy
3 specific organisms that require airborne precautions:
1) TB
2) Chicken pox
3) Measles
5 things airborne precaution involves:
1) Single room
2) Disposable apron or consider gown if manoeuvring the patient
3) Disposable gloves
4) High efficiency filter mask (FFP3 mask)
5) Eye protection
What are the 2 before and 3 afters of hand decontamination?
When can alcohol gel be used?
When does soap and water need to be used?
What are the 6 steps to hand decontamination?
2 befores of hand decontamination:
1) Before touching a patient
2) Before clean/aseptic procedure
3 afters of hand decontamination:
1) After body fluid exposure risk
2) After touching patient
3) After touching patient surroundings
Alcohol gel can be used between patients if hands sociably clean
After about 4 consecutive uses of alcohol gel, we need to wash hands to remove build-up of dried gel
Must use soap and water after examination of a patient with diarrhoea and after removing gloves
6 steps to hand decontamination:
1) Bare below the elbows plus removal of watches and rings with stones
2) Wet hands and then apply soap to all surfaces of the hands
3) Rinse hands
4) Dry hands on paper towels
5) Turn off tap with elbows or paper towel
6) Dispose of towel without contaminating hands
What are the 3 factors in the vicious cycle of infection?
What are 4 bacteria where we have to double check treatment plan?
3 factors in the vicious cycle of infection:
1) Bacterial infection
2) Antimicrobial usage
3) Antimicrobial resistance
4 Bacteria where we have to double check treatment plan:
1) Methacillin resistant S. aureus (MRSA) – gram positive
2) Vancomycin Resistant Enterococcus (VRE) – gram positive
3) Carbapenemase Producing Organism (CPO) – gram negative
4) Extended Spectrum B-lactamse (ESBL) – gram negative
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