Iatrogenic/Nosocomial/Health-Care Associated Infection & Prevention

Question 1

What percentage of HAIs are preventable? How many infections and deaths each year are due to HAIs?

Answer 1

• 30 - 50%

- 200,000 infections and 7,000 deaths each year

Question 2

What are three major practices health care workers can use to prevent HAIs?

Answer 2

• hand hygiene, bare-below-the-elbows, and ANTT (aspetic non-touch technique)

Question 3

Alcohol hand rubs have no activity against _______ and poor activity against ________.

Answer 3

• no activity against spores ( Clostridium difficile)

- poor activity against norovirus

Question 4

What is the major principle behind ANTT?

Answer 4

• (aspectic non-touch technique)

- that the main infection risk to the patient is the health care professional

Question 5

ANTT ensures the health care worker maintains a state of aspesis. How does this differ from a sterile state?

Answer 5

• asepsis: free from pathogenic material

- sterile: free from all microorganisms

Question 6

In ANTT, what is a key-part? What is a key-site?

Answer 6

• key-parts: equipment

- key-sites: the patient

Question 7

What are the three main types of transmission?

Answer 7

• contact, droplet, and airborne

- droplet = can travel short distance; airborne = can travel long distance

Question 8

MRO (multi-resistant organism): nmMRSA

Answer 8

• non-multi-resistant Methicillin-resistant Staph. aureus

Question 9

MRO (multi-resistant organism): mMRSA

Answer 9

• multi-resistant Methicillin-resistant Staph. aureus

Question 10

MRO (multi-resistant organism): VRE

Answer 10

• vancomycin-resistant Enterococcus faecium

Question 11

MRO (multi-resistant organism): ESBL

Answer 11

• expanded spectrum beta-lactamase (producing pathogens)

Question 12

What are the three classification of surgical wounds?

Answer 12

• clean, clean-contaminated, and contaminated

Question 13

Clean Classification of Surgical Wounds

Answer 13

• no inflammation encountered
• the respiratory, alimentary, and GIT are not entered
• ex) mastectomy, hip replacement

Question 14

Clean-Contaminated Classification of Surgical Wounds

Answer 14

• GIT, genito-urinary, or respiratory tract is entered, but without significant spillage
• ex) laryngectomy, appendectomy

Question 15

Contaminated Classification of Surgical Wounds

Answer 15

• system tract is entered with gross spillage
• dealing with anything infected
• ex) large bowel resection

Question 16

What is a BSI? Which iatrogenic pathogens cause it?

Answer 16

• blood-stream infection

- common iatrogenic pathogens: VRE, P. aeruginosa, Acinetobacter sp.

Question 17

PIVC

Answer 17

• peripheral IV canula

- ex) cubittal fossa

Question 18

CVL

Answer 18

• central venous line/canula

- ex) femoral, jugular