patient safety Flashcards
what do HCAIs result from?
healthcare associated infections result from direct contact with a healthcare setting or from medical or surgical intervention
what is the significance of HCAIs?
they pose serious risk to those affected as can result in significant harm, is top of the Government agenda for safety and quality agenda and is in the general public’s expectations for quality of care
what are the most common HCAIs?
hospital acquired pneumonia, MRSA, C difficile, norovirus, surgical wound infection, catheter related UTI and cannula related cellulitis and glycopeptide resistant enterococci
what is the epidemiology of HCAIs?
around 30000 affected per year
18 fold reduction in MRSA bloodstream and 5 fold reduction in C Difficile since 2006
2007 9000 deaths attributed to MRSA or C difficile
2011 prevalence was 6.4%
what is the cost of HCAIs to NHS?
1bn per year and 56m after discharge
what is used to prevent HCAIs?
Epic3 national evidence based guidelines - comprehensive set of guidelines in hospitals and other acute care settings based on best currently available evidence
what are the five distinct interventions of Epic3 guidelines?
- hospital environmental hygiene
- hand hygiene
- use of PPE
- safe use and disposal of sharps
- principles of asepsis
what is clostridium difficile?
it is a gram positive anaerobe which lives in oxygen free environments and in adverse conditions produces spores which are resistant to disinfectants, drying, heat and light
how is C difficile spread?
mostly through direct contact through HCPs or via contaminated spores which can contaminate area around patients bed and surfaces, equipment, toilets and commodes and lives for many months
what is the presentation of C difficile and what is it associated with?
it is 20-30 watery, foul smelling green stools per day particularly in the immunocompromised, elderly and debilitated
what increases the risk of C difficile and why?
antibiotic use especially third generation cephalosporins - reduce the normal gut flora so C difficile can overgrow and spread through fecal oral route
what does C difficile cause?
asymptomatic carriage of organism, antibiotic associated diarrhoea, pseudomembranous colitis, toxic megacolon and death
what is SIGHT?
it is the way to identify and manage C difficile. S= suspect when there is no other alternative, I=isolation, G - gloves and apron, H=hand washing and T= test by sending for toxin culture
where are lots of germs found and why?
90% under the finger nails because 20% of women and 40% of men do not wash hands after going to toilet - after one single day of not washing hands a single bacteria can become 1 billion
when are the five moments for hand washing?
before patient contact, after bodily fluid exposure risk, after aseptic procedure, after patient contact, after contact with patient surroundings
