HAIs

Question 1

Define HAIs

Answer 1

Traditionally occurring >48 hrs after hospital admission, but can also refer to infections with multiresistant organisms acquired in the community

Question 2

How many HAIs are there in Australia annually?

Answer 2

200,000

Question 3

On average how much does a HAI increase length of hospital stay?

Answer 3

2.5x

Question 4

Give examples of infections commonly spread directly from person-to-person

Answer 4

Scabies

Herpes simplex

Question 5

Give examples of infections commonly spread via a contaminated intermediate object or person

Answer 5

MRSA
VRE
Influenza
Norovirus

Question 6

Give 5 examples of infections spread by droplet transmission

Answer 6

Influenza
Pertussis
SARS
Neisseria meningitidis
Rhinovirus

Question 7

Characteristics of droplet infection

Answer 7

> 5um particles

Drop to ground by ~1m

Question 8

Characteristics of airborne transmission

Answer 8

<5um particles

Stay suspended in the air and can be inhaled by susceptible hosts over long distances

Question 9

Give 3 examples of infections spread by airborne transmission

Answer 9

TB
Measles
Varicella

Question 10

Primary mode of spread of MRSA

Answer 10

Contaminated hands of healthcare workers

Question 11

Give 4 examples of multi-resistant GNRs

Answer 11

Klebsiella
Acinetobacter
Enterobacter
Pseudomonas

Question 12

What are the most common demographics infected with multi-resistant GNRs?

Answer 12

Community

Returned travellers

Question 13

What are the 6 main sites and types of infection in HAIs?

Answer 13

Surgical site
IV line associated
Nosocomial pneumonia (often ventilator associated)
Catheter associated UTI
Prosthetic joint infection
Diarrhoea

Question 14

5 major hospital associated bacterial pathogens

Answer 14

MRSA
VRE
Multiresistant GNRs
C. difficile
TB

Question 15

4 major hospital associated viral pathogens

Answer 15

Respiratory viruses e.g. influenza
Norovirus
Varicella
Measles

Question 16

2 major hospital associated fungal pathogens

Answer 16

Aspergillus

Candida

Question 17

What type of infection does norovirus cause?

Answer 17

Gastroenteritis

Question 18

How is norovirus spread?

Answer 18

Contaminated food or water
Touching contaminated surfaces
Via droplets from vomitus

Question 19

How do you establish whether an outbreak has occurred?

Answer 19

Subtype pathogen

Try to identify source

Question 20

When is it not appropriate to use alcohol based handwash products?

Answer 20

If hands visibly soiled

If pt has norovirus or C. diff

Question 21

5 moments of hand hygiene

Answer 21

Before touching a pt
Before procedure
After procedure or body fluid exposure risk
After touching pt
After touching pt's surroundings

Question 22

When are standard precautions used?

Answer 22

For all pts at all times when risk of exposure to blood, all body fluids (except sweat), non-intact skin and mucous membranes

Question 23

What equipment is used in standard precautions?

Answer 23

Gloves, gowns, goggles

Question 24

What are contact precautions?

Answer 24

Use of gowns and gloves for all pt contact

Question 25

When are contact precautions used? Give 4 examples

Answer 25

Diarrhoea Excessive wound drainage Multidrug resistant organisms Respiratory viruses

Question 26

What additional piece of equipment is required for droplet precautions?

Answer 26

Surgical masks

Question 27

When are droplet precautions used? Give 3 examples

Answer 27

Pertussis Meningococcus Respiratory viruses

Question 28

When is a single room appropriate?

Answer 28

For anything above standard precautions (contact, droplet, airborne) Airborne precautions room should have door closed

Question 29

What piece of equipment is specific to airborne precautions?

Answer 29

Negative pressure ventilation using N95 mask

Question 30

When are airborne precautions used? Give 5 examples

Answer 30

``` TB Varicella Measles Pandemic influenza SARS ```

Question 31

What are 2 ways decolonisation can be achieved?

Answer 31

Nasal mupirocin for Staph aureus (incl MRSA) | Chlorhexidine

Question 32

What are "bundles" of care?

Answer 32

3-5 evidence based processes tied together as a bundle (e.g. central line bundle, ventilator bundle, MRSA bundle), where compliance is "all or nothing" Designed to reduce HAIs

Question 33

What is the goal of surgical antibiotic prophylaxis and how is this achieved?

Answer 33

Prevention of surgical site infection | Ensure maximal concentration at time of incision (usually via single dose)

Question 34

When is surgical antibiotic prophylaxis used? Give examples

Answer 34

If significant risk of infection (e.g. colonic resection) | If infection has devastating consequences (e.g. prosthetic joint infection)

Question 35

What 6 vaccinations should healthcare workers have to prevent risk of infection?

Answer 35

``` Influenza Hep B MMR Varicella Hep A and pertussis in certain groups ```

Question 36

List 6 important preventative measures for HAIs

Answer 36

``` Hand hygiene Abx stewardship Transmission precautions Bundles Environmental cleaning Abx prophylaxis ```