Healthcare Associated Infections

Question 1

Healthcare Associated Infections Outline

Answer 1

Infections that appear within 30 days of recieving healthcare (eg hospitals, GPs, ect)

Question 2

Exogenous HAIs Types

Answer 2

enviorment/equipment acquired, patient-patient acquired and staff-patient acquired

Question 3

Endogenous HAIs Types

Answer 3

Acquired from patients own flora (contamination from different regions of body). Harder to prevent then exogenous

Question 4

HCAIs Considerations Outline

Answer 4

morbidity increase , mortality increase, increased patient and hospital costs, increased public awareness and antimicrobial resistance

Question 5

How preventable are HAIs and association between HAIs and antibiotic resistance

Answer 5

50% of HAIs are preventable. 71% of HAIs

Question 6

Most common type of HCAI

Answer 6

Pneumonia (31%), urinary tract (20%), bloodstream (13%) and surgical site (12%)

Question 7

Least common types of HCAIs

Answer 7

Skin/soft tissue (4%), systemic (5%) and GIT (9%)

Question 8

HCAI Risk Factor

Answer 8

Environmental (overcrowding, shared facilities and equipment upkeep), microorganisms (virulence) and patients (immunosuppression, invasive devices, age and previous antibiotic use)

Question 9

Most common pathogen to cause HCAIs

Answer 9

Coagulase negative streptococci (15%), streptococcus aureus (15%), enterococcus spp (12%) and candida spp (11%)

Question 10

2 types of surgical site infection

Answer 10

Superficial (red and hot to touch) and deep (can be implant associated, infection settles in foreign body)

Question 11

Surgical Site Infection Pre-operation risk factors

Answer 11

Skin flora (MRSA colonisation) and comorbidities (eg diabetes, obesity, malnutrition)

Question 12

Intra-operaion Surgical Site Infection Risk factors

Answer 12

Contaminated procedure (perforated bowel), foreign body implantation, contaminated hands/instruments/dressings and airborne contamination

Question 13

Post-operation surgical site infection risk

Answer 13

Poor wound care and contamination from drains/catheters

Question 14

Most common SSIs pathogens

Answer 14

Staph aureus (including methicillin resistant), beta-haemolytic streptococci Group A, anaerobes (eg bacteroides spp), gram negative bacilli (eg E Coli) and enterococci. Anaerobes, gram negative bacilli and enterococci enter via abdominal wounds

Question 15

Hospital Acquired Pneumonia predisposing factors

Answer 15

Post-operative state: compromised breathing, disrupted normal flora. Incubation: substances bypassing upper respiratory defences and aspiration risks: drowsiness or poor swallow due to neurological disease (eg stroke)

Question 16

Hospital Acquired Pneumonia Outline

Answer 16

P aeruginosa and other gram negative bacilli

Question 17

Ventilated Associated Pneumonia Outline

Answer 17

Pseudomonas Arigenousa forms a biofilm in taps/vents (moist areas). If taps/ vents aren’t cleared routinely species can infect anything it’s sprayed onto.

Question 18

UTIs Outline

Answer 18

Mainly caused by E Coli. Can be spread by catheters (intralumenal = break in drainage system/contamination by urine bag and extraluminal = insertion). Infections within the same patients is a result of wiping

Question 19

Pathogens for central line blood stream infections

Answer 19

Staph aureus, coagulase-negative streptococci, enterococci and candida albicans (in immunocompromised individuals)

Question 20

Why are there so many HCAIs in the ICU

Answer 20

Hands on care, indwelling devices, patient overcrowding, antibiotic ressistance (MRSA, VRE)

Question 21

Device Related Infection Examples

Answer 21

Ventilator associated pneumonia, catheter associated UTIs, central venous catheter BSIs, Prosthetic joint infections

Question 22

HCAI Prevention

Answer 22

Hand hygiene, CDC guidelines, infection control training, PPE and vaccination

Question 23

HCAI Precautions

Answer 23

Hand hygiene preformed before and after every patient contact, PPE (prevent body fluid exposure), use and dispose equipment correctly, environmental cleaning, clean shared patient equipment and aseptic technique

Question 24

Transient Organisms Def

Answer 24

Organisms that colonise superficial layers of skin, picked up from enviorment. Easily transfered from hands to patients

Question 25

Resident Organisms Def

Answer 25

Organisms deep in skin layers resistant to removal. Part of bodies normal flora

Question 26

Cleaning Def

Answer 26

Removal of dirt without removing contaminating organisms. Done by simple detergents

Question 27

Disinfection Def

Answer 27

Reduction of viable microbes without destroying spores/prions. Done by physical (heat) and chemical means

Question 28

Sterilisation Def

Answer 28

Removal of any type of microorganism including spores but excluding prions. Can be done many ways eg; autoclaves, hot air ovens, ethylene oxide, sporicidal chemicals and irridation

Question 29

2 types of hand cleaning

Answer 29

alcohol gel and hand washing

Question 30

Standard Precautions For Uniform

Answer 30

No ties, no wrist watches, no rings, no fake nails, short sleeves, use apron and gloves (change after every patient) and hand hygiene must be preformed every time gloves come off.

Question 31

Contact Precautions Before Entering Room

Answer 31

Clean hands, put apron on, put gloves on

Question 32

Contact precautions when exiting room

Answer 32

dispose of gloves, dispose of apron and wash hands

Question 33

Droplet and Contact Precautions when entering room

Answer 33

Wash hands, put apron on, surgical mask on, gloves on

Question 34

Droplet and Contact Precaustions when leaving room

Answer 34

Dispose of gloves, dispose of apron, dispose of surgical mask and clean hands

Question 35

Airborne Precautions When entering room

Answer 35

Clean hands, put on apron, put on PPF2 mask, gloves on

Question 36

Airborne Precautions When Exiting Room

Answer 36

Dispose gloves, dispose apron, dispose PPF2 mask and clean hands

Question 37

What room is used for patients with airborne concerns

Answer 37

Negative pressure isolation room. Whenever door opens air only moves into room not out

Question 38

Contact Plus Precaustions When Entering Room

Answer 38

Clean hands, put on long sleeved apron and put on gloves

Question 39

Reasons to monitor HCAIs

Answer 39

Improve practice, anticipate problems, classification of microbes and outbreak protocols

Question 40

Outbreak Def

Answer 40

2+ linked cases of same illness. Observed cases exceed expected number