Nosocomial Infections

Question 1

What are some primary concerns with VAP?

Answer 1

increased death rates (46% mortality for ventilated patients with VAP); increased costs, increased LOS

Question 2

When are some suspecting signs of VAP?

Answer 2

when a mechanically ventilated patient has evidence of new or progressing pulmonary infiltrate along with fever, leukocytosis, and purulent tracheobronchial secretions

Question 3

VAP is considered if the patient was ventilated within ______ hours of the onset of infection.

Answer 3

48 hours

Question 4

What is the basic patho of VAP?

Answer 4

microorganisms gain access to normally sterile lower part of the respiratory tract

Question 5

What is included in the VAP prevention “bundle”?

Answer 5

hand hygiene, HOB at least 30 degrees; mouth care q2h with chlorohexidine, DVT prophylaxis, PUD prophylaxis, interruption of sedation to assess readiness for extubation, subglottic suctioning— conventional ET with hi-lo continuous suction port

Question 6

An infection within ______ days of an operation is considered to be a possible surgical site infection…. but what are the other guidelines?

Answer 6

within 30 days of operation AND infection only involves skin or subq tissue of incision AND (one of the following): purulent drainage, organism from aseptically obtained cx of fluid or tissue from superficial incision, or at least one of the following symptoms (pain or tenderness, localized swelling, redness, heat)

Question 7

What are some potential risks for a SSI?

Answer 7

diabetes, malnutrition, steroid use, nicotine use, prolonged hospital stay, preop colonization of staph, perioperative transfusions

Question 8

What is the 2nd most common HAI in the US?

Answer 8

VAP

Question 9

VAP is responsible for _____ % of infections that occur in the ICU.

Answer 9

25%