What are HAIs
Health-care associated infection
What are the parameters for airborne precautions?
- Use a private room with negative air pressure that has 6 to 12 air changes per hour.
- Keep room door closed.
- N-95 respirator
- People not immunized for measles or varicella should not enter, if they do use a respirator.
- Use a surgical mask during transport.
What diseases require airborne precautions?
- Tuberculosis (pulmonary) - confirmed or suspected
- Chicken pox (varicella)
- Herpes zoster (varicella-zoster) - disseminated
- SARs (severe acute respiratory syndrome)
What are the parameters for contact precautions?
- Private room if possible, cohort if needed.
- Wear gloves when entering. Change gloves when in contact with fecal material or wound drainage.
- Wear gown when entering. Remove before leaving.
- C.Diff and Norovirus require soap and water hand washing.
- Minimize contact with environment during transfer.
- Dedicated patient care equipment.
- Thoroughly disinfect common items used before leaving.
What diseases require contact precautions?
- Methicillin resistant bacteria (MRSA)
- Enteric infections (C.Diff, E.Coli, Hep. a, Norovirus)
- Major, uncontrolled wound drainage.
- Scabies or lice (for 24 hours after treatment)
- Varicella (in addition to airborne precautions)
- Hemorrhagic fever
What are the parameters for droplet precautions?
- Private room if possible. Cohort with 3-6 feet spatial separation from visitors and other patients.
- Simple isolation mask when entering room.
- Pull curtain in cohort room.
- Surgical mask during transport.
What diseases require droplet precautions?
- MRSA in sputum
- Pneumonia (Neisseria, Meningococcus, Hemophilus influenza)
- Multi-drug resistant Streptococcus pneumonia
- Pneumonic plague
- Parvo virus B19
What are neutropenia precautions?
Low neutrophil count (WBCs)
What are the parameters for neutropenia precautions?
- Private room
- No ill visitors/caregivers in room
- Minimize risk of their own flora
- Sign posted on door
- Gloves at all times
- Mask on patient outside of room
- No cut flowers or plants in room
- No fresh fruit, vegetables, or raw eggs in diet
What are standard precautions?
- Precautions used with every patient.
- Use hand hygiene before entering or leaving room.
- Gloves when in contact with body fluids, non-intact skin (including rashes), mucous membranes, used equipment, linen and trash.
- Change gloves when soiled or when moving from a dirtier area to a cleaner one.
- Use a gown if you may be soiled.
- Use a mask and eye protection if you might be splashed.
- Do not recap sharps or use one-handed method.
- Discard sharps immediately.
- Activate safety sharps immediately.
What, in infection prevention, is one of the top 10 leading causes of death in the US?
What link in the chain of infection can you eliminate?
Mode of transmission
What are infectious agents?
What actions do we take to eliminate germs?
- Sterilizing surgical instruments
- Cleaning reusable equipment
- Safe food handling practices
- Telling sick coworkers to stay home
What are reservoirs?
- Where the germs live and grow.
- Generally wet.
- Most important are people. (Sick people or healthy people with their flora)
What are portals of exit?
- The way germs get out of the reservoir.
- Break in the skin, natural orifice, body fluid
What are modes of transmission?
- Ways we carry germs from one patient to another.
- Hands and things that move from patient to patient.
What is a portal of entry?
Hole in the body germs can get into.
What is a susceptible host?
- Someone able to take on germs and get infected.
- Partially eliminated by vaccination and natural disease that causes immunity.
What is the most important procedure for infection prevention?
When do you wash your hands with soap and water?
- If they are visibly soiled.
- Norovirus or C.Diff
What is an infection?
Germs are present, invading tissues and causing tissue damage and causing symptoms.
What is colonization?
Germs are present, not invading tissues and not causing symptoms.
- the patient's own germs they come in with.
- includes normal flora and pathogens
- germs the patient did not come in with
- either exo or endogenous can cause HAIs
What are blood borne pathogens and what are the main ones?
- Organisms in the blood that can cause disease.
- Hep.B, Hep.C, HIV
How can bloodborne pathogens be transmitted?
- Bodily fluid contact with mucous membranes (such as eyes or mouth) or broken skin
What goes into a red bag?
Biohazard waste that is dripping.
How can you tell if a patient has TB?
- Cough that lasts more than 3 weeks
- Unexplained weight loss or loss of apetite
- Night sweats
- Bloody sputum
How do you diagnose TB?
Microscope examination of sputum
What are the 4 types of isolation?
Recurring chickenpox all over
Powered air purifying respirator
What are contact enteric precautions?
- Precautions used for C.Diff, norovirus and undiagnosed diarrhea.
- Bleach based disinfectant
A patient has a cough and weight loss, should they be isolated and what is the possible diagnosis?
Yes, airborne precautions, TB
A patient has respiratory symptoms, should they be isolated and what could be a possible diagnosis?
Yes, droplet precautions, influenza.
A patient has a rash, should they be isolated and what could be a possible diagnosis?
Yes, airborne and contact precautions, chicken pox or measles.
A patient has diarrhea, should they be isolated and what could be a possible diagnosis?
Yes, contact precautions, C.Diff or norovirus
A patient has a draining wound, should they be isolated?
Yes, contact precautions.
A patient has dementia, should they be isolated and why?
Yes, because they could wander and touch things, causing spread of infection.
How many people have ordinary staph aureus?
What are the 4 main kinds of HAIs?
- Bloodstream infections
- Surgical site infections
- Urinary Tract Infections
What are natural host defenses?
- Mucous membranes
- Cleansing flow
- Normal flora
- Stomach acids