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Questions and Answers
Nosocomiology is the study of hospital acquired ______
infection
Nosocomial infections are acquired during the process of care in a ______
hospital
For a HAI, the infection must be unrelated to the original illness that brings patients to the hospital and neither present nor ______ as at the time of admission
incubating
Nosocomial infection can be caused by Bacteria, ______, and Fungi
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Factors that increase the opportunity for people to acquire infections inside the hospital include the use of indwelling ______
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Many hospital personnel fail and neglect to follow basic infection control, such as ______ washing between patient contacts
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Disposable gloves must be worn when direct contact with ______ is expected.
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Gloves should NEVER be ______.
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No ______ should be worn under gloves.
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Hands should be washed prior to donning ______ and immediately after removing them.
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No artificial ______ should be worn under gloves.
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Surgeon's gloves should be worn during ______.
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The goal of IPAC is to break a link on the chain of ______
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The reservoir is the habitat in which the agent normally lives, grows, and ______
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Portal of Exit: How does the organism leave the ______?
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The portals of entry: Respiratory, faeco-oral, cuts in the ______
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Common device-related infections include Central line-associated blood stream ______
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Ventilator-associated pneumonia (VAP) is an example of a device-related ______
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YOUR 5 MOMENTS FOR HAND HYGIENE 1- Before touching a ______ WHY? To protect the patient against colonization and, in some cases, against exogenous infection, by harmful germs carried on health care worker hands
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YOUR 5 MOMENTS FOR HAND HYGIENE 2- Before clean / aseptic ______ WHY? To protect the patient against infection with harmful germs, including his/her own germs, entering his/her body WHEN?
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YOUR 5 MOMENTS FOR HAND HYGIENE 3- After body fluid exposure ______ WHY? To protect health care worker from colonization or infection with patient’s harmful germs and to protect the health-care environment from germ spread
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YOUR 5 MOMENTS FOR HAND HYGIENE 4- After touching a ______ WHY? To protect health care worker from colonization with patient germs and to protect the health-care environment from germ spread WHEN?
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YOUR 5 MOMENTS FOR HAND HYGIENE 5- After touching patient ______ WHY? To protect you from colonization with patient germs that may be present on surfaces / objects in patient ______ and to protect the health-care environment against germ spread
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Hand Hygiene Routine hand-washing Washing hands with plain ______ and water. Is the mechanical removal of soil and dirt and transient flora (10-15 sec). Hand antisepsis Is the removal & destruction of transient flora using antimicrobial ______ or alcohol based hand antisepsis (for 60 seconds). Surgical hand scrub Removal or destruction of transient flora and reduction of resident flora using antimicrobial ______ or alcohol based detergent with effective rubbing (for least 2-3 min).
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When removing gloves, grasp outside of the glove with the opposite gloved hand and peel off. Hold removed glove in gloved hand then slide fingers of ungloved hand under the remaining glove at rest. GLOVES REMOVAL Masks & Protective eye wear Masks & Protective eye wear -Masks protect the wearer from splashes onto mouth or nose by any fluid and from air-born infections.- Masks should fully cover the nose and mouth and prevent fluid penetration.- Masks should fit snuggly over the nose and mouth. Change masks between patients or if mask becomes soiled or wet and it is recommended that masks be changed during lengthy treatment procedures. If you change the mask, you must first remove your gloves; do not touch your mask with your gloved hand. Types of mask Standard face mask: Protect the wearer from splashes onto mouth or nose by any fluid however it does not protect wearer from inhaling infectious airborne particles e.g.influenza virus.- High efficiency mask (Respirator) e.g.N95 mask) - Prevents inhalation of infectious air-borne particles, thus protects wearer from being infected with air-borne diseases. Gowns & Aprons Should be applied when: Spraying or spattering of blood or body fluids is anticipated e.g.surgical procedures. Gowns must not permit blood or body fluids to pass through. Medical wear and protective cloths: Pharmacy consideration Do not routinely handle medications with your bare ______.
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When removing gloves, grasp outside of the glove with the opposite gloved hand and peel off. Hold removed glove in gloved hand then slide fingers of ungloved hand under the remaining glove at rest. GLOVES REMOVAL Masks & Protective eye wear Masks & Protective eye wear -Masks protect the wearer from splashes onto mouth or nose by any fluid and from air-born infections.- Masks should fully cover the nose and mouth and prevent fluid penetration.- Masks should fit snuggly over the nose and mouth. Change masks between patients or if mask becomes soiled or wet and it is recommended that masks be changed during lengthy treatment procedures. If you change the mask, you must first remove your gloves; do not touch your mask with your gloved hand. Types of mask Standard face mask: Protect the wearer from splashes onto mouth or nose by any fluid however it does not protect wearer from inhaling infectious airborne particles e.g.influenza virus.- High efficiency mask (Respirator) e.g.N95 mask) - Prevents inhalation of infectious air-borne particles, thus protects wearer from being infected with air-borne diseases. Gowns & Aprons Should be applied when: Spraying or spattering of blood or body fluids is anticipated e.g.surgical procedures. Gowns must not permit blood or body fluids to pass through. Medical wear and protective cloths: Pharmacy consideration Do not routinely handle medications with your bare ______.
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When removing gloves, grasp outside of the glove with the opposite gloved hand and peel off. Hold removed glove in gloved hand then slide fingers of ungloved hand under the remaining glove at rest. GLOVES REMOVAL Masks & Protective eye wear Masks & Protective eye wear -Masks protect the wearer from splashes onto mouth or nose by any fluid and from air-born infections.- Masks should fully cover the nose and mouth and prevent fluid penetration.- Masks should fit snuggly over the nose and mouth. Change masks between patients or if mask becomes soiled or wet and it is recommended that masks be changed during lengthy treatment procedures. If you change the mask, you must first remove your gloves; do not touch your mask with your gloved hand. Types of mask Standard face mask: Protect the wearer from splashes onto mouth or nose by any fluid however it does not protect wearer from inhaling infectious airborne particles e.g.influenza virus.- High efficiency mask (Respirator) e.g.N95 mask) - Prevents inhalation of infectious air-borne particles, thus protects wearer from being infected with air-borne diseases. Gowns & Aprons Should be applied when: Spraying or spattering of blood or body fluids is anticipated e.g.surgical procedures. Gowns must not permit blood or body fluids to pass through. Medical wear and protective cloths: Pharmacy consideration Do not routinely handle medications with your bare ______.
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Gloves must be removed by grasping outside of the glove with the opposite gloved hand and peeling off. Hold removed glove in gloved hand then slide fingers of ungloved hand under the remaining glove at rest. GLOVES REMOVAL Masks & Protective eye wear Masks & Protective eye wear -Masks protect the wearer from splashes onto mouth or nose by any fluid and from air-born infections.- Masks should fully cover the nose and mouth and prevent fluid penetration.- Masks should fit snuggly over the nose and mouth. Change masks between patients or if mask becomes soiled or wet and it is recommended that masks be changed during lengthy treatment procedures. If you change the mask, you must first remove your gloves; do not touch your mask with your gloved hand. Types of mask Standard face mask: Protect the wearer from splashes onto mouth or nose by any fluid however it does not protect wearer from inhaling infectious airborne particles e.g.influenza virus.- High efficiency mask (Respirator) e.g.N95 mask) - Prevents inhalation of infectious air-borne particles, thus protects wearer from being infected with air-borne diseases. Gowns & Aprons Should be applied when: Spraying or spattering of blood or body fluids is anticipated e.g.surgical procedures. Gowns must not permit blood or body fluids to pass through. Medical wear and protective cloths: Pharmacy consideration Do not routinely handle medications with your bare ______.
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Gloves must be removed by grasping outside of the glove with the opposite gloved hand and peeling off. Hold removed glove in gloved hand then slide fingers of ungloved hand under the remaining glove at rest. GLOVES REMOVAL Masks & Protective eye wear Masks & Protective eye wear -Masks protect the wearer from splashes onto mouth or nose by any fluid and from air-born infections.- Masks should fully cover the nose and mouth and prevent fluid penetration.- Masks should fit snuggly over the nose and mouth. Change masks between patients or if mask becomes soiled or wet and it is recommended that masks be changed during lengthy treatment procedures. If you change the mask, you must first remove your gloves; do not touch your mask with your gloved hand. Types of mask Standard face mask: Protect the wearer from splashes onto mouth or nose by any fluid however it does not protect wearer from inhaling infectious airborne particles e.g.influenza virus.- High efficiency mask (Respirator) e.g.N95 mask) - Prevents inhalation of infectious air-borne particles, thus protects wearer from being infected with air-borne diseases. Gowns & Aprons Should be applied when: Spraying or spattering of blood or body fluids is anticipated e.g.surgical procedures. Gowns must not permit blood or body fluids to pass through. Medical wear and protective cloths: Pharmacy consideration Do not routinely handle medications with your bare ______.
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Study Notes
Nosocomiology and Hospital Acquired Infections
- Hospital acquired infection (HAI) is an infection acquired during the process of care in a hospital, which was not present or incubating at the time of admission.
- For a HAI, the infection must be unrelated to the original illness that brings patients to the hospital and neither present nor incubating as at the time of admission.
- HAIs can occur 48 hours or more after hospital admission, up to 3 days after discharge, or up to 30 days after an operation.
Causes of Nosocomial Infections
- Bacteria, viruses (HBV, HCV, HIV), fungi (Candida, Aspergillus), and parasites can cause nosocomial infections.
- Factors that increase the risk of acquiring infections inside the hospital include:
- Large numbers of sick people with poor nutritional status and immunocompromised conditions.
- Severity of underlying illness.
- Empirical use of antibiotics leading to emergence of resistant strains.
- Use of indwelling catheters and surgery.
- Prolonged hospital stay.
- Medical staff moving from patient to patient, providing a way for pathogens to spread.
- Failure to follow basic infection control practices, such as hand washing between patient contacts or before procedures.
Infection Control Practices
- Gloves removal: grasp outside of the glove with the opposite gloved hand, peel off, and hold removed glove in gloved hand.
- Masks and protective eye wear:
- Protect the wearer from splashes onto mouth or nose by any fluid and from air-borne infections.
- Masks should fully cover the nose and mouth and prevent fluid penetration.
- Change masks between patients or if mask becomes soiled or wet.
- Gowns and aprons:
- Should be applied when spraying or spattering of blood or body fluids is anticipated.
- Gowns must not permit blood or body fluids to pass through.
Standard Precautions
- Components:
- Hand hygiene.
- Personal protective equipment.
- Safe injection practice.
- Care of environment.
- Clean equipment between patients.
- Textiles and laundry.
- Sharp injury prevention.
- Respiratory hygiene – Cough etiquette.
- Waste disposal.
Barrier Precautions
- Specialized clothing or equipment worn by an employee for protection against infectious material.
- Gloves:
- Must be worn when direct contact with blood/body fluid is expected.
- Must be worn when examining a lacerated or non-intact skin.
- Must be worn when working directly with contaminated instruments or equipment.
- Must be worn when health care workers have skin cuts, lesions, and dermatitis.
Gloves Protocol
- Hands should be washed prior to donning gloves and immediately after removing them.
- Gloves should never be washed.
- No jewelry should be worn under gloves.
- No artificial nails should be worn under gloves.
- Surgeon's gloves should be worn during surgery.
- Gloves should be selected that are of good quality and with suitable size.
Chain of Infection
- All six links of the chain must be intact in order for an infection to be transmitted from one person to another.
- The goal of infection prevention and control (IPAC) is to break a link on the chain of infection.
- The reservoir is the habitat in which the agent normally lives, grows, and multiplies.
- Portal of exit: how the organism leaves the reservoir.
- Portals of entry: respiratory, faeco-oral, cuts in the skin, blood, or mucous membrane.
Types of Nosocomial Infections
- Urinary tract infections.
- Respiratory tract infections.
- Surgical site infections.
- Bloodstream infections.
- Gastrointestinal (GI) infections, including Clostridium difficile.
- Skin infections, endometritis, sinusitis, and soft tissue infections.
Device-Related Infections
- Central line-associated blood stream infection.
- Ventilator-associated pneumonia (VAP).
- Foley catheter-associated urinary tract infection.
- Device-related infections account for about two-thirds of HAI.
Hand Hygiene
- 5 moments for hand hygiene:
- Before touching a patient.
- Before clean/aseptic procedure.
- After body fluid exposure risk.
- After touching a patient.
- After touching patient surroundings.
Hand Hygiene Routine
- Hand-washing: mechanical removal of soil and dirt and transient flora (10-15 sec).
- Hand antisepsis: removal and destruction of transient flora using antimicrobial soap or alcohol-based hand antisepsis (for 60 seconds).
- Surgical hand scrub: removal or destruction of transient flora and reduction of resident flora using antimicrobial soap or alcohol-based detergent with effective rubbing (for at least 2-3 minutes).
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Description
Learn about hospital acquired infections that occur during the process of care in a hospital. Understand the criteria for a HAI and the time frames within which infections can be classified as nosocomial. Explore the common causes of nosocomial infections such as bacteria and viruses like HBV and HCV.
