HAIs

Question 1

Definition

Answer 1

infection in patient that occurs after admission
- often associated w/ surgery or medical device
- includes respiratory viruses

Question 2

Types of HAIs

Answer 2

• surgical site infections
• CLABSI
• CAUTI
• C diff
• MRSA

Question 3

Microbiome

Answer 3

• patients entering hospital acquire and share fecal flora w/ environment
• can acquire pathogenic/antibiotic resistant/ more virulent organisms

Question 4

Prevention

Answer 4

• cleaning and disinfection
• sterilization
• guidance procedures & protocols
• hand hygiene
• standard precautions

Question 5

Standard precautions

Answer 5

• assume all patients are potentially infectious
• dont infect patients/get infected
• developed during HIV epidemic
• hand hygeine, barrier use, disinfection, patient placement, handling of linens, safe injections

Question 6

Transmission based precautions

Answer 6

• contact: hand hygiene, gloves/gowns
• droplet: masks
• airborne: respirators
• patient isolation

Question 7

Hand hygiene

Answer 7

• most effective way to prevent infection
• alcohol hand rub (microbes), soap and water (soil)
• barriers: time, ease with workflow

Question 8

Environmental cleaning and disinfection

Answer 8

• products used are registered with EPA
• floors, doorknobs, medical devices, etc

Question 9

Cleaning

Answer 9

removes dirt and organic matter from surfaces w/ soap or detergents

Question 10

Disinfection

Answer 10

kills viruses and bacteria on surfaces using chemicals

Question 11

Ventilation

Answer 11

• Filtration based in MERV
• filtration, air changes per hours, fresh air intake

Question 12

Airborne infection isolation rooms/ negative pressure rooms

Answer 12

• keep contaminated air in the room
• lower pressure relative to the hallway

Question 13

Potable water and drains

Answer 13

• flow of water results in release of microbes into the water and air
• biofilms

Question 14

Medical devices

Answer 14

• Central line: large diameter of catheter, frequent access, sicker patients, breaks integrity of skin
• Catheter: breaks natural protection of urethra
• Ventilator: breaks protection of airway from oral secretions, patients often sedated

Question 15

Diagnostic stewardship

Answer 15

• inappropriate tests: patient harm, worse quality metrics
• lab tests imperfect

Question 16

Active surveillance

Answer 16

infection prevention teams ask for evaluation to identify infection

Question 17

Passive surveillance

Answer 17

identify pathogens through routine patient data

Question 18

Reporting

Answer 18

• hospital -> CDC/NHSN -> CMS
• clinicians -> state/local health -> CDC