Outbreak!

Question 1

What is a Healthcare Associated Infection (HAI)?

Answer 1

It is an infection you might catch when getting healthcare in hospitals, care homes, doctors’ surgeries, health centres or receiving care at home

The most common types of infection in hospitals are urine infections, infections after surgery (operations), skin infections, sickness and diarrhoea

Question 2

Hospital acquired infection:

• Generally an infection acquired after being in hospital for more than __ hours
• For some organisms this will vary depending on the ________ period of the organism
• All infections are __________ - somehow…..

Answer 2

48

incubation

transmissible

Question 3

Proportion of HAIs due to different infections such as what?

Answer 3

• UTI (22.6% of all HAI) – mainly related to catheterisation
• Surgical Site Infection (18.6%)
• Respiratory Tract Infection (17.5%) – intubation accounted for about a quarter of these
• Bloodstream infections (10.8%) – many Central Venous (CVC) Catheter related
• Gastrointestinal infection (6.8% versus 15.4%)
• Skin and soft tissue infection (4.0%)

Question 4

what is an outbreak?

Answer 4

An outbreak of an infection is defined as 2 or more cases of a infection linked in time and place

• N.B.
• 1st Purpose of IPCT is to PREVENT individual infections AND outbreaks!!
• Purpose of surveillance is to DETECT and IDENTIFY a possible outbreak at the earliest opportunity

Question 5

what is involved in the chain of an infection?

Answer 5

Question 6

what are examples of infectious agents?

Answer 6

• Bacteria
• Virus
• Fungi
• Prion

Question 7

what are examples of reserviors?

Answer 7

• Humans
• Equipment
• Environment
• Food
• Animals

Question 8

what are examples of portals of exits?

Answer 8

• Blood and body fluids
• Skin scales/wound
• Coughing and sneezing

Question 9

what are examples of different modes of transmission?

Answer 9

direct or indirect

inhalation

ingesitong of contaminated food

Question 10

what are examples of different portals of entry?

Answer 10

skin/surgical wounds

eyes or mouth

respiratory tract

intesitnal tract

tubes

Question 11

what are examples of Susceptible hosts?

Answer 11

• Underdeveloped immune system
• Decreasing immune system
• Drugs or diseases
• Tubes

Question 12

what are different ways to break the chain of infection?

Answer 12

Question 13

how do you break the chain in regards to the mode of transmission?

Answer 13

Question 14

what are the 5 moments of hand hygine?

Answer 14

Question 15

how do you break the chain in regards to the reservoir?

Answer 15

Question 16

how do you break the chain in regards to the portal of entry?

Answer 16

Question 17

how do you break the chain in regards to the susceptible host?

Answer 17

Question 18

how do you break the chain in regards to the portal of exit?

Answer 18

Question 19

What are some Transmission based precautions (TBPs) in regards to contact precautions?

Answer 19

• Contact
• Gloves
• Apron

Question 20

Transmission based precautions (TBPs) in regards to droplet precautions?

Answer 20

• Droplet
• Gloves
• Aprons
• Masks
• Eye protection

Question 21

how do you breka the chain in regards to the infectious agent?

Answer 21

Question 22

Transmission based precautions (TBPs) in regards to airborne precautions?

Answer 22

• Droplet
• Gloves
• Aprons
• Masks
• Eye protection

Question 23

What’s a droplet

Answer 23

• >5µm
• Spread assumed to be about 1m
• Drop to ground

Question 24

What’s an aerosol

Answer 24

• <5µm
• Much more widespread
• Remain suspended in the air

Question 25

Why does this matter???

Answer 25

Airborne spread infections are more highly transmissible and therefore require different precautions 40µm is limit of visibility to human eye

Question 26

what is cleaning

Answer 26

• Physical removal of organic material and decrease in microbial load

Question 27

what is disinfection?

Answer 27

• Large reduction in microbe numbers - spores may remain

Question 28

what is sterilisation?

Answer 28

• Removal/Destruction of ALL microbes and spores

Question 29

What is classed as low risk and what needs to be done about it?

Answer 29

Intact skin contact e.g. stethoscopes, cots, Mattresses Cleaning compatible with manufacturer’s instructions

Question 30

What is classed as medium risk and what needs to be done about it?

Answer 30

Mucous membrane contact e.g. bedpans, vaginal specula, Endoscopes Disinfection or sterilisation as appropriate

Question 31

What is classed as high risk and what needs to be done about it?

Answer 31

e.g. surgical instruments Sterilisation

Question 32

how is cleaning done?

Answer 32

* Manufacturer’s instructions * Detergent and water * DRYING IS AN IMORTANT PART OF THE PROCESS! * Cleaning essential PRIOR to disinfection and Sterilisation if these are required

Question 33

what are different methods of disinfection?

Answer 33

Heat: * Pasteurisation (e.g. bedpans, linen, dishwashers) * Boiling (vaginal specula, ear syringes) Chemical: * Chemicals vary in their organism activity range * Needs to be equipment compatible * Examples: Alcohol, chlorhexidine, hypochlorites, hydrogen peroxide

Question 34

what are methods of sterilisation?

Answer 34

* Steam under pressure (autoclave) * Hot Air Oven * Gas (ethylene dioxide) * Ionising Radiation

Question 35

what are different mehtods of surveillance?

Answer 35

• Local Surveillance: - Laboratory Based - Ward/Clinical Area Based * National Surveillance * All healthcare workers!