CH12

Clostridium difficile

causes gastrointestinal diseases

nosocomial infection (HAI)

hospital acquired infection

Healthcare epidemiology

the study of the occurrence, determinants, and distribution of health and disease within healthcare settings. Primary focus is on infection control and the prevention of healthcare-associated infections

Transmission-Based Precautions

These are used for patients who are known or suspected to be infected or colonized with highly transmissible or epidemiologically important pathogens for which additional safety precautions beyond Standard Precautions are required to interrupt transmission within healthcare settings

1. Urinary tract infections (UTIs) 2. Surgical site infections (also referred to as postsurgical wound infections) 3. Lower respiratory tract infections (primarily pneumonia) 4. Bloodstream infections (septicemia)

The four most common types of HAIs are:

Protective Environments

The preferred placement for patients who are especially vulnerable to infection. Patients with severe burns or leukemia, transplant or immunosuppressed patients, patients receiving radiation treatment, leukopenic patients, and premature infants.

airborne infection isolation room (AIIR)

The preferred placement for patients who are infected with pathogens that are spread via airborne droplet nuclei (5 m or less in diameter), and therefore require Airborne Precautions

handwashing

The single most important measure to reduce the risks of transmitting pathogens from one patient to another or from one anatomic site to another on the same patient is:

Contact Precautions, Droplet Precautions, Airborne Precautions

The three types of Transmission-Based Precautions are:

Standard Precautions

These are applied to the care of ALL patients in ALL healthcare settings, regardless of the suspected or confirmed presence of an infectious agent

1. Increased number of drug-resistant pathogens 2. Failure of healthcare personnel to follow infection control guidelines 3. Increased number of immunocompromised patients

Three major factors contributing to HAIs are:

fatal

Antibiotic-resistant infections tend to be more _______ than normal infections

1. Overcrowding of hospitals and shortages of healthcare staff 2. The indiscriminate use of antimicrobial agents 3. A false sense of security about antimicrobial agents 4. Lengthy and more complicated types of surgery 5. Increased use of less highly trained healthcare workers 6. Increased use of anti-inflammatory and immunosuppressant agents 7. Overuse and improper use of indwelling devices

Beyond the three main factors, seven additional factors contributing to HAIs are:

sharps containers

For disposal of sharps, there are specifically designed puncture-resistant containers known as "________ ________"

OSHA

General regulations for medical waste disposal includes following ______ standards for disposal of medical wastes

proper education, disciplined compliance

HAIs can add several weeks to a patient's hospital stay and may lead to serious complications and even death. Additionally, insurance companies rarely reimburse healthcare facilities for costs associated with HAIs. HAIs can be avoided through ________ ________ and __________ ________ with infection control practices

infection control guidelines

HAIs can be reduced through strict compliance with

many venues

Hospital-acquired infections can spread through:

70

Hospitals are filled with antibiotics; many pathogens have already been exposed. As such, approximately ______% of HAIs involve drug-resistant bacteria

positive pressure (air cannot enter except via the filter)

In a protective environment, the air in the room is under:

negative pressure (air stays in)

In an airborne infection isolation room (AIIR), the air in the room is under:

1. healthcare-associated infections (HAIs) 2. community-acquired infections

Infectious diseases can be divided into two categories:

1. disinfection and sterilization techniques 2. air filtration 3. use of ultraviolet lights 4. isolation of especially infectious patients 5. wearing gloves, masks, and gowns whenever appropriate

Means of reducing the incidence of HAIs include:

indwelling device (catheters, ventilators, IVs, etc.)

Most HAIs involved some kind of:

5

Nosocomial diseases are usually preventable; however, about ___ % of people admitted to a hospital contract one

high-quality healthcare resources

Nosocomial infections are usually only a problem in countries with access to:

increasing

Over the past couple decades, the number of HAIs has been steadily:

Escherichia coli, Pseudomonas aeruginosa, Enterobacter spp., Klebsiella spp.

Pathogens most often involved in HAIs include the following four Gram-negative bacilli:

Staphylococcus aureus, coagulase-negative staphylococci, Enterococcus spp.

Pathogens most often involved in HAIs include the following three Gram-positive cocci:

1. Use disposable equipment and supplies whenever possible 2. Disinfect or sterilize equipment soon after use 3. Use individual equipment for each patient 4. Use disposable thermometers or thermometer covers

Patients' gowns, bedding, towels, hospital equipment, telephone, computer keyboard, etc. are fomites. To reduce such sources of infection, four strategies include:

1. Elderly patients 2. Women in labor and delivery 3. Premature infants and newborns 4. Surgical and burn patients 5. Diabetic, cancer, and transplant patients 6. Patients receiving treatment with steroids, anticancer drugs, antilymphocyte serum, and radiation 7. Immunosuppressed patients 8. Patients who are paralyzed or are undergoing renal dialysis or catheterization

The eight groups of patients most likely to develop HAIs include:

All healthcare workers

________ ________ ________ must fully comprehend the problem of HAIs, must be completely knowledgeable about infection control practices, and must personally do everything in their power to prevent HAIs from occurring