HAI January 24, 2018

Bell Work 1. What is a quarter to eight in the morning in military time? 0845 0745 7:45 a.m. 2. Which of the following is NOT standard practice for a patient with tuberculosis? Those who enter the room should wear respiratory protection. Maintain a room temperature of 90 degrees. Keep the room at negative pressure. Move the patient to an isolation room. 3. Give an example of a disease for the following pathogens: Bacteria, Virus and Fungus

Standard Assess the differences between healthcare associated infections and non-healthcare associated infections using examples drawn from mock case studies. Support explanations with relevant surveillance statistics, preventive measures, and methodologies concerning outbreak detection, management, and education.

Objectives By the end of class, students will be able to: Know the difference between healthcare associated infections and non-healthcare associated infections Recognize best preventative measures for preventing infections

Health Care Associate Infections (HCAI) Infections that patients acquire during the course of receiving treatment for other conditions within a healthcare setting Increase cost: $26-33 billion annually CDC estimates 1 in 25 hospital patients has an infection

Types of Infections Catheter-associated urinary tract infections Surgical site infections Bloodstream infections Pneumonia Clostridium difficile

Catheter-Associated urinary tract infections A urinary tract infection (UTI) is an infection involving any part of the urinary system, including urethra, bladder, ureters, and kidney. UTIs are the most common type of healthcare- associated infection reported Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine.  Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay.  Risk factor for developing a UTI is prolonged use of the urinary catheter. 

Surgical Site Infections https://www.youtube.com/watch?v=MPBWyp-z_lI occurs after surgery in the part of the body where the surgery took place Surgical site infections can sometimes be superficial infections involving the skin only. Other surgical site infections are more serious and can involve tissues under the skin, organs, or implanted material. CDC provides guidelines and tools to the healthcare community to help end surgical site infections 

Bloodstream Infections Central line-associated bloodstream infections (CLABSIs) result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system, yet these infections are preventable. A central line (also known as a central venous catheter) is a catheter (tube) that doctors often place in a large vein in the neck, chest, or groin to give medication or fluids or to collect blood for medical tests. Central lines access a major vein that is close to the heart and can remain in place for weeks or months and be much more likely to cause serious infection. Central lines are commonly used in intensive care units.

Pneumonia Ventilator-associated pneumonia is a lung infection that develops in a person who is on a ventilator. A ventilator is a machine that is used to help a patient breathe by giving oxygen through a tube placed in a patient’s mouth or nose, or through a hole in the front of the neck. An infection may occur if germs enter through the tube and get into the patient’s lungs

What is C. Diff? Bacterium that causes inflammation of the colon, known as colitis. People who have other illnesses or conditions requiring prolonged use of antibiotics, and the elderly, are at greater risk of acquiring this disease. The bacteria are found in the feces. People can become infected if they touch items or surfaces that are contaminated with feces and then touch their mouth or mucous membranes. Healthcare workers can spread the bacteria to patients or contaminate surfaces through hand contact.

Symptoms of C. Diff Watery diarrhea (at least three bowel movements per day for two or more days) Fever Loss of appetite Nausea Abdominal pain/tenderness

More about HAI Occur across the continuum of care and can be transmitted between different health care facilities. Recent studies suggest that implementing existing prevention practices can lead to up to a 70 percent reduction in certain infections

Ambulatory Facilities Healthcare, infections, and antibiotic resistance have moved beyond hospitals Hospitals Dialysis Facilities Ambulatory Facilities Long-term Care

Objectives for Healthy People 2020 A central line-associated bloodstream infection (CLABSI) is a serious HAI that occurs when germs (e.g., bacteria) enter the bloodstream through the central line (a long flexible tube placed in a large vein that empties out near the heart). These infections result in thousands of deaths each year and several million dollars in added costs to the U.S. health care system.  Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that is resistant to many antibiotics. In medical facilities, MRSA causes life-threatening bloodstream infections, pneumonia, and surgical site infections. 

States with Mandatory Public Reporting Policies for Healthcare-Associated Infections DC* 2004 2015 States required to publicly report some healthcare-associated infections

State Prevention Programs CDC supports at least one HAI coordinator in every state through the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) Cooperative Agreement State health departments work to: Track infections in healthcare facilities Implement prevention strategies across healthcare settings using CDC’s tools and evidence-based guidelines

Health Care Associate Infections (HCAI) https://www.youtube.com/watch?v=M75c2zmjkT0 https://www.youtube.com/watch?v=RX06_ZgFTdg

What is the Number 1 way to prevent infection? HANDWASHING!!!

How do you break the chain of infection HANDWASHING!

Hand Hygiene https://www.youtube.com/watch?v=zCVu_1d9AJ8

Exit Ticket What is the most common type of healthcare-associated infection reported? When a patient requires prolonged use of antibiotic they are at greater risk of acquiring this disease. ____________________ can access a major vein that is close to the heart and can remain in place for weeks or months and be much more likely to cause serious infection. _____________________is a lung infection that develops in a person who is on a ventilator. ______________________is a type of bacteria that is resistant to many antibiotics. In medical facilities, it causes life-threatening bloodstream infections, pneumonia, and surgical site infections.