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HEALTH CARE ASSOCIATED INFECTION
Healthcare associated infections (HAI) are infections acquired during medical care in hospitals or other healthcare facilities. Some key points: - HAI affect around 10% of hospital patients and costs are doubled compared to patients without infections. Common sites of infection include urinary, surgical and pneumonia. - Risk factors for HAI include crowded hospital conditions, patients with compromised immune systems, increasing antibiotic resistance in bacteria. Procedures like catheterization and ventilation also increase risk. - HAI can be prevented through proper hand hygiene, sterilization of equipment, isolation of infected patients, and avoiding unnecessary medical procedures. Surveillance by infection control teams is also important to reduce infection rates.
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HEALTH CARE ASSOCIATED INFECTION
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- 2. HEALTHCARE ASSOCIATED INFECTION (HAI) 2 Alsoknown as Nosocomial infection / /Hospital acquired infection / Hospital associated infection Also occupational infections among staff For patients : Infections that first appear 48hrs or more after hospital admission or within 30 days after discharge.
- 3. Some Statistics forHAI: Affects ~ 10% of all in-patients Delays discharge Costs 2 x more than if there is no infection Show increasing trend among patients and staff 3
- 4. 4 Crowded hospital conditions Newmicroorganism Increasing people with compromised immune system Increasing Bacterial resistance (MRSA,resistant Gram negatives) HAI reducible by 10- 30% RISE IN HAI AS A RESULT OF 4 FACTORS
- 5. HAI - EPIDEMIOLOGY 5 Canbe exogenous (external organism) and endogenous (opportunist normal flora) Host susceptibility : important factor in development of HAI MEDICAL EQUIPMENTS AND PROCEDURES (surgery) are often responsible for infections
- 6. HAI :Mode ofTransmission Contact/hand borne (most common) Air borne Oral route Parenteral route Vector borne 6
- 7. 1. Contact (mostcommon) Direct (physical contact) ◦ eg when a staff turns a patient, gives patient a bath , examination of patient 7
- 8. 8 Indirect-contact Transmission Involves contactof a host with a contaminated intermediate object ， eg: Contaminated instruments / needles/dressings Contaminated gloves that are not changed between patient. Contaminated surface by needles (Jarum diletak atas permukaan selepas ambil darah ! ）》》》 Dried blood can transmit HEPATITIS B/C
- 9. 9 RISIKO HAI Hep Bvirus can live outside d body at least 7 days Hep C virus can live outside d body for 16h - 4 days
- 10. 10 2.VECTOR TRANSMISSION Transmitted throughinsects eg mosquitoes and fleas. ( eg Denggi) 3.AIR BORNE TRANSMISSION Tiny droplet nuclei that remain suspended in air. （ Eg TB)
- 11. 11 4.DROPLET TRANSMISSION Droplet generatedby sneezing, coughing or respiratory tract procedures eg suction EX : Influenza,TB
- 12. AGENTS OF HAINFECTIONS 12 VIRUS BACTERIA FUNGI
- 13. Hospital Procedure PoseMany Risks to HAI Nebuliser mask Catheterization IV Procedure Dressing Bedpans Urinals Dirty couch etc. 13
- 14. Predisposing Factors fOR HAI Age（ Young children ， Elderly ） Severity of Illness Medical conditions Immuno compromised Malnutrition Obesity 14
- 15. COMMON SITES OFHAI Patients in Labour Room / ICU Patients undergoing invasive procedures /operation. Areas of hospital with poor ventilation 15
- 16. 5 COMMON TYPESOF HAI 1. Urinary Tract Infections (UTI) 2. Surgical Wounds Infections (SWI) 3. Pneumonia 4. Skin 5. Blood stream infection/ Bacteremia Staff : URTI/ Conjunctivitis /Pertussis/TB etc 16
- 17. COMMON SITES OFINFECTION 17
- 19. URINARYTRACT INFECTIONS 19 Most commoncause of HAI 80% of UTI are associated with indwelling catheters.
- 20. SURGICAL SITE INFECTIONS 20 Frequent Definitionis mainly clinical (purulent discharge around wounds or at insertion site of drain, or spreading cellulites from wounds) The infections can be exogenously or endogenously
- 21. NOSOCOMIAL PNEUMONIA 21 Most importantare patients on ventilators in ICU. Recent and progressive radiological opacities of pulmonary parenchyma, purulent sputum and recent onset fever.
- 22. PREVENTION & CONTROLOF HAI 1. Observance of aseptic technique 2. FREQUENT HAND WASHING esp. between patients 3. Cleaning, and disinfection of linen and furniture etc) 22
- 23. 23 PPE:Wear Gloves For tworeasons: Provide a protective barrier and prevent contamination of hands Reduce likelihood that microorganism present on hands will be transmitted to patients during procedure.
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- 25. HAND HYGIENETO PREVENTHAI 25 You can get 100s to 1000s of bacteria on your hands by doing simple tasks like:Assisting pt up in bed /Touching pt’s gown or bed sheets HandWashing is Important Because… 80% of disease is spread by your hands. Hand Hygiene : single most effective intervention to reduce the cross transmission of HAI
- 26. PREVENTION & CONTROLOF HAI 4. Sterilization of instrument eg nebulizer/oxygen mask/Use of single-use disposable items 5. Patient isolation eg Pertussis/TB etc 6. Avoidance of medical procedures that can lead to HAI ( eg. urinary catheter) 26
- 27. HAI :What ismost Important Effective surveillance and action by infection control team to reduce infection rates. Important role of team : monitor compliance and practices to prevent HAI
- 28. EXAMPLE OF HAI TBin HCW 28
- 29. HCW - TBCases & Notification Rate, Malaysia 2003- 2014 Control & Prevention Measures of TB among HCWs Risk for TB among HCWs is consistently higher than general population worldwide (Joshi, 2006) 29
- 30. ii. ADMINISTRATIVE CONTROL •Periodic TB Screening for HCWs Control & Prevention Measures of TB among HCWs 30
- 31. iii. PPE • N95(respirator) must be used in high risk TB areas TB ward, chest clinic Isolation room Procedure room eg. sputum induction room • HCW to use N95 • Patient to use Surgical Mask Control & Prevention Measures of TB among HCWs 31
- 32. Control & PreventionMeasures of TB among HCWs Conclusion In addition to having TB guidelines with environmental / engineering; administrative; and respiratory- protection controls; HCWs must change their behaviour towards healthy and safer work culture in order to prevent & control TB at the workplace. 32
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