Hospital Infection Prevention & Control

What is Infection Prevention & Control?

Preventing or stopping the spread of infections in healthcare settings

What does HAI mean?

Healthcare-Associated Infections

What is the prevalence of hospital patients have at least 1 HAI in humans?

3.2 %

What are the FOUR types of HAI in humans?

• Central line-associated bloodstream infections

(CLABSI)

• Catheter-associated urinary

tract infections (CAUTI)

• Surgical site infections (SSI)

• Ventilator-associated pneumonia (VAP)

What is the % of reported outbreaks of nosocomial infection in previous 5 years?

82%

What is the % that reported >1 outbreak?

45%

What was the reported significant health problems attributable to zoonotic infections among hospital personnel in previous 2 years?

50%

What are the NINE Veterinary HAI Organisms?

• Salmonella enterica

• MRSA

• Escherichia coli

• Cryptosporidium parvum

• Enterococcus spp.

• EHV-1

• Pseudomonas spp.

• Acinetobacter baumannii

• Clostridium difficile

Of the NINE veterinary HAI organisms, which agents reported in zoonotic transmission?

Salmonella enterica, Cryptosporidium parvum, MRSA

What was the percentage of dogs in the small animal ICU that got diagnosed with HAI?

16.3%

What are the common reasons why dogs get HAI?

• Surgical site inflammation

• Urinary tract inflammation

• I.V. catheter site inflammation

• Significant GI disorders

• Fever of undetermined origin

• Acute respiratory disorders

• Septicemia

What is the most common cause of DOG HAI?

surgical site infection

What was the percentage of cats in the small animal ICU that got diagnosed with HAI?

12%

What are the common reasons why cats get HAI? (7)

• Urinary tract inflammation

• Surgical site inflammation

• I.V. catheter site inflammation

• Fever of undetermined origin

• Significant GI disorders

• Acute respiratory disorders

• Septicemia

What is the most common cause of HAI in cats?

urinary tract infection

In the equine ICU, what was the amount of horses that got HAI?

19.7%

What are the common reasons why horses get HAI? (5)

• Surgical site inflammation

• Significant GI disorders

• I.V. catheter site inflammation

• Fever of undetermined origin

• Sepsis

• Acute respiratory disorders

What is the amount per year in direct medical cost of HUMAN HAI?

$28.4 billion

What is the cost to society from early death and lost productivity?

$12.4 billion

How much money does a salmonella outbreak cost in an equine hospital? (bolded)

$ 4.12 million

What are some things that cause this economic burden to be so high? (5)

• Lost revenue

• Hospital closure

• Decreased caseload

• Facility remediation/

decontamination

• Patient bills

What are the SIX basic principles of infection prevention and control?

• Hand hygiene

• Standard precautions

• Isolation precautions (transmission-based precautions)

• Aseptic technique

• Cleaning, disinfection, and sterilization

• Antimicrobial stewardship

What is the #1 measure to prevent transmission of HAI?

hand hygiene

What makes hand more susceptible to colonization with transient bacteria?

Dermatitis/skin breakdown

T/F Transient bacteria pose transmission risk of HAI

True

When should you practice hand hygiene? (6)

• Immediately before and after

patient contact, especially invasive procedures

• Before and after contact with

items in the patient's

environment

• After exposure to patient bodily

fluids (e.g., discharge, specimen

handling)

• Before putting on gloves and

especially after glove removal

• After using the restroom

• Before eating

slide 17 shows how hands are cleaned and the areas and such, check it out

Okay girl

What is the ,inimum set of interventions required for ALL patients "first line of defense?

standard precautions

What are some examples of Standard precautions? (7)

• Hand hygiene

• Respiratory hygiene &

cough etiquette

• Appropriate use of PPE

• Safe work practices

• Safe injection practices

• Environmental hygiene

• Patient placement

What are FOUR examples of isolation precautions?

• Contact precautions

• Droplet precautions

• Airborne precautions

• Protective equipment/neutropenic precautions

What are somethings that you can do to help with isolation? (8)

• Remove practice outerwear and equipment

• Gather all supplies/meds before donning PPE

• Hand hygiene

• Put on PPE

• Attend to patient

• Clean and disinfect equipment

used to care for patient

• Remove PPE

• Hand hygiene

What is a processes for keeping away disease-causing microorganisms?

Aseptic Technique

What are interventions to reduce number of

microorganisms to reduce transmission

risk?

Medical asepsis

When are some cases where you would want ot make sure that medical asepsis is maintained?

▪ Placement of IV lines

▪ Urinary catheters

▪ Any indwelling device

What is the sterile technique maintains microbial count to irreducible minimum?

Surgical asepsis

What is a case where you would want Surgical asepsis?

Invasive surgical procedures

T/F there should be removal of foreign material

(soil, organic material) before disinfection

True

What can you use to clean?

Surfactant/detergent

T/F Cleaning removes 90% of germs , you should NOT skip this step!

True

What is important about disinfection?

Contact time

T/F Cleaning and disinfection are the same

False they are different steps

What destroys all microorganisms, including bacterial spores?

sterilization

What are the TWO ways that we can sterilize?

• Steam (~40 mns)

• Dry heat (1-6 hrs depending on temp)

What is actions taken to preserve the effectiveness and availability of antimicrobial drugs through responsible decision-making and conscientious oversight, while safeguarding animal, public, and environmental health?

Antimicrobial Stewardship

What organization regulates medically important antimicrobial use in feed/drinking

water?

FDA Veterinary Feed Directive

What are THREE other things that the FDA Veterinary Feed Directive does?

• Required veterinary oversight

• Removed production uses (growth promotion/feed efficiency)

• Driven by increasing threat of

antimicrobial resistance

Clindamycin, Fusidic acid, Glycopeptides (e.g.,

vancomycin), Macrolides, Rifampin, what bacteria has intrinsic resistance?

Enterobacteriales

Ampicillin-sublactam, Cefotaxime,

Chloramphenicol, Tetracyclines, Trimethoprim-

sulfamethoxazole, what bacteria has intrinsic resistance?

Pseudomonas aeruginosa

Aminoglycosides, Cephalosporins,

Clindamycin, Fusidic acid, Trimethoprim,

Trimethoprim-sulfamethoxazole, what bacteria has intrinsic resistance?

Enterococcus spp

Cephalothin, Fusidic acid, Streptogramins,

Trimethoprim, what bacteria has intrinsic resistance?

Campylobacter jejuni

T/F A veterinary team's best work can be undone by a breach in infection control, prevention, and biosecurity

True