1. NOSOCOMIAL INFECTIons (HOSPITAL ACQUIRED INFECTIONS) by lovella d
NOSOCOMIAL INFECTIons (HOSPITAL ACQUIRED INFECTIONS) by lovella d. kanu, m.d

2. Objectives: Define hospital acquired infections
identify the 5 major types of hospital acquired infections
To discuss and apply the top CDC Recommendations to prevent hospital acquired infections
To emphasize the importance of adequate hand hygiene

3. Definition: Infection in a hospitalized patient
Not present or incubating on admission
Hospital acquired infection

4. Why does this matter?

5. Hospital-acquired infections cost $10 billion a year: study
Five most common health care-associated infections strike 440,000 U.S. Patients each year
sept. 3, 2013, at 12:00 p.M.

6. CDC SURVEY
1 In 25 Hospital Patients Has At Least One Healthcare-associated Infection.
722,000 HAIs In U.S Acute Care Hospitals In 2011.
About 75,000 Hospital Patients With HAIs Died During Their Hospitalizations.
More Than Half Of All HAIS Occurred Outside Of The Intensive Care Unit.

7. EPIDEMIOLOGIC INTERACTION

8. SOURCES OF INFECTION

10. TYPES OF HOSPITAL ACQUIRED INFECTIONS
Central Line Associated Blood Stream Infections (CLABSIs)
Surgical Site Infections (SSSIs)
Catheter Associated Urinary Tract Infections (CAUTI)
MRSA Bacteremia
Clostridium Difficile Infections

11. Illinois Vs The National Baseline
Cook County Vs University Of Chicago Vs Loyola

20. How do we get rid of the extra staph???

21. Top CDC Recommendations to Prevent HAIs
To Prevent Catheter-Associated Urinary Tract Infections (CAUTIs):
Use of Catheter Only when indicated
Insert and Maintain by properly trained persons
aseptic technique
maintain unobstructed urine flow
hand hygiene recommendations and standard precautions

22. To prevent surgical site infections (SSIS)
Before surgery
antimicrobial prophylaxis
treat remote infections-before elective operations
avoid hair removal at the operative site unless it will interfere with the operation; do not use razors
antiseptic agent and technique for skin preparation

23. DURING SURGERY
keep or doors closed during surgery except as needed for passage of equipment, personnel, and the patient
After Surgery
maintain immediate postoperative normothermia
sterile dressing
control blood glucose level
discontinue antibiotics

24. To Prevent Central Line-Associated Bloodstream Infections (CLABSIs) Outside ICUs
• Remove unnecessary central lines • follow proper insertion practices • comply with hand hygiene recommendations • Use adequate skin antisepsis • provide education on central line maintenance and insertion

25. To Prevent Clostridium difficile Infections (CDI)
Contact precautions
• hand hygiene
• cleaning and disinfection of equipment and environment
• laboratory‐based alert system
• educate about CDI

26. To Prevent MRSA Infections
hand hygiene
Contact Isolation
rapidly report MRSA lab results
Provide MRSA education for healthcare providers

27. common finding!!!!

28. SO WHY DON’T STAFF WASH THEIR HANDS?
(COMPLAINCE ESTIMATED AT LESS THAN 50%)

29. References
Gould CV, umscheid CA, agarwal RK, et al. Guideline for the prevention of catheter-associated urinary tract infections 2008.
Centers for disease control and prevention.
Meddings j, saint s, fowler ke, et al. The ann arbor criteria for appropriate urinary catheter use in hospitalized medical patients
Scott II

30. Please break into your assigned small groups
THANK YOU

31. POST TEST REVIEW:
1. What are the 5 major types of hospital acquired infections (HAIs)?
- Central line associated blood stream infections (CLABSI)
- Surgical site infections (SSIs)
- Catheter associated urinary tract infections (CAUTI)
- MRSA bacteremia
- Clostridium difficile infections
2. What is the simplest most effective measure of preventing HAIs
- Hand hygiene

32. 3. For how long should one’s hands be rubbed together for effective hand washing? A. 1 minute B. 45 seconds C. 30 seconds D. 15 seconds 4. Based off CDC recommendations, post-op blood glucose should be maintained at atleast 200 mg/dl without complications

33. 5. When do you discontinue prophylactic antibiotics after surgery?
Within 24 hrs, and 48hrs if cardiac
6. Do antibiotic impregnated central lines decrease CLABSI?
Yes, antibiotic impregnated lines have been shown to reduce CLABSI

34. 7. When can the central line be used for blood draws or meds?
When needed
B. Only once a day
Rarely if at all and then only after a sterile alcohol scrub of the hub for 15 seconds.
 8. A patient admitted for diarrhea secondary to c-difficile and MRSA should be place under what type of precautions?
A. Droplet B. Contact C. Airborne D. A & b e. All of the above

35. Thank you