Why is Infection Prevention Important?
Why is Infection Prevention Important?
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Healthcare is delivered in a range of settings, from hospitals to care delivered in clients' homes or social care settings. Healthcare-associated infections (HCAIs) can occur in any setting where healthcare is delivered. HCAIs are defined as any infection as a result of healthcare interaction that has taken place, or has occurred, 48 hours (general rule) after admission to a healthcare setting.
Healthcare workers, carers and family members are also at risk of acquiring infections when caring for patients. HCAIs can occur in otherwise healthy individuals, especially if invasive procedures or devices are used.
HCAIs can exacerbate existing or underlying conditions, delay recovery and adversely affect quality of life.
During the past two decades, HCAIs have become a significant threat to patient safety. The UK government sees antibiotic resistance as a threat comparable with terrorism.
Patient treatment can be undermined by the transmission of infections within the healthcare settings; particularly problematic are those infections caused by antimicrobial-resistant micro-organisms [1].
Infections
six most common types of HCAIs found in acute care hospitals are:
Respiratory tract infections 22.8%
Urinary tract infections 17.2%
Surgical site infections 15.7%
Clinical sepsis 10.5%
Gastrointestinal infections 8.8%
Bloodstream infections 7.3%
Vulnerability to Infections
The risk or susceptibility to infection increases when you are living either permanently or temporarily in a shared care setting. So, the risks of infection is lowest in your own home and highest in a hospital due to invasive devices and procedures. Care homes and other settings where people live communally also pose a risk.
Some people are more susceptible to healthcare-associated infections. This could be due to:
Obligations of Employers and Employees
Not all HCAI can be prevented, but organisations are responsible for providing training, policies and PPE, as well as reporting structures to minimise HCAI as far as possible.
It is everyone's responsibility to maintain consistent infection prevention and control practice and a safe working environment
Uniform
For those healthcare staff who are required to wear uniform, including those working in community and primary care, they must wear a clean uniform every day.
Presentation
Healthcare staff, including those working in community and primary care, must look presentable and professional. Staff with long hair must have it tied back and off the collar.
Bare arms
Healthcare staff, including those working in community and primary care, must not wear jewellery, rings with stones, acrylic nails, wristbands and watches. Arms should be bare below the elbow to facilitate hand hygiene.
Antimicrobial Resistance
Antimicrobial resistance (AMR) is the biggest threat to public health. It happens when micro-organisms (such as bacteria, fungi, viruses and parasites) change when they are exposed to antimicrobial drugs, such as antibiotics, antifungals, antivirals, antimalarials and antihelmintics
Carbapenems
Carbapenems are powerful broad-spectrum antibiotics that are often the last line of effective treatment for patients with multidrug-resistant infections, including those caused by ESBL-producing bacteria (extended spectrum beta-lactamases).
Cases of carbapenem resistance in E. coli and Klebsiella in the UK started to increase during 2008 and 2009
Antimicrobial resistance (AMR)
Antimicrobial resistance (AMR) is resistance of a micro-organism to an antimicrobial medicine to which it was previously sensitive. Resistant organisms (they include bacteria and viruses) are able to withstand attack by antimicrobial medicines, such as antibiotics and antivirals, so that standard treatments become ineffective and infections are prolonged, with longer periods of infectivity, and may spread to others. Inappropriate and irrational use of antimicrobial medicines provides favourable conditions for resistant micro-organisms to emerge, spread and persist.
UK 5-year action plan for antimicrobial resistance 2019 to 2024
This is the UK Government's 5 year action plan which has been designed to ensure progress towards a 20-year vision on AMR, in which resistance is effectively contained and controlled. The report recognises that no new classes of antibiotic have been discovered since the 1980s and that this, together with the increased and inappropriate use of the drugs already available, means we are heading rapidly towards a world in which antibiotics no longer work.
The report focuses on three keyways of tackling AMR:
Reducing the need for, and unintentional exposure to, antimicrobials
Optimising use of antimicrobials
Investing in innovation, supply and access
Methods of Infection Spread
There are a number of ways that infection can spread.
Vectorhhhh
Flies, rats, mice and cockroaches can spread vector-borne diseases. These include dengue fever, West Nile virus, lyme disease and malaria.
Needle
stick
A number of infections can be spread by needlestick injuries. This includes hepatitis B, hepatitis C and the human immunodeficiency virus (HIV) which leads to AIDS (acquired immune deficiency syndrome).
Direct contact
Examples of infections that can be spread by skin-to-skin contact (for example, contaminated hands) are MRSA and E. coli. Also, C.difficile spores can be transferred via contaminated hands. E coli is a common cause of urinary tract infection.
Ingestion
Examples of infection acquired by ingestion (eating and drinking) include salmonella, campylobacter and E.coli 0157. C.difficile spores can also be ingested via contaminated hands.
Droplets and Airborne
Influenza is a respiratory illness spread by droplets through coughing and sneezing. This can contaminate surfaces and indirectly spread infection via contaminated hands.
An airborne disease is any disease that is caused by pathogens that can be transmitted through the air, for example measles and chickenpox.
Fomites
Fomites are objects or materials which are likely to carry infection, such as clothes, utensils, and furniture. Dirty commodes are one piece of equipment, if not cleaned thoroughly, can be implicated in spreading infection.
The transmission of infection depends on six elements which link together like a chain as shown in the diagram. The elements are infectious agent, a reservoir for it to live, a site of exit, and a mode of transmission to a susceptible host via a site of entry.
We will explore this more in the next chapter.
Which of the following two patients would you consider high risk?
Choose one option and select Submit.
Young person with no other medical conditions and no previous hospital admissions, no medication. Routine elective surgery when he had his tonsils removed
Woman in her 70s, multiple hospital admissions, antibiotics in community, non-intact skin, recent inpatient tertiary hospital
Answer
Answer
2.
Age, multiple/recent hospital admissions and antibiotic prescribing are all risk factors for the development of healthcare-associated infections.
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