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Semelhante a ICU NOSOCOMAIL INFECTION AND INFECTION CONTROL
Semelhante a ICU NOSOCOMAIL INFECTION AND INFECTION CONTROL (20)
ICU NOSOCOMAIL INFECTION AND INFECTION CONTROL
- 1. TAIBA UNIVERSITY NURSING FACULTY ICU NOSOCOMIAL INFECTION AND INFECTION CONTROL Presented by : Abdul Aziz Abdul Rahman Ali Alfuraidan
- 2. Content: Learning Objectives Abbreviations Back ground of hospital acquired infection. Definition of nosocomial infection. Epidemiology. Causative agents of nosocomial infections. Modes of transmission . Risk of Infections in ICU. Why May Be in ICU and Why Do They Come to ICU? ICU Patients Differ From Many Patients. ICU Care is more Invasive. Factors that increase nosocomial infection in ICU Common nosocomial infection
- 3. Common nosocomial infection sites Risk Factors for Nosocomial UTIs Prevention of Nosocomial UTIs Risk Factors for Nosocomial BSIs Prevention of Nosocomial BSIs Risk Factors for Nosocomial BSIs Risk Factors for VAP. Prevention of VAP. Critical Care Nursing's Roles in Nosocomial Infection. References
- 4. LEARNING OBECTIVES : Know the epidemiology of nosocomial infections Understand the various modes of transmission of nosocomial infections Know the various strategies for prevention and control of nosocomial infections
- 5. Abbreviations: (NSIs) : nosocomial infections (MODS) :Multiple Organ Dysfunction Syndrome (SIRS) : Systemic Inflammatory Response Syndrome (COPD) : chronic obstructive pulmonary disorder . (UTI): urinary tract infection . (BSI): blood stream infection . (VAP): ventilated associated pneumonia.
- 6. BACKGROUND OF HOSPITAL AQUIRED INFECCTION • Nosocomial infections have been recognized for over a century as a critical problem affecting the quality of health care and a principal source of adverse healthcare outcomes. • Nosocomial infection comes from Greek words “nosus” meaning disease and “komeion” meaning to take care of. • It is also called : HOSPITAL AQUIRED INFECTION
- 7. DEFINITION OF NOSOCOMIAL INFECTION: An infection acquired in a patient in a hospital or other healthcare facility in whom it was not present or incubating at the time of admission or the residual of an infection acquired during a previous admission.
- 8. EPIDEMOLOGY •Nosocomial infections can be exogenous (external organism) and endogenous (opportunist normal flora). •Host susceptibility Is an important factor in the development of nosocomial infection. •Medical equipments and procedures (surgery) are often responsible for infections.
- 9. CAUSATIVE AGENTS OF NOSOCOMIAL INFECTION Different pathogens may cause nosocomial Infections:
- 11. 1- CONTACT TRANSMISSION: Most important and frequent mode of transmission of nosocomial infections, is divided into two subgroups : •Direct-contact transmission •Indirect-contact transmission.
- 12. •Direct-contact transmission: Involves a direct body surface-to-body surface contact and physical transfer of microorganisms between a susceptible host and an infected or colonized person, such as occurs when a person turns a patient, gives a patient a bath. •Indirect-contact transmission: Involves contact of a susceptible host with a contaminated intermediate object, usually inanimate, such as contaminated instruments, needles , or dressings, or contaminated gloves that are not changed between patients
- 13. 2-DROPLET TRANSMISSION: Droplet generated by sneezing coughing or respiratory tract procedures like bronchoscopy or suction. 3-VECTOR TRANSMISSION: Transmitted through insects and other invertebrates animals such as mosquitoes and fleas.
- 14. 4-AIR BORNE TRANSMISSION: Tiny droplet nuclei that remain (<5) suspended in air. 5-COMMON VEHICLE TRANSMISSION: Transmitted indirectly by materials contaminated with the infections.
- 15. Risk of Infections in ICU Patients hospitalized in ICUs are 5 to 10 times more likely to acquire nosocomial infections than other hospital patients . The frequency of infections at different anatomic sites and the risk of infection vary by the type of ICU, and the frequency of specific pathogens varies by infection site. Contributing to the seriousness of nosocomial infections, especially in ICUs, is the increasing incidence of infections caused by antibiotic-resistant pathogens.
- 16. Why May Be in ICU and Why Do They Come to ICU? They are admitted for : • Shock (Hypovolemic ,Cardiogenic , Septic Shock and (SIRS) ). • Respiratory Failure (Acute (Moderate to severe respiratory failure, resulting from conditions like pneumonia or (COPD) and Chronic). They need mechanical support and mechanical ventilation. • Renal Failure.
- 17. • Neurological Conditions : A variety of neurological or brain disorders are seen in ICU. These may include strokes, infections, lack of oxygen to the brain tissue (cerebral anoxia) resulting in tissue death, traumatic injuries or other changes that occur when a patient is critically ill. • Bleeding and Clotting : Bleeding and clotting in critically ill patients are quite common. • MODS .
- 18. ICU Patients Differ From Many Patients : We have to pay more attention to those patient because they are : • The sickest patients (multiple diagnoses, multi-organ failure, immunocompromised, septic and trauma). • Move less • Malnourished • More obtunded (Glasgow coma scale) • Having Diabetics and Heart failure.
- 19. ICU Care is more Invasive • More invasive life lines and procedures including surgeries . • Longer length of stay . • More IV and parenteral drugs. • More tube feeding and parenteral nutrition . • More ventilation.
- 20. FACTORS THAT INCREASES CROSS INFECTION IN ICU • Lack of Hand washing facilities . • Patient close together or sharing rooms. • Understaffing. • Preparation of IVs on the unit. • Lack of isolation facilities. • No separation of clean and dirty AREAS. • Excessive antibiotic use. • Inadequate decontamination of items & equipment's. • Inadequate cleaning of environment.
- 21. COMMON NOSOCOMAIL INFECTIONS The following are the most common nosocomial infections: •Urinary tract infection •Catheter associated infection Pneumonia (ventilator-associated) •Blood stream infections. •Surgical sites infection
- 22. COMMON SITES OF NSIs INFECTION
- 23. Risk Factors for Nosocomial UTIs •Female gender •Other active site of infection •Diabetes mellitus •Renal insufficiency •Duration of catheterization •Insertion of catheter late in hospitalization •Presence of ureteral stent •Using catheter to measure urine output •Disconnection of catheter from drainage tube •Retrograde flow of urine from drainage bag
- 24. Prevention of Nosocomial UTIs •Avoid catheter when possible & discontinue ASAP •Aseptic insertion by trained HCWs •Maintain closed system of drainage •Ensure dependent drainage •Minimize manipulation of the system •Silver coated catheters
- 25. Risk Factors for Nosocomial BSIs •Heavy skin colonization at the insertion site •Internal jugular or femoral vein sites •Duration of placement •Contamination of the catheter hub
- 26. Prevention of Nosocomial BSIs •Limit duration of use of intravascular catheters o No advantage to changing catheters routinely •Maximal barrier precautions for insertion o Sterile gloves, gown, mask, cap, full-size drape o Moderately strong supporting evidence •Chlorhexidine preparation for catheter insertion o Significantly decreases catheter colonization; less clear evidence for BSI. o Disadvantages: possibility of skin sensitivity to chlorhexidine, potential for chlorhexidine resistance.
- 27. Risk Factors for VAP : •Duration of mechanical ventilation •Chronic lung disease •Severity of illness •Age •Head trauma •Elevated gastric pH •Aspiration of gastric contents •Reintubation •Upper abdominal or thoracic surgery •Supine head position •NG tube
- 28. Prevention of VAP •Semirecumbent position of ventilated patients (head of bed at 45°)
- 30. Prevention and control of nosocomial infections generally can be done by the following ways: COMMON SITES OF INFECTION Designed to prevent transmission of microorganisms by common routes in hospitals. Because agent and host factors are more difficult to control, interruption of transfer of microorganisms is directed primarily at transmission. Critical Care Nursing's Roles in NSIs
- 31. Sterilization: Sterilization of all reusable equipments such as ventilator, humidifier and any device that come in contact with the respiratory tract. Wear Gloves: They are worn for two reasons: • Provide a protective barrier and prevent contamination of hands. • Reduce the liklihood that microorganism present on the hands will be transmitted to the patients during invasive and other patient care procedure.
- 32. •Wear Aprons Wearing an apron during patient care reduces the risk of infections. •Apron is must for preventing yourself from getting disease. •Reduce the individual susceptibility to infection by : • Encourage and maintain caloric intake and protein in the diet. • Monitor the use or overuse of antimicrobial therapy. • Give antimicrobial therapy was prescribed in 15 minutes of scheduled time • Minimize the length of hospital stay.
- 33. • Instruct individuals and families to know the causes, risks of infection and transmission power • Report of infectious diseases. Get educated: Learn about your conditions and treatment is the best way to prevent an error. Get involved: Be assertive about your rights To be a part of the decision process for your medical care
- 35. References: Wenzel RP. The Lowbury Lecture. The economics of nosocomial infections. J Hosp Infect. 1995 Oct;31(2):79–87. Singh-Naz N, Sprague BM, Patel KM, Pollack MM. Risk factors for nosocomial infection in critically ill children: a prospective cohort study. Crit Care Med. 1996 May;24(5):875–878. Gould D. Nurses' hand decontamination practice: results of a local study. J Hosp Infect. 1994 Sep;28(1):15–30. Genné D, de Torrenté A, Humair L, Siegrist HH. Taux de contamination des stéthoscopes en milieu hospitalier. Schweiz Med Wochenschr. 1996 Dec 28;126(51-52):2237–2240.