"Not what you want to hear,but what you need to know"
Nosocomial Infections Hospital Acquired InfectionsInfection in a hospitalized patient who wasadmitted for a reason other than that infectionNot present or incubating on admission Occurring up to 30 days after discharge
Some Statistics for HAI:•Affects approximately 10% of all in-patients• Delays discharge• Costs two times more than if there is no infection• Direct cause of deaths
How to Avoid InfectionsDo not go to the hospital unless you Are badly injured or very ill
How to Avoid InfectionsDo not go to the hospital Unless someoneWho is dependent on You For assistance Is hospitalized
How to Avoid Infections LIMIT VISITORS OR NO VISITORS
How to Avoid InfectionsIf you go to a hospital For any reason, Take a shower and Change your clothes When you get home
How to Avoid InfectionsInsist on Handwashing By Visitors By Staff By Physicians
Predisposing Factors To Get an HAIAgeSex (Females after cardiac surgery)Severity of IllnessOther medical conditionsImmunosuppressive CompromisedMalnutritionObesity
Other Factors That Increase Risk of an HAIMore sick patients are admittedMore invasive proceduresNew microorganismsIncreasing bacterial resistance toantibiotics
The problem of HAIUSA – Urinary tract infections: 2.4 per 100 admissions – Pneumonia: 1 case per 100 admissions – Surgical site infections: 2.8 per 100 operations – One death every 6 minutesNorway – One of 19 patients admitted will develop a HAI
Cost of NCIExtra days in hospital: Urinary tract infections: 6 Pneumonia: 12 Surgical site infections: 7
Where Do The Microbes Come From? patients own flora cross infection from medical personnel cross infection from patient to patient hospital environment- inanimate objects -
Spread of Infection AirborneSneezing Coughing Air ventilation systems Air conditioners
Sometimes an illness is passed to others by a carrier, or a person who has beeninfected by a germ but does not look or feel sick. This person may carry the germin their nose, throat, or stomach. They can pass the germ to others by coughing,sneezing, or by not washing their hands properly.
Spread of Infection Direct ContactHands Clothing Clinical Equipment
Spread of Infection Indirect ContactBedpans, Urinals Remember the X’s on previous photo
HAI Urinary Tract Infections PreventionLimit length of time to have catheter Drink plenty of waterWhen walking with catheter hold or keep the bag mid-thigh or lower
HAI Post-Operative Prevention CoughDeep Breathing ExercisesGet out of bed and WALK
HAI IV Catheter PreventionImmediately contact the nurse: Redness Burning Pain Hot to touch Cold to touch Swelling at the site
Many People Don’t Realize When They Have Germs on Their Hands• You can get 100s to 1000s of bacteria on your hands by doing simple tasks like: – Assisting patients up in bed – Touching hands – Touching any object in the room – Touching the patient’s gown or bed sheets – Do Not forget Door Knobs
Hand Washing is ImportantBecause… • 80% of disease is spread by your hands. • Hand washing is the most effective way to prevent the spread of respiratory illness. • Some germs can live on dry surfaces for several hours and moist surfaces like, sinks for 3 days.
Hand Hygiene is the single mosteffective intervention to reduce thecross transmission of HAI infections
Visible soilingHands that are visibly soiled orpotentially grossly contaminatedwith dirt or organic materialMUST by washed with liquidsoap and water
Alcohol Hand Rubs• Require less time• Can be strategically placed• Readily accessible• Multiple sites• All patient care areas
Hand hygiene is thesimplest, most effectivemeasure for preventing hospital-acquired infections.
BE YOUR OWN ADVOCATEWhen it comes to our health care, we patientsmust be sure we understand exactly what therisks and benefits are to any form of test ortreatment before we give consent.Begin with, “Doctor, let me make sure Iunderstand….” Then restate what the doctorjust told you. If the doctor corrects you, thenrestate it again until you know you have it right.
BE YOUR OWN ADVOCATEYou will need to be able to: Listen and take notes Research your condition Ask intelligent questions If you are not able to advocate for yourself, don’t be too embarrassed to ask for help.
BE YOUR OWN ADVOCATEDont wait to be asked.Most patients are too overcome to think about whatthey need.They may not know what they need, and they mayfeel embarrassed.
BE YOUR OWN ADVOCATEAsk questions politely:Ask for staff to use another needle if they have already poked you with it.Ask staff to wash their hands before they help you.Ask staff to wear gloves.
BE YOUR OWN ADVOCATEAsk questions politely:Ask for your room or bathroom to be cleaned. Be specific if there is a problem.Ask for a blanket to be placed on the wheelchair before you sit in it.Ask for a blanket to be placed in the chair in your room before you sit on the chair.
BE YOUR OWN ADVOCATEGet copies of all tests. Before you leave, be sure ask the doctor for copies of all tests. They wont offer them, so you need to ask. Having them is tremendously helpful when visiting other doctors.In Panama, you are responsible to get all of your laboratory, x-rays and other test results. They are not automatically sent to your physician.
WHAT IS THE CONNECTION OF ANTIBIOTIC USE TO HAI?• High prevalence of resistant bacterial strains present in the hospital• High capacity of bacteria to mutate to resistant strains• Misuse and overuse of antibiotics
Viruses• cause most common respiratory illnesses, such as colds and coughs• cause a variety of infections• may take 2-3 weeks to resolve completely• some viruses can be prevented by vaccines and immunizations• antibiotics do not work for viruses
Bacteria• make you sick when they are where they don’t belong or grow more rapidly than normal• live in your mouth, nose and throat• are necessary for normal body functions like digestion• are one of the oldest living things on Earth
Antibiotic Resistant Bacteria Are:Bacteria that mutate and are able toresist the antibiotics that are meant tokill them.This is a normal process speeded up bythe overuse and misuse of antibiotics. 8
Why is Antibiotic Misuse a Problem?1. Antibiotics become less effective and may not work the next time you use them.2. Improper use of antibiotics leads to more antibiotic resistant bacteria.3. Antibiotic resistant bacteria can be spread throughout the community and from person to person. 7
Support AppropriateAntibiotic Use In Panama!Everyone Can Help Keep Antibiotics Working• By using antibiotics only when needed• Following good hygiene practices
What to Expect When You Are Ready To Be Discharged from the HospitalWithout all of the professional medical helpyou have a better chance of recoveryYou will be home with all of your familiargerms
At Home Prevention Tips for After Surgery:Take a Good Multivitamin Drink lots of water Eat lots of protein if there is nocontraindication Fruits and Veggies are helpful to preventproblems with constipation
At Home Prevention Tips for After Surgery:Get Plenty of Rest ASAP & with MDs ok – Get up and dosome walking around the house Limit your VISITORS
At Home Prevention Tips for After Surgery:Take your pain medication as prescribed byyour physician DO NOT try to be brave and hold backfrom controlling your pain It takes more medicine to control pain ifyou wait too long
Warning Signs of a Possible Infection:Fever Redness at the surgical site or injury Heat at the surgical site or inury
Warning Signs of a Possible Infection:Shortness of Breath Nausea and Vomiting Generalized weakness
What to Do if You Think You Have and Infection:Contact your physician
What to Do if You Think You Have and Infection:• Always take antibiotics exactly as prescribed• Finish the whole prescription - do not stop when you feel better• Never save antibiotics for a future illness – or share with others• Do not take your friends pills or any old antibiotics hanging around your home. They may not work for that specific germ. 10
What to Do if You Think You Have and Infection:Take a marker and outline the borders of the redness noted.This will allow you to see if your antibiotic is working. 10