This document discusses healthcare-associated infections, also known as hospital-acquired infections. It defines these as infections patients develop after admission to a hospital that were not present upon admission. Common types include urinary tract infections, pneumonia, and surgical site infections. The document outlines various routes of transmission like contact, airborne, and through medical equipment. It emphasizes the importance of universal precautions like hand hygiene, protective equipment, and cleaning/disinfection to prevent the spread of infections in healthcare settings.

1. BY: MS. RINKAL PATEL
NURSING TUTOR CUM CLINICAL INSTRUCTOR AT
SANDIPANI INSTITUTE OF NURSING SCIENCE

2.  Healthcare-associated infections are also known as
hospital acquired infections or nosocomial infection.
 As the name suggests, hospital acquired means the
infection that the patient gain or acquired during his/ her
hospital stay while receiving treatment for other diseases
condition.

3.  The terms hospital acquired infection, hospital-associated
infection, hospital infection or nosocomial infection
(nosocomion, meaning hospital) is defined as infection
developing in patients after admission on the hospital,
which was neither present in the incubation period at the
time of hospitalization.
 Such infections may become develop evident during their
stay in the hospital or, sometimes, after their discharge.

4.  Nosocomial infections are commonly transmitted
when health care providers become complacent and
do not practice correct hygiene regularly.
 Also increase treatment in recent decades means that
a greater percentage of people who are hospitalized
today are likely to be seriously ill with more weakened
immunity systems then in the past.
 Moreover, some medical procedures bypass the body’s
natural protective barriers.
 Since medical staff moves from patient, the staff
themselves serves as a means for spreading pathogens.

5. 1. Exogenous: Hospital- infection is mostly exogenous
from another patient or member of the staff or from the
environment in the hospital. Patient and hospital
personnel suffering from infection, or asymptomatic
carrier are the most important sources. Environmental
sources include inanimate objects, air, water and food in
the hospital. Inanimate objects in the hospital are
medical equipments, bed pans, surfaces contaminated by
patients secretions, excretions, blood & body fluids.
2. Endogenous: Patients own flora may invade the patient’s
tissue during some surgical operation or instrumental
manipulation.

6.  There are four main routes of transmission of infection:
1. Contact
2. Airborne
3. Oral route
4. Parental route
5. Common hospital acquired infections

7. Hands or clothing: The hands of hospital staff are an
important vehicle of spread of infection. There is
adequate scope of transmission of microorganisms
from one person to another by contact of hands and
clothing’s of attendants.
Inanimate objects: Certain instruments, if not
properly disinfected, may transmit pathogenic
organisms.

8. Droplets: Droplets of respiratory infection is
transmitted by inhalation.
Dust: Dust from bedding, floors, exudates dispersed
from a wound during dressing and from skin by
natural shedding of skin scales, may contribute in
spread of infections.
Aerosol: Aerosol produced by nebulizers, humidifiers
and air conditioning apparatus transmit certain
pathogens to the respiratory tract.

9.  Hospital food may contain antibiotic- resistant
bacteria, which may colonies the intestine and later
cause infection in susceptible patient.

10.  With the introduction of disposable syringes and
needles, transmission of infection by parenteral route
has been infrequent.
 However, certain infections may be transmitted by
blood transfusion or tissue donation, contaminated
blood products and contaminated infusion fluids.
 Hepatitis B and HIV are two viruses which may be
transmitted in this way.

11. Urinary tract Infection: This is usually associated
with catheterization or instrumentation of urethra,
bladder or kidneys. Infection can be prevented by
strict asepsis during catheterization.
Respiratory infection: Aspiration in unconscious
patients and pulmonary ventilation may lead to
nosocomial pneumonia.
Wound and skin sepsis: the incidence of
postoperative infection is higher in elderly patient.

12. Catheter- associated
urinary tract
infections(CAUTI)
Ventilator- associated
pneumonia (VAP)
Central line- associated
blood stream infection(
CLABSI)
Surgical site infections
(SSI)

13.  Catheter-associated infections (CAUTI) are the most
common types of healthcare- associated infection.
 The one of risk factors for CAUTI is long-term use of
indwelling catheters.
 The CAUTI are defined as the urinary tract infections in
the patient with current urinary tract catheterization or the
patients who are catheterized within the past 48 hours.

14.  Ventilator-associated pneumonia is defined as pneumonia
that develops within 48-72 hours of endotracheal
intubation.
 The features of VAP includes:
 The presence of infiltrates in the chest, which are evident
on chest X-ray.
 Signs of systemic infections like fever and changes in the
WBC count.
 Changes in sputum characteristics and identification of the
growth of microorganisms.

15.  Central line- associated bloodstream infections are
one of the healthcare- associated infection.
 The one of the risk factors for CAUTI is long-term use
of indwelling catheters.
 The CAUTI are defined as the urinary tract infections
in the patient with current urinary tract catherization
hours.
 on or the patients who are catheterized within the past

16.  Surgical site infections are one of the major reasons for
hospital morbidity, increase in the ICU admission
rates, doubling the mortality rates, and increase the
overall length of the hospital stay.
 The SSI are the infections that occur in the incision
site, which are created by an invasive surgical
procedure.

17. Gastrointestinal infections: Food poisoning &
neonatal septicemia in hospitals have been reported.
Burns: S. aureus, pseudomonas aeruginosa are
responsible for hospital- acquired infections in cases
of burns.
Bacteremia & septicemia: these may be
consequences of infection at any site but are generally
caused by infected intravenous cannonade. Infection
can be prevented by proper skin toilet before ‘cut-
down’. Intravenous in diarrhea should be replaces by
oral fluids as early as possible.

18.  As we known infection prevention and control are
challenging in most healthcare settings. In human
beings microorganisms are present in various locations
like skin surface and gastrointestinal tract.
 Normally, the microorganisms do not causes any
infection, but when they enter in the people who are
immunocompromised, infection can occur.

19.  Universal precautions are certain set of practices of
avoiding the contact with patient's body fluids, by
using gloves, gown, goggles and face shields.
 Universal precautions were first introduced in 1985-
1988.

20.  Group of practices followed for infection prevention
and control.
 The principle behind using universal precautions is
that all blood, body fluids, secretions, excretions (
except sweat), nonintact skin and mucous membranes
may contain organisms.

21.  There are two tire approach of universal precaution.
1. Standard precaution
2. Transmission- based precaution

22.  Standard precautions are defined as the practice for
infection prevention and control & are applied to the
entire patient irrespective of confirmed or suspected
infection.
 These precautions are mandatory in all of the settings
where health care is delivered.
 It can also be defined as the set of practice used in
healthcare setting to prevent the transmission of the
disease, which is nonintact, mucus member, blood &
body fluids.

23.  Effective hand hygiene
 Personal pretotective equipment
 Prevention of needle stick injuries from sharp
instruments
 Respiratory hygiene or cough etiquette
 Cleaning of the environment
 Careful handling of the linen
 Proper waste disposal appropriate cleaning and
disinfection of patient care equipment
 Respiratory hygiene

24.  These precautions are used in the patients who are
susceptible and having known infections, which can
be spread through air, droplet or contact.

25. Airborne precautions: used in the clients who are
susceptible or having the infections that can spread
through air. These are spread by airborne droplet
nuclei smaller than 5 microns.
Droplet precautions: used in the client who are
susceptible or having the infection that transmit
through large particles. These are spread by the
droplet larger than 5 microns.
Contact precautions: used for patient who are
susceptible or infected with multidrug resistant
organisms (MDRO).