Infection Control

 

• 5 moments of hand hygiene

  BARFS:

  • Before patient contact.
  • Before Aseptic technique.
  • Right after patient contact.
  • After body Fluid contact.
  • After patient Surroundings contact.

• Hospital acquired infections

  Definition

  Infections that start >48 hours post-admission.

  Infection control measures

  Methicillin-resistant Staphylococcus aureus (MRSA)

  • Screen all on admission with nasal swab and swab of any skin lesions.
  • Eradicate if found with nasal mupirocin 2% in white soft paraffin. Chlorhexidine wash if found on skin.
  • Cleared after 3x -ve tests 1 week apart.

  Clostridioides difficile

  • 48 hrs isolation for any suspected C. diff i.e. any unexplained diarrhoea.
  • Spreads in spores, which can survive a long time outside of the body, so thorough cleaning of affected rooms required.
  • See Clostridioides difficile infection for more details.

  Norovirus

  • Prompt isolation of affected patients and/or formation of cohort bays of affected patients.
  • Healthcare workers with suspected infection should stay off work for 48 hrs post resolution of symptoms. Ideally they should provide a stool sample for analysis, because if infection is confirmed they can safely care for affected patients due to immunity.

• Notifiable diseases

  Commoner:

  • CNS: meningitis/meningococcal septicaemia, encephalitis.
  • Respiratory: TB, Legionnaires, whooping cough.
  • GI: food poisoning and suspected food poisoning, haemolytic uraemic syndrome, infectious bloody diarrhoea.
  • Acute infectious hepatitis (but not chronic).
  • Malaria
  • Measles, mumps, rubella.
  • Certain Group A Strep infections: scarlet fever, invasive GAS (necrotizing fascitis, toxic shock syndrome).

  Rare:

  • Respiratory: anthrax, SARS.
  • GI: cholera, diphtheria, enteric fever (typhoid, paratyphoid)
  • Skin: leprosy, plague, smallpox.
  • Neurological: poliomyelitis, rabies, botulism, tetanus
  • Non-focal: typhus, VHF, yellow fever, brucellosis.