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HOSPITAL ACQUIRED INFECTIONS. VENTILATOR ASSOCIATED PNEUMONIA & MRSA Leyla Chiepodeu & Ernest Oppong. BACKGROUND. HAIs are a major public health problem 1.7 million HAI in 2012 99,000 deaths occurred from HAI in 2012. PURPOSE.

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hospital acquired infections

HOSPITAL ACQUIRED INFECTIONS

VENTILATOR ASSOCIATED PNEUMONIA & MRSA

Leyla Chiepodeu & Ernest Oppong

background
BACKGROUND
  • HAIs are a major public health problem
  • 1.7 million HAI in 2012
  • 99,000 deaths occurred from HAI in 2012
purpose
PURPOSE
  • Discuss risks factors associated with Ventilator Associated Pneumonia (VAP) and Methicillin Resistant Staphylococcus Aureus ( MRSA)
  • Explore methods that will help reduce or eliminate them
risk factors associated with vap
RISK FACTORS ASSOCIATED WITH VAP
  • Duration on mechanical ventilator
  • Decreased level of consciousness
  • Weak immune system
  • Preexisting lung
methods of prevention
METHODS OF PREVENTION
  • Standard precaution
  • Mouth care with chlorhexidine
  • Head of the bed higher than 30 degree
  • Oral endotracheal
  • “Sedation vacation”
  • Conversion of tracheostomy tube when MV no longer needed
methicillin resistant staphylococcus aureus
Methicillin Resistant Staphylococcus Aureus

BACKGROUND

  • First described in 1960’s
  • Hospital acquired MRSA infection costs about $35,367 compared with $13,973 for other HAI’s.
  • In 2005, Virginia passed a bill requiring acute care hospitals in the Commonwealth to report healthcare-associated infections to the Centers for Disease Control and Prevention (CDC). The law went into effect July 1, 2008.
slide7
Plan
  • 1. Developing/Enhancing HAI Program Infrastructure;
  • 2. Surveillance, Detection, Reporting, and Response;
  • 3. Prevention and control
  • 4.Evaluation, Oversight, and Communication.
prevention and control
Prevention and control

Hand Hygiene

  • Most important method in preventing spread of infections is HAND HYGIENE.
    • Hand sanitizer, hand washing
    • Noncompliance may be due to poor knowledge of guidelines,

inadequate facilities, time pressures, skin dryness.

Adherence to antibiotic regimen

    • Prescribers need to use narrow-spectrum antibiotics when appropriate

and reduce the duration of therapy when appropriate.

    • Teach patients to take antibiotics as prescribed and to finish the whole course of medication therapy.
prevention and control cont d
Prevention and control (cont’d)

Isolation precautions

  • Use universal standard precautions for handling body fluids
  • Wear gown/gloves
  • Follow hospital/clinic isolation protocol
  • Remove and dispose PPE in patients room and wash your hands prior to leaving the patients room.
  • Make sure visitors are aware of isolation status and recommend them to don PPE prior to entering patients room.
  • If appropriate leave equipment in patients room.
prevention and control cont d1
Prevention and control (cont’d)

Room environment/Equipment

  • Follow strict room decontamination procedures after patient discharge and make sure all equipment are wiped down.
  • All surfaces in the room are presumed contaminated and should be cleaned.
prevention and control cont d2
Prevention and control (cont’d)

Surveillance

  • Screen most patients on admission and ideally upon discharge (critical care)
    • May be cost effective in the long run
    • Early detection
  • Surveillance of health care providers to increase compliance
    • Video surveillance – Cost, HIPAA
    • Self Reporting – Honesty issues
    • Measuring equipment use – Cost effective, not very reliable

Education

    • Patient education
    • Nurse education
references
References
  • Blot, S., Serra, M., Koulenti, D., Lisboa, T., Deja, M.,Myrianthefs, P., Manno,E., Diaz, E.,Topeli, A., Martin-Loeches, I., Rello, J., (2011). Patient to nurse ratio and risk of ventilator-associated pneumonia in critically ill patients. 20:1-9
  • Cason, C., Tyner, T.,Saunders,S., Broome, L., (2007). Nurses’s implementation of guidelines for ventilator-associated pneumonia from the centers for disease control and prevention, 16(1), 28-37.
  • McNicoll, L., &Marsella, M. (2010). The Growing Problem of Methicillin-resistant Staphylococcus aureus: Will Hospitals Prevail?. Medicine & Health Rhode Island, 93(9), 267-270.
  • TorpyJM, Lynm C, Glass RM. Ventilator-Associated Pneumonia. JAMA. 2007;297(14):1616. doi:10.1001/jama.297.14.1616.
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