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Hospital Acquired Infections (Nosocomial Infections) - UTI, CLABSI, HAP and SSI | Made Easy

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hi friends in this lecture I want to

talk about hospital acquired infections

you know this was a very common cause of

adverse patient outcomes so in terms of

the scope of this problem this affects

about 5 to 15 percent of all

hospitalized patients and 40 percent of

patients in the ICU specifically the

World Health Organization estimates that

mortality or the death rate from

healthcare associated infections ranges

anywhere from 20 to 80 percent that's

pretty dramatic the most common form of

infection in hospitalized patients is

actually a urinary catheter related

infections or UTI and there's been a

major focus in terms of how we can

minimize that has a lot to do with

really confirming that the patient

actually needs to have a catheter place

making sure that the catheter placement

is done under complete sterile technique

and that most importantly the catheter

is removed once it's no longer needed

right it's the longer that's in there

the higher the likelihood of the patient

is getting infected

so again UTI is the most common form of

hospitalized patient infections let's

talk a little bit more about UTIs see it

accounts for about 40% of all hospital

acquired infections more than 80% of

these are attributed to the use of

indwelling catheter and basically to

reduce the risk again you want to adhere

to strict indications for when the

catheter should be placed you want to

maintain sterile technique during

insertion and again you want to remove

it promptly when it's no longer needed

right so simply follow these three

things here and studies have shown that

following these three

simple things can simply reduce the

likelihood of UTI another big a

hospital-acquired infection that people

have paid a lot of attention to ease the

central line-associated bloodstream

infection you might be familiar with

Peter Pronovost from John Hopkins and he

really popularized the use of checklist

for the insertion and the management of

central lines and actually showed that

they absolutely eliminated infections

from central lines simply by

implementing this checklist so this

checklist was you know certain rules and

protocols for placing the central line

and monitoring and managing the central

line and again it was very effective in

reducing infections so the problem with

central line infections is that you have

a direct access to the bloodstream right

and when these catheters get infected

patients become back to remet they

become septic and again this in some

cases can leads to significant morbidity

and even mortality all right so we

talked about UTIs and we talked about

central line infections and now I will

go on to some of the other things that

you might see as well

one is hospital acquired pneumonia so

now this is almost always going to

happen in a ventilated patient and

typically it's going to be at least two

days after admission and after

incubation that this will manifest see

these ventilated associated pneumonia or

a specific type of hospital-acquired

pneumonia they are more serious because

patients tend to be sicker and they are

less able to mount an effective immune

response

this actually come up second right after

UTIs so what are the common symptoms of

a hospital-acquired pneumonia so it will

be things like coughing fever chills

fatigue malaise headache maybe lack of

appetite and nausea vomiting shortness

of breath so it's really a law

list of kind of general malaise type

symptoms patients might also have

stabbing chest pain that gets worse with

deep breathing or coughing so how do we

prevent this so simple measures of

infection control like hand hygiene

incredibly effective

so washing our hands using gloves and

using gown and mask especially when we

were doing invasive procedures patients

who are incubated they found that

elevating the head of the bed is very

helpful it reduces the risk of

aspiration and again these are very

simple steps that can be taken to

prevent a very serious complication I

also now want to talk about surgical

site infections so this is a special

kind of infection that we will see on

the surgical units obviously following a

surgical procedure

anywhere where incision is placed some

of these infections are going to be

limited just to the skin right

and these want to be our superficial

infections or cellulitis those are often

going to be treated simply with

antibiotics but occasionally you can

have a more serious infection that

involves deep tissue or a body cavity or

it could be involving internal organs or

implanted material so think about the

total hip replacement or the total knee

replacement if those get infected yes

that's a very serious problem and that

level of infection is going to require

more than just using antibiotic so again

if it's just a superficial infection

you know cellulitis oftentimes simply we

use we keep these patients on

antibiotics and we'll take care of that

but if it's a deeper infection you're

you gonna need to do a little bit more

so the thing to remember here is that an

abscess cannot be adequately treated

with antibiotics alone an abscess

requires drainage so those could treat a

completely different than a superficial

Unity's so it is important to understand

and differentiate that too because the

management is very different so my dear

friends this is the end of this lecture

on hospital acquired infections if you

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