Hospital Acquired Infection

Hospital Acquired Infection (HAI)

Introduction (પરિચય)

Hospital health care system માં patient treatment, surgery, investigation અને nursing care માટે admit થાય છે. પરંતુ ક્યારેક hospital stay દરમિયાન patient ને new infection develop થાય છે, જે admission સમયે present નથી હોતું. આ infection ને Hospital Acquired Infection (HAI) કહેવામાં આવે છે.

Patient hospital માં diseaseની treat કરાવવા આવે છે, પણ hospital environment, contaminated instruments, improper aseptic technique અથવા poor hand hygiene કારણે additional infection develop થાય છે.

Hospital માં ઘણા pathogenic microorganisms present હોય છે જેમ કે:

• bacteria

• virus

• fungi

• parasites

  
  

જો infection control measures proper રીતે follow ન થાય તો આ microorganisms

-patient થી patient

-nurse થી patient

-equipment થી patient spread થઈ શકે છે.

HAI health care system માટે major challenge છે કારણ કે:

-Patient morbidity (બીમારી) વધે

-Mortality rate વધે

-Hospital stay લાંબો થાય

-Treatment cost વધે

-Antibiotic resistance develop થાય

Therefore infection prevention and control practices hospital nursing care નો very important part છે.

Definition (વ્યાખ્યા)

“An infection that develops 48 hours or more after hospital admission and was not present or incubating at the time of admission.”

Hospital માં admission પછી 48 કલાક અથવા તેથી વધુ સમય પછી develop થતી infection, જે admission સમયે હાજર ન હોય તેને Hospital Acquired Infection કહે છે.

Nosocomial Infection (Nosocomial Infection શું છે?)

Nosocomial infection essentially Hospital Acquired Infection નું જ બીજું નામ છે તેમ‌ કહી શકાય.

Word origin:

Greek word “Nosos” = disease

Greek word “Komeion” = to take care

Disease that occurs during medical care in hospital.

Nosocomial infection mainly developed

-surgery પછી

-catheter use દરમિયાન

-ventilator use દરમિયાન

-long hospital stay દરમિયાન

Examples:

Post-operative wound infection

Catheter associated UTI

Hospital pneumonia

4. Epidemiological Interaction (Epidemiological Triangle)

Infection develop થવા માટે three important components જરૂરી છે.

આ concept ને Epidemiological Triangle કહેવામાં આવે છે.

1. Agent (Infectious agent)

Agent એટલે microorganism જે disease cause કરે છે.

Common hospital pathogens:

Staphylococcus aureus

E.coli

Pseudomonas

Klebsiella

Hepatitis virus

Agent infection cause કરે છે ત્યારે:

virulence high હોય

quantity sufficient હોય

2. Host (Host / દર્દી)

Host એટલે person who receives infection.

All patients equally susceptible નથી.

High risk patients:

• elderly patients

• newborn babies

• malnourished patients

• cancer patients

• diabetic patients

• immunocompromised patients

• Host resistance immunity પર depend કરે છે.

3. Environment (પર્યાવરણ)

Environment microorganisms grow કરવા માટે favourable conditions આપે છે.

Hospital environment માં infection spread થવા માટે factors:

• overcrowding wards

• poor sanitation

• contaminated equipment

• improper ventilation

• unclean surfaces

👉 When Agent + Host + Environment interact, infection transmission થાય છે.

Source of Infection (Infection નો source)

Source એટલે place from where microorganisms originate and spread.

Hospital માં infection ના sources:

1. Human Source

Human beings infection spread કરવાનો main source હોઈ શકે છે.

Examples:

infected patients

health care workers

visitors

Nurse hand hygiene maintain ન કરે તો infection patient માં spread થઈ શકે છે.

2. Environmental Source

Hospital environment પણ infection source બની શકે છે.

Examples:

air contamination

water contamination

dust particles

bed linen

floor surfaces

3. Equipment Source

Medical equipment properly sterilized ન હોય તો infection spread થઈ શકે છે.

Examples:

catheter

IV cannula

ventilator tubes

surgical instruments

Exogenous and Endogenous Infection

Hospital acquired infections two main types માં divide થાય છે.

Exogenous Infection (External infection)

Exogenous infection outside source માંથી આવે છે.

Sources include:

other patients

health care workers

contaminated instruments

hospital environment

Example:

Contaminated surgical instrument થી wound infection.

Important point:

Infection comes from external environment.

Endogenous Infection (Internal infection)

Endogenous infection patient ના own body flora થી develop થાય છે.

Normally body માં harmless bacteria હોય છે.

But when immunity low થાય છે, these bacteria cause infection.

Examples:

urinary infection

surgical wound infection

respiratory infection

Important point:

Infection originates from patient's own microorganisms.

Types of Hospital Acquired Infection

HAI types:

1. Urinary Tract Infection (UTI)

Most common hospital infection.

Main cause:

prolonged catheterization

poor catheter care

Symptoms:

burning urination

fever

cloudy urine

2. Surgical Site Infection (SSI)

Surgery પછી wound infected થાય છે.

Signs:

redness

swelling

pus discharge

pain

fever

Risk factors:

poor sterilization

improper wound care

3. Respiratory Infection

Ventilator use કરનારા patients માં pneumonia develop થાય છે.

This is called Ventilator Associated Pneumonia (VAP).

Symptoms:

cough

fever

breathing difficulty

4. Bloodstream Infection

IV catheter અથવા central line થી microorganisms bloodstream માં enter થાય છે.

This leads to sepsis.

5. Gastrointestinal Infection

Contaminated food or water થી infection થાય છે.

Example:

diarrhea

food poisoning

Mode of Transmission (Infection ફેલાવાનો માર્ગ)

Microorganisms different routes દ્વારા spread થાય છે.

1. Direct Contact Transmission

Infected person સાથે direct contact થવાથી infection spread થાય છે.

Example:

Touching infected wound.

2. Indirect Contact Transmission

Contaminated objects દ્વારા infection spread થાય છે.

Examples:

instruments

dressings

bed linen

3. Droplet Transmission

Coughing અથવા sneezing દરમિયાન droplets દ્વારા infection spread થાય છે.

Examples:

influenza

respiratory infections

4. Airborne Transmission

Microorganisms air માં suspended રહે છે અને inhalation દ્વારા infection થાય છે.

Examples:

tuberculosis

measles

5. Vehicle Transmission

Contaminated food, water, blood દ્વારા infection spread થાય છે.

6. Vector Transmission

Insects દ્વારા infection spread થાય છે.

Examples:

mosquitoes

flies

Prevention of Hospital Acquired Infection (HAI)

1. Hand Hygiene

Hand washing is the most effective method to prevent infection.

Nurses should wash hands:

before patient care

after patient contact

after handling body fluids

Alcohol based hand rub પણ use થાય છે.

2. Aseptic Technique

Procedures દરમિયાન sterile technique maintain કરવી જોઈએ.

Examples:

wound dressing

catheter insertion

IV insertion

3. Sterilization and Disinfection

Medical instruments properly sterilized હોવા જોઈએ.

Methods:

autoclave

chemical disinfectants

boiling

4. Use of Personal Protective Equipment (PPE)

Examples:

gloves

mask

gown

goggles

PPE infection transmission reduce કરે છે.

5. Isolation Precautions

Infectious patients માટે isolation ward use થાય છે.

Barrier nursing technique follow થાય છે.

6. Biomedical Waste Management

Hospital waste proper तरीके dispose કરવો જોઈએ.

Improper disposal infection spread cause કરે છે.

7. Environmental Hygiene

Hospital cleanliness maintain કરવી જરૂરી છે.

Examples:

-floor cleaning

-surface disinfection

-proper ventilation

8. Rational Use of Antibiotics

Unnecessary antibiotics use antibiotic resistance cause કરે છે.

Therefore antibiotics proper prescription મુજબ use કરવી જોઈએ.