Deviation in the Standard of Care Respecting Universal Precautions Resulting in Nosocomial Infections (Hospital Acquired Infections)

Evaluate breaches in the standard of care to determine if there was a Deviation in the Standard of Care Respecting Universal Precautions Resulting in Nosocomial Infections (Hospital Acquired Infections)

Answer the following questions to find out if the standard of care was followed for your case.

  • Was the patient’s pre-operative blood glucose level assessed?
    Yes
    No surgical procedures were performed
    No
    Why is this important?
    An elevated blood glucose level may be associated with diabetes mellitus or hyperglycemia and place the patient at a greater risk of developing infections.
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  • Was the environment cleaned and disinfected? Why is this important?
    Answer this question
    Environmental cleaning, disinfection and sterilization are basic and important measures used to prevent or reduce infections in the hospital environment.
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  • Were isolation precautions implemented for patients with suspected infections? Why is this important?
    Answer this question
    Isolation precautions must be used in the care of patients with suspected or confirmed infections.
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  • Were lab results indicative of infection immediately reported? Why is this important?
    Answer this question
    Results that are positive for infection need to be reported immediately to a physician so that treatment or further evaluation may be implemented.
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  • Were standard universal precautions implemented to control the patient’s infection? Why is this important?
    Answer this question
    A system of standard universal isolation precautions must be performed to prevent the spread of infections.
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  • Were isolation precautions implemented? Why is this important?
    Answer this question
    There are three isolation categories that reflect the major modes of microorganism transmission in nosocomial settings; contact, droplet and airborne spread.
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  • Was the intravascular catheter inserted? Why is this important?
    Answer this question
    Attention to sterile technique is important for minimizing catheter-associated infection.
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  • Were urinary catheters inserted? Why is this important?
    Answer this question
    The single most important factor for preventing foley catheter-related complications is limiting their use to appropriate indications.
    (2009) 34 EINJAA S4 S38-S42

  • Were any active infections treated prior to performing elective surgical procedures? Why is this important?
    Answer this question
    Patients with evidence of an active infection prior to elective surgical procedures must complete treatment for the infection, prior to surgery.
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  • Were prophylactic antibiotics administered? Why is this important?
    Answer this question
    Among surgical patients, surgical site infections (SSI) are the most common nosocomial infections. The goal of antibiotic prophylaxis is to prevent SSI by reducing the burden of micro-organisms at the surgical site during the operative procedure.
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  • Were antiseptic agents and techniques for skin preparation used? Why is this important?
    Answer this question
    Pre-operative application of antiseptics to the patient’s skin reduces the risk of surgical site infections.
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  • Was post-operative normothermia maintained? Why is this important?
    Answer this question
    Peri-operative hypothermia may promote surgical site infection by triggering thermo-regulatory vasoconstriction that, in turn, may decrease subcutaneous oxygen tension. Therefore, peri-operative normothermia must be maintained.
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  • Was the urinary catheter insertion documented? Why is this important?
    Answer this question
    Urinary catheters are responsible for most nosocomial infections.
    (2009) 89 ESRCNA 2 475-481

  • Was a closed drainage system maintained after the catheter was inserted? Why is this important?
    Answer this question
    The use of a closed catheter urinary drainage system is the gold standard in the prevention of catheter associated urinary tract infections.
    (2009) 34 EINJAA S4 S38-S42

  • Was unobstructed urine flow maintained? Why is this important?
    Answer this question
    Obstruction must be monitored and back flow prevented.
    (2009) 34 EINJAA S4 S38-S42

  • Was the urinary catheter left in place only as long as needed? Why is this important?
    Answer this question
    The simplest strategy for preventing catheter-related urinary tract infection is catheter removal. For male patients who are incontinent, condom catheters may be used.
    (2009) 89 ESRCNA 2 475-481

  • Were appropriate agents used for skin antisepsis? Why is this important?
    Answer this question
    Use of antiseptic solution for skin disinfection at the catheter insertion site helps prevent catheter-related infection.
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  • Were appropriate central line insertion practices followed? Why is this important?
    Answer this question
    Intra-vascular catheters need to be inserted and managed with strict adherence to CDC (Centers for Disease Control and Prevention) guidelines.
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  • Was adequate hub/access port disinfection performed? Why is this important?
    Answer this question
    Contaminated needleless connectors, catheter hubs, or injection ports are recognized sources for central venous catheter (CVC)-associated infections.
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