Other typical symptoms of infection and may be absent or suppressed underlying disease. Clinical treatment of hospitalized patients with fever should include a thorough medical history and evaluation of clinical status, as well as data on the length of hospitalization, underlying disease, diagnostic and therapeutic procedures, intravenous catheters, urinary catheters, previous antibiotic use, as well as knowledge of the most common causes of infection of the respective department. The general clinical characteristics of nosocomial infections with serious severity of the disease and often poor prognosis. This is due to non-resistance of the patients, mainly due to the underlying disease, as well as specific pathogens commonly resistant to multiple antibiotics.
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Other typical symptoms of infection and may be absent or suppressed underlying disease. Clinical treatment of hospitalized patients with fever should include a thorough medical history and evaluation of clinical status, as well as data on the length of hospitalization, underlying disease, diagnostic and therapeutic procedures, intravenous catheters, urinary catheters, previous antibiotic use, as well as knowledge of the most common causes of infection of the respective department.
The general clinical characteristics of nosocomial infections with serious severity of the disease and often poor prognosis. This is due to non-resistance of the patients, mainly due to the underlying disease, as well as specific pathogens commonly resistant to multiple antibiotics.
So in diagnosis and treatment of nosocomial infections must constantly reflect on the special condition hospitalized patient, hospital environment, and a thorough understanding of the causes of these infections and their antimicrobial susceptibility. The most important and the most common nosocomial infections are: urinary tract infection, pneumonia, bacteremia and sepsis, and surgical site infections. Those infections are common, but not dangerous and generally do not cause death.
The causes of them are particularly gram-negative enterobacteria, in hospital wards usually E-coli bacteria, and intensive care units p.
Aeruginosa, Proteus spp. Pneumoniae, and so on. The disease is usually accompanied by high fever and other general symptoms and pathological findings in urine. Use of Antibiotics for first 4 to 5 days after catheterization markedly reduces the risk of urinary tract infection. The prevention is usually the most important, with great care needs to be handled urinary bag and catheter patency control, because obstruction markedly increases the risk of infection.
It is recommended that a shorter grip urinary catheter, and the long-term administration changes every weeks. The greatest risk for acquiring nosocomial infections is intubation and mechanical respiration, then aspiration in patients with impaired consciousness, a frequent complication after surgery and after organ transplant.
Because of droplet transmission those infections are most often brought in from the outside environment. In the prophylaxis of nosocomial pneumonia is the most important risk factors for elimination, then strict adherence to all preventive procedures, and regular and loving care of the airways.
There are many risk factors for developing nosocomial sepsis, the most important being associated with the use of central venous catheters and other venous supplies. Infusion, transfusion of blood and its derivatives, and intravenous antibiotics increase the risk of bacteremia and sepsis.
According to the pathogenetic model creation, sepsis can be primary and secondary. If it occurs without any known or newly discovered sources of bacteria, it is called primary, and if it is associated mainly with causes through the blood. Secondary sepsis comes from a famous bacterial foci, mainly as a result of urinary tract infections and digestive organs.
In the intensive care units, due to aggressive diagnostic and therapeutic procedures, primary sepsis is more frequent, while in other hospital wards secondary sepsis is more frequent. The incidence of primary sepsis, associated with intravenous catheters, can be reduced by proper installation and maintenance procedures, careful application and infusion of drugs through the catheter and the short use.
When already resulting sepsis is necessary to remove a central venous catheter, and if it is really necessary, set new one on the second place. Frequency of them depends on the hospital ward, type of surgery, the surgeon and his team, as well as on the patient. Their real incidence is very difficult to determine, especially when hospitalization was short or surgery is done outpatient. The most important prophylactic measures are the application of antibiotic prophylaxis at the start of the procedure with a high risk, strict adherence to aseptic procedures in the operating room and regularly wound in the postoperative period.
However, their clinical course and outcome does not depend on the place of acquiring the infection, and those are not different from diseases that occur in a patient outside hospital. Due to the specifics of the outbreak and spread of nosocomial infections, their detection, treatment and eradication require a complex approach and teamwork from different medical professionals. Anyway, all medical professionals are faced with this problem and are required in the scope of its duties and obligations to implement measures to prevent nosocomial infections.
Continuous prophylaxis of nosocomial infections is very complex, laborious and expensive process. Therefore it is necessary to be well organized and team work on the prevention and control of nosocomial infections, including continuing education of staff of all profiles expertise, to know risk factors of occurrence and spread of these infections and prevention and improving the safety of their own work.
The problem of hospital infections iscontinuously topical, because ofcontinuosappearance of new moments, and now they are a growing number of immunocompromised patients, more complex diagnostic and therapeutic procedures, antibiotic resistance and more frequent occurrence of opportunistic infections.
Each hospital ward has its own specific risk factors for nosocomial infections and the most common causes of the occurrence of characteristic symptoms.
Therefore, doctors and nurses, and other staff must meet with the importance of nosocomial infections, stimulating factors inception, the first symptoms and diagnostic procedures, most frequently isolated pathogens and their antimicrobial susceptibility.
Hand washing is the most important measure in preventing hospital-acquired infections, and it must constantly stand. The most common infection spread indirectly, transferring patients from one post to another, through the hands of hospital staff.
Therefore, careful hand washing with soap and water for at least 30 seconds is necessary after each contact with the patient or their secretions and contaminated objects and before the care of another patient. Effective measures are achieved and strict adherence to the rules for the isolation of patients and the use of protective devices and clothing.
Wearing gloves is recommended when working with all patients with contact mode of transmission of infection, in any contact with mucous membranes, non-intact skin, blood, body fluids and secretions. For the implementation of measures to prevent and fight against hospital infections, including staff training, the Commission is responsible for nosocomial infections, which exists in every hospital.
The Commission develops and approves Regulations on monitoring, prevention and control of nosocomial infections. The State Committee brings operating instructions of hospital committees and coordinates all activities. Compulsory composition of hospital committee is prescribed by ordinance which includes: director, head nurse hospital, three doctors and a specialist nurse who is employed full-time in jobs fotrsurveillance of hospital infections.
The first step in the fight against hospital infections is registration of their appearance. Nurses in the process of care spend most time with the patient and they always first register infection. Infection should be immediately reported to the Commission for nosocomial infections. After registration, the commission must investigate the source and route of transmission, analyze the results of microbiological pathogens and antimicrobial susceptibility, issue instructions on the proper care and other procedures with patients, sterilization and disinfection and give instructions to suppress any nosocomial infections.
The Commission maintains records and performs continuous control methods and procedures to take care for the overall supervision of the work of the hospital, the disinfection and sterilization, exercises control over the water supply and transport facilities, food and waste material in the hospital.
Commission drafts and revises recommendations and checklists that prescribe mode at all stages of care and treatment of patients. CONCLUSION The present findings indicate that it is impossible to avoid the risk in hospital, and it is practically impossible to talk about the eradication or elimination of nosocomial infections. Nosocomial infections are an important part of assessing the quality of health services. Controlling hospital infections activity is to improve the quality aimed at improving patient care and health care of workers.
In the member states of the European Union, Iceland and Norway for about 25, deaths a year patients is associated with nosocomial infections associated with multiply resistant strains. Increase morbidity and mortality, particularly in patients treated in intensive care units, related to mechanical ventilation, central venous catheter and urinary catheter.
In providing quality and safe health services hospital infections are an important risk, it is necessary in any medical institution to implement a strategy for managing risk for nosocomial infections based on the basic principles of quality assurance and risk prevention, such are: Identify the risk of nosocomial infections Evaluate it and analyze it Implement the changes and continue with continuous improvement.
Damani: Manual of infection Objavljeno dana.
Moogutaur The present findings indicate that infeicije is impossible to avoid the risk in hospital, and it is practically impossible to talk about the eradication or elimination of nosocomial infections. Nosocomial infections are still a very big problem of modern medicine, in developed countries is much more important than the classic infectious diseases. Intrahospitalne infekcije Thus there is a link between antibiotic use or abuse and the emergence of antibiotic resistant bacteria causing IHI The both urinary tract infections and surgical site infections are the most frequent IHI. Hospital Epidemiology and Infection Control. After the antiseptic procedures replaced aseptically, which are still the basis for the fight against hospital infections in surgery.
INTRAHOSPITALNE INFEKCIJE PDF