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Lecture notes Acute Care (SHN2004)

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Infection Prevention in Pre, Peri and Post Patient

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  • April 24, 2024
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  • 2021/2022
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SHN2004 – IP in Pre, Peri and Post Operative Patient


Infection Prevention and Control in the
Pre, Peri and Post-operative Patient

Learning outcomes
 Identify the factors that can contribute to the potential risk of infection at each of
the following stages:
o Pre-operatively
o Peri-operatively
o Post-operatively

Infection risks for the surgical patient - Public Health Wales, (2020)
 Surgical site infection (wound)
 Bacteraemia (bloodstream infections) – i.e. sepsis
o C.20% of patients who suffer this go on to die – therefore it is a life-
threatening infection
 Respiratory tract infections
 Urinary tract infections

Surgical site infection (SSI’s) – Public Health Wales (2020)
 Can cause some short-term pain and discomfort for the patient
 Can lead to discharge from the wound, but they are easily treated, usually with a
course of antibiotics.
 Deep and organ space infections have generally spread further, have more severe
signs and symptoms (such as abscesses), and are more likely to require further
surgery or prolonged treatment in some cases.
 SSIs can therefore be a burden to the patient and an added cost to the NHS.
o For the patient it can mean longer stays in hospital, general impact on overall
health (whether short-term or long-term, impact on employment, family life
etc.)
 Public Health Wales Surveillance
o Surveillance of SSIs post-surgery to determine infection rates associated with
various surgical procedures.
o Schemes mandated by the Welsh Government for all hospitals include:
 Caesarean section
 Orthopaedic procedures, including hip and knee replacements
 General surgical procedures (primarily colorectal) piloted in 2018.
o Looking to feedback these results to NHS in order to reduce the risks and
occurrence of such infections
o https://phw.nhs.wales/services-and-teams/harp/healthcare-associated-
infections-hcai/#Surgical%20Site%20Infections
 Broken down into health boards etc.

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, SHN2004 – IP in Pre, Peri and Post Operative Patient


 Prevalence Survey of Healthcare Associated Infection - Device Usage and
Antimicrobial Prescribing (Public Health Wales, 2017)




o Problems of devices in situ – major risk factor to causing infection 
assessing and reviewing whether such a device is needed
 Characteristics of HAI (Healthcare Associated Infections) in Welsh hospitals 2017
o Three most common infections within the acute hospitals:
 Pneumonia (19.2% of infections)
 UTIs (15.9%)
 SSIs (11.3%)
o 5 key infection types (UTI, pneumonia, BSI, SSI, GI)
o Acute care > a third of patients had a PVC in situ & one in six had a urinary
catheter
 HAI prevalence by patient specialty in acute hospitals 2017




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