Frequently Asked Questions

What can patients do to help reduce their chances of infection in general?

Patients should always follow instructions given to them by your health care team.  Frequent hand cleaning is another way to prevent the spread of infection. Hand hygiene involves everyone in the hospital, including patients.

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How is a central line associated bloodstream infection (CLI) treated?

Treatment depends on the type of catheter, the severity of the infection and the patient’s overall health. Generally, your doctor will prescribe antibiotics to fight the infection and the central line may need to be removed. In some cases, the line is flushed with high doses of antibiotics to kill the germs causing the infection so that the line does not have to be removed

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What can patients do to prevent a central line associated bloodstream infection (CLI)?
  • Ask lots of questions.
  • Find out why you need the line and where it will be placed.
  • Learn what steps the hospital is taking to reduce the danger of infection.
  • Wash your own hands often. Use soap and water or an alcohol-based hand rub containing at least 60 per cent alcohol.
  • Try not to touch your line or dressing. 
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What are health care providers doing to prevent a central line associated bloodstream infection (CLI)?
  • All health care providers should practice proper hand cleaning techniques.
  • Everyone who touches the central line must wash their hands with soap and water or use alcohol-based hand rub.
  • Wear sterile clothing – a mask, gloves and hair covering – when putting in the line.
  • The patient should be covered with a sterile drape with a small hole where the line goes in.
  • The patient’s skin should be cleaned with “chlorhexidine” (a type of soap) when the line is put in.
  • Choose the most appropriate vein to insert the line.
  • Check the line every day for infection.
  • Replace the line as needed and not on a schedule.
  • Remove the line as soon as it is no longer needed.  

Health care providers who insert a central line in the vein of a patient fill out a central line insertion check list and procedure note which dates, tracks and documents the procedure.

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What are some of the risk factors for a central line associated bloodstream infection (CLI)?

Anyone who has a central line can get an infection. The risk is higher if you:

  • Admitted to the ICU
  • Have a serious underlying illness or debilitation
  • Receiving bone marrow or chemotherapy
  • Have the line in for an extended time 
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What are some of the symptoms of a central line associated bloodstream infection (CLI)?
  • Redness, pain or swelling at or near the catheter site
  • Pain or tenderness along the path of the catheter
  • Drainage from the skin around the catheter
  • Sudden fever or chills 
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What is a central line associated bloodstream infection (CLI)?

Central line infections occur when a central venous catheter (or “line”) is placed in the patient’s vein and the line gets infected. Patients in the intensive care unit (ICU) often require a central line since they are seriously ill and require a lot of medication for a long period of time. When a patient requires long-term access to medication or fluids through an intravenous (IV), a central line is put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream. The bacteria can come from a variety of places (skin wounds, environment etc.), though it most often comes from the patient’s own skin.

How is a central line associated bloodstream infection (CLI) treated?

Treatment depends on the type of catheter, the severity of the infection and the patient’s overall health. Generally, your doctor will prescribe antibiotics to fight the infection and the central line may need to be removed. In some cases, the line is flushed with high doses of antibiotics to kill the germs causing the infection so that the line does not have to be removed. 

How is C. difficile diarrhea detected or diagnosed?

If CDI is suspected, a stool (bowel movement) sample is tested in a laboratory for the toxin it makes. The test takes several hours to perform and most hospitals do this test in their own laboratory. Those hospitals that do not do this test themselves will send the stool sample to another laboratory to do the test. Sometimes a doctor will look directly into the bowel with a special scope (called a sigmoidoscope or colonoscope) to detect abnormal changes in the lining of the bowel that mean that C. difficle is causing the diarrhea. 

How is C. difficile diarrhea detected or diagnosed?

If CDI is suspected, a stool (bowel movement) sample is tested in a laboratory for the toxin it makes. The test takes several hours to perform and most hospitals do this test in their own laboratory. Those hospitals that do not do this test themselves will send the stool sample to another laboratory to do the test. Sometimes a doctor will look directly into the bowel with a special scope (called a sigmoidoscope or colonoscope) to detect abnormal changes in the lining of the bowel that mean that C. difficle is causing the diarrhea. 

How is C. difficile diarrhea detected or diagnosed?

If CDI is suspected, a stool (bowel movement) sample is tested in a laboratory for the toxin it makes. The test takes several hours to perform and most hospitals do this test in their own laboratory. Those hospitals that do not do this test themselves will send the stool sample to another laboratory to do the test. Sometimes a doctor will look directly into the bowel with a special scope (called a sigmoidoscope or colonoscope) to detect abnormal changes in the lining of the bowel that mean that C. difficle is causing the diarrhea. 

What is Clostridium difficile Infection (or C. difficile)?

Clostridium difficile Infection (CDI) is often abbreviated to C. difficile or C. diff for short.

C. difficile is a germ that can be found, on occasion, in people’s bowels. It does not always cause problems or symptoms but in some cases can. In some people who are also taking antibiotics, the germ can grow because the antibiotics kill off many of the “good” and harmless germs that normally prevent the C. difficile from growing to high numbers.

C. difficile makes a toxin that damages the fragile lining of the bowel causing inflammation and loose watery bowel movements (diarrhea) and inflammation.

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Where can I get more information about this and other Patient Safety Indicators?
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What can I do to protect myself from C. difficile?

It is not possible to prevent every case of C. difficile infection but each of us can protect ourselves and others by cleaning our hands often. Health-care providers in hospitals must clean their hands according the Ontario Ministry of Health and Long-Term Care’s and hygiene guidelines. If you are receiving care in a hospital it is OK to ask anyone providing care to you if they have cleaned their hands. Cleaning your own hands after using the toilet, before you eat, after blowing your nose and any time they are dirty is a basic and important step to prevent the spread of all infections including C. difficile. Taking antibiotics only as needed and as prescribed by your doctor or nurse-practitioner (advanced practice nurse) and watching out for diarrhea are also important.

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Can a person die from C. difficile infection?

Yes, in severe cases of CDI, death can occur. This is uncommon and tends to occur in those people with other severe health problems. The vast majority of people recover from CDI.

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How is C. difficile diarrhea detected or diagnosed?

If CDI is suspected, a stool (bowel movement) sample is tested in a laboratory for the toxin it makes. The test takes several hours to perform and most hospitals do this test in their own laboratory. Those hospitals that do not do this test themselves will send the stool sample to another laboratory to do the test. Sometimes a doctor will look directly into the bowel with a special scope (called a sigmoidoscope or colonoscope) to detect abnormal changes in the lining of the bowel that mean that C. difficile is causing the diarrhea. 

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What is the treatment for C. difficile infection (CDI)?

If a person has diarrhea due to CDI, a doctor will prescribe a type of antibiotic that kills the C. difficile germs. The two most commonly used antibiotics to treat CDI are metronidazole and vancomycin.

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What precautions are used to prevent the spread of C. difficile in the hospital?

C. difficile can be spread from one person to another by contact, hand hygiene is critical to preventing its spread in a health-care setting.

If a patient is positive for C. difficile they are placed on Contact Precautions.

So what are Contact Precautions?

Contact Precautions aim to limit the spread of C. difficile to other patients and to health care providers. You may be placed in a private room or with other patients who are also carrying the bacteria. A sign may be placed on your door to remind others who enter your room about these special Contact Precautions. Those caring for you as well as visitors will be asked to clean their hands, gown and glove before entering your room. Everyone who enters and leaves your room must clean their hands well. The room and equipment in the room will be cleaned and disinfected regularly.

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What are the symptoms?

If you get the C. difficile germ you most often do not develop any symptoms of diarrhea at all. People, particularly those taking antibiotics, may get diarrhea. The diarrhea can range from mild to severe with many bowel movements in a day and accompanied by abdominal pain and cramps.

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How does someone get C. difficile?

The C. difficile germ enters your body by ingestion of C. difficile spores. This is why cleaning your hands is so important to prevent picking up C. difficile and other germs. You can pick up the C. difficile germ anywhere, but the C. difficile germ is especially common in hospitals because hospitals have many people being given antibiotics. The chances of the C. difficile germ spreading from person to person is much higher in a hospital than it is in your own home, for example.

C. difficile is one of the most common infections found in hospitals and long-term care facilities, and has been a known cause of health-care associated diarrhea for about 30 years.

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Who is at risk of contracting C. difficile?

Healthy people are not usually susceptible to C. difficile. Seniors and people who have other illnesses or conditions being treated with antibiotics and those who take acid-suppressing stomach medications are at greater risk of an infection from C. difficile.

Can someone die from MRSA?

Most people do not die if they are infected with MRSA. However in severe cases of MRSA bacteremia, death can occur. This is uncommon and tends to occur in those people with other severe health problems. The vast majority of people recover from MRSA, once their health is restored.

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What is the treatment for MRSA?

If a patient is carrying MRSA, generally no treatment is necessary, as the organism is not causing an illness and often will be cleared on its own when the person’s health is restored. If it is determined that the patient is infected (they have a blood infection, skin infection or wound infection etc.) then the patient will treated with the appropriate antibiotic as determined by a physician.

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How is MRSA found?

Swabs are performed when patients are admitted to the hospital and periodically for patients whom are at risk. The swabs are sent to the laboratory for analysis and if positive, the laboratory notifies infection prevention and control so that the patient can be placed on Contact Precautions.

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What Contact Precautions are used to limit the spread of MRSA?

Contact Precautions aim to limit the spread of MRSA to other patients and to health care providers. You may be placed in a private room or with other patients who are also carrying the bacteria. A sign may be placed on your door to remind others who enter your room about these special contact precautions. Those caring for you as well as visitors will be asked to clean their hands, gown and glove before entering your room. Everyone who enters and leaves your room must clean their hands well. The room and equipment in the room will be cleaned and disinfected regularly.

,
What precautions are used to prevent the spread of MRSA in the hospital?

Because MRSA is spread from one person to another by contact, hand hygiene is critical to preventing its spread in a health-care setting. KGH actively conducts regular surveillance to find cases of MRSA infection and to identify carriers of MRSA. If a patient is positive for MRSA they are placed on Contact Precautions.

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How is MRSA spread?

MRSA is spread from one person to another by contact, usually on the hands of caregivers. MRSA can be present on the health care provider’s hands either from touching contaminated material from infected persons or from touching articles contaminated by a person carrying MRSA, such as towels, sheets and wound dressings. MRSA can live on hands and objects in the environment for extended periods of time.

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Who is at risk of contracting MRSA?

Risk factors for MRSA infections include invasive procedures, prior treatment with antibiotics, prolonged hospital stay, stay in an intensive care or burn unit, surgical wound infection and close proximity to someone who is carrying MRSA. 

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What is a bacteremia?

A bacteremia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

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What is Methicillin-resistant Staphylococcus aureus (MRSA)?

Staphylococcus aureus is a germ that lives on the skin and mucous membranes of healthy people. Occasionally, Staphylococcus aureus is a  cause of human infection. When Staphylococcus aureus develops resistance to certain antibiotics, it is called Methicillin-resistant Staphylococcus aureus or MRSA.

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Where can I get more information about this and other Patient Safety Indicators?
How is MRSA found?

Swabs are performed when patients are admitted to the hospital and periodically for patients whom are at risk. The swabs are sent to the laboratory for analysis and if positive, the laboratory notifies infection prevention and control so that the patient can be placed on Contact Precautions.

How is MRSA found?

Swabs are performed when patients are admitted to the hospital and periodically for patients whom are at risk. The swabs are sent to the laboratory for analysis and if positive, the laboratory notifies infection prevention and control so that the patient can be placed on Contact Precautions.

How is MRSA found?

Swabs are performed when patients are admitted to the hospital and periodically for patients whom are at risk. The swabs are sent to the laboratory for analysis and if positive, the laboratory notifies infection prevention and control so that the patient can be placed on Contact Precautions.

How is MRSA spread?

MRSA is spread from one person to another by contact, usually on the hands of caregivers. MRSA can be present on the health care provider’s hands either from touching contaminated material from infected persons or from touching articles contaminated by a person carrying MRSA, such as towels, sheets and wound dressings. MRSA can live on hands and objects in the environment for extended periods of time.

Can someone die from MRSA?

Most people do not die if they are infected with MRSA. However in severe cases of MRSA bacteremia, death can occur. This is uncommon and tends to occur in those people with other severe health problems. The vast majority of people recover from MRSA, once their health is restored.

,
What is the treatment for MRSA?

If a patient is carrying MRSA, generally no treatment is necessary, as the organism is not causing an illness and often will be cleared on its own when the person’s health is restored. If it is determined that the patient is infected (they have a blood infection, skin infection or wound infection etc.) then the patient will treated with the appropriate antibiotic as determined by a physician.

,
How is MRSA found?

Swabs are performed when patients are admitted to the hospital and periodically for patients whom are at risk. The swabs are sent to the laboratory for analysis and if positive, the laboratory notifies infection prevention and control so that the patient can be placed on Contact Precautions.

,
What Contact Precautions are used to limit the spread of MRSA?

Contact Precautions aim to limit the spread of MRSA to other patients and to health care providers. You may be placed in a private room or with other patients who are also carrying the bacteria. A sign may be placed on your door to remind others who enter your room about these special contact precautions. Those caring for you as well as visitors will be asked to clean their hands, gown and glove before entering your room. Everyone who enters and leaves your room must clean their hands well. The room and equipment in the room will be cleaned and disinfected regularly.

,
What precautions are used to prevent the spread of MRSA in the hospital?

Because MRSA is spread from one person to another by contact, hand hygiene is critical to preventing its spread in a health-care setting. KGH actively conducts regular surveillance to find cases of MRSA infection and to identify carriers of MRSA. If a patient is positive for MRSA they are placed on Contact Precautions.

,
How is MRSA spread?

MRSA is spread from one person to another by contact, usually on the hands of caregivers. MRSA can be present on the health care provider’s hands either from touching contaminated material from infected persons or from touching articles contaminated by a person carrying MRSA, such as towels, sheets and wound dressings. MRSA can live on hands and objects in the environment for extended periods of time.

,
Who is at risk of contracting MRSA?

Risk factors for MRSA infections include invasive procedures, prior treatment with antibiotics, prolonged hospital stay, stay in an intensive care or burn unit, surgical wound infection and close proximity to someone who is carrying MRSA. 

,
What is a bacteremia?

A bacteremia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

,
What is Methicillin-resistant Staphylococcus aureus (MRSA)?

Staphylococcus aureus is a germ that lives on the skin and mucous membranes of healthy people. Occasionally, Staphylococcus aureus is a  cause of human infection. When Staphylococcus aureus develops resistance to certain antibiotics, it is called Methicillin-resistant Staphylococcus aureus or MRSA.

,
Where can I get more information about this and other Patient Safety Indicators?
How is MRSA spread?

MRSA is spread from one person to another by contact, usually on the hands of caregivers. MRSA can be present on the health care provider’s hands either from touching contaminated material from infected persons or from touching articles contaminated by a person carrying MRSA, such as towels, sheets and wound dressings. MRSA can live on hands and objects in the environment for extended periods of time.

How is MRSA spread?

MRSA is spread from one person to another by contact, usually on the hands of caregivers. MRSA can be present on the health care provider’s hands either from touching contaminated material from infected persons or from touching articles contaminated by a person carrying MRSA, such as towels, sheets and wound dressings. MRSA can live on hands and objects in the environment for extended periods of time.

How is the VAP case count and rate calculated?

The actual number of VAP cases (case count) will be shown if the number is zero or totals five or more cases associated with that hospital site. If the number is greater than zero but less than five cases, it will be shown as <5 (less than five) in the case count column. The VAP rate is the number of new cases of VAP in the ICU per 1,000 ventilator days. To calculate this rate the total number of VAP cases in the ICU after 48 hours of mechanical ventilation in the ICU is divided by the total number of ventilator days for patients 18 years and older.

How is the VAP case count and rate calculated?

The actual number of VAP cases (case count) will be shown if the number is zero or totals five or more cases associated with that hospital site. If the number is greater than zero but less than five cases, it will be shown as <5 (less than five) in the case count column. The VAP rate is the number of new cases of VAP in the ICU per 1,000 ventilator days. To calculate this rate the total number of VAP cases in the ICU after 48 hours of mechanical ventilation in the ICU is divided by the total number of ventilator days for patients 18 years and older.

How is the VAP case count and rate calculated?

The actual number of VAP cases (case count) will be shown if the number is zero or totals five or more cases associated with that hospital site. If the number is greater than zero but less than five cases, it will be shown as <5 (less than five) in the case count column. The VAP rate is the number of new cases of VAP in the ICU per 1,000 ventilator days. To calculate this rate the total number of VAP cases in the ICU after 48 hours of mechanical ventilation in the ICU is divided by the total number of ventilator days for patients 18 years and older.

How is VAP treated?

Since VAP is caused by bacteria in the lungs, it is treated with antibiotics. 

How is VAP treated?

Since VAP is caused by bacteria in the lungs, it is treated with antibiotics. 

How is VAP treated?

Since VAP is caused by bacteria in the lungs, it is treated with antibiotics.